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Flashcards in Random Tidbits Deck (120)
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1

How do you diagnose allergic contact dermatitis?

Patch test

2

How do you treat allergic contact dermatitis?

Wash with water or Burow's soln

Topical steroids

3

Where do infants get atopic dermatitis?

on cheeks, diaper area, extensors

4

Where do adults get atopic dermatitis?

flexor surfaces, hands, face, neck

5

How do you treat seborrheic dermatitis?

selenium sulfide/zinc/ketoconazole/cold tar shampoos

6

How do you remove crusts in seborrheic dermatitis?

warm oil and sulfur shampoos

7

What does stasis dermatitis look like?

edema, scaling, brown pigment, petechiae, ache in legs while standing

8

What is the mainstay of tx with stasis dermatitis?

compression socks

9

What does nummular eczema look like?

coin shaped plaques w/ papules on erythematous base c crusting

10

Where do people get dishydrotic eczema?

palms and soles

11

What does dishydrotic eczema classically look like?

tapioca pudding

deep clustered vesicles, papules, scaling, lichenification

12

How do you treat dishydrotic eczema?

wet dressings with burow's, antihistamines

13

Does lichen simplex chronicus have:

a) papules?

b) plaques?

c) scaling?

a) no

b) yes

c) no!

14

What is the mainstay of tx for lichen simplex chronicus?

occlusive dressings to stop scratching

15

When do people get asteatotic dermatitis?

after hot baths, especially in the winter!

16

What is the pathophys of psoriasis?

keratin hyperplasia

inflamed cells

dilated blood vessels

Type 4 hypersensitivity

17

Where do people get plaque psoriasis?

trunk, scalp, extensors

18

What is pathognomonic of plaque psoriasis?

yellow-brown "oil spot" discoloration of nail beds

19

What sign will be + for plaque psoriasis and what is it?

Auspitz's Sign

When you peel off a scale and it shows pinpoint bleeding

20

"50 y.o. man with no history of psoriasis has sudden bright red, scaling papules covering his entire torso and upper extremities. He reports having a cold a while ago that he just can't seem to get over. What does this most sound like?"

this hx matches with guttate psoriasis

(buzz word = raindrop or splatterpaint)

21

Where do people get palmoplantar pustular psoriasis?

palms and soles

22

What is the mainstay of treatment for psoriasis?

Topical steroids

(Plaque = also Vitamin A/D)

(Guttate = also oral abx)

(PPP = also cover in plastic wrap)

23

Christmas tree pattern on torso

Herald Patch

Disease?

Pityriasis rosea

24

What is the tx for pityriasis rosea?

It's self-limiting! 3-8weeks

Lotions, antipruritics

25

What infection is associated with lichen planus?

HCV

26

What are the 5 P's of lichen planus?

purple

polygonal

planar

pruritic

papules

27

How do you dx fungal infections?

KOH prep will be +

28

beefy red with satellite lesions. what is it?

some sort of yeast infection

29

What is the tx for almost all mucocutaneous fungal inf? (thrush, vaginal, balanitis, candidal intertrigo)

topical nystatin

30

"Young pt returns from tropic area after tanning a lot and using lots of tanning oils with hypopigmented lesions"

tinea versicolor

(caused by malassezia furfur)

31

What does tinea versicolor look like on KOH prep?

spaghetti and meatballs

32

how do you tx tinea versicolor?

rx strength shampoo

33

What is the most common type of dermatophytes?

Trichophyton rubrum

34

How are dermatophytes transmitted?

fomites, animals, soil

35

Where is tinea pedis and what is the common term for it?

feet - Athlete's foot

36

Where is tinea corporis and what is the common term for it?

trunk, arms, legs, neck

ringworm

37

How long should you continue topical antifungal tx for ringworm?

1-2 weeks after it has cleared

38

Where is tinea cruris and what is the common term for it?

upper thigh and groin

jock itch

39

How long do you continue tx for tinea cruris?

months to years

40

What disease is alopecia areata associated with?

alzheimer's disease

41

What is pathognomonic for alopecia areata?

exclamation point hair

(the disease consists of round patches of hair loss)

42

How do you treat alopecia areata?

intralesional triamcinolone

systemic steroids but only a temporary fix

43

What is tinea unguium?

onychomycosis

fungus (trichophyton rubrum) of fingernails or toenails

44

Which type of onychomycosis is associated with immunocompromised?

Proximal Subungual Onychomycosis

Begins proximally on nail fold

45

What is the diagnostic testing for onychomycosis?

ALWAYS do lab testing to confirm!

*Histology of nail clipping

KOH, wet mount, or fungal culture

46

How do you tx onychomycosis?

only treat those with discomfort or immunocomp

oral terbinafine daily for 12 weeks

remission common

47

What is paronychia?

infection/abcess of lateral nail fold

48

How do you treat paronychia?

I+D with nerve block

local wound care, topical abx (bacitracin)

49

How do you tx lice?

topical insecticides (permethrin 1% cream rinse) once, then a week later

50

do head lice transmit ID?

do body lice?

no

yes

51

what do pubic lice look like?

brown grey specks

52

What do bedbug (cimex lectularius) bites look like?

papular utricaria

53

What will you see if you suspect scabies?

widespread skin-colored lesions

*burrows found at places without hair follicles (webs of hands, belt line, edge of socks)

*red papules/nodules on scrotum and shaft

54

How do you tx scabies?

permethrin 5% cream to all skin sites

also, oral ivermectin

treat partner

55

What causes generalized muscle pain, spasms, rigidity, and a target lesions?

black widow bites

56

How do you treat black widow bites?

pain: IV opioids or muscle relaxants

rigidity: IV calcium gluconate 10%

57

What causes progressive local necrosis, as well as fever, HA, malaise, arthralgias, nausea, and vomiting?

brown recluse bite

58

How do you treat a brown recluse bite?

local wound care, abx, oral steroids, excision

59

what is the patho of acne vulgaris?

plugged follicles lead to keratinization and retained sebum

leads to bacterial growth and release of fatty acid

60

What are the 4 grades of acne?

1: comedones

2: papulopustular

3: pustularnodular

4: nodulocystic

61

How do you tx acne?

benzoyl peroxide topical

topical abx

azeleic acid, glycolic acid, salycylic acid

topical retinoids (trenitoin)

etc

62

What are the 3 stages of rosacea?

1. persistent red c telangectasia

2. that + papules and pustules

3. that + nodules, edema, and more severe sx

63

How do you tx rosacea?

topical metronidazole***

64

What is a brown to black plaque that is velvety and appears stuck on?

seborrheic keratosis

65

is SK benign or malignant?

benign

66

What appears as dry skin with a rough, erythematous border, caused by repeated exposure to the sun?

actinic (solar) keratosis

67

Is AK benign or malignant?

pre-malignant

68

How do you tx AK?

topical 5-fluorouracil 2x daily for 2-4 weeks

cryo or laser surg

69

What is an epidermal inclusion cyst?

cyst filled with cream-cheese like keratin

70

Looks like a nodule with a pearly border, telangectasia, and a central ulceration?

basal cell carcinoma

71

Where are you most likely to get BCC?

ear, face, neck

72

How do you dx BCC?

punch or shave bx

73

What is the tx of choice for BCC?

electric curettage

74

Does BCC spread fast or slow?

Does it metastasize?

slow

no

75

Appears as red, firm nodules, scaly with crusting.

Looks like unhealing sore, sometimes bleeds

squamous cell carcinoma

76

Does SCC spread fast or slow?

Does it metastasize?

slow

yes

77

How do you dx SCC? What will you see?

bx

large, pleomorphic, hyperchromic nuclei

78

What is a variant of SCC that is a dome-shaped nodule with a crater at the center?

keratocantoma

79

Does melanoma spread fast or slow?

Does it metastasize?

fast

yes

80

What is the most common type of skin CA?

BCC

81

How do you dx a melamona?

Full thickness bx

NOT a shave or punch bx!

82

Who gets Kaposi sarcoma?

HIV/immunocomp

83

What does erythema multiforme look like?

macules that become papules, with vesicles and bullae at center

target lesions

84

What manifestation of erythema multiforme is practically diagnostic?

mucosal lesions with pain, erosion

85

Pt. presents with sx of a URI, with cutaneous lesions on the trunk that are painful, sting, and burn. It started about 4 days ago as a rash, and now he has loose skin and blisters. There are also lesions on his mucosal surfaces. What sign will be +?

This is SJS or TEN

Nikolsky sign is +

86

Pt has had a rapid progression of local erythema and severe tenderness, and there appears to be ruptured bullae at the site that have turned black. Pt has a fever, tachycardia, hypotension, and an altered mental status. What will the labs look like?

This is necrotizing fasciitis

Triad: inc WBC, inc BUN, dec Na

Also get histopathologic, radiologic, and gram stain

87

what causes necrotizing fasciitis?

group A strep

88

How do you treat necrotizing fasciitis?

aggressive debridement

abx

89

Who gets necrotizing fasciitis?

It's rare.

Immunocomp, DM, malignancy, C4 deficiency, some meds

90

Pt has systemic sx with a local warm, red and tender spot that has swelled up. It's hard to distinguish where the lesion ends. Pt remembers having a cut in that spot last week. How will you treat?

This is cellulitis

Tx with abx (dicloxacilin, cephalosporin, macrolide)

91

Where do people get erysipelas?

face and lower extremities

92

What causes erysipelas?

group a strep

93

How do you treat erysipelas?

penicillin, macrolides

94

"honey colored crust" on child's face

impetigo

95

How do you treat impetigo?

topical mupirocin [bactroban]

96

"gray to white tan, flat papules with rough, pebble-like surfaces"

verrucae

97

How will you dx verrucae?

Microscope: hyperplasia, hyperkeratosis, koilocytic squamous cells

immunofluorescence: HPV cells

98

How do you treat common verrucae?

salycylic acid, cryo, electrodecussation, imiquimod

or you could excise surgically

99

What strains of HPV cause

a) cervical ca?

b) common warts?

a) 16/18

b) 6/11

100

Pt. has a fever and sore throat. on PE, you notice vesicles on the posterior pharynx that have ruptured, leaving a gray exudate. Rapid strep test is negative. What do you suspect?

HSV1

101

How will the initial infection of HSV2 present?

pt has been very sick for a week

developed vesicles on genitalia with crusted, ruptured ulcers

102

What will you see on Tzank smear for HSV?

multinucleated giant cells

103

Pt has skin colored papules on his genitals, with a dome shape and a central umbilication that has white underneath the depression. He is sexually active. How will you treat this?

This is molluscum contagiosum.

It's self-limiting, so you don't need to treat.

If requiring tx, use imiquimod, cryo, curettage, retin-a

104

rash over 1 dermatome

varicella zoster

105

Pt. with DM has velvety hyperpigmentation. Where would you most likely find this hyperpigmentation?

Acanthosis nigricans

in the body folds

106

What is the #1 risk for melasma?

OCP! and pregnancy

107

how do you tx melasma?

skin-lightening creams like hydroquinone, azelaic acid

108

Pt. reports pain at the base of their spine, and on PE you notice swelling, redness, and draining pus at the PSIS. What causes this?

This is pilonidal disease

Cause by multiple ingrown hairs (probably)

109

Pt has pruritic wheals after eating shellfish that are worsened when scratching. What will diascopy show?

Utricaria

Diascopy shows it's blanchable

110

How do you treat utricaria?

What type of hypersensitivity is it?

antihistamines, prednisone

type 1

111

How do you dx vitiligo?

Wood's lamp

112

Pt has a tender abcess at the site of an apocrine gland (e.g. in her armpit). She is wondering what you can do for her.

It's usually self-limited, so probably watchful waiting.

Look for S aureus and consider abx

113

How do you tx a stage 2-4 decubitus ulcer?

moise sterile gauze (Gelfoam)

hydrocolloid

debridement

114

Which degrees of burns have capillary refill?

1 and 2 (superficial)

115

Which degrees of burns have blistering?

2 (deep) and 3

116

Which degrees of burns have no pain

2 deep (no pain unless pressure)

3 and 4

117

Which degree of burn extends down through the dermis?

2nd (deep) and on

118

Which type of burn is moist?

2nd superficial

119

How do you care for burns?

clean with soap and water

debride

remove blisters only if they've ruptured

pain: acet, NSAIDs, +/- opioids

Abx (superficial = topical; silver sulfadiazine = 2nd/3rd)

press if not superficial

IVF

(ABCD PP fluids - abx, blisters, clean, debride, pain and press, IV fluids)

120

What looks like utricaria, but has large, tense bullae, and appears mostly in the elderly?

bullous pemphigoid