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Pance Re-Up > Dermatology #2 > Flashcards

Dermatology #2 Flashcards

1
Q

Pityriasis Rosacea is associated with what?

A

Human herpesvirus 7

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2
Q

Describe the symptoms of Pityriasis Rosacea

A

-Viral Prodrome
-Herald Patch (solitary salmon colored patch on trunk)
-Pruritic papules in Christmas tree pattern that follows cleavage lines on trunk

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3
Q

Lichen Planus is an immune related condition that is associated with

A

Hepatitis C infection

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4
Q

Describe the rash of Lichen Planus

A

6 P’s
-Pruritic, Purple, Planar (flat), Polygonal (irregular), Papules, Plaques (Raised)

-Wickham Striae: white lines on skin or oral mucosa

-Koebner’s Phenomenon: new at sites of trauma

-Nail dystrophy

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5
Q

Where are the three areas the lichen planus affects MC?

A

Wrist, ankles, mouth

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6
Q

Treatment for lichen planus

A

Topical corticosteroids; however, most resolve spontaneously over 8-12 months

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7
Q

What are three common culprits of fixed drug eruptions?

A

NSAIDs, Antibiotics, Antiepileptics

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8
Q

MC pre-malignant skin condition

A

Actinic Keratosis

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9
Q

Actinic keratosis is the ____________ and risk factors include _____, ____, and ______

A

proliferation of keratinocytes

Sun exposure, male gender, and increased age

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10
Q

Symptoms of actinic keratosis

A

Dry, rough sandpaper like papules with transparent or yellow scaling

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11
Q

What test should be done for actinic keratosis and why

A

Punch biopsy to determine if AK or SCC

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12
Q

Treatment for AK

A

-Localized: liquid nitrogen cryotherapy
-Multiple: Topical 5-FU and Imiquimod

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13
Q

The MC benign epiderma tumor

A

Seborrheic keratosis

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14
Q

Seborrheic keratosis is the __________ and looks like

A

benign proliferation of immature keratinocytes

Velvety, warty, stuck on appearance

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15
Q

MC etiology of onychomycosis

A

T. Rubrum

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16
Q

Symptoms of onychomycosis

A

-Opaque nail, thickened, discolored
-MC on great toe

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17
Q

Diagnostics for onychomycosis

A

-Fungal culture and rapid test (KOH prep) before treatment
-Periodic acid-schiff test (most sensitive)

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18
Q

First line treatment for onychomycosis and two contraindications to using this medication

A

Terbinafine

-Hepatitis and Alcohol use (hepatotoxicity)

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19
Q

MCC of a paronychia

A

Staph A

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20
Q

What is a paronychia

A

Infection of the lateral and proximal nail folds < 6 weeks

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21
Q

Etiology of a paronychia (why does it occur?)

A

Nail biter: normal oral flora

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22
Q

Treatment for paronychia

A

-Mild: warm water soaks
-Moderate: Oral Cephalexin or Dicloxacillin (Clinda or Aug if nail biter)

-MRSA: Bactrim, Clinda, Doxy

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23
Q

A paronychia can progress to a _______, which has symptoms of fluctuant of the pad of the fingertip. What is the treatment?

A

Felon

Incision and drainage, Cephalexin afterwards

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24
Q

Alopecia Areata is immune mediated and targets _____ hair follicles. What are some symptoms of this type of alopecia?

A

Anagen

Exclamation point hairs: tapering near proximal hair shaft
Nail abnormalities: pitting, fissuring, roughening

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25
Q

Treatment for alopecia areata

A

Intralesional corticosteroids

26
Q

The MC type of alopecia in both genders is _______. Explain the difference in distribution of this condition among genders

A

Androgenic alopecia

Males: bitemporal thinning –> vertex
Females: between frontal and vertex of scalp

27
Q

What is the pathophysiology of androgenic alopecia?

A

DHT is the key androgen. It shortens the anagen phase (growth phase) in the normal cycle of hair.

28
Q

What is seen on dermoscopy in a patient with androgenic alopecia?

A

Mini hair and brown perihilar casts

29
Q

Treatment options for androgenic alopecia

A

-Topical Minoxidil: widens blood vessels
-Oral Finasteride: androgen inhibitor. Stops conversion of testosterone –> DHT
-Hair transplant

30
Q

Treatment of choice for pediculosis (lice)

A

Topical Permethrin shampoo x 10 minutes

Remove nits with fine tooth comb

Wash bedding, clothes and dry them in high heat

31
Q

Besides being a clinical diagnosis, what other thing can you use to diagnose pediculosis?

A

Wood’s lamp

32
Q

What is one common adverse effect of Lindane, an alternative treatment for pediculosis?

A

Seizures

Do not give in pregnancy

33
Q

Scabies is a mite infection due to what organism? The females burrow into the skin to lay eggs, feed, and defecate

A

Sarcoptes scabiei

34
Q

Symptoms of scabies

A

-Pruritis at night
-Linear burrows on intertriginous zones (web spaces of fingers, scalp, toes)
-Red, itchy papules on penis, body folds

35
Q

Treatment for scabies

A

Permethrin topical (8-14 hours before showering) Reapply 1 week later

36
Q

If the patient has Norweigan Crusted Scabies, what is the treatment?

A

Oral Ivermectin

37
Q

Although bed bugs have a painless bite due to anesthetic and then proteases break down tissue, how can you diagnose this?

A

Look for blood stained bedding

-Supportive treatment only

38
Q

1 cause of death of envenomation

A

Bee stings

39
Q

What type of reaction is a bee sting?

A

Type I immediate reaction (IgE local reaction)

40
Q

Symptoms of a black widow spider bite

A

-Local symptoms (pain at site)
-Neurologic symptoms within 2 hours
-Muscle pain
-Spasms, rigidity, tachycardia, HTN

41
Q

What does the rash look like in a black widow bite?

A

-Blanched circular patch with surrounding red perimeter and central target lesion

42
Q

The venom of a brown recluse spider is

A

cytotoxic and hemolytic…can be necrotic

43
Q

What does the rash or bite site look like in a brown recluse bite?

A

Erythema at site –> blanching due to vasoconstriction –> red halo for 24 hours –> hemorrhagic bullae –> eschar formation

44
Q

What type of tick and what is the bacteria that causes Lyme Disease?

A

Borrelia Burgdorferi on the Ixodes Scapularis (deer tick)

45
Q

What are the MC states where Lyme’s occurs?

A

Northeast (CT, MA, NY, NJ)

46
Q

Symptoms of Lymes

A

-Erythema Migrans: bullseye rash
-Neurologic symptoms: CNVII nerve palsy (MC)
-AV Block (MC)
-Intermittent arthritis (knee pain)

47
Q

Although Lyme is a clinical diagnosis, what can be done to prove this diagnosis?

A

ELISA (serologic testing) then Western Blot if positive

48
Q

Treatment for Lyme

A

Doxycycline BID x 10-21 days
-Amoxicillin if a child or pregnant

49
Q

However, if the Lyme disease is late or severe, what is the treatment?

A

IV Ceftriaxone (with nerve palsy or AV block)

50
Q

Rocky Mountain Spotted Fever, MCC by _____, occurs in what states?

A

Rickettsia Rickettsii

Southcentral and Southeastern States

51
Q

What are the two vectors for RMSF?

A

Dermacentor andersoni & Variablis

52
Q

Explain the rash of RMSF

A

Petechial rash on wrists/ankles then spreads to trunk

53
Q

Treatment for RMSF? If Pregnant?

A

Doxycycline (first line)

Chloramphenicol (if pregnant)

54
Q

What is Ehrlichiosis?

A

Tick borne illness that infects and destroys WBCs

55
Q

What is the etiology of Ehrlichiosis?

A

Amblyorama (Lone Star Tick)

56
Q

True or False: the symptoms of Ehrlichiosis are nothing special. Malaise, fever, with no special rash.

A

True

57
Q

Treatment for Ehrlichiosis?

A

Doxycycline

-Chloramphenicol (second line)

58
Q

A peripheral smear can be done for Ehrlichiosis. What should be seen on it with this condition?

A

Morulae in WBCs

Mulberry shaped aggregates

Leukopenia

59
Q

What is one thing to remember and keep in mind when considering weakness, malaise, and ataxia after a tick bite?

A

Tick Paralysis

-Remove the tick!

60
Q

Explain the four degrees of sunburns

A

1st: local erythema, resolves in days
2nd: blisters, painful, resolves in 2 weeks
3rd: painless, dry, leathery
4th: to muscle/bone, amputation

61
Q

What are some risk factors for skin cancer?

A

Fair skin, age, family history, sun exposure, sunburns, radiation, immunosuppression

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