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Derm 5 Bullous Dz
Bullous Diseases and Neoplasms
| Question | Answer |
|---|---|
| Which sign is described and what disease is it a/w?: deep palpation of the RUQ-> arrest of inspiration due to back pain | Murphy's sign: cholecystitis |
| Which sign is described and what disease is it a/w?: Charcot's triad (fever, jaundice, RUQ pain), hypotension, mental status changes | Reynold's pentad: Cholangitis |
| Which sign is described and what disease is it a/w?: RLQ pain on passive extension of the hip | Psoas sign: appendicitis |
| Which sign is described and what disease is it a/w?: RLQ pain on passive internal rotation of the flexed hip | obturator sign: appendicitis |
| Which sign is described and what disease is it a/w?: LUQ pain and referred L shoulder pain | Kehr's sign: splenic rupture |
| Which sign is described and what disease is it a/w?: ecchymosis of the skin overlying the flank | Grey-Turner's sign: pancreatitis |
| Which sign is described and what disease is it a/w?: ecchymosis of hte skin overlying the periumbilical area | Cullen's sign: pancreatitis |
| What is the tx for RSV bronchiolitis? | Racemic epi or albuterol +/- supplemental O2 |
| WHat is Beck's triad? When is it seen? | Hypotension, distended neck vv, and distant heart sounds. Seen in cardiac tamponade |
| What is the prognosis of untreated pemphigus vulgaris? | Fatal if untreated |
| What is the difference in treatment between pemphigus vulgaris and bullous pemphigoid? | Pem vulgaris responds better to high dose systemic steroids whereas bullous pem responds better to topical steroids |
| What is the classic presentation of porphyria cutanea tarda? | Chronic blistering on skin-exposed areas, hyperpigmentation and hypertrichosis on face, cutaneous thickening/scarring. |
| Who is the typical porphyria cutanea tarda pt? | Alcoholic or Hep C pt |
| From the presentation, how might pemphigus vulgaris be distinguishable from bullous pemphigoid? | Think of Gus Gus the fat mouse from Cinderella. pemphiGUS has flaccid/flabby blisters that are easy to pop/slough off= + Nikolsky. Gus likes to eat, so pemphiGUS has oral ulcers. Bullous pemphigoid has tense blisters, -Nikolsky sign, and rare oral ulcers. |
| What do the Ab target in bullous pemphigoid? | BM (B for Bullous, B for Basement); hemidesmosomes. |
| What do the Ab target in pemphigus vulgaris? | Epidermal adhesion molecules; desmosomes. |
| Which type of melanoma matches the following description?: MC type of melanoma | supf spreading |
| Which type of melanoma matches the following description?: non-pigmented melanoma | amelanotic |
| Which type of melanoma matches the following description?: dark papule on the legs or trunk that bleeds with minor trauma | nodular |
| Which type of melanoma matches the following description?: occurs on palms, soles, or beneath nail plate in pts w/dark skin | acrolentiginous |
| Which type of melanoma matches the following description?: dark lesion larger than 6mm wiht irregular, asymmetric borders | supf spreading |
| What is the most important prognostic indicator in cases of melanoma? | Depth/thickness of lesion. THis is why you NEVER do a shave bx! Must do a punch bx. |
| What are the tx options for actinic keratosis? | 5-FU cream, cryotherapy, imiquimod |
| What is the classic appearance of BCC? | Pearly papule with rolled edges and central ulceration with telangiectasias |
| What is the classic appearance of SCC? | Papule or ulcer with irregular borders, scaling or keratotic. May have bleeding. May be painful or painless. |