Step 3 - Dermatology | Conjunto de Fichas

Pregunta	Respuesta
abs are produced against antigens in the IC spaces of epidermal cells. Causes are idopathic, ACE inhibitors, and Penicillamine	Pemphigus Vulgaris
what disease have a positive nikolsky's sign	Pemphigus, Staph scalded skin, TEN
tx of pemphigus	predisone, and if don't work add azathioprine, mycophenolate, cyclophosphamide
Bullous pemphigoid defineing factors	can be caused by sulfa, thicker walled and less likely to rupture, no oral lesions, mortality lower
tx of bullous pemphigoid	steroids, alt are tetracycline, and erythromycin with nicotinamide
defining Pemphigus foliaceus	can be autoimmue as well as from ACE I and NSAIDs; more superficial and easily rupture, no oral lesions and treat with steroids
Associations with porphyria cutanea tarda	ETOH, liver dz, hep C, OCP, hemochormatosis (PCT increases liver iron stores), diabetes
patient with nonhealing blisters on sun exposed areas, hyperpigmentation, hypertricosis of face	porphyria cutanea tarda
Dx of PCT	urinary porphyrins
tx of PCT	stop drinking ETOH, stop all estrogen use, use barriers to sun, phlebotomy to remove iron and Deferoxamine, Chloroquine increases ext of porphyrins
most common causes of urticaria	asa, nsaids, morphine, codeine, penicillin, phenytoin, quinolone, insect bites, peanuts, sellfish, tomatoes, strawberrys, emotions, latex
assoc with chronic urticaria	dermatographism, cold, vibration
tx of urticaria	benadryl, hydroxyzine, or cyproheptadine; if life threaten add systemic steroids; chronic therapy H2- loartadine, fexofenadine; desensitze if cant avoid trigger but stop BB prior to treatment if epi is needed
mobiliform rash	lympohcytic so can be treated with antihistamines and rarely steroids.
what causes Erythema multiforme	PCN, Phenytoin, NSAIDs, Sulfa, herpes simplex, mycoplasam (seen on palms and soles)--tx antihistamies and the condition
medications that cause SJS/TEN	PCN, Sulfa, NSAIDs, Phenytoin, and phenobarb
tx SJS and TEN	steroids and ABx no proven benefit; tx as burn patients with wound care and rehydration; IGs, cyclophosphamide, cyclosporine and thalidomide can be used
fixed drug reaction	will happen in the same spot they preset with rexposure, look like large bruise almost; treated with topical steroids.
painful red nodules on anterior shins, TTP, non ulcerating, last about 6 weeks	Erythema nodosum
when is erythema nodosum seen	pregnancy, staph infection, coccidiodomycosis, histo, sarcoid, IBD, Syphilis, Hepatitis, Yersinia; treat with NSAIDs and analgesics and disease
Onychomycosis or tinea capetus	need orals for long periods of time; terbinafine (hepatotox, check LfTs) and intraconazole; can use griseofulvin but less effective
all other fungal infection not on hair or nails use?	topicals: ketoconazole, clotrimazole, Econazole, terbinafine, miconazole, sertaconazole, sulconazole, tolnaftate, naftifine
ketoconazole SE	hepatotox and causes gynocymastia when used orally (fluconazole no topical form)
tx of impetigo, erysipelas, cellulitus, folliculits, and carbuncles	dicloxacillin (IV oxacillin or nafcillin), cephalexin, ceadroxil (IV cefazolin); if PCN allergic use macrolides or floroquinolones (not cipro); if resistance or in hosp a while use IV vanc and change to oral linezolid or bactrim
Impetigo can cause GN and rheumatic fever?	false can cause GN not Rheumatic fever (staph or group A strep (pyogenese))
tx impetigo	mupirocin or systemic abx
Erysipelas basics	caused by strep pyogenes; used systemic abs mentioned before
how do we treat cellulitis generally	treat emperically and give IV if showing signs of sepsis
what bacteria causes furuncles, folliculits and carbuncles around hair follicules	usu staph, some follifulitis can be due to pseudomonas.
tx of folliculitis	topical mupirocin
furuncles and carbuncles tx	oral anti staph abx like dicloxacillin or cefadroxil
patient presents with high fever, portal of entry into skin, pain out of proportion to appearance, bullae, crepitus	necrotizing fasciitis
tx of necrotizing fasciitis	amp/sulbactam, ticarcillin/clavulanate, pip/tazo; if pyogenes then clinda + PCN
dx testing for unclear dx of HSV	initially zanck smear, most accurate is viral culture
best tx of HSV	oral acyclovir and if resistant use foscarnet
when is VZV treated	if child is immunocompromised, or primary infection occurs in adults
complications of VZV	PNA, hepatitis, Dissemination
predispose to shingles	elderly, leukemia, lymphoma, HIV, steroids
tx of vzv	acyclovir, gabapentin, tca, topical capsaicin; non immune adults need vaccine in 96hrs of exposure for effect
tx HPV warts	cryotherapy, laser, trichloroacetic acid, or podophyllin (careful in preg); Imiquimod (longer but less damaging to skin)
sen and spp of RPR and VDRL	in primary 75%, 25% false negative; in secondary 100%; latent positive serology and negative manifestation (early and late)
tx of Pediculosis	same as scabes with permetherin and lindane
clinical definition of TSS	fever>102, SBP<90, desquam rash, vomiting, involves MMM, inc Cre/CPK/LFT, lowers Plt cnt, confusion
tx of TSS	fluids, pressors, abx oxacillin/nafcilllin/ cefaolin; if resistant vanco or linezolid
anthrax dx and tx	gram stain and culture of lesions; cipro/doxy
seborrheic Keratosis basics	stuck on apperance, removed with liquid nitrogen or curretage, no malig potential, and not related to other skin findings
actinic keratosis	premalig lesions, tx lesions cryotherpathy,5FU, imiquimod, retinoic acid or curretage
SCC occurence	less common than BCC except in ESRD patients the occurence is opposite
BCC	shiny pearly appearance
KS tx	start HAART, and Adriamycin and vinlbastine

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	Creado por Jaimie Shah hace alrededor de 11 años