Week 1 - Dermatology Week

Question 1

Immovable joints are also called? What is an example of an immovable joint?

Answer 1

Synarthroses; Ghomphoses - The fibrous joint between the tooth and its socket.

Question 2

Slightly moveable joints are called? What is an example of a slightly moveable joint?

Answer 2

Amphiarthroses; the fibrous syndesmosis between the ulna and radius.

Question 3

Primary cartilage is _______? Secondary cartilage is ______?

Answer 3

Hyaline; Fibrous

Question 4

Freely moveable joints are also called? An example is?

Answer 4

Diathroses; Synovial Joints

Question 5

Trauma applied to a loose packed joint will often result in ______ while trauma applied to a close packed joint will often result in ______?

Answer 5

Dislocation; Fracture or Fracture-Dislocatation

Question 6

A preceding history of streptococci infection; acute onset of numerous small, scaly, drop-like plaques; in young adults or childrens sounds liek a diagnosis of?

Answer 6

Guttate Psoriasis

Question 7

Give an overview for the treatment of psoriasis.

Answer 7

Mild to moderate: Topical corticosteroids and amolients. Vitamin D analogs, topical retinoids can be used in combination for best results.

Severe: Phototherapy and/or systemic retinoids, methotrexate, steroids, cyclosporine, or biologics {anti-TNF and anti-IL-12/23}.

Question 8

What are three topical steroids commonly used from least to most potent?

Answer 8

Hydrocortisone, Dexamethasone, Betamethasone Dipropionate

Question 9

Pitting of the nails is sometimes seen in what dermatological condition?

Answer 9

Psoriasis

Question 10

Name several types of psoriasis.

Answer 10

Plaque, Scalp, Guttate, Nail, Pustular, Arthritic

Question 11

Define: Macule, Papule, Patch, Plaque, Nodule, Vesicle, Pustule, Bulla, Cyst, and Ulcer.

Answer 11

Macule: Flat lesions differing from the surrounding skin in colour, ≤ 1 cm.

Papule: Small, elevated lesion ≤ 1 cm. A papule with scales is called “papulo-squamous”.

Patch: A macule > 1 cm.

Plaque: An elevated lesions whose surface area is greater than its height above the skin. Essentially large plaques.

Nodule: Palpable and solid lesion which is deeper than a papule. ≤ 1 cm.

Vesicle: Elevated, circumscribed lesion which contains fluid. ≤ 1 cm.

Pustule: Elevated, circumscribed lesion which contains purulent exudate.

Bulla: A vesicle > 1 cm.

Cyst: A sac which contains fluid or semi-solid material.

Ulcer: A “hole in the skin” with destruction of at least the epidermis and upper dermis.

Question 12

What condition is characterized by flat-topped, papulosquamous, violaceous, itchy papules and patches on the flexor aspect of the wrist?

Answer 12

Lichen Planus

Question 13

When bacteria act on the secretions of _______ glands a scent is produced. Inflammation of these glands is called _______ and may be very painful.

Answer 13

Apocrine, Hidradenitis Suppurative

Question 14

Recall the red flags of skin melanoma.

Answer 14

Asymmetry

Border {Irregular}

Colour {Non-Uniform}

Diamter {> 6 mm}

Evolving {Change}

Question 15

Localized, clutstered, and painful blisters are seen in?

Answer 15

Herpes Simplex Infection

Question 16

HSV infection, mycoplasma pneumonia infection, barbituates, and sulphonamides may cause target-like erythamtous lesion swith dusky centers called _______ ________. These usually appear on what area of the skin?

Answer 16

Erythema Multiforme; The soles of the hands and palms of the feet.

Question 17

Tinea presents in a ring-like configuration and is caused by _______ _______. What is it treated with? How is tinea capis treated differently?

Answer 17

Superficial Dermatophytes; Topical Antifugals; Oral Antifungals.

Question 18

The “burrows” of scabies often affect the?

Answer 18

Finger webs, flexor aspect of the wrists, axillary folds, and the male genitalia.

Question 19

HSV 1 almost always causes ______ while HSV 2 almost always causes _______.

Ulcers crust over in ~4 days and complete healing occurs after _______ days.

Answer 19

Facial-Oral Herpes; Genital Herpes.

8 - 9 Days

Question 20

Herpes reamains locailized in all cases except?

Answer 20

Eczema Herpeticum, when atopic dermatitis occurs with HSV infection.

Question 21

Chicken Pox occurs with lesions in _______ stages and is treated with _______. Aspirin should be avoided as _______ may be developed.

Answer 21

Different; Calamine Lotion; Reye’s Syndrome.

Question 22

Umbilicated lesions of the face and neck are seen with?

Answer 22

Molluscum Contagiosum

Question 23

Characteristic findings of impetigo include? What causes impetigo?

Answer 23

Vesicles, bullae, and pustules which become covered by a golden yellow crust. Imeptigo is caused by group A beta-hemolytic streptococci.

Question 24

Benign pigmented macules which are well demarcated and brown. Very common in caucasians older than 60.

Answer 24

Lentigo, Lentigo Simplex does not require any treatment while Solar Lentigo should be momitored for any concerning changes.

Question 25

What can be given to treat Androgenetic Alopecia?

Answer 25

Finasteride, an inhibitor of 5-alpha-reductase {which converts testosterone to dihydrotestosterone}.

Question 26

Telogen Effluvium Alopecia results from?

Answer 26

An increased proportion of hair follicles being in the telogen {resting} phase.

Question 27

Alopecia Areata results from what? What is used to treat it?

Answer 27

Believed to be caused by an autoimmune mechanism. Can be treated with topical or intralesion injections of steroids.

Question 28

Pruritus, Violaceous Erythema +/- Edema of the Eyelids {Heliotrope}, and Flat-Topped Violaceous Papules on the Knuckles {Gottron's Papules} are typical of what condition?

Answer 28

Dermatomyositis

Question 29

What is the primary cause of Stevens Johnson Syndrome? What is the presetation of SJS?

Answer 29

Starting a new medication, the best treatment is to stop the offending agent. Presents as a severe Erythema Multiforme with multiple lesions on the soles of the feet and palms of the hands. In addition to this, there is extensive erosion and crusting of the lips, oral mucosa, and sometimes genital mucosa. The most severe form is Toxic Epidermal Necrolysis. Rapid onset, red plaques which blister and then slough off the body.

Question 30

Painful nodules on the shin, often with fever, malaise, and arthralgia which generally resolve spontaneously in a few weeks are associated with?

Answer 30

Erythema Nodosum - an inflammation of the subcutaneous fat. Managed with NSAIDs and sometimes systemic steroids.

Question 31

Palpable Purpura is associated with what? Where does the rash with this condition typically affect?

Answer 31

Vasculitis; The legs and ankles, there are dozens or hundreds of palpable purpuric papules. The papules are non-blanchable.

Question 32

A distinct form of vasculitis consisting of papable purpura affecting the ankles, legs and buttocks, most often affecting children. It is associated with abdominal pain and hematuria, and often follows upper respiratory tract infection caused by Streptococcal infection.

Answer 32

Henoch-Schonlein Purpura

Question 33

Venous ulcers are often {painless/painful} while arterial ulcers are often {painless/painful}.

Answer 33

painless; painful

Question 34

Antihistamines are useful in alleviating?

Answer 34

Pruritis

Question 35

A potentially invasive, primary cutaneous carcinoma arising from kertinocytes of the skin and mucosa. When they invovle the entire thickness of the epidermis is in known as Bowen Disease. Most often occur on sun exposed areas of the skin.

Answer 35

Squamous Cell Carcinoma Raised, Palpable, Skin Colored to Red Papules or Paques with Scaling.

Question 36

A cancer of low metastatic potential and a translucent surface which is common among fair skinned individuals. There are often prominent telangiectatic vessels over the lesion.

Answer 36

Basal Cell Carcinoma. There are three types, Nodular BCC {most common}, Superficial BCC {spreads superficially}, and Morpheaform BCC {resembles a scar}. Can be treated with Imiquimod {immunomodulating agent} and/or Mohs Micrographic Surgery.

Question 37

Name and describe the four kinds of Malignant Melanomas

Answer 37

**Superficial Spreading:** The most common type {60-70%} which may occur at any site but is most common on the trunk and legs. Usually an irregularly shaped macule with different shades of color. **Nodular:** Second most common type {15-30%} most commonly seen on the trunk, head, and neck. Often presents as a blue to black {sometimes pink to red} nodule which may bleed or ulcerate. **Lentigo Maligna:** Third most common {10%} which often occurs in older individuals in sun damaged skin. Slow growing asymmetric brown to black macule with irregular borders and different shades of color. **Acral Lentiginous:** Around 5% of melanomas, typically occurs on the palms and soles, or around the nail apparatus. Most commnly seen in dark skinned individuals.

Question 38

A rare, multisystemic inflammatory disease which affects multiple organs and has chronic relapses. Main symptoms include recurrent oral aphthous ulcers, genital ulcers, erythema nodosum, superficial thrombophlebitis, skin pustules, iridocyclitis, posterior uveitis, arthritis, epididymitis, vascular and central nervous system lesions…

Answer 38

Behcet's Disease Behcet’s is treated with systemic glucocorticoids/corticosteroids or other immunosuppressive agents.

Question 39

The Diagnosis of Lupus Requires ≥ 4 of SOAP BRAIN MD which consists of?

Answer 39

Serositis Oral Ulcers Arthritis Photosensitivity Blood Disorders Renal Involvement Antinuclear Antibodies Immunological Phenomena Neurological Disorder Malar Rash Discoid Rash