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PANCE Dermatology
| Question | Answer |
|---|---|
| Classic locations of psoriasis vulgaris? | Extensor surfaces: knees, elbows, scalp and nails. Mean age 30yo. Autoiummune etiology due to exo/endogenous stratum corneum damage attracts Ab's->epithelial turnover->hyperplasia and scales. |
| Demographic of acne rosacea? | 30-50yo females (3 females:1 males). |
| Spread of pemphigus vulgaris? | Small vesicles on mouth/nose -> rest of body due to keratinocytes. + Nickolsky sign (blistering when rubbed). 40-60yo. Bullous pemhigoid RARE and has tense bullae. |
| Etiology of M.furfur? | Competitive inhibition of tyrosinase -> melanocyte toxicity from dicarboxylic azalaic acid when in hyphal form (M.furfur from T.versicolor). Tx: selenium sulfide shampoo or po ketoconazole. |
| Top etiologies of Impetigo contagiosa? | S.aureus (bullous vs. non-bullous) >> S.pyogenes (sensitive to PCN). GBS in newborns. Impetitgo can lead to scalded skin syndrome and poststrep glomerulonephritis. Tx for BULLOUS impetigo is po Cephalexin?erythro/Mupirocin (or clox, diclox, and azithro). |
| Location of dermatitis herpetiformis? | Scalp, shoulders, anterior knees/elbows, and small of back. |
| Location of Lichen Planus? | Mouth, anterior forearms, genitalia, small of back and posterior calf. |
| Location of Seborrheic rashes? | Scalp and chin, posterior head/neck/shoulders, sternum, perianal region, groin, umbilicus. |
| Most common Type IV (delayed) hypersensitivity rxn? | Allergic contact dermatitis (mediated by T-lymphocytes). Nickel watches and poison ivy top offenders. Paraphenylenediamine in hair dyes. |
| In angioedema, with an asthmatic patient, what is most likely to cause skin lesions? | ASA. Epi 1st line if hypotensive vs. antihistamines if normotensive. Bactrim does not cause hives, but does caus SJS. |
| Most common drug used in suicide attempts in US? | Acetaminophen (causes liver toxicity). |
| Actinic keratosis vs. seborrheic keratosis? | AK: premalignant for SCC. Rough texture & adherent with POOR BORDERS. Tx 5-FU, cryotx, curretage and excision. Scraping->Auspitz sign. Present in numbers. SK: Waxy pigmented scale, STUCK ON appearance usually TEMPLE and TRUNK with DEFINED BORDERS. NO BX |
| Volcano-shaped lesion with central keratotic center? | Keratoacanthoma. |
| Most common skin cancer? | BCC. |
| Most metastatic potential of skin cancers? | (Malignant) Melanoma. |
| Classic ulceration at the vermillion border of the lip is what? | SCC. p53 mutation. R/O BOWEN DISEASE (indolent SCC eczematous vs. psoriasiform). |
| Best location for bx of suspected BCC/SCC? | Full-thickness bx. at EDGE of lesion for path and staging. Only 1-2MM border for BCC/SCC and 2CM for MELANOMA. |
| Most common location for dermatofibroma? | Redish-brown papule or nodule on legs. |
| Discoloration, loss of sensation and cyanosis around wound can denote? | Necrotizing fasciitis. |
| Pt. with marked weight loss and otherwise healthy could have what Vitamin deficiency? | Vitamin A (oil-soluble vitamins are A,D,E,K) as it supports retinal pigment and epithelial tissues, mucous membranes and adrenal cortex. Vitamin C for collagen, Vitamin E for cell membrane stabilization. |
| Etiology of Pytiriasis rosea? | HHV 7. |
| Treatment for keloids? | Intralesional corticosteroid injection. |
| Long-duration ester local anesthetic? | Tetracaine. |
| Woods lamp positive disease causing sharply demarcated scaly patches in the genitocurual creases? | Erythrasma with "coral red immunoflourescence". Tx Erythromycin 250mg PO QID x7d. Tinea cruris is NOT Woods lamp +. |
| Order of wound healing? | Neutrophils line wound edges w/in 24h -> continuous epithelial cover in 24-48h -> macrophages replace neutrophils as granulation tissue fills in -> fibroblasts create collagen fibers by Day 5. Full healing may take 1 year. |
| 6yo child with ALL develops vesicular rash and sister just recovered from Chicken Pox. What is most serious potential complication? | Pneumonia -> IV acyclovir + Ig. NO ASA DUE TO VZV. |
| Tx. for polymorphous rash, cervical lymphoadenopathy and strawberry tongue? | ASA + IV Ig for Kawasaki's Disease. |
| Use Rule of Nines for over what age? | >14yo. |
| Range of nevi? | Dysplastic/melanocytic -> Halo -> Junctional -> Compound -> Intradermal. |
| Parkland Formula for 1st 24h IV fluid? | 4ml/kg x % BSA + 2000mL D5W for maintenance fluid. |
| Rash that starts on face and spreads "head to toe"? | Measles. Esp. if Koplik Spots are mentioned. |
| Levido reticularis caused by? | Vasomotor instability of dermal blood vessels (not confused with Raynound's with venous spasm in saphenous system). |
| Tx for black widow spider bite? | Narcotic analgesic + methocarbamol (muscle relaxant) + calcium gluconate (dec. regidity). Antivenin for very young or elderly. |
| Best management for AK? | Liquid nitrogen/cryosurgery (not curettage). Account for pt's age. |
| Treatment options for skin infections? | po diclox -> IV vanc if MRSA. |
| Signs of scleroderma (systemic sclerosis)? | Telangiectasias, pigment changes, dysphagia, GI dysmotility and pulmonary fibrosis. Raynaud's and polyarthralgias in 90% of pts. |
| Rx for typical staph or step skin infection? | topical Mupirocin for 2w -> po Keflex. NO STEROIDS! |
| Common offender for a fixed drug eruption? | Acetaminophen. |
| CLASSIC STREP INFECTIONS? | (PCNs -> Cephalosporins esp. Cefalexin): otitis media, streptococcal pharyngitis, bone and joint infections, pneumonia, cellulitis, UTIs and prophy for bacterial endocarditis. |
| CLASSIC STAPH INFECTIONS? | (Mupirocin or Diclox->Keflex): Focal: Blepharitis, chalazion, stye & subq abscesses (boils or furuncles) or deep carbuncles->Osteomyelitis, septic arthritis, endocarditis, septicemia, nec. pneumonia. TSS/SS, gastroenteritis Diffuse skin infxns: Impeti |
| Organism causing 12 yo w/ HYPERKERATOTIC PAPULES on both hands? | Simple warts from HPV. Hands and fingers most common for verruca vulgaris. |
| ANNULARLY shaped lesions in a general dist'n in a teenager is associated with what? | DM (granuloma annulare). May be seen in thyroid and SLE affected pts. |
| 2mo old BOTTLE FED infant with sharply defined scaling red facial rash that is unresponsive to hydrocortisone 2.5% ointment that is irratible and has diarrhea? | ORDER CBC w/ Zn LEVEL to r/o ZINC DEFICIENCY being only bottle-fed. |
| 4mo old with dry, itchy rash that does not resolve, but only slightly improves, and uses baby wash and lotion but screams when the lotion is applied? | Atopic dermatitis (S.AUREUS) from overuse of soaps, cold-dry environments, illness, stress, itchy clothing and allergies. Lotions sting the degraded skin barrier. Improves with warm, humid environments. Use soap-free cleansers and topic steriods. |
| Swollen and painful, small BUMP on radial dorsum of WRIST with jelly-like consistency? | Ganglion cyst from defect in joint capsule or tendon sheath. |
| Treatment for cold uticaria? | Antihistamines -> ebastine. |
| 12yo with palmar surface lesions for less than a week which bleed profusely with minimal provocation thought to be a BUG BITE? | Pyogenic granuloma. Starts with minor trauma like a bug bite with collarette scale. Tx is shave excision and ablation of the underlying vessels. |
| Koplik spots are associated with what viral exanthem? | Rubeola...for buccal mucosa. Red (brick) brown rash from face->feet with fever, nasal d/c, conjunctivitis and cough. |
| Progression of lamellar ichthyosis? | Born with a membrane that sheds in a few weeks and replaced with large, gray scales w/o resolution. Fissures on hands and feet common. |
| Etiology of guttate psoriasis? | Group A Strep infection. |
| Cause of 2 day old with macules and central vesicles and pustules which spare the palms and soles w/o fever? | Erythema toxicum. Benign in newborns and resolves spontaneously. |
| Etiology of finger-sized bruises/yellow-brown macules that urticate when stroked? | Urticarial pigmentosa from NSAIDS, temperature extremes, codeine and scopolamine accumulating mast cells |
Created by:
ed24