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150 Cards in this Set
- Front
- Back
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Derm |
inhibit collagen production |
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Derm
2 dangerous drugs if pregnant |
thalidomide
isotretonin |
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Rashes
allergic contact dermatitis is this type of hypersensitive rxn |
type 4 or delayed hypersensitivity
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Rashes
allergic contact dermatitis testing why not prick or scratch test |
epicutaneous patch testing
they test for I or IgE mediated allergies |
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Rashes contact dermatitis of face/neck treatment... |
topical steroids low potency topical steroid like hydrocoritsone to reduce thinning of skin to avoid acne and cutaneous atrophy |
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Rashes |
Keobner phenomenon
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Rashes psoriasis complication after stopping oral steroids... |
Li and betablockers pustular psoriasis, so avoid systemic steroids to treat psoriasis |
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Rashes Most dangerous form of psoriasis... |
rule out SLE or cutaneous lymphoma
erythrodermic psoriasis is derm emergency due to high risk for infection and electrolyte abnormalities. |
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Rashes |
lichen planus
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Rashes |
wickham striae |
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Rashes |
topical steroids |
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Rashes |
cause lichenoid drug eruptions. they are more generalized than LP and avoid mucosa and wickham striae |
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Rashes It mimics... |
pityriasis rosea secondary syphilis, so check RPR |
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Rashes
excessive discharge of sebaceous glands of scalp (heavy greasy or yellow) treatment |
seborrheic dermatitis
azole antifungal cream |
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Rashes
morbilliform (measles- like eruption) drug exanthem (eruptive disease) |
most common drug rash
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Rashes |
anticonvulsants DRESS - Drug Reaction with Eosinophilia and Systemic Symptoms |
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Rashes |
stop the drug |
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Rashes How is it different from stasis dermatitis and vasculitis... |
stasis dermatitis - affects broad areas of legs and do not remit spontaneously |
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Rashes |
heat rash - blockage and rupture of eccrine sweat glands |
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Rashes treatment... |
acantholytic dermatosis or grover disease cooling measures |
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Acne |
open blackhead |
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Acne
red pustules, nodules or cysts that are deep and painful in and around hair follicle |
inflammatory acne
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Acne
mild acne (comedone) treatment (combo) |
AM topical Abx with or without benzoyl peroxide
PM topical retinoid |
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Acne |
AM topical Abx with or without benzoyl peroxide
PM topical retinoid oral Abx (doxy or minocycline) |
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Acne Most dangerous acne drug with pregnancy... |
isotretinoin and oral abx (doxy or minocycline) tazarotene is very teratogenic |
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Acne
chronic inflammatory condition with small red pus filled pustules with flushing of mid face |
rosacea
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Acne
How to differentiate rosacea from SLE or dermatomyositis… Skin finding to help differentiate... |
biopsy
prominent papules and pustules are not seen in malar rash of SLE |
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Acne
papular pustular rosacea is..... erythemato-telangiectatic is... |
pap pust - inflammatory
red-tele - vascular |
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Acne |
topical flagyl |
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Acne |
Hidradenitis suppurativa |
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Skin/Nail treatment (2)... |
S aureus topical clina or benzoyl peroxide |
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Skin/Nail
abscess involving hair follicle.. collection of inflamed or infected follicles that form contiguous mass... |
furuncle |
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Skin/Nail |
impetigo
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Skin/Nail |
nonbullous impetigo
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Skin/nail |
bullous impetigo - less common |
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Skin/nail |
topical muporicin (antibiotic cream) and antistaph Abx and good hygeine (prevent spread) |
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Skin/nail
deep infection of dermis with lymphatic spread usually face. tender indurated red nonpitting plaque treatment. common cause. |
erysipelas
penicillin Group A strep |
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Skin/nail treatment.... |
Corynebacterium ERYTHRASMA |
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Skin/nail |
keratolysis (skin infection) |
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Skin/nail |
branching hyphae on KOH prep from skin scraping
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Skin/nail |
tinea versicolor or pityriasis versicolor (dx with KOH) |
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Skin/nail |
HSV infection |
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Skin/nail |
herpes zoster
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Skin/nail If zoster affects face/eyes (2)... |
people over 60yo start acyclovir and call optho |
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Skin/nail |
6,11,16,18
no |
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Skin/nail Treatment for common warts... |
concern for malignant transformation to sq cell ca so perform biopsy nothing, resolve spontaneously over months or salicylic acid and cryotherapy |
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Skin/nail Verruca Plana (flat wart) is worsened... |
topical 5% imiquimod mild trauma causes auto-innoculation. So shaving can warts worse on the face |
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Skin/nail pearly papules with waxy surface that occur... Who is at risk... |
pox virus skinfolds and genital area kids and sexually actice |
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Stings/bites |
mite, feces or eggs under microscope with KOH or simple mineral oil |
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Sting/bites
brown recluse spider bite is limited to midwest and southeast, so necrotic painful lesions are usually |
pyoderma gangrenosum or MRSA
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Wounds Do not need... Wounds heal faster when kept _______ and ______... |
cover with petroleum jelly and dressing antibiotic cream is not needed. moist and occluded. |
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Wounds
first degree burns treated 2nd degree burns need to monitored for.... and evalutated for.... |
cool compress, NSAIDS, gentle skin care |
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Cancer Looks like.... |
nodular basal cell ca pearly translucent papule on face/neck (skin exposure) |
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Cancer |
actinic keratosis (pre-malignant) |
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Cancer
2nd most common skin ca treatment risk for mets |
sq cell ca
Mohs surgery 2-5% |
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Cancer
red, volcano-like nodule with prominent central keratin plug... subtype of... |
keratoacanthoma
sq cell ca |
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Cancer concerning.... diagnosis... |
malignant melanoma excisional biopsy |
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Cancer
melanoma vs benign pigmented lesion prognosis for melanoma treatment: |
ABCDE (Evolution)
Diameter >6mm prognosis - tumor depth or breslow depth surgical excision |
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Cancer |
sun - lentigo maligna, use shallow shave biopsy due to superficial status |
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Cancer Sunscreen protects against... |
seborrheic keratoses melanoma and non melanoma skin cancers |
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Cancer
dysplastic nevi are not considered.... multiple dysplastic nevi confer... |
pre-cancerous
greater risk of melanoma |
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Skin
acrochordon is known as... seen in... |
skin tag
insulin resistance or DM2 |
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Skin
epidermal inclusion cyst is mistaken for... treatment... |
furuncle
I&D. no abx. (not abscess) |
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Skin [important facet of treatment of eczema] |
emollients. (soften or smoothen) |
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Skin |
urticaria |
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Skin |
urticaria |
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Skin |
nonsedating H1 blocker and H2 blocker are more effective than single H1 blocker |
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Skin
urticaria with angioedema must carry |
epi pen
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Skin |
autoimmune blistering disease
biopsy |
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Skin |
systemic steroids |
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Skin diagnosis... |
celiac disease IgA |
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Skin |
SLE
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Skin if anti-histone antibodies are present... |
anti-malarialal agents drug induced lupus |
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Skin |
dermatomyostitis
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Skin |
dermatomyositis itches |
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Skin
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Henoch Schonlein purpura |
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Skin Diagnosis... |
purpura biopsy |
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Skin |
rheumatoid nodules
acclerated nodulosis after given MTX for RA |
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Skin
CKD and ESRD are at risk for ________ treatment (2) |
itch and dry skin
topical steroids phototherapy |
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Skin |
calciphylaxis due to impaired Ca/Po4 balance
less than 6mo due to sepsis of ulcers Na thiosulfate and meticulous wound care |
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Skin how does compare to general popn: solid organ transplant @ risk: |
sq cell ca. nonmelanoma skin cancer |
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Skin
great imitator... violaceous papules, nodules, plaques occur... |
sarcoid
sites of trauma (tattoo or surgical scar) |
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Skin |
streptococcal infection
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Skin |
Lofgren syndrome with is acute sarcoid that resolves in 2-3yrs |
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Skin |
EN |
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Skin |
erythema nodosum is seen more in UC |
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Skin
ESLD have deposits of bile salts within the skin... |
intense itch and xerosis (abnormal dryness)
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Skin |
porphyria cutanea tarda (PCT)
urine porphyrins control iron overload (phlebotomy) |
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Skin |
type 3 cryoglobulinemia |
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Skin
most common toxic rxn to chemotherapy |
hand-foot syndrome (painful red/violet of hands and feet) |
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Skin |
Sweet syndrome |
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Skin Why is sweet syndrome concerning... |
systemic steroids check CBC or bone marrow to eval AML |
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Skin |
vitiligo |
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Skin
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erythema multiforme (EM) |
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Skin |
less than 10% - SJS |
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Skin
peripheral edema, erosions from severe itching, scaling, and LN involving 80-90% of skin surface |
erythroderma
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Skin |
cutaneous T cell lymphoma |
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Hair Hair loss 3-5mo after baby delivery or stress to body like illness or surgery... treatment... |
scarring alopecia telogen effluvium. resolves after few months |
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Hair |
alopecia areata (nonscarring) |
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Nail |
psoriatic arthritis
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Nail |
painful or other comoboridities like DM |
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Mouth |
oral hairy leukoplakia |
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Mouth concern... |
sq cell ca do biopsy quickly because it is aggressive in that area. |
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Mouth |
Behcet disease
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Ulcers |
compression and unna boot |
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Ulcers |
arterial ulcers |
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Ulcers |
ABI less than 0.6 |
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Ulcers seen in... |
debride necrotic tissue and offload pressure diabetes |
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Ulcers |
aggressive treatment to avoid amputation
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Skin keloid treatment... |
vitiligo steroid injection |
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Sting/Bite itchy rash in linear pattern (series of bites "breakfast lunch dinner") that are painless... treatment (2)... |
Bedbugs topical steroids and oral antihistamine |
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Ulcers gauze impregnated with a thick, creamy mixture of zinc oxide and calamine to promote healing... |
unna boot for venous stasis ulcer |
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Nail transverse horizontal linear depressions or ridges from severe illness such as chemo or sepsis... |
Beau lines |
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Herpes Herpes labialis can be reactivated by... |
UV light (bad sunburn causes outbreak around mouth) |
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DM brown to black velvety hyperpigmentation of the skin found @ posterior and lateral folds of the neck, the armpits, groin, navel, forehead, and other areas.... Linked to.... |
acanthosis nigracans insulin resistance (obese patients) |
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Nail before starting anti-fungal on patient with nail dystrophy... |
nail biopsy with fungal culture and KOH examination because 50% of cases are not fungal based. |
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Emergency Stephen Johnson Syndrome/Toxic epidermal necrolysis: 1. before starting treatment... 2. if drug induced... 3. if infection induced... 4. steroids is for... |
skin biopsy stop drug treat infection EM major (not SJS or TEN) |
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Skin and systemic disease young person who is sexually active with macules and papules and fever/malaise/diarrhea... diagnosis (2)... |
Acute HIV seroconversion HIV antibody may have false negative early in infection so check viral load as well. |
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Eczema Atopic dermatitis is at risk of developing itchy hands... diagnosis for allergic contact hand eczema... |
hand dermatitis patch testing for allergic contact hand eczema |
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HCV palpable purpura of lower extremities with glomerulonephritis, neuropathy, arthritis and pulm inflammation... significant labs (2)... Treatment... |
cryoglobulinemic vasculitis low C4 elevated RF rituximab |
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Derm urgency recurrent EM (erythema multiforme) treatment... |
likely due to HSV, so acyclovir |
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Pruritis itching of extensor forearms, arms, or upper back which later causes rash; itch is worse with sun exposure... |
brachioradial pruritis which is neuropathic itch related to cervical spine issues. "itch without a rash." biopsy is not helpful. |
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Skin ESRD that develops skin thickening of distal extremities with limited mobility after undergoing MRI with gad... diagnosis... treatment... |
nephrogenic systemic fibrosis skin biopsy kidney transplant |
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Skin/nail annular scaly plaque found scattered throughout whole body... diagnosis.. treatment... |
tinea corporis or ring worm KOH skin prep with banching hyphae topical antifungal |
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Rashes itching, scaling, and redness similar to psoriasis and eczema affecting most of the body area... |
cutaneous T cell lymphoma |
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Skin Venous stasis treatment... when to avoid treatment... |
leg compression stockings which reduce venous HTN avoid stockings if significant PAD. |
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Allergic Rhinitis If empiric meds fail to improve allergic rhinitis... |
allergy skin testing is better than IgE antibody assay or RAST. So before testing, give empiric meds first. |
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Urticaria Avoid this test for acute or chronic urticaria... |
ANA testing |
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Allergy chronic urticaria: avoid these meds... |
systemic and topical corticosteroids |
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Allergy Check C1 inhibitor levels... |
low C1 inhibitor is seen in angioedema. NOT hives or urticaria |
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Allergy HAE or hereditary angioedema has 2 tests… This drug does not improve HAE... |
Low C1 inhibitor and C4 level epinephrine is not effective for HAE |
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Allergy shock with no obvious cause... |
consider anaphylaxis |
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Allergy Anaphylaxis that fails SC or IM epinephrine... |
try IV epinephrine or glucagon |
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Allergy test for drug allergy... |
skin testing not RAST or ELISA |
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Allergy drug fever is a form of…. Treatment... |
hypersensitivity and may occur without rash. stop offending agent |
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Allergy If immunodeficient with VERY low serum immunoglobulins, do not test this… if Ig are just low (NOT VERY LOW)... |
do not test response to vaccines because antibody response will be absent or LOW test antibody response to tetanus and toxoid and pneumovax |
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Allergy if isolated IgA defiency, avoid this treatment and why… What about blood transfusion... |
standard IV immune globulin because patient may have IgG or IgE directed antibodies to transfused IgA. need washed RBC. |
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Allergy standard treatment for CVI or common variable immunodeficiency... |
IV immune globulin |
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Allergy If repeat episodes of disseminated gonohhrea or neisseria meningitis... |
test CH50 assay to eval complement deficiency |
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Abscess size of abscess without systemic symptoms that can be treated with just I&D alone... |
less than 5cm |
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Tinea Why is it important to treat onychomycosis in PVD or DM2 patients... |
to prevent cellulitis |
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Tinea patient with thick yellow crumbling toenails... |
do not start anti fungal without KOH scraping and positive culture |
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Derm unknown skin rash or dermatophyte infection... |
do NOT start anti fungal and steroid cream |
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Scabies Scabies and AIDs… Still itching after treatment for scabies… Treatment... |
extensive scaling without itch. do not re-treat. can still have persistent itching for 2 wks after treatment. permethrin |
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Bite red ulcer after sandfly bite in middle east... |
Leishmaniaisis |
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Zoster vaccinate… treatment... |
to all adults above 60yo even if history of chicken pox. valcyclovir or famciclovir. NOT topical agent. |
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Eczema Always use this for part of eczema treatment... |
emollients which increase water uptake in skin. |
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Bullae IgA at epidermal surfaces on direct immunofluoresence… linear IgG deposits on basement membranes… Treatment for both... |
pemphigus vulgaris or IgA pemphigus Bullous pemphigoid on basement membrane oral steroids |
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Cancer early detection of asymptomatic metastatic melanoma and survival... |
DOES not improve survival do not select follow up X-rays or labs |
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EM not a treatment for erythema multiforme... |
corticosteroids |
