Dermatology Flashcards
Appearance: Lichen planus
- Pruritic, violaceous, polygonal, flat-topped papules with white lacy lines (Wickham striae) - Most common site: flexor aspect of the wrists - Mucous membranes: Milky-white papules with white lacework on the buccal mucosa
Repeated mechanical trauma (friction) and other types of physical trauma such as scratching, chronic pressure, or cuts along with allergic or irritant contact reactions may trigger vitiligo on areas such as the neck, elbows, and ankles . Also called “isomorphic response,” which describes the development of skin disease in sites of skin trauma.
Koebner phenomenon
Staph. aureus and atopic dermatitis
Staph superantigens activate T cells, macrophages
Punched out erosions in atopic dermatitis
pain and pustular lesions secondary to a viral infection (usually HSV-1), which can spread rapidly leading to severe morbidity and mortality
Eczema herpeticum
Rx: acyclovir
aggresive T-cell lymphoma: erythroderma, finely scaly and indurated
Sezary syndrome
Rx: extracorporeal photopheresis (ECP), romidepsin
— are topical immunomodulatory agents that affect the T-cell and mast-cell function and inhibit the synthesis and release of multiple proinflammatory cytokines.
Unlike topical corticosteroids, TCIs do not induce skin atrophy, striae, or telangiectasias and are increasingly used for the treatment of facial vitiligo.
Tacrolimus and pimecrolimus
a calcium and calmodulin dependent serine/threonine protein phosphatase which activates the T cells of the immune system.
Calcineurin
Low risk basal cell ca, not morpheaform, not recurrent: Rx
Curretage, electrodessication
Bisphosphonate therapy: 10 year risk has to be above
20%
Bacterial endocarditis abx prophylaxis
- Prosthetic valve
- Valve repair with prosthetic material
- Heart transplant + valvulopathy
- History of endocarditis
- Certain CHDs
Exposure to HIV+ needlestick: testing of stuck person
- HIV antibody
- HBsAg antibody
- Hep C antibody
- CBC
- LFT
- Creatinine
Pneumonia: OnDx
Calculate PSI
The PSI stratified adults with radiographic evidence of pneumonia into five classes for risk of death from all causes within 30 days of presentation. Predictor variables were based upon the medical history, physical examination, and selected laboratory and radiographic findings readily available at the time of patient presentation. In contrast with previous prediction rules, the PSI application uses two steps that parallel decision-making processes the physician usually follows during a patient encounter. Step 1 of the rule identifies patients in the lowest risk class (risk class I) based upon the absence of 11 demographic, comorbid conditions, and physical examination findings.
These factors consist of:
●Age >50 years
●The presence of coexisting conditions:
- Neoplastic disease
- Heart failure
- Cerebrovascular disease
- Renal disease
- Liver disease
●The presence of physical examination abnormalities:
- Altered mental status
- Pulse ≥125/minute
- Respiratory rate ≥30/minute
- Systolic blood pressure <90 mmHg
- Temperature <35°C or ≥40°C
If one or more Step 1 risk factors are present, the evaluation of illness severity proceeds to Step 2 (table 1); if no Step 1 factors exist, patients are assigned to the lowest severity risk class I. The second step stratifies the remaining patients into risk classes II, III, IV, or V based upon the total amount of points assigned to each risk factor identified. A total point score is computed by adding the patient age in years (years minus 10 for females) and the points for each applicable risk factor. Total scores of 70 or under correspond to class II, 71 to 90 to class III, 91 to 130 to class IV, and over 130 to class V (calculator 1).
Elevated PA pressure + elevated PCWP
Pulmonary venous hypertension
Left heart failure
Erythematous, lichenified Rash around 31 year old woman’ neck, wrists, ear lobes
History of AD
Nickel sensitivity
tinea corporis: Rx
terbinafine
