dermatology board review – Flashcards
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primary lesion definition secondary lesion definition, give ex
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a. result of disease process no outside intervention. Vesicle b. lesion altered by outside manipulation, tx or natural course of disease. Example: crust-develops when vesicle ruptures
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< 1cm primary lesions a. describe the 4 types b. what is the dermatologic term c. give examples
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a. flat, solid raised, fluid filled or pustule filled b. macule, papule, vesicle, pustule c. freckle, raised nevus (mole), varcilla/hepatic lesion, acne
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> 1 cm primary lesions a. 3 types describe b. c.
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a. flat discolored area (non palpable), raised, fluid filled b. patch, plaque, bullae c. vertiligo, psoriasis, insect bite or second degree burn
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Any size primary lesions a. 3 types b. dermatologic term c. examples
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a. raised encapsulated fluid filled lesion, circumsribed area of skin edema, flat red purple discoloration b. cyste, wheal, purpura c. intradermal cyst, hives urticaria, petechai (will not blanch)
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secondary lesions any size a. 3 types b. dertmatologic term c. examples
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a. linear raised often covered with a crust, raised lesions produced by dried serum and blood, skin thickening, raised superficial areas that flake easily b. excoriation, crust, lichenificaton, scales c. scratch marks, impetigo, callus, dandruff
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Give type of lesion and primary/secondary a. freckle b. cyst c. raised nevus d. insect bite e. impetigo f. psoriasis g. varicilla h. impetigo i. scab j. callus h. scratch mark i. herpatic lesions j. dandruff k. cafe au lait spots l. vertiligo m. apthous stomatitis i. wart
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a. macule primary 1 cm c. papule-primary 1 cm e. pustule-primary 1cm g. vesicle-primary < 1 cm h. pustule-primary 1cm l. patch m. erosion-secondary lesion i. papule primary < 1 cm
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secondary lesions > 1 cm a. erosion b. ulcer d. fissure
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a. loss of epidermis-apthous stomatitis b. loss of epidermis and dermis-arterial ulcer, sphyllitic chancre c. athletes foot
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distributions of lesions-give examples a. annular b. scattered c. confluent or coalescent d. clustered e. linear f. reticular g. dermatomal/zosteriform h. serpingeous
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a. circular-tinea fasciale (ringworm) b. scattered-rubella/maculopapular rash c. confluent/coalescent-tinea versicolor, psoriasis d. clustered-acne, drug induced rash e. linear-poison ivy, poison oak f. reticular-net like cluster-erythema infectiousum (5th disease) g. shingles, herpes zoster h. tinea corporis
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3 types of acne-differentiate a. comedones and pustules b. comedones and papules
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a. moderate acne-key is pustules and open comedones b. primary-open closed comedones and papules
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most common precancerous lesion that can progress to SCC
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a. actinic keratosis predominatly on sun exposed areas of the face , neck, back of hands and foremars B. TX: 5 FU, imiquimod cream, dicolfenac el, photodynamic therapy, tissue distruction
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shingles treatment
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a. zostavax-pain and itch. typically > 50 years of age
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define as SCC or BCC a. oral cavity b. metastasis risk low c. pearly nodule d. AK e. telangiectasia f. less common g. metastasis risk high h. older > 60
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BCC a. pearly white nodule w/wo central erosion b. more common than SCC c. telangiectasia d. metastasis risk low e. sun exposed areas g. fair skinned > 40 SCC a. less common b. sun exposed areas c. can arise from AK d. red conical hard lesions w/wo ulceration e. less distingtive borders d. lip, oral cavity, genitalia e. fair skinned > 60
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ABCDE of malignant melanomas
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E is elevation D diameter > 6mm
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melanoma risk factors
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risk factors HARMM (history, age, regular derm visit, mole changing and male) if pt has 2 or more 100% sensitive a. intense year round sun exposure b. blistering sunburns in childhood c. freckles or burns easily d. family hx of melanoma e. > 50 years old
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dark skinned people where do you look for melanomas
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a. under nails, on hands and soles of feet
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liver disease produces what type of nails
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terry's nails nail plate turns white with ground glass appearacne
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dm, anemia, hyperthyroidism, syphillis can cause this painless seperaton of the whitened opaque nail plate from the pinker translucent nail bed.
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onycholysis not caused by fungal infection
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local trauma from nail biting, manicuring, or frequent hand exposure in grown toe nail
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paronychia
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koilonychia
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spoon shaped nails from anemia or B12 deficiency
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White spots-leukonychia
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overly vigourus manicuring
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Mee's lines
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aresenic poisioning, heart failure, hodgkins disease
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severe illness, truama and cold exposure can cause this type of nail. allergies or eczema
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beaus lines allergies/eczema
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fungal infection of the nails& tx
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onychomycosis-oral antifungals-itracaonazole or terbiniafine thickened brittle and discolored miconazole or clotrimazole
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a.Terrys nails b. Onycholysis c. Paronychia d. Koilonychia e. Leukonychia f. Mee's lines g. Beau's lines h. Onochomycosis
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a. nail plate turns a white ground glass appearance (liver diseases) b. painless seperation of the whitened opaque plate from nail bed. DM, anemia, hyperthyroid, syphillis c. Local trauma-in grown toe nail. manicure gone bad, staph d. spoon shaped nail from Fe anemia, or B12 e. White spots from vigours manicuring f. Arsenic poisoning, heart failure g. allergies, illness, trauma,kidney issues h. fungal infection
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most skin cancers are
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BCC
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most dangerous skin cancer
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melanoma, spread quickly
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Acne what should you start with then step up to
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a. Benzol peroxide-bacteriocidal b. Salcylic acid c. azelaic acid d. Tretinoin e. Differen g. TAzarotene mild acne: <15 inflammatory lesions, <20 comedones. usually just topical retinoid moderate acne: comedone lesions. Kerolytic + abx, either topical or sytemic severe acne: cysts accutaine
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Topical abx commonly prescirbed with acne
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a. Clina, erythro, tetracylcines
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for rosacea common abx
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flagyl
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with tetracycline what must you be careful iwth
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pregnancy do not prescribe or children < 9 yo
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Severe unresponsive acne, common agent is
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Accutaine
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folliculitis furuncle carbuncle cellulitis large boil that can be necrotizing boil-localized infection of a hair foligle inflammed hair follicle all 3 are caused by
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staph aureas
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cellulitis outpt most common causative agent
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strep pyogenes
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Match creams oral valacyclovir, vitamin E derivative, permethrin lotion. imiquimod cream, topicalketoconazole, topical metronidazole, ammonium lactate solution a. psoriasis vulgaris b. herpes zoster-varicella c. scabies d. verruca vulgaris e. Tinea pedis g. rosacea h. keratosis pilaris
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a. Vit E derivative b. oral valacyclovir c. permthrin d. imiquimod cream e. oral ketoconazole f/g. oral metronidazole h. ammoniumm lactate solution
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tinea versicolor is a fungal infection caused by
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a. pityrosporum orbiculare
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best antimicrobial therapy for CA MRSA skin infection a. dicloxacillin b. cefadroxil c. Bactrim d. Augmentin
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c.
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best antimicrobial for Group A strep a. Bactrimm + Amoxicillin b. Doxy/minocylcine + amoxicillin c. Clindamycin
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all of them, just make sure you do Bactrim + Blactam
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impetigo is caused by
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staph
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bacterial skin infections best antimicrob a. cephalexin b. dicloxacillin c. clindamycin or augmentin
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all
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what are these a. candida balanitis b. candida intertrigo c. Tinea capitus d. Tinea corporis e. Tina cruris g. Tinea pedis/manuum h. tinea unguium i. tinea versicolor
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a. infection of the penis b. skin folds c. head d. body e. jock itch g. fingers and hands h. nail bed i. body-different fungus not dermatophyte
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if a pt has allergic contact dermatitis you should advise them to wash their hands vigourously
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no. treatment is topical steroids
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often a first sign of HIV infection is this skin condition
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psoriasis tx: topical steroids, salicylic acid shampoo, UVB light exposure
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this has a herald patch, erupton lasts 4-8 weeks. it is an acute inflammatory disorder , What should you test for with this
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a. ptirysis rosea christmas tree pattern check for syphillis b. tx is with oral antihistamines topical antipuritic
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bulls eye rash, with erythema migrans
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lyme disease
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lab tests for above
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ELISA and western blot
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Treatment for above
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doxy, amoxy, macrolilde
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This type of skin condition is caused by a tick bite but it is more of a maculopapular rash with abdominal pain and their is joint pain
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maculopapular rash, abdominal pain and joint pain
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bilateral anti cubital fossa lichenification is usually
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eczema
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epidermis and dermis loss is usually a
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an ulcer
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treatment for shingles vs vaccine
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acyclovir, zostavax
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keratosis pilaris
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plugging of skin follicles
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steven johnsons syndrome other name
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erythema multiforme
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difference btw chicken pox vs small pox
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chicken pox a. 2-3 mm vesicles that start on the trunk, appear on limbs 2-3 days later, different stages of lesions b.contagious for 48 hrs before the onset of vesicular rash, during rash formation and during the several days while the vesicles dry up. c tx is effective if started within the first 5 days to shorten course of disease small pox a. flat red spots, within 2 days turn into blisters, start in the oral mucosa, palate and all teh lesions are in the same stage of development b. isolate to prevent spread c. no cure once infected
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cutenous anthrax a . how does it spread b. what does the lesion look like c. tx d. what do you need to do
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a. clothing, shoes, body b. pruritic papule that becomes an ulcer than black eschar most is cutaneous c. vaccine , abx FQ d. report to health dept
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most common organism with a carbuncle a. staph aureas b. streptococcus
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a. staph if it was strep it would be group A strep pyogenes
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organism that causes syphillis
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treponeum pallideum darkfiled microspic exam is used to dx it
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prognosis of malignant melanoma is directly related to....
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the thickness of the lesion
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chronic fascial acne is adults
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acne rosacea
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open comedones closed comedones
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a. blackheads b. white heads
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herpes zoster is contagious to those who have not had chicken pox T/F
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t
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painful joints and distinctive rash in a butterfly distribution on the face. the rash has red papules and plaques with a fine scale
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sle classic malar rash-butterfly rash with distribution on cheeks and nose painful joints
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treatment for severe uncontrollable atopic dermatitis
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a. uv light
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another word for skin tag
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acrochordon
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drug of choice for tinea capitus
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oral griseofulvin for 6-8 weeks, topicals take too long to work
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is tenting normal in older adults
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yes
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vitamin C deficiency results in 2 symptoms
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bleeding gums and delayed wound healing
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acute anaphylaxis epi dose
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1:1000 SQ
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darkfield microscopic exam
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syphillis
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prognosis of malignant melanoma is directly related to the thickness of the lesion t/f what is the assessment tool for that
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breslow
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70 year old client iwth herpes zoster vesicle on the tip of the nose may indicate
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opthalmic zoster, can lead to blindess so refer to opthalmology
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how long is varicella contagious
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till the vesicle rash crusts up contagious 48 hrs before the onset of the vesicular rash formation and during the several days while the vesicles dry up treatment only effective if started the first few days avoid pregnant woman
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most common trigger for rosacea
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sun exposure
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with pediculosis can itching occur for up to 1 week post treament
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yes
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vital exanthem of koplik's spots are present in
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rubeola
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erythema migrains erythema multiforme
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lyme SJS syndrome=-caused by meds , herpes simpl
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characteristics only to herpes zoster
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appears on one side of the body, dermatone
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erysipelas
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subtype of cellulitis caused by group A strep. in the upper dermis and superficial lymphatics, start abx
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drug of choice for tinea capitus
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oral griseofulvin
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which part of the skin stores melanin
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epidermis
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lichen planus, 5 P's
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lichen planus-occurs in older adults, primary skin lesion with the 5 p's. purple, polygonal, planar, pruritic, papules
