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*Pance Re-Up * > Dermatology #3 > Flashcards

Dermatology #3 Flashcards

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1
Q

MC type of skin cancer

A

basal cell carcinoma

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2
Q

Explain a basal cell carcinoma

A

slow growing, local invasion, no METs

MC on head, neck, trunk, nose

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3
Q

What does a basal cell carcinoma LOOK like

A

Small, raised, pearly, raised borders and central ulceration with telangiectasias that is friable (bleeds)

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4
Q

What diagnostic should be done for basal cell carcinoma

A

Punch or shave biopsy

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5
Q

Treatment for basal cell carcinoma

A

Moh’s for facial involvement

Cryotherapy, Imiquimod, 5-FU

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6
Q

2nd MC type of skin cancer

A

Squamous Cell Carcinoma

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7
Q

Risk factors for SCC

A

Sun exposure (biggest)
Actinic Keratosis
HPV Infection

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8
Q

What is Bowen’s Disease?

A

SCC in situ (hasn’t invaded the dermis yet)

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9
Q

Symptoms of a SCC

A

Erythematous, elevated nodule with white scaly or crusted, bloody margins

Nonhealing ulcer or erosion on the head, lips, hands, neck

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10
Q

Because a shave biopsy is often inadequate, what is the diagnostic of choice for SCC?

A

Punch or excisional biopsy

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11
Q

Treatment for SCC

A

-Surgical excision
-Moh’s, Imiquimod, 5FU
-Chemo if METs

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12
Q

MCC of skin-related cancer death

A

Melanoma

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13
Q

Where does a melanoma usually MET to?

A

Liver, lungs, lymph nodes, brain

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14
Q

Biggest risk factor for melanoma

A

UV radiation

Large number of nevi, tanning, etc.

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15
Q

What is the MC type of melanoma and where does it occur in both genders?

A

Superficial spreading

-Trunk in men
-Legs in women

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16
Q

What is acral lentiginous?

A

Type of melanoma that occurs in dark-skinned people on the palms, soles, nail beds

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17
Q

Explain ABCDE and how it relates to melanoma?

A

Symptoms of melanoma and when you should be suspicious

Asymmetry
Borders (irregular)
Color (varied)
Diameter (>6 mm)
Elevation

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18
Q

Diagnostics for melanoma

A

-Full thickness excisional biopsy + lymph node biopsy

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19
Q

How much should you excise based on size of melanoma?

A

> 1-2mm thick: take 2 cm
2-4 mm thick: 2cm marginal tissue

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20
Q

A Kaposi Sarcoma is associated with _______ and is predominantly in which population?

A

HHV8 infection

HIV with CD4 < 100

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21
Q

Symptoms of Kaposi Sarcoma and Treatment

A

Painless, nonpruritic macular papule or nodules brown, red in color, plaque or violaceous lesions

HAART therapy if HIV related
Chemotherapy

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22
Q

Condyloma Acuminata are _______ and appear as cauliflower like lesions on the genitals. How do you diagnose these?

A

Genital warts

Whitening of the lesion with acetic acid

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23
Q

Although 80% of condyloma acuminata spontaneously resolve, what are some treatment options?

A

Cryotherapy

Topical Podofilox

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24
Q

What is the vaccine given to prevent genital warts and what is the schedule?

A

2 doses, 6 months apart

Gardasil 9: 6, 11, 16, 18, 31, 33, 45, 52, 58

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25
Name the 9 HPV strains protected against in Gardasil 9. Is this vaccine safe in pregnancy?
6, 11, 16, 18, 31, 33, 45, 52, 45 Not safe in pregnancy
26
Molluscum Contagiosum is due to _______ and appears as
Poxvirus Discrete, dome-shaped flesh colored or pearly waxy papules with central umbilication
27
Treatment for molluscum contagiosum
None needed
28
HSV Type 1 vs HSV Type 2
Type 1: Saliva (oral lesions) Type 2: Sexual contact (genital lesions)
29
Explain primary lesions of Type 1 vs Secondary lesions
Primary: Tonsillopharyngitis in adults and gingivostomatitis in kids Secondary: herpes labialis (cold sore) grouped vesicles on erythematous base
30
What is a herpetic whitlow?
on finger, from contact of a Type 1 lesion Happens a lot in health care workers
31
What is the most sensitive and specific test for HSV? But what is the gold standard for HSV 1?
PCR HSV Serology for Type 1
32
What other diagnostic can be done for HSV and what is seen?
Tzanck smear: multinucleated giant cells
33
Treatment for HSV
Orał Valacyclovir or Acyclovir
34
Varicella Zoster Virus, caused by ______, has two parts. Which is which.
HHV 3 Primary/Varicella (Chickenpox) Secondary (Zoster) Shingles
35
Symptoms of Varicella
-Prodrome Period -Erythematous macules--> papules-->vesicular --> crust over -Asynchronous rash that evolves -Dew drops on a rose petal
36
True or False: Chickenpox can spread 48 hours PRIOR to onset of the rash
True
37
What is seen on a Tzanck smear of VZV, even though it is mostly a clinical diagnosis?
Multinucleated giant cells (same as HSV)
38
Treatment for Varicella
-12 years or younger: supportive -13 years or older: Acyclovir
39
Two MC complications of varicella
-Bacterial superinfection (MC in kids) and varicella PNA (leading cause of death)
40
Risk factors for Zoster
Age > 50 Immunocompromised
41
Describe the rash of VZV Zoster
-Eruption of painful rash that is unilaterally present in a single dermatome that doesn't cross the midline
42
What is a common condition associated with Zoster and what is the treatment?
Post-herpetic neuralgia Gabapentin or Pregabalin --TCA if no relief with above
43
What is given post-exposure as prophylaxis to those exposed to Zoster or if they are immunocompromised?
VZ IG
44
Post Exposure to varicella, what should be given? And to whom?
VZ IG given within 96 hours of exposure to immunocompromised, newborns of moms with VZV, or those with no evidence of immunity
45
Neonatal Varicella occurs if the mom has the virus in what time frame?
5 days before to 2 days after delivery
46
When should VZ IG be given to neonates at risk for varicella and when is it not needed?
If mom has it 5 days prior to 2 days post delivery Not needed if infection in mom > 5 days before birth
47
What is herpes zoster ophthalmicus?
Shingles in the ophthalmic division of CNV (Trigeminal Nerve)
48
Symptoms of herpes zoster opthalmicus
Unilateral pain in eye, forehead, top of head Keratitis, uveitis, conjunctivitis Hutchinson's Sign: vesicles at the tip of the nose
49
What diagnostic is done for herpes zoster opthalmicus and what is seen?
Slit lamp examination: dendritic branching with fluorescein
50
Treatment for herpes zoster ophthalmicus
Oral acyclovir
51
What is Herpes Zoster oticus?
AKA Ramsay-Hunt Syndrome VZV in facial nerve (CNVII)
52
If CNVIII is involved, what should you expect in herpes zoster oticus?
Vestibular disturbances (vertigo, dizziness, etc.)
53
Symptoms of herpes zoster oticus
Triad: Ipsilateral facial paralysis + ear pain + vesicles in ear canal/auricle
54
Treatment for herpes zoster oticus
Valacyclovir + Prednisone
55
What are veruccae, what causes them, and what is one common exam finding?
Warts caused by HPV Thrombosed capillaries
56
Cervical warts, MCC by which strains of HPV, increase the patient's risk for cervical cancer
HPV 16 and 18
57
Although most veruccae resolve within 2 years, what are some treatment options you can give the patient?
Topical: Imiquimod, 5-FU Cryotherapy
58
MC opportunistic pathogen
Candida
59
What is seen on exam in a patient with oropharyngeal candidiasis (thrush)?
Friable white plaques that leave erythema if scraped off
60
Treatment for thrush
Nystatin swish and swallow Clotrimazole troches
61
What is seen on exam in a patient with Candida Esophagitis?
On endoscopy, you see white linear plaques
62
Treatment for Candida Esophagitis
Oral Fluconazole
63
How do you diagnose Candidiasis in general?
KOH smear = budding yeast and pseudohyphae
64
What is intertrigo?
Candida infection that causes pruritic beefy red rash with distinct borders and satellite lesions in moist areas
65
What is the treatment for intertrigo
Clotrimazole topical

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