Skin

Question 1

why do you need to reappl suncreen

Answer 1

P450 enzymes in teh skin can degrade it

Question 2

clinical manifestation of contact dermatitis

Answer 2

erythema
induration (thick)
scaling
vesiculation

Question 3

irritant contant dermatitis due to

Answer 3

not immunologic

depends on dose applied

Question 4

characteristics of irritant contact derm

Answer 4

pink to red patches or plaques
blisters
itching
michenification (epidermal thickening)

Question 5

allergic contact dermatitis due to

Answer 5

delayed type4 hypersensitivity reaction
first exposure creates antigen on second exposure presents the antigen to t cells that are now sensitized and activates immune response

Question 6

when does allergic contact dermititis occur

Answer 6

within 12 hr of sensitization

peaks 48-72 hr

Question 7

contact urticaria due to

Answer 7

IgE mediated

histamine release

Question 8

presentation of contact urticaria

Answer 8

transient
pruritic
edematous
pink papules or wheals

Question 9

protective agents from Uv radiation

Answer 9

melanin and amino acids

Question 10

what is photosensitivity

Answer 10

abnormal sensitivity to UV and visible light due to endogenous or exogenous factors

Question 11

difference between phototoxicity and photoallergy

Answer 11

toxicity due to activation of certain compounds due to light and can occur at first exposure and allergy is the generation of antigen activation

Question 12

what is phototxicity

Answer 12

occurs at first exposure

chemicals from meds absorb UV light and reach higher energy excited state

Question 13

acute phototoxicity reaction

Answer 13

skin red
blister within minutes to hours after light exposure
basically a sunburn

Question 14

chronic phototoxicity skin reaction

Answer 14

hyperpigmentation - spots

thickening

Question 15

drugs causing phototoxicity

Answer 15

amiodarone

flouroquinolone

Question 16

what is photoallergy

Answer 16

type 4 delayed hypersensitivity requires prior sensitization

Question 17

uv light role in photoallergy

Answer 17

necessary to convert a potential photosensitizing chemical into a hapten that binds to a tissue antigen = allergic response at next exposure

Question 18

presentation of maculopapular eruptions

Answer 18

morbilliform
start on trunk adn spread to entire body
flat or raised red lesion
symmetrical
itchy macules and papules
small red spots that are itchy and raised

Question 19

when does maculopapular eruptions occur

Answer 19

appear within first week of therapy

common in amox

Question 20

clinical presentation or urticaria

Answer 20

pink or red raised papules and plaques
localized vasodilation adn transudation of fluid from small cutaneous blood vessels
angioedema due to vasodilation
large, more red

Question 21

mechanism of urticaria

Answer 21

type 1 (IgE)
type 3
direct effects on mast cells
inhibition of prostaglandins

Question 22

fixed drug eruption presentation

Answer 22

bright dusky red
oval or circular patch with central pigmentation
blister
sometimes burning

Question 23

where do fixed drug eruptions occur

Answer 23

at the same sites on reapeated admin of drug

face hands feet mouth

Question 24

when does fixed drug eruptions heal

Answer 24

7-20 days after discontinuing

Question 25

erythema multiforme caused by

Answer 25

type 3 immune reaction

Question 26

erythema multiforme presents as

Answer 26

red maculae that become edematous and papular | concentric rings of different color : red, purple, white, black

Question 27

common sites of erythema multiforme

Answer 27

face hands limbs mucous membranes

Question 28

what is SJS

Answer 28

severe varient of erythema multiforme

Question 29

SJS presentation

Answer 29

``` mucosal and conjunctival edema erosions fever myalgia vomiting diarrhea arthralgia skin lesions severe with denudation (detach from body) ```

Question 30

complications of SJS

Answer 30

``` keratitis conjunctival scarring blindness pneumonia dehydration esophagitis ```

Question 31

drug causes of SJS

Answer 31

ibuprofen penicillin salyicylate also some genetic predisposition but unclear

Question 32

severity of TEN

Answer 32

life threatening high mortality rates

Question 33

clinical manifestations of TEN

Answer 33

prodromal: malaise, sore throat, headache, myalgia, fever, cough acute onset of cutanoues manifestations within hours or days macular lesion with burning sensation that enlarges over the body large blister with redness detachment of epidermis (necrosis)

Question 34

areas effected by TENs

Answer 34

``` palms soles mouth throat nose trachea eyelid cornea conjunctiva ```

Question 35

complications of TEN

Answer 35

``` similar to second degree burns fluid adn electrolyte disorder septicemia pneumonia hepatocellular damage GI ulcer nephritis myocardial damage ```

Question 36

mechanism of TEN

Answer 36

cytotoxic intermediates produced during metabolism of carbamaxepine immunologic metabolic

Question 37

what is erythema nodosum

Answer 37

inflammatory reaction of the SC fat | creates dark nodules

Question 38

presentation of drug induced lupus erythematosus

Answer 38

red rash on face in the form of a butterfly fever malaise arthritis

Question 39

what is purpura

Answer 39

bleeding into the skin

Question 40

causes of purpura

Answer 40

drugs that interfere with platelet aggregation or coagulation cytotoxic drugs direct endothelial damage (bleomycin)

Question 41

causes of hyperpigmentation

Answer 41

deposit of melanin in the dermis or stimulation of melanin production amiodarone oral contraceptive