Dermatology Flashcards
(140 cards)
1
Q
what is this showing
A
bullous pemphigoid
2
Q
_ is an acquired autoimmune blistering skin d.o caused by linear deposition of abs to _ at the _ junction
A
bullous pemphigoid
hemidesmosomes
epidermal-dermal
3
Q
more severe form of bullous pempigoid the involves the mucous membranes
A
pemphigus vulgaris
4
Q
what is this showing
A
top layers of skin slip away from lower layers when rubbed -> nikolsky sign
5
Q
positive nikolsky sign is associated w. which blistering skin d.o
A
pemphigus vulgaris
6
Q
where are bullae located w. bullous pemphigoid (4)
A
axillae
thighs
groin
abdomen
7
Q
dx for bullous pemphigoid
hallmark findings
A
dx: skin bx w. immunofluourescence
findings: deposition of IgG and C3 basement membrane
8
Q
pruritit scalp, body, or groin
small white specs on hair shaft
A
lice
9
Q
ovoid grayish-white eggs
A
nits
10
Q
management of lice
A
-launder fomites in H2O > 131 degrees
-topical permethrin w. wet combing, repeat in 9 days
-permethrin to body, leave on 8-12 hr
-STI screen if pubic
-eyelashes: ophthalmic petroleum jelly
-severe: oral ivermectin
-treat whole fam
11
Q
rule of 9’s for burns
vs
palmar method
A
12
Q
degrees of burns
A
1st: sunburn - blanches w. pressure, +- tender skin
2nd: partial thickness - red/blistered, very tender skin
3rd: full thikness - tough/leathery, non tender skin
4th: into bone and muscle
13
Q
minor vs major burn criteria
A
minor:
adults: <10% TBSA
kids/old: < 5% TBSA
< 2% full thickness
major:
adults: > 25% TBSA
kids/old: > 20% TBSA
> 10% full thickness
14
Q
indications for IVF for burns
IVF of choice
A
children: > 10%
adults: > 15%
LR IV x 24 hr
15
Q
what is this showing
A
pilonidal cyst: abnl hairgrowth at tailbone containing hair/skin
16
Q
pilonodial cysts result from
A
abscess -> sinus tract at upper part of natal cleft
17
Q
teenager w. intermittent pain, discomfort, and swelling above the anus or near tailbone
A
pilonidal cyst
18
Q
tx for pilonidal cyst
A
I&D/remove
find sinus tract
cefazolin + metro/augmentin if cellulitis
19
Q
acute bacterial skin/skin structure infxn involving dermis and subcutaneous tissue
A
cellulitis
20
Q
classic sx of cellulitis
A
pain
erythema
warmth
swelling
21
Q
describe skin findings of cellulitis
A
flat margins, not well demarcated
22
Q
mc cause of cellulitis in kid vs adults
A
kids: h.flu, strep pneumo
adults: staph, strep
23
Q
dx for cellulitis
A
culture all purulent wounds
24
Q
tx for cellulitis:
MSSA:
MRSA:
animal bite:
puncture wound:
A
MSSA: cephalexin vs dicloxacillin
animal bite: augmentin
puncture wound: cipro (think pseudo)
MRSA: bactrim vs clinda vs doxy vs vanco/linezolid
25
2 areas mc affected by pressure sores
sarum
hip
26
stages of pressure ulcers
stage 1: localized erythema, no blanching, bony surface
stage 2: partial loss of dermal layer, pink ulceration
stage 3: full dermal loss, subcutaneous fat often exposed
stage 4: full thickness ulceration exposing bone/tendon/muscle
27
common complication of pressure sore
osteomyelitis
28
tx for pressure ulcers
stage I: aggressive preventive, thin film dressings
stageII: occlusive dressing, transparent films, hydrocolloids
stage III-IV: debridement, calcium alginate dressing, hydrocolloids, occlusive dressings, +/- debridement
29
5 rf for pressure ulcers
> 65 yo
impaired circulation
immobilizatoin
malnutrition
incontinence
30
what stage pressure ulcer is this
I
31
what stage ulcer is this
III
32
what stage ulcer is this
II
33
what stage ulcer is this
IV
34
4 types of dermatitis to know
contact
atopic
seborrheic
perioral
35
2 types of contact dermatitis
allergic
irritant
36
what is this showing
well demarcated erythema, erosions, vesicles -> contact dermatitis
37
2 common causes of allergic dermatitis
what type of hypersensitivity is it
nickel
poison ivy
type IV
38
5 causes of irritant dermatitis
**diaper rash**
cleaners
solvents
detergents
urine
feces
39
tx for contact dermatitis
burow's solution (aluminum acetate)
topical steroids
zinc oxide
40
zinc oxide makes you think of
tx for diaper rash
41
what is this showing
pruritic, eczematous lesions, xerosis, lichenification -> **atopic dermatitis **
42
mc location of atopic dermatitis: adolescents vs infants
adolescents: flexor creases -> ex antecubital and popliteal folds
infants: face, scalp
43
atopic dermatitis is a type _ hypersensitivity
1
44
rapidly evolving red rash, may be blistered or swollen
eczema
45
what is this showing
nummular eczema
46
first line tx for eczema
topical steroids
47
erythematous yellowish greasy scales - crusted lesions
seborrheic dermatitis (cradle cap)
48
mc location for seborrheic dermatitis: infants vs adults/adolescents
infants: scalp
adults/adolescents: body folds
49
tx for seborrheic dermatitis
ketoconazole shampoo/topical
50
what is this showing
papulopustular plaques/scales around the mouth -> perioral dermatitis
51
what pt pop does perioral dermatitis mc affect
what is the tx
young women
topical metronidazole
52
tx to avoid for perioral dermatitis
steroids
53
classification of rashes
infectious vs noninfectious
54
noninfectious rashes to know
eczema
contact dermatitis
psoriasis
seborrheic dermatitis
drug eruptions
rosacea
hives (utircaria)
allergic dermatitis
xerosis (dry skin)
55
erythematous, morbilliform, maculopapular rash starting on head and spreading downward
measles
56
5 causes of breast discharge
mastitis/breast abscess
breast cancer
gynecomastia
inflammatory breast cancer
hypogonadism
57
nipple discharge, breast enlargement, overweight
gynecomastia
58
nipple discharge, sexual dysfxn, reduced sex drive
hypogonadism
59
what mite causes scabies
sarcoptes scabiei
60
what rash is associated w. scabies
pruritic papules
s shaped/linear burrows on the skin
worse at night
severely itchy
61
where is scabies commonly located
web spaces of hands, wrists, waist
62
definitive dx for scabies
microscopic eval of skin scrape
63
tx for scabies
topical permethrin 5% to entire body -> wash off after 8-14 hr
repeat in one week
wash all fomites in high heat, no contact w. body x 72 hr
alt/severe: oral ivermectin
64
mc adverse drug rxn
skin
65
derm sx of impending CVD
-anaphylaxis
-DRESS (drug rash w. eosinophilia/systemic sx)
-SJS/TEN
-extensive bullous rxn
-generalized erythroderma
66
tx for anaphylaxis or widespread urticaria
epinephrine
prednisone
antihistamines
67
what is this showing
drug rxn
68
2 spider bites to know
brown recluse
black widow
69
what spider is this
brown violin on the abdomen -> brown recluse
ps this is my least favorite flashcard of all time
70
what spider is this
red hourglass on abdomen -> black widow
ps this is tied for my least favorite flashcard of all time
71
brown recluse bites are assocaited w. _ symptoms
black widow bites are associated w. _ symptoms
brown recluse: skin necrosis
black widow: neurologic
72
skin sx of brown recluse bite
first 3-4 hr: local burning, central necrosis, erythematous margin around ischemic center halo
24-72 hr: hemorrhagic bullae w. eschar formation -> necrosis
73
tx for brown recluse bite
wound care
local symptomatic measures
delayed excision
74
neuro manifestations of black widow bite
n/v
Ha
fever
syncope
convulsions
+/- rxn at bite site
75
tx for black widow bite
wound care
local symptomatic measures
+/- opioids/benzos
anti-venom in kids/elderly
76
what is this showing
large, confluent, erythematous plaques
bullae near jaw
**erysipelas**
77
well-demarcated, raised, superficial skin infxn w. lymphatic involvement
erysipelas
78
erysipelas is always caused by
GAS (pyogenes)
79
systemic sx of erysipelas
f/c
80
dx and tx for erysipelas
dx: C&S
tx:
-mild: pen g
-moderate: bactrim + pcn/cephalexin
-severe: carbapenems + linezolid OR vanco
81
severe hypersensitivity complex affecting skin and mucus membranes
SJS
82
progression of SJS
1. flu like prodrome
2. painful red/purplish rash that spreads and blisters
3. layers of skin peel away in sheets -> Nikolsly sign
83
more severe form of SJS
toxic epidermal necrolysis (TEN)
84
SJS affects _% of the body
TEN affects _% of the body
SJS: 3-10%
TEN: >30%
85
dx for SJS/TEN
skin bx showing necrotic epithelium
86
tx for SJS/TEN
early admit to burn unit
lytes/fluids/nutrition
ABC
eye care
IVIG
87
_ may increase risk of sepsis in SJS/TEN
steroids
88
what is this showing
SJS
89
what is this showing
TEN
90
zoster presentation: primary vs later
primary: vesicles on an erythematous base
later: dewdrops on a rose petal
91
herpes zoster starts on the _ and spreads down
face
92
how is zoster transmitted
respiratory droplets
93
after manifesting as chicken pox, zoster remains latent in the
dorsal root ganglion
94
what is this showing
shingles
95
definitive dx for zoster
tzanck smear -> multinucleated giant cells
96
shingles involving CN V
zoster opthalmics
97
what is this showing
dendritic lesions on slit lamp exam -> zoster opthalmicus
98
zoster involving CN VII -> otalgia, lesions on the ear, auditory canal, and TM - facial palsy auditory sx
zoster oticus -> ramsay hunt syndrome
99
tx for shingles
acyclovir vs valacyclovir vs famciclovir
**w.in 72 hr to prevent post herpetic neuralgia**
100
what is post herpetic neuralgia
pain > 3 mo
paresthesias
decreased sensation
101
tx for postherpetic neuraltia (3)
gabapentin vs TCA
topical lidocaine
capsaicin
102
when is the zoster vaccination recommended
50 and older
2 doses 2-6 months apart
103
crusting facial lesions
red rash w. golden "honey-colored crust"
impetigo
104
2 pathogens associated w. impetigo
**s. aureus - mc**
GABHS
105
progression of impetigo
1. papules -> vesicles w. surrounding erythema
2. vesicles rupture -> form thick adherent, golden crust
106
_ is a common finding w. impetigo rash
LAD
107
mc age for impetigo
2-5
108
where do impetigo sores mc start
nose/mouth
109
4 hallmarks of impetigo
nonpainful
pruritic
honey colored
weeping
110
4 rf for impetigo
warm humid climate
poverty
crowding
poor hygiene
111
what is secondary impetigo
forms at site of abrasion/scratches
112
dx for impetigo
gram stain w. culture
113
tx for impetigo
mild: topical mupirocin
severe: dicloxacillin vs cephalexin
MRSA: doxy, clinda, bactrim
114
when can kids return to school after starting abx for impetigo
24 hr
115
complication of impetigo
post strep GN
116
skin rash triggered by rxn to foods, meds, stress, or irritants
urticaria
117
describe urticaria
blanchable, pruritic, raised, red or skin colored papules, wheels, plaques
**disappear w.in 24 hr**
118
localized urticaria appearing where the skin is rubbed (histamine release_
darier's sign
119
painless, deeper form of urticaria affecting lips, tongue, eyelids, hands, genitals
angioedema
120
what are the different types of antihistamines
1. **H1 blockers:**
**-first gen:** hydroxyzine, diphenhydramine
**-second gen:** allegra, claritin, clarinex, zyrtec
2. **H2 blockers:** cimetidine, ranitidine
121
first gen antihistamines (hydroxyzine, diphenydramine) are mc used to treat
insomnia
anxiety
122
second gen antihistamines (allegra, claritin, clarinex, zyrtec) are mc used to treat
skin conditions
123
what is this showing
uticaria/hives
124
4 systemic d.o that cause itching
allergies
liver dz/jaundice
CKD
psychogenic
125
5 viral exanthems to know
erythema infectiosum (fifth dz/parvo)
hand-foot-mouth dz
measles
rubella
roseola (sixth dz)
126
what is this showing
"slapped cheek rash"
erythema infectiousum/parvo/5th dz
127
what is this showing
lacy, reticular rash -> erythema infectiosum/parvo/5th dz
128
what pathogen causes hand-foot-mouth dz
coxsackievirus type A
129
what is this showing
hand-foot-mouth dz
130
cough
coryza
conjunctivitis
cephalocaudal spread
4 c's of measles
131
describe the rash associated w. measles
morbilliform, maculopapular brick red rash beginning on face, progressing to palms/soles
132
what is this
measles
133
what is this showing
koplik spots -> precedes measles
134
describe koplik spots
small red spots in buccal mucosa w. blue-white pale center
135
tx for measles
supportive
antiinflammatories
isolation x 1 week after rash onset
136
rubella rash first appears on the _ face
and has _ spread
face
cephalocaudal spread
137
major risk w. rubella
teratogenic in 1st trimester -> deafness, cataracts, TTP, mental retardation
138
roseola (6th dz) is caused by
HSV 6 or 7
139
only childhood exanthem that begins on the trunk and spreads to the face
roseola
140
progression of roseola (6th dz)
1. high fever prodrome x 3-5 days
2. rose pink maculopapular blanchable rash on trunk/back and face
