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PPOM1 Block 4 > Lecture 189 > Flashcards

Lecture 189 Flashcards

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1
Q
A
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2
Q

What are the characteristics of urticaria (hives)?

A

Intensely pruritic, well-demarcated, pink, annular swellings of the superficial dermis

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3
Q

What is angioedema?

A

Swelling of deeper dermal and subcutaneous tissues, commonly affecting the tongue, lips, mouth, face, and neck

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4
Q

What causes autosomal dominant hereditary angioedema?

A

C1-esterase inhibitor deficiency

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5
Q

Acquired angioedema is secondary to what pharmaceutical class?

A

Angiotensin-converting enzyme

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6
Q

What leads to vasodilation and edema in angioedema?

A

Increased bradykinin binding with bradykinin beta2 receptors

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7
Q

What medications are used to treat hereditary angioedema?

A

Icantibant and ecallantide

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8
Q

What is the most common infectious cause of erythema multiforme (EM)?

A

Herpes simplex virus (HSV)

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9
Q

What type of immune response is directed at viral antigens in erythema multiforme?

A

Cell-mediated immune response

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10
Q

What does EM minor lack?

A

Involvement of mucosal membranes or systemic symptoms

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11
Q

Where do EM lesions typically originate?

A

Soles and palms

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12
Q

How long does it take for EM lesions to appear?

A

3-5 days

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13
Q

How long does it take for EM lesions to resolve?

A

14 days

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14
Q

What percent of BSA is involved in SJS?

A

<10%

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15
Q

What percent of BSA is involved in TEN?

A

> 30%

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16
Q

What type of reaction leads to SJS/TEN?

A

Drug-specific CD8+ cytotoxic T cell-mediated reaction

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17
Q

What is the Nikolsky sign?

A

Ability to extend the area of epidermal detachment with gentle lateral pressure

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18
Q

What sign is positive in SJS/TEN?

A

Positive Nikolsky

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19
Q

What is the typical onset of SJS/TEN?

A

1-3 weeks after initial drug exposure

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20
Q

Where do SJS/TEN lesions typically originate?

A

On the trunk and then spreads to upper extremities and face

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21
Q

What differentiates SJS/TEN from SSSS?

A

SJS/TEN has mucosal involvement

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22
Q

What population is primarily affected by SSSS?

A

Children

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23
Q

What type of staph is implicated in SSSS?

A

Staph aureus

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24
Q

What clinical sign is positive in SSSS?

A

Positive Nikolsky

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25
What happens to the skin in SSSS?
Skin becomes scalded, blistered, erythematous, and edematous with flaccid bullae
26
How long does epidermis desquamation take in SSSS?
3-5 days
27
How is SSSS treated?
IV antibiotics (nafcillin, oxacillin)
28
What type of infection is mediated by Group A streptococcus (GAS) exotoxins or Staphylococcus aureus toxin?
Toxic shock syndrome
29
What do GAS exotoxins or TSST-1 act as?
Superantigens
30
What type of rash is associated with TSS?
Desquamative rash
31
Where is the TSS rash typically found?
Palms and soles
32
How soon after symptom onset does a TSS rash appear?
1-3 weeks after illness onset
33
How is TSS treated?
IV clindamycin + vancomycin or nafcillin
34
What autoimmune condition is characterized by IgG antibodies against desmoglein 3?
Pemphigus vulgaris
35
What clinical sign is positive in pemphigus vulgaris?
Positive Nikolsky sign
36
What does a skin biopsy showing IgG deposits in a reticular pattern indicate?
Pemphigus vulgaris
37
What autoimmune blistering condition involves flaccid bullae and mucosal involvement?
Pemphigus vulgaris
38
How is pemphigus vulgaris treated?
Plasmapheresis and IVIG
39
What type of hypersensitivity reaction is DRESS?
Delayed type IV T-cell-mediated hypersensitivity reaction
40
What is the typical time from drug initiation to onset of symptoms in DRESS?
2-8 weeks
41
What is the most common visceral manifestation of DRESS?
Liver injury
42
How does DRESS differentiate from SJS/TEN?
Mucosal involvement is mild, skin detachment is rarely seen
43
What type of bacteria causes meningococcemia?
Gram-negative diplococcus Neisseria meningitidis
44
How long does it take for symptoms to develop after exposure in meningococcemia?
3-4 days
45
What type of rash is seen in meningococcemia?
Petechial/purpuric rash
46
How is meningococcemia treated?
IV third-generation cephalosporin + IV vancomycin
47
What is necrotizing fasciitis?
An aggressive, rapidly progressing skin and soft tissue infection characterized by muscle fascia and subcutaneous tissue necrosis
48
What bacteria most often cause necrotizing fasciitis?
Gram-positive cocci (Staph aureus, Strep, Clostridium, anaerobes)
49
What is a sign of necrotizing fasciitis?
Excruciating pain out of proportion to presenting symptoms and subcutaneous emphysema and crepitus
50
How is necrotizing fasciitis treated?
Immediate surgical debridement
51
What causes Herpes Zoster ophthalmicus?
Latent VZV in the trigeminal ganglion that reactivates, affecting the ophthalmic branch of CN V
52
What is Hutchinson's sign?
Vesicular lesions on the tip of the nose
53
What does Hutchinson's sign indicate?
VZV involvement of the Nasociliary branch of the ophthalmic division of CN V
54
How long after the VZV viral prodrome do skin lesions develop?
1-5 days
55
What type of infection is Rocky mountain spotted fever (RMSF)?
Bacteria infecting vascular endothelial cells lining small and medium vessels
56
How soon do RMSF symptoms start after a tick bite?
4-10 days
57
What is the classic triad of RMSF?
Fever, headache, and a petechial or maculopapular rash that starts at the wrists and ankles
58
What is the treatment of choice for RMSF?
Doxycycline
59
What percent of BSA is the head and neck?
9%
60
What percent of the BSA is each arm?
9%
61
What percent of the BSA is each leg?
18%
62
What percent of the BSA is the genitalia?
1%
63
What type of burn involves only the epidermis?
Epidermal (superficial) burn
64
What type of burn involves the epidermis and superficial dermis?
Superficial partial-thickness burn
65
What type of burn involves the epidermis and deeper portions of the dermis?
Deep partial-thickness burn
66
What type of burn extends through the entire dermis into subcutaneous fat?
Full-thickness burn
67
What type of burn extends into muscle/bone?
Deeper burn injury
68
What % of TBSA burns meet criteria for a severe burn?
>10% TBSA
69
What happens in Kawasaki disease?
Inflammatory cells invade arteries, leading to disruption of the internal elastic lamina
70
What makes up the CRASH criteria?
Conjunctivitis, Rash, Adenopathy, Strawberry-tongue, Hand (and feet) edema
71
What type of rash is characteristic of Kawasaki disease?
Polymorphus often on palms and soles
72
What type of dermatological emergency is associated with a high risk of coronary artery vasculitis?
Kawasaki disease
73
How is Kawasaki disease treated?
Aspirin, IVIG
74
How soon after symptom onset should IVIG be administered in Kawasaki disease?
Within 10 days
75
How long does a fever need to be present for a Kawasaki diagnosis?
>5 days
76
How long does the measles virus incubate for?
10 days
77
How long does the prodromal phase last in measles?
3 days
78
When does a measles rash appear?
3 days after onset of prodromal phase
79
What are the symptoms indicative of measles?
Cough, conjunctivitis, coryza, Koplick spots, and fever
80
What are Koplik spots?
Small white spots on an erythematous base on the buccal mucosa, appearing 1-2 days before measles rash
81
What describes the measles rash?
A maculopapular erythematous rash that starts on the face and spreads cephalocaudally
82
What vitamin supplementation is recommended during treatment of measles?
Vitamin A

PPOM1 Block 4 (44 decks)

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