Board Review Derm

Front 1

What are some dermatologic cardiac signs

Back 1

cyanosis, in nail beds, clubbing of digits, edema of both LE, livedo reticularis, cutaneious bleeding from coumadin therapy

Front 2

what yo see with coumadin induced bleeding

Back 2

"coumadin necrosis" effects breast , htigh, buttock, , pain to erythma to hemorrhage ot necrosi, starts within 2-5 days of starting therapy, opbese, emale is typicla, swicht pt. to heparin or lovenox

Front 3

derm signs of endocarditis

Back 3

splinter hemorrhages in nails, osler's nodes - small tneder nodules htat develop in the finger or toe pads. They peresit for hours to days
Janeway lesions - small purpuric hemorrhages iwth a slightly nodular appearanc ehtaat occur on the palms an ssoles; seen in acute infective endo

Front 4

erythema multiforme

Back 4

kids mostly,
HSV I nad II come sout first hen skin lesions, all lesions appear with 7 hrs. no necrosis or edema, no drug involemnt

Front 5

Name 2 CLASS 1 STEROIDS

Back 5

HERES 4>>

TEMOVATE

DPROLENE

ULTRAVATE

PSORCON

Front 6

Raynaud's phenomenon is also known as constriction of small digital arteries., and is typically associated w/ connective tissue disorders. Persistent blue discoloration seen in those w/ Raynauds is known as ______________

Back 6

Acryocyanosis.

Affects the entire hand/foot

The cause is unknown!

Front 7

Erythromelalgia is rare It is associated with what condition?

Back 7

Thrombocytopenia

Front 8

Raynaud's disease occurs in the absence of connective tiisue disorders. What are some of the tx for this?

Back 8

Exposure to cold avoided

Vasodilators (nifedipine)

Topicals (nitroglycerin)

Front 9

What is the tx for Henoch Schonlien Purpura?

Back 9

IV/ORAL steroids

NSAIDs for joint pain

Front 10

Erythema nodusum tx involved?

Occurs most commonly?

Back 10

Children & young adults

They experience an inflammatory process of fat (panniculitis)

Front 11

Wegner's granulomatosis is a rare disease. It is R-O-U-G-H on the body.

what do these letters indicate in wegners?

Back 11

R-O-U-G-H

R- radiograph the chest
O- oral ulcers
U- urinary sediment
G- granulomas
H- hemoptysis

Front 12

What is the circulating antibody we look for in dx wegners?

Back 12

What is the circulating antibody we look for in dx wegners?

Front 13

How do you treat Wegner's pydoderma gangrenosum like lesion?

Back 13

Oral Tacrolimus

SYSTEMIC STEROIDS!

Front 14

Polyartertis nodosa & kawasaki disease are both examples of what kind of vessel disease?

Back 14

Medium sized vessel disease

Front 15

Polyarteritis nodosa (PAN) is a rare, necrotizing vasculitis affecting small and medium sized arteries. It is painful.

It occurs more commonly in_____, ______, and ______

Back 15

PAN occurs more commonly in men.
4:1 ratio M/F.

It is a multi-system dx, involving the kidneys, heart, liver, and GI, but not the LUNGS!

Occurs more commonly in:
IV DRUG USERS, LUPUS PTS, HEP B & C PTS

Front 16

TXing PAN consists of?

Back 16

Systemic steroids

Front 17

Stomatitis or strawberry tongue is seen in Kawasaki Disease. What other disease is it seen in?

Back 17

Wegners granulomatosis

Front 18

Giant cell arteritis commonly affects which arteries?
If left untreated, it can lead to__________

Back 18

The carotids

Blindness. Giant cell can lead to BLINDNESS!

Front 19

What is the tx for vitilago?

Back 19

It is by no means definite,
but UVB, light therapy.

Also, dermablend make up.

Front 20

Subungual melanomas clues---- include........

Back 20

solitary lesions
width>3cm
variable pigment
rapid increase in size
hutchinson's sign
yes it can happen to anyone.
thumb most comon!
DANGEROUS DX: more advanced by the time you diagnose, poorer survival 49% survival in 5 years

Front 21

Stevens Johnson syndrom

Back 21

respiratory illness first, then 1-14 days later red macuel to bullus eruptions in mouth, common in children, use nsaid, tetracycline, anticonvulsants, admit to burn ward if serious enough, balance electrolytes, steroids

Front 22

Toxic epidermal necrolysis

Back 22

TEN - rare drug reaction, very vatal, 7-21 days ater taking drug, not well defined plaques, skin dtachments, steroids, nsaids, stop drug, burn ward

Front 23

pyoderma gangrenosum

Back 23

ulcers with vioaceous undermined borders
women, 20-50 years
pustules on a red base --> scars
linked ot inflammatory bowel disease (for boards in reality idiopathic)
linked to rheujatoid arthritis
tx: prednisone, doxycycline, cyclosporine, infiximab, etanercept, adalimumap, topicals injections

Front 24

calciphylaxis

Back 24

rare and fatal (80%)
female (3:1)
red plaques in ivedo pattern becom black gangrenous plaque
TX: debridement, hyperbaric chamber, parathryroidectomy, bisphoosphonates, iv sodium thiosufate

Front 25

derm signs of renal disease

Back 25

half and half nail - proxima is white distal is red brown (10% of renal dx pt. )
edema o LE, xerosis, itchy
koilonychia,
terry's nails (leukonychia on all nails except for 1-2 mm area)
hepatitis c infection: cryoglbuinemia / palapable purpura

Front 26

derm signs of hyper thyroid dx.

Back 26

pretibial myxedema (thyroid dermopathy) in Graves dx; shiny waxy indurated plax orange peel.
sweate ie hyperhidrosis

Front 27

signs of hypothryoidism

Back 27

dry xerotic skin, decreased hair,

Front 28

signs of diabetes

Back 28

prayer sign, yellow nails, lipidica diabeticorum, bullous diabeticorum, acanthosi nigricans, diabetic dermopaty, granulam annulare, tinea, onychomycosi, yellowish nails, ulcer,s xerosis

Front 29

Tx: NLD

Back 29

topical steroids under occlusion,
kenalog injection

Front 30

bullosis diabeticorum

Back 30

tense blister on eet plnatar aspect, legs, self limiting, no scars, negative nikosly's sign (in nikolsky's sign when you push down on blister it spreads)

Front 31

Acanthosis nigricans

Back 31

velevety hyperpigmented plaques on the neck and axilla look like dirty skin, often sign of insulin resistance

Front 32

What are the layers of the epidermis

Back 32

straum coneum, stratum lucidum(only in palms and soles) , starum franulosum, stratum spinosum, stratum germinatum,

Front 33

What are the tissue layers of the skin

Back 33

epidermis, dermis, subuctaneious lyaers

Front 34

what is a macule

Back 34

a macule is a primary skin lesion that is circumscribed alteration the color oth skin, not visibly raised or depressed presenting any change in the consistency of the skin. i.e. flat changein color

Front 35

What is a patch?

Back 35

a patch is a macule 1cm or greater

Front 36

what is a papule

Back 36

a papule a raised lesion from 1mm to 1 cm in diameter.

Front 37

what is a plaque ?

Back 37

A plaque is a raised lesion that is > 1 cm in diameter

Front 38

What is a nodule?

Back 38

A nodule is a primary lesion which is solid and larger than 1 cm in diameter conisisting off inflammatory cellur iniltrates or neoplasm

Front 39

What is a wheal/

Back 39

a WHEAL IS A PRIMARY LESION WHICH IS A PLATEAU LIKE ELEVATION PRODUCE BY EDEMA IN TH

Front 40

What is a bulla ?

Back 40

a fluid filled lesion > 5 mm

Front 41

What ia pustule ?

Back 41

a pustule is a primary lesion that is a cdircujmscribed liquid accumulation of ree pus as seen in acne or impetigo

Front 42

What is a skin tumor?

Back 42

A tumor is a primary lesion of new growth varyin size and composed of skin and subcutaneous tissiu. It can be either benign or mlignant

Front 43

What are secondary lesions?

Back 43

secondary lesions evolve over time from primary lesions usually because of scratching or infecton?

Front 44

What is a scale

Back 44

A scale is a secondary lesion, ti is exfoiationo accumulated debris of dead startum corneum and results rom inperect cornificatio;

Front 45

What is a crust?

Back 45

A crust is a secondary lesion that represents a superficial loss of epidermis as a reuslt of scratchin or rubbing

Front 46

What is a skin tumor?

Back 46

A tumor is a primary lesion of new growth varyin size and composed of skin and subcutaneous tissiu. It can be either benign or mlignant

Front 47

What is a fissure?

Back 47

Afissure is a secondary chainge in the skin that presents as a linear crack in the epiderms.

Front 48

What are secondary lesions?

Back 48

secondary lesions evolve over time from primary lesions usually because of scratching or infecton?

Front 49

What is a scale

Back 49

A scale is a secondary lesion, ti is exfoiationo accumulated debris of dead startum corneum and results rom inperect cornificatio;

Front 50

What is a crust?

Back 50

A crust is a secondary lesion that represents a superficial loss of epidermis as a reuslt of scratchin or rubbing

Front 51

What is a fissure?

Back 51

Afissure is a secondary chainge in the skin that presents as a linear crack in the epiderms.

Front 52

What is a skin tumor?

Back 52

A tumor is a primary lesion of new growth varyin size and composed of skin and subcutaneous tissiu. It can be either benign or mlignant

Front 53

What are secondary lesions?

Back 53

secondary lesions evolve over time from primary lesions usually because of scratching or infecton?

Front 54

What is a scale

Back 54

A scale is a secondary lesion, ti is exfoiationo accumulated debris of dead startum corneum and results rom inperect cornificatio;

Front 55

What is a crust?

Back 55

A crust is a secondary lesion that represents a superficial loss of epidermis as a reuslt of scratchin or rubbing

Front 56

What is a fissure?

Back 56

Afissure is a secondary chainge in the skin that presents as a linear crack in the epiderms.

Front 57

What is an eroison?

Back 57

An eroiosn is a secondary lesion. it is a shallow scooped out superficial loss of all or part of ht eepidermis.

Front 58

What is an ulcer?

Back 58

An ulcer is a secondary skin lesion. It is damaged skin of varying depth.

Front 59

How are stage one (national pressure ulcer classification) pressure ulcers stage and treated

Back 59

Stage one pressure ulcers appear as non-blanchabel erythema of intact skinm, heralding lesion o skin ulceration. treat with debriding hyperkeratotic tissue and off loading pressure.

Front 60

Stage tw0 (national presure ulcer classification) stage and treated

Back 60

Stage two pressure ulcers have partial thickness skin loss, inviliving epidermis, dermis or both. The ulcer is supericial and presents clinically as an abrasion, blister or shallow crate. Use pressure releif topical antibiotic, and simple dressing

Front 61

How are stage 3 (NPUC) pressure ulcer stge and treated?

Back 61

Stage thre pressure ulcers rperesent ull thicnkess skin loss, invoving damage ot or necrosis of the subcutaneious tissue htat may extend downto but not through the underlying fscia. The ulcer presents clinically as a deep crater with or without undrmining of adjacent rissue. Vascular workup, systemic antibiotics, pressure relief and wound care shoudl be ocnsidered

Front 62

How are stage four (NPUC) pressure ulcer sage dand treated

Back 62

Stage four pressure ulcers represent full thickness skin loss with estensive destruction, tissue necrosis, or damage ot muslce bone, tendon, joint capsuel. Underming and sinus tracts also may be associated with stage four pressure ulcer. hospitalizaiotn for vascular workup, operative surgical debridemenbt stytemic antibiotics, and wound care shoudl be considered.

Front 63

How is a keloid difined.

Back 63

keloid is aggressive scar tissue that extends beyond the area of original trauma

Front 64

What is lichenification

Back 64

lichenification is thicnening o the skin with exaggeratin fo the normal skin lines, yperpigmentation scaleing pruritius oten accompany. Favors antgerior ankles and suggrests repetive rubbing or scratching

Front 65

What are telangiectasias

Back 65

Telangieectasia are visible dilated superficial blood vessels sseen in connection wieth certain heritable dieases. e.g. familial telangiectasia; associated with liver dieases and pregancy and as a sequel to x-ray treatment. Often seem about he the ankles i nthe elderly.

Front 66

How is a KOH examination performed?

Back 66

scrape epiderma flakes ot galss slied, apply 20% KOH, warm or use dimethy sulfoxide sovent (DMSO) wait tne minutes, examine under low power and reduced light.

Front 67

What are Koen's tumors

Back 67

multiple firm perungual ibromas associated with tuberous sclerosis.

Front 68

Describe the clinical findings in epeidermolyisis bullosa (EB)simplex

Back 68

EB presens as spontaneuos blisters of the ingers toes knees or elbows from minor trauma beginning at birth or early childhood. The blisters heal without scarring. The disease is due to defects in keratins 5 and 14 and is an autosomal dominant trait.

Front 69

What is a papulosquamous skin disorder?

Back 69

Any of a number of erythematous or purple papules and plaques topped with scales

Front 70

Which papulosquamou sdieases can be seen on the foot or ankle

Back 70

psoriasis, lichen planus, lichen nitidus and pityriasis rubra pilaris can be seen on the foot and ankle.

Front 71

Describe the characteristic rash of pityriasis rosea.

Back 71

Pink to erythematous maculo-papular rash of the chest and or pack following a viral infection. Spares the soles. Starting with a single 2-4 cm sharply diefined thin oval plaques witha characteristic collarette of scale then with a few dys to weeks, crops of similar but smaller lesions follwo and resolve sponatneously.

Front 72

What is pmpholyx

Back 72

Pompholyx is an episodiec vesiculobullos eczema f othe palms and oles especially edges of ingers. Multiple deep seated pruritic nits and evolving vesicles.

Front 73

What is and id reacction and how is it manged?

Back 73

Immune mediated, synmpathetic response to acute tinea, sterile erutpions distant rom the acute site i.e. fingers palms chest or back. Treathe primary tinea na did reactio will resolve with it.

Front 74

What are several intra epdiermal bullous diseases?

Back 74

Allergic ocntact dermatitis a allergic contact dermatitis, epidermal bullosa simplex, bullous diabeticorum, herpes simples and zoster are all exampels of intra-epidermal bullous dieases

Front 75

What are several sub-epidermal bullous dieases?

Back 75

bullou spemhigoid, dystrophic epidermal bullosa and porpyria cutanea tarda

Front 76

What are the most comomn pustular skin eruptions?

Back 76

folliculitis, impetigo, and acne

Front 77

What do the lesion fo pusular psoriasis contain?

Back 77

only leukocytes, no vacteria

Front 78

Describe the primary lesion of lichen planus

Back 78

pruriic purple and pink papule s and plaques on the flexor wrist . may caus epterygium nail dystrophy
purple, pruritic, planus, polished, plaques

Front 79

What are the characteristic oral finidings of lichen planus?

Back 79

Wicham's triae, a white netlike or reticulated patterned discoloration of ht ebuccal mucosa

Front 80

Describe the isomorphic response in lichen planus

Back 80

the development of new lesion sin response oexternal taruma or scrathcing.

Front 81

What is lichen simplex chronicus?

Back 81

lichenified plaque due to scratching, treat by stopping scratchin, also topical steroid may help

Front 82

How does granuloma annulare usually present clinically, what is the clinical course?

Back 82

Typically presents with violaceous or flesh colored dermal papules arranged inan annular coniguration affecting dorsum fo hands nad feet, usually resolves spontaneously

Front 83

List the clinical features of tuberous sclerosis.

Back 83

Multiple sebaceous adenoma, mental retardation, koen's tumors

Front 84

List several key features o fhenoch-schonlein purpura (HSP)

Back 84

intermittient purpura of the extemites and buttocks usually affecting children. Abdomina pain, arthralgia, and hematuria may accompany the purpura

Front 85

What is erythema nodosum

Back 85

inlammatory nodules and iniltrates int eh subcutaneous layers of ht e lower extremities associated witha Streptococccus infection, sarcoidosis or drugs espeiclally oral contraceptives

Front 86

What are the key skin features o scleroderma?

Back 86

Scleroderma presents with morphea (firm sclerotic indurated plaques). the lesions are often multiple smooth topped with a white center and purple border.

Front 87

What is porokeratosis plantaris discreta

Back 87

PPD is a small plantar focal hyperkeratosis with central horny plug that is probably a pressure induced keratosi. Some believe it is a plugged eccrine duct or cyst.

Front 88

Which organism usualy cause chnonic tinea pedis?
vesicular tinea pedis

Back 88

chronic tinea pedis - trichophyton rubrum
vesicular tinea pedis - trichopyton mentagrophytes

Front 89

Which clinical types of onychomycosis are associatated with AIDS

Back 89

white superficaial nad proximal subungual onychomycosis have been associatated with AIDS.

Front 90

How do you treat pedal scabies

Back 90

topical permethrin (Elimite), sulphur or chlordaine (Lindane), applied ear to toes.