Term
macule
-common primary skin lesion- |
|
Definition
freckle
flat discoloration <1 cm |
|
|
Term
patch
-common primary skin lesion- |
|
Definition
vitiligo
flat discoloration > 1 cm |
|
|
Term
papule
-common primary skin lesion- |
|
Definition
raised nevus
raised lesion - < 1cm - different or same color as skin |
|
|
Term
vesicle
-common primary skin lesion- |
|
Definition
varicella
fluid filled, <1cm |
|
|
Term
plaque
-common primary skin lesion- |
|
Definition
psoriasis
raised lesion > 1cm, different or same color as surrounding skin |
|
|
Term
purpura
-common primary skin lesion- |
|
Definition
petechai, ecchymosis
lesions caused by rbc trapped in skin |
|
|
Term
pustule
-common primary skin lesion- |
|
Definition
impetigo, acne
vesicle like lesion w purulent content |
|
|
Term
wheal
-common primary skin lesion- |
|
Definition
hive
circumscribed area of skin edema |
|
|
Term
nodule
-common primary skin lesion- |
|
Definition
epidermal cyst
raised lesion >1cm usually mobile |
|
|
Term
bullae
-common primary skin lesion- |
|
Definition
blister w second degree burn
fluid filled > 1 cm |
|
|
Term
-secondary skin lesion-
excoriation |
|
Definition
| marks produced by scratching |
|
|
Term
lichenification
-secondary skin lesion- |
|
Definition
thickening to skin (callous like)
-reccuent scratching |
|
|
Term
fissure
-secondary skin lesion- |
|
Definition
narrow linear crack in epidermis , exposing dermis
-spit lip, athletes foot |
|
|
Term
erosion
-secondary skin lesion- |
|
Definition
partial loss of epidermis- heals without scar
-open area from open blister |
|
|
Term
ulcer
-secondary skin lesion- |
|
Definition
loss of dermis and epidermis- heals with scar
-pressure wound |
|
|
Term
scale
-secondary skin lesion- |
|
Definition
raised flaking lesion
dandruff, psoriasis |
|
|
Term
atrophy
-secondary skin lesion- |
|
Definition
loss of skin marking and skin thickness
-excessive a nd high dose corticosteroids |
|
|
Term
-pattern of skin lesion-
annular |
|
Definition
|
|
Term
-pattern of skin lesion-
confluent or coalescent |
|
Definition
| multiple lesions blending together |
|
|
Term
-pattern of skin lesion-
reticular |
|
Definition
|
|
Term
-pattern of skin lesion-
dermatomal |
|
Definition
| along a neurocutaneous dermatome |
|
|
Term
-pattern of skin lesion-
linear |
|
Definition
|
|
Term
ointment amount needed for;
hands, head, face or analgenital |
|
Definition
|
|
Term
ointment amount needed for;
one arm, anterior or posterior trunk |
|
Definition
|
|
Term
ointment amount needed for;
one leg |
|
Definition
|
|
Term
ointment amount needed for;
entire body |
|
Definition
|
|
Term
what has the greatest absorbability
-gel and lotion
or
-cream and ointment |
|
Definition
| cream and ointment have greater absorption |
|
|
Term
mech of action of topical corticosteroid is
-
-
- |
|
Definition
anti-inflammatory
immune suppression
vasoconstricitve |
|
|
Term
| to increase potency of topical corticosteroid- pt may.... |
|
Definition
| cover with occlusive dressing |
|
|
Term
low potency topical corticosteroids
-
-
- |
|
Definition
hydrocortisone
fluocinolone
triamcinolone |
|
|
Term
midrange potency topical corticosteroids
-
- |
|
Definition
betamethasone cream
mometasone |
|
|
Term
high potency topical corticosteroids
-
- |
|
Definition
fluocinolone
desoximetasone |
|
|
Term
| super-high potency topical corticosteroids |
|
Definition
betamethasone gel/oint
clobetasol
halobetasol |
|
|
Term
|
Definition
| block activity at histamine receptor sites |
|
|
Term
| first generation antihistamines |
|
Definition
diphenhydramine
chlorpheniramine |
|
|
Term
| second generation antihistamines |
|
Definition
loratadine
desloratadine
certrizine
fexofenadine
levocetirizine |
|
|
Term
impetego is usually caused by
-
- |
|
Definition
group A streptococci
staphylococcus aureus |
|
|
Term
bullous impetego caused by-
% of impetego |
|
Definition
|
|
Term
non-bullous impetego is usually caused by-
% of impetigo- |
|
Definition
staphylococci
and/or
streptococci |
|
|
Term
| topical impetigo treatment |
|
Definition
mupirocin (bactroban)
retapamulin (altabax)newer & expensive |
|
|
Term
oral impetigo treatment
-use when- |
|
Definition
dicloxacillin
1st & 2nd gen cephalosporin
azythromycin
clarythromycin |
|
|
Term
| when topical and first line oral impetigo tx fails use- |
|
Definition
trimethoprin-sulfamethoxazole
clindamycin
minocycline -not in kids <11
doxycycline -not in kids <11 |
|
|
Term
| children w impetigo should be kept out of school ____ hours after tx is started |
|
Definition
|
|
Term
| spectrum of mupirocin (bactroban) |
|
Definition
|
|
Term
componts that cause acne
-
- |
|
Definition
increased sebum w blocked follicles
propionibacterium |
|
|
Term
|
Definition
open closed comedomes
cysts
pustules |
|
|
Term
|
Definition
benzoyl peroxide
retin-a
accuntane |
|
|
Term
| drugs that can cause acne |
|
Definition
|
|
Term
accutane
used for-
common adverse-
serious side effects-
preg risk- |
|
Definition
cystic acne
dry skin-
-intracranial htn, hypertruglyceridemia, elevated liver enzymes, cheilitis, changes in mood, suicide idealtion
-teratogenic |
|
|
Term
| accutane- in females- precautions |
|
Definition
2 neg preg test ( one on second day of menses before beginning
-2 forms of bc
- monthly preg test |
|
|
Term
|
Definition
| use sunscreen- photosentitivity |
|
|
Term
| in acne, topical antibiotics work best for which lesions |
|
Definition
|
|
Term
| used to treat acne rosacea |
|
Definition
| metronidazole gel (metro gel) |
|
|
Term
| moniter what labs if pt is on accutane |
|
Definition
liver enzymes
triglycerides
preg test |
|
|
Term
infectin risk
dog bite ___%
cat bite____% |
|
Definition
|
|
Term
| initial therapy for bites |
|
Definition
vigorous irigation with antibiotic and debridement as needed
-consider prophylactic antibiotic w/in 12 hrs |
|
|
Term
| rabies risk with human bites? |
|
Definition
|
|
Term
| common infective agent in cat bites |
|
Definition
|
|
Term
|
Definition
| oral amox with clavulanate |
|
|
Term
what kind of burn can be treated out patient
%-
degree-
location- |
|
Definition
< 10 %
1st or 2nd degree
no hand, foot or cosmetic area |
|
|
Term
| out-pt treatment for mild burns |
|
Definition
-mafenide acetate (sulfamylon)
-silver sulfate (silvadene)
or
petroleum gauze dressing |
|
|
Term
| 1st degree burn description |
|
Definition
| erythema, hyperemia, pain, blanchable |
|
|
Term
| 2nd degree burn description |
|
Definition
|
|
Term
| 3rd degree burn description |
|
Definition
| minimal pain, often surrounded by painful 1st and 2nd degree burn |
|
|
Term
| in estimating body surface burned, the palm is __% |
|
Definition
|
|
Term
rule of 9s in burns
ant&post head-
ant&post arm-
ant leg-
post leg-
chest/abd-
back-
gentalia- |
|
Definition
|
|
Term
|
Definition
|
|
Term
type 1 hypersensitvity reaction
occurs when __ _ antibodies occupy receptor sites on ____ cells
causing- |
|
Definition
immune globulin E (IgE)
mast
-degradation of the mast cell and subsequent release of histamine causing vasodilation, muccous and swelling |
|
|
Term
| type 1 hypersensitvity reaction are divided into 2 groups |
|
Definition
|
|
Term
| the atopy subgroup of type 1 hypersensitvity reaction contains which conditions |
|
Definition
allergic rhinitis
atopic dermatitis
allergic gastroenteropathy
allergy based asthma |
|
|
Term
the atopy subgroup of type 1 hypersensitvity reaction
localized or systemic? |
|
Definition
|
|
Term
| allergic contact dermatitis is a form of |
|
Definition
|
|
Term
atopic dermatitis have a strong familial component
true/false |
|
Definition
|
|
Term
| common causes of contact dermatitis |
|
Definition
nickel
rubber adhesive in shoes/gloves
toiletries
topical meds |
|
|
Term
| criteria for diagnosing atopic dermatitis |
|
Definition
itching (cardinal sign)
red or inflammed rash
dryness/scaling
vesicles when severe |
|
|
Term
| common location for atopic dermatitis |
|
Definition
folds of arms/legs
in infants- maybe face, usually not diaper area |
|
|
Term
| lab findings in atopic dermatitis |
|
Definition
elevated serum IgE
elevated eosinophils |
|
|
Term
atopic dermatitis treatment
-preventative- |
|
Definition
avoid offending agents
reduce dryness by limiting soap/water exposure
low dose topical steroid |
|
|
Term
atopic dermatitis treatment
-treatment of flare- |
|
Definition
antihistamines
topical/systemic corticosteroids
cool water or burows solution compresses |
|
|
Term
| pimecrolimus (elidel) and tacrolimus (protopic) are _____________ and used as nonsteroidal tx for atopic dermatitis |
|
Definition
|
|
Term
| pimecrolimus (elidel) and tacrolimus (protopic) mechanism of action |
|
Definition
| block T cell and Mast cell activation |
|
|
Term
pimecrolimus (elidel) and tacrolimus (protopic)
high risk for -
use only when-
not for- |
|
Definition
cancer
al other methods have failed
children <2 |
|
|
Term
| shingles caused by ____ virus |
|
Definition
|
|
Term
| shingles in younger person- consider- |
|
Definition
| HIV or other immune compromise |
|
|
Term
during acute shingles chix pox virus is shed and can infect others
true/false |
|
Definition
|
|
Term
| is shingles communicable? |
|
Definition
|
|
Term
| lab comfirmation finding for shingles |
|
Definition
| tzanck smear will show giant multinucleated cells in all herpetic infections |
|
|
Term
| give high dose __ ___ __ and __ within 72 hours to reduce severity, scaring and host herpetic neuralgia after shingles |
|
Definition
acyclovir
valacyclovir
famciclovir
-systemic corticosteroids |
|
|
Term
| shingles rash resolves in ___ days |
|
Definition
|
|
Term
| postherpetic neuralgia defined |
|
Definition
| pain lasting > 1 month after lesions are gone |
|
|
Term
| treatment for postherpetic neuralgia |
|
Definition
lidocaine patch
tricyclic antidepressant
opiods |
|
|
Term
antifungals used in nail fungus
-
-
-
often used as _____ therapy |
|
Definition
-sporanox
-lamisil
-diflucan
pulse therapy, 1 wk on, 3 wk off x 3 months |
|
|
Term
| antifungals can cause _____ in liver enzymes |
|
Definition
|
|
Term
itraconazole (sporanox) inhibits cytochrome P-450 3A4 pathways and so interacts with what drugs
-
-
-
- |
|
Definition
diazepam
digoxin
anticoagulants
some HIV protease inhibitors |
|
|
Term
fluconazole (diflucan)inhibits cytochrome P-450 3A4 pathways and so interacts with what drugs
-
-
- |
|
Definition
carbamazapine
benzodiazepines
calcium channel blockers |
|
|
Term
| terbutaline (lamisol) has ____ drug interaction protential |
|
Definition
|
|
Term
| scabies tend to burrow where |
|
Definition
finger webs
axillary folds
belt line
areola
penis/scrotum |
|
|
Term
how do scabies lesions present
initially-
progress to- |
|
Definition
-burrows
-vesicular/papular with excoriation from scratching |
|
|
Term
| how to free clothes/bedding of scabies |
|
Definition
-wash in hot water-
or dry in hot dryer
or bag for 1 wk |
|
|
Term
|
Definition
permethrin lotion
left on for 8-14 hrs |
|
|
Term
| puritis after scabies treatment persists how long |
|
Definition
|
|
Term
psoriasis description-
location- |
|
Definition
-silvery scales over red plaque
-exterior surfaces like knees and elbows |
|
|
Term
| topical corticosteroids work how for psoriasis |
|
Definition
anti-inflammatory
mild antimitotic |
|
|
Term
| high potency topical corticosteroids side effects |
|
Definition
skin atrophy
telangiectasia
acne
stria
subclinical adrenal supression |
|
|
Term
| topical tar preparations can be helpful for what condition |
|
Definition
|
|
Term
|
Definition
topical antomitotic
psoriasis |
|
|
Term
| options for severe psoriasis covering >30% of body |
|
Definition
ultraviolet A light
cyclosporin
methotrexate
systemic retinoids
infliximab |
|
|
Term
| seborrheic dermatitis is located in what areas |
|
Definition
high concentrations of sebaceous glands
-scalp
-eyelid margins
-nasolabial folds
-ears
-upper trunk |
|
|
Term
| treatment options for seborrheic dermatitis |
|
Definition
-topical antifungal-oral if severe
-class 4 or lower topical corticosteroids
-immune modulators-pimecrolimus, tacrolimus
-sulfer/sulfonamide combos
-propylene glycol |
|
|
Term
| seborrheic keratosis tends to ___ in the winter and ____ in the summer |
|
Definition
worsen in winter
improve in summer |
|
|
Term
| sunscreen helps to protect against__ and ___but not against__ |
|
Definition
squamous cell
basal cell
not against malignant melanoma |
|
|
Term
| sunscreen helps to protect against__ and ___but not against__ |
|
Definition
squamous cell
basal cell
not against malignant melanoma |
|
|
Term
| malignant melanoma arises from |
|
Definition
|
|
Term
| the most common fatal skin malignancy |
|
Definition
|
|
Term
| the ABCDE mnemonic for skin CA is used to ID what kind of CA |
|
Definition
|
|
Term
basal cell carcinoma mnemonic
PUT ON S |
|
Definition
pearly papule
ulcerating
telangiectasia
on scalp-face-pinnae
nodules
slow growing |
|
|
Term
malignant melenoma mnemonic
ABCDE |
|
Definition
asymetrical
border irregular
color not uniform
diameter larger than 6mm
evolving |
|
|
Term
squamous cell carcinoma mnemonic
NO SUN |
|
Definition
nodular
opaque
sun exposed area
ulcerating
nondistinct border |
|
|
Term
Basal cell carcinoma
latency period-
metastatic risk- |
|
Definition
|
|
Term
squamous cell carcinoma
growth rate-
metastaic risk- |
|
Definition
more rapid than BCC
low but significant risk |
|
|
Term
| actinic keratosis defined |
|
Definition
| UV induced skin lesions that can evolve into SCC |
|
|
Term
| actinic keratosis description |
|
Definition
small rough area
3-10 mm
cam be scaly and red |
|
|
Term
|
Definition
| wheals or hives usually as an allergic reaction |
|
|
Term
| the most common cause of urticaria is type ____ hypersensitivity reaction |
|
Definition
|
|
Term
| type 1 hypersensitivity reaction occurs when IgE occupies ___ causing __ and release of___ |
|
Definition
receptor sites on the mast cells
-degredation of mast cell
and release of histamine, vasodilation, muccous gland stimulation, tissue swelling |
|
|
Term
| type 1 sensitivity reaction types |
|
Definition
|
|
Term
| uticarial lesions last how long |
|
Definition
2-24 hrs
(new lesions can form- extending outbreak to 1-2 weeks |
|
|
Term
| most common reactions in atopy subgroup |
|
Definition
allergic rhinitis
stopic dermatitis
allergic gastritis
allergy based asthma |
|
|
Term
| atopic reactions are systemic/local |
|
Definition
|
|
Term
| atopic reactions tend to have ____ component |
|
Definition
|
|
Term
| treatment for systemic atopic reactions |
|
Definition
antihistamines
topical corticosteroids
leukotriene modifiers
-systemic corticoseroids for severe flares |
|
|
Term
anaphylactic reactions are usually triggered by
-
-
- |
|
Definition
|
|
Term
|
Definition
urticaria
vasodilation
angioedema
bronchospasm |
|
|
Term
angioedema and urticaria are both _____anaphylactic reactions
and life threatening only if____ |
|
Definition
subcutaneous
affects airway |
|
|
Term
|
Definition
|
|
Term
most common types of nongenital warts
human papillomavirus #- #- #- |
|
Definition
|
|
Term
| nearly all verruca vulgaris lesions (warts) disappear without treatemtn after how much time ___ months |
|
Definition
|
|
Term
occlusal
duofilm
duoplant
are ____ agents
uset to treat_ |
|
Definition
|
|
Term
imiquimod is an___
can be sued to treat- |
|
Definition
|
|
Term
cellulitis is usually caused by what pathogens
-
- |
|
Definition
gram +
streptococci or staph aureus |
|
|
Term
antibiotic for cellulitis with lor risl of MRSA
-
-
- |
|
Definition
dicloxacillin
azithromycin
clarithromycin |
|
|
Term
| MRSA is resistant by what mechanism? |
|
Definition
| staphylococcus aureus that produces betalactamase- an enzyme that neutralizes penacillins |
|
|
Term
| antibiotic groups that have some stability in the presnece of beta-lactams |
|
Definition
macrolides
certian cephalosporins
semisynthetic penicilin
or adding a betalactamase to tx(clavulanate) |
|
|
Term
| a-febile person w abcess < 5cm tx- |
|
Definition
| I&D and culture w sensitivity |
|
|
Term
| a-febile person w abcess > 5cm tx- |
|
Definition
| I&D with antimicrobial tx |
|
|
Term
| most strains of CA-MRSA remain sensitive to - |
|
Definition
TMZ-SMX or Bactrim
- in large/multiple lesions w or w/o fever, add rifampin |
|
|
Term
| rifampin is a cytocrom 450 isoenzyme inhibitor and so can reduce effective of- |
|
Definition
methodone
cyclosporin
oral contraceptives
many antivirals |
|
|
Term
| CA-MRSA cellulitis appearance |
|
Definition
| often as boil oe abcess, may have dark/black center |
|
|
