Rapid Review Derm Flashcards
(110 cards)
1
Q
Stuck on appearance
A
Seborrheic keratosis
2
Q
Red plaques with silvery white scales and sharp margin
A
Psoriasis
3
Q
Most common type of skin cancer
Lesion pearly-colored papule with translucent surface and telangiectasias
A
Basal cell carcinoma
4
Q
Honey crusted lesions
A
Impetigo
5
Q
Febrile pt w/ Hx DM presnts with red, swollen, painful LE
A
Cellulitis
6
Q
Positive Niklosky’s sign
A
Pemphigus vulgaris
7
Q
Negative Niklosky’s sign
A
Bullous pemphigoid
8
Q
55 yo obese pt presents with dirty, velvety patches on back of beck
A
Acanthosis nigricans-check FBG to r/o DM
9
Q
Dermatomal distribution
A
Varicella zoster
10
Q
Flat topped papules
A
Lichen planus
11
Q
Iris like target lesions
A
Erythema multiforme
12
Q
Lesion characteristically occurring in linear pattern in areas where skin comes into contact with clothing or jewelry
A
Contact dermatitis
13
Q
Presents with herald patch, Christmas tree pattern
A
Pityriasis rosea
14
Q
Pinkish, scalding flat lesions on chest and back, KOH prep has “spaghetti and meatballs” apperance
A
Tinea (pityriasis) versicolor
15
Q
4 characteristics of nevus suggestive of melanoma
A
Asymmetry
Border irregularity
Color variation
Diameter increasing
16
Q
Premalignant lesions from sun exposure that can lead to SCC
A
Actinic keratosis
17
Q
Dewdrops on rose petal
A
Lesions of primary varicella
18
Q
Cradle cap
A
Seborrheic dermatitis
Tx conservatively with bathing and moisturizer
19
Q
Associated with Propionibacterium acnes and changes in androgen levels
A
Acne vulgaris
20
Q
Painful, recurrent vesicular eruption of mucocutaneous surfaces
A
Herpes simplex
21
Q
Inflammation and epithelial thinning of anogenital area, predominantly in postmenopausal
A
Lichen sclerosus
22
Q
Exophytic nodules on skin with varying degrees of scaling or ulceration; 2nd most common skin cancer
A
SCC
23
Q
Macule
A
flat lesion that differs in color from surrounding skin <1 cm diameter
24
Q
Patch
A
small circumscribed area differing in color from the surroundings surface >1cm diameter
25
Papule
Elevated solid lesion that is generally small <5mm
26
Plaque
Elevated solid lesion >5 mm
27
Cyst
Epithelial lined sac containing fluid or semisolid material
28
Vesicle
Fluid-filled, very small (<5 mm) elevated lesion
29
Bulla
Large vesicle >5 mm
30
Wheal or hive
Area of localized edema that follows vascular leakage and usually disappears within hours
31
Erosion
Circumscribed, superficial depression resulting from loss of some or all of epidermis
32
Ulcer
Deeper depression than erosion resulting from erosion of epidermis and upper dermis
33
Scale
Abnormal shedding or accumulation of stratum corneum in flakes
34
Crust
Hardened deposit of dried serum, blood, or purulent exudates
35
LIchenification
Thickening and hardening of skin with accentuation of normal skin marking
36
Scar
Healing defect of dermis
37
Type I hypersensitivity reaction - describe and give mechanism
Anaphylactic and atopic
Antigen crosslinks IgE on PRESENSITIZED mast cells and basophils- release vasoactive amines (histamine and LT) -- reaction due to preformed ab
38
Type II hypersensitivity reaction - describe and give mechanism
Cytotoxic
| preformed IgM and IgG bind antigen an enemy cell - lysis via complement or phagocytosis (MAC)
39
Type III hypersensitivity reaction - what are 3 types?
Immune complex
Serum sickness
Arthus reaction
40
Immune complex: type of hypersensitivity and mechanism
Type III
| Ag-Ab complexes activate complement-attract PMN-release lysosomal enzymes
41
Serum sickness: type of hypersensitivity and mechanism
Ab to foreign proteins produce in about 5 d - immune complexes form and deposit in membrane- lead to tissue damage due to complement fixation
42
Arthus reaction: type of hypersensitivity and mechanism
Type III
| Local reaction to antigen by preformed Ab charactized by vascular necrosis and thrombosis
43
Type IV hypersensitivity reaction - describe and give mechanism
Delayed/cell mediated
Sensitized T cells encounter antigen and release lymphokines that activate macrophages
Because is cell mediated is NOT TRANSFERABLE BY SERUM
44
Anaphylaxis, asthma, urticarial drug reaction ,wheal and flare - what type of hypersensitivity run
Type I- anaphylactic and atopic
45
AI hemolytic anemia, erythroblastosis fetalis, Goodpasture, rheumatic fever - what type of hypersensitivity run
Type II-cytotoxic
46
Polyarteritis nodosa, immune complex GMN, SLE, RA - what type of hypersensitivity run
Type III: immune complex
47
Drug reaction- what type of hypersensitivity run
Type III: serum sickness
48
Hypersensitivity pneumonitis- what type of hypersensitivity run
Type III: arthus reaction
| Rarely occurs 4-12 hrs after vaccination
49
TB skin test, transplant rejection, contact dermatitis- what type of hypersensitivity run
Type IV: delayed/cell mediated
50
Psoriasis cause
T cell mediated - dermal inflammation and epidermal hyperplasia
51
Tx seborrheic dermatitis
Selenium sulfide
Zn pyrithione
Topical steroid
Topical antifungal
52
Tx psoriasis
Steroid + keratolytic, tar, anthralin
IV
Methotrexate if bad
Retinoids and D3
53
Rash of extensor surface
Psoriasis
54
Rash of flexor surface
Atopic dermatitis
55
Associated with psoriasis
Seronegative arthritis
56
Tx hives/urticaria
Antihistamine
| If anaphylaxis: antihistamine, Epi, IVF, airway
57
Tx drug eruption
Stop drug, antihistamine, topical steroid
58
Number of days before cutaneous drug reaction seen
7-14
59
Major trigger Erythema multiforme
HSV lip
60
Total body surface area of exfoliation SJS vs TEN
SJS 30%
61
Tx SJS and TEN
Tx like burn: IVF, cover skin, watch lytes, careful of infection, thermoregulation problems,
Can use systemic steroids and IVIG in early stages
62
Etiology SJS/TEN vs SSSS
SSSS- infection
| SJS/TEN- drug
63
Tx erythema nodosum
NSAIDs, remove offending agent
64
Tx bullous pemphigoid vs pemphigoid vulgaris
Bullous: Steroids, azothioprine
Vulgaris: high dose steroids, + immunomodulator-IVIG, MMF, rituximab; azothioprine, cyclophosphamide
65
Tzanck smear
Dx HSV: multinuclear giant cell
| Tzanck goodness its not herpes!
66
Tx HSV
acyclovir oral or IV
Can use valacyclovir, famciclovir
Daily Tx if > 6 outbreaks per yr
67
Tx VZV
Acyclovir
| Vaccine available
68
Molloscum contagiosum-type of virus; Dx
Poxvirus
| Giemsa or Wright stain shows inclusion bodies
69
Tx molloscum contagiosum
Freezing, curetting, trichloroacetic acid
70
Tx verrucae
Cryotherapy, podophylllin, trichloroacetic acid, imiquimod, 5FU
71
Tx eryspelas
Penicillin (usu. GAS infection)
72
Tx impetigo
Abx w/ staph coverage- cephalosporins, erythromycin, topicals
Topical usu good enough but oral to prevent spread
73
Scarlet fever, cause, Tx
Strep pyogenes
| Penicillin
74
Tx salmonella typhi
Fluoroquinolone and 3rd cephalosporin
| If chronic carrier consider cholecystectomy
75
Ludwing angina- what; presentation?
What: bilateral cellulitis of submental, submaxillary, sublingual spaces that results from infected tooth
S/S: dysphagia, drooling, fever, red warm mouth- can asphyxiate
76
Most common cause cellulitis
GAS, Staph (MRSA)
77
Tx cellulitis
7-10 oral abx if mild; 10-14 d cephalosporin or beta lactamase resistant abx
IV abx if DM, bad, old, hand or eye, etc
If MRSA: vanc or linezolid
78
Necrotizing fasciitis
Causes
Signs
Tx
S pyogenes
Mixed: S aureus, E coli, C perfringens
S/S: tissue necrosis, putrid discharge, bullae, pain, gas production
Tx: Strep 1. Pen G 2. Clinda
Anaerobic: Metronidazole or 3rd ceph
79
Folliculitis - causes, hot tub
Staph, Strep, Gram N, sometimes Candida
| Pseudomonas- hot tub
80
Furuncle vs carbuncle
Furuncle deep infection of hair follicle, progressed from folliciltis
Carbuncle many furuncles
81
Tx 1. comedonal acne
2. pustulocystic or inflammatory
3. sever cystic
1. topical tretinoin + benzoyl peroxide
2. benzoyl peroxide + topical abx (erythromycin or clindamycin), oral if resistant to topical
3. Isoretinoin- test LFT, chol, TG, beta HCG
82
Tx pilonoidal
I and D
83
Abx cause serious photosensitivity
Tetracycline and doxycycline
84
KOH prep reveals spaghetti and meatballs
Tinea versicolor
85
Cause tinea versicolor
Malasezia furfur
86
Tx tinea versicolor
Ketoconazole or selenium sulfide
87
Candidiasis Tx
1. oral
2. skin
3. diapr
1. oral fluconazole, nystatin swish and swallow
2. topical antifungal
3. topical nystatin
88
Dermatophyte - 3 common bugs
Trichophyton
Microscporum
Epidermophytin
89
Tx dermatophyte
Topical antifungals ok
| Capitis must be oral
90
Tx scabies
5% permethrin from neck down
| can use oral ivermectin
91
Tx lice
head: pyrethrin (RID), benzoyl alcohol, remove nits
Body: wash, permethrin or pyrethrin
Pubic: RID
92
Tx rosacea
topical metronidazole
93
Tx vitiligo
Psoralens, sunlight, PUVA
94
Tx actinic keratosis
Cryotherapy
5FU
Imiquinod
Biopsy
95
Commonest causes SCC
Sun
| Arsenic
96
Examples of macule
```
Cafe au lait spot
Vitiligo
Freckle
Junction nevi
Ink tattoo
```
97
Examples of Patch
Nevus flammeus
Vitiligo
Tinea corporis
98
Examples of Papule
```
Acrochordon (skin tag)
Basal cell carcinoma
Molloscum contagiosum
Intradermal nevi
Lichen planus
```
99
Example Plaque
```
Bowen disease
Mycosis fungoides
Psoriasis
Eczema
Tinea corporis
```
100
Examples of Nodule
```
Rheumatoid nodule
Tendon xanthoma
Erythema nodosum
Lipoma
Metastatic carcinoma
```
101
Examples of wheal
Urticaria
Dermographism
Urticaria pigmentosa
102
Examples of vesicle
Herpes simplex
Herpes zoster
Dyshidrotic eczema
Contact dermatitis
103
Examples of bulla
Pemphigus vulgaris
Bullous pemphigoid
Bullous impetigo
104
Examples of pustule
Follicultis
Impetigo
Acne
Pustular psoriasis
105
Examples of cyst
Acne
Epidermoid cyst
Pilar cyst
106
Hidranitis suppurativa - define, bugs, Tx
Chronic follicular occlusion and apocrine inflammation 2/2 recurrent abscess
Bugs: Staph
Tx: I and D, cephalosporin
107
Mom pregnant and has chicken pox
Give immunoglobulin b/c can transmit to newborn
108
Enzyme def in prophyria cutanea tarda
Hepatic uroporphyrinogen decarboxylase
109
Tx porphyria cutanea tarda
Phlebotomy
Low dose chloroquie
Sunscreen
Avoid triggers: estrogen, alcohol, tobacco
110
Hereditary angioedema cause
Lack of C1 esterase inhibitor
Swelling of kips eyelids, airway, bowel
AD, C4 is low
