ANP Certification Derm Flash Cards.txt
Card Set Information
ANP Certification Derm Flash Cards.txt
ANP Certification Derm Flash Cards
ANP Certification Derm Flash Cards
Where do you find acanthosis nigricans?
Cutaneous manifestation of hyperinsulinemia. Moist, velvety found neck, axilla, also may have skin tags in same area.
Recluse spider bite lesion?
Red, white, blue. Core is blue necrotic
Onychomycosis, tinea of nail
Scalp. See alopecia patches
Tinea of hands
Athletes foot. Moist and stinky or dry and scaly.
What does KOH slide provide?
Diagnosis for tinea and other dermatophytes. Will see hyphae and spores.
What is noted in Pityriasis rosea?
"Herald Patch" may need antihistamines
What does pityriasis mean?
Pityriasis commonly refers to flaking (or scaling)of the skin.
Acne Rosacea what is it and what can it lead to?
Chronic facial acne, may lead to rhinophyma of nose with irregular bulbous thickening
What exacerbates Acne Rosacea flares?
Flushing in response to ETOH, sun, cold, skin products, wind, etc
Tinea of Beard
Plain old acne
highly inflammatory disease presenting with comedones, nodules, abscesses, and draining sinus tract
Tinea Corporis/ Tinea circinate?
Ringworm. Ring-like pruritic rash
Jock itch. Red, pruritic rash with fine scales
Characteristics of candidal groin infection?
Bright red rash with satellite lesions
Bright red diffuse rash, indicative of bacterial infection
Starts as inflammatory papule, becomes necrotic
How does Silvadene (Silver sulfadiazine) work?
It is bactericidal. Acts on cell membrane and cell wall.
How does silver nitrate work?
How does one get an Orf skin ulcer?
Contact with sheep or goats, parapoxvirus transmits across species
How do you diagnose candidiasis?
What is a Kopick's spot?
A buccal mucosal lesion that appears before skin rash of measles
How do you identify clubbing?
See thickening and broadening of ends of fingers. Bulbous appearance with swelling of terminal phalanges.
What degree of change is noted in nailbed/digit angle in clubbing?
Increase from 160 to 180 degrees
Where do you find a Podagra lesion?
It is gout of the great toe, from hyperuricemia causing uric acid crystal deposit
What food causes gout exacerbation?
High purine foods, such as organ meats.
What drugs are contraindicated in gout?
Salicylates. They block renal excretion of uric acid
What happens if itch continues to occur during the week after lice treatment?
Most likely due to inflammatory reaction to lice bites causing itch
What is an annular lesion?
Ring shape lesion
What is acral location?
Located on an extremity
Rash of scarlet fever?
Diffuse erythema sandpaper rash texture
Toxic shock syndrome rash?
Diffuse, sunburn like erythroderma
Nonn confluent, discrete papules, erythematous
What lesions can be pustular?
Acnes, folliculitis, candidiasis,
What are the characteristics of Lichen Planus?
"5 P's": well-defined pruritic, planar, purple, polygonal papules. The commonly affected sites are near the wrist and the ankle
What does long term use of topical corticosteroids cause?
Cutaneous atrophy, telangiectasis, easy bruise-ability
Name for infection of hair follicle that causes abscess and what microorganism causes it?
Furuncles (boils), Carbuncles. Staph aureus.
How does topical corticosteroids work?
Decrease inflammation and allergic reaction and cause vasoconstriction.
Potency classes number range of Corticosteroids?
Class 1 is highest potency. Class 7 is lowest.
Where is Hydrocortisone in the class range for corticosteroid?
Where is triamcinolone in the class range for corticosteroid?
Where is Betamethasone in the class range for corticosteroid?
What drugs can induce acne?
Topical Vitamin A concerns?
Need to use sunscreen
What drug treats acne Rosacea?
Oral Accutane side effects?
Elevated triglycerides, elevated LFTs, depression, suicide, teratogenic
What should Accutane be taken with?
Highly lipophilic, eat with fatty foods
Restrictions on Accutane RX for women?
Only one month supply, no refills, be on BCP
What is another name for an open comedone?
Closed comedone alternate name?
Treatment for minor acne?
Treatment for moderate acne?
Treatment for severe cystic acne?
How do you treat a cat bite?
Can cause Pasteurella multocida infection, give Augmentin x 10 days, culture wound, and don't suture shut
What is the rule of 9s for burns? And what is a good 'ruler'
To tell percent of BSA of burn. The palm of the hand is 1% BSA
What are BSA burn calculations that are 4.5%
4.5% is face, or posterior head, or front of arms, or back of arms
What are BSA burn calculations that are 9%
9% is front of leg or back of leg
What are BSA burn calculations that are 18%
18% would be entire chest or entire back
What is another name for atopic dermatitis?
Eczema, at type I hypersensitive RXN
What are examples of immunomodulators?
Pimecrolimus (Elidel) and Tacrolimus (Protopic)
What is immunomodulators mechanism of action?
Block T cell stimulation by antigen presenting cells and inhibits mast cell activation.
Side effect of immunomodulators drugs?
What does a positive Tzanck smear show and what is it positive for?
Giant Multinucleated cells. Herpetic lesions.
Infection of Herpes in what Cranial Nerve can cause blindness?
Cranial Nerve #5, the ophthalmic branch of trigeminal nerve can cause result in corneal blindness.
What can clue you in to the fact that you have herpes on CN 5?
Herpetic lesion will be noted on tip of nose
What location of lesions carry highest incidence of post herpetic neuralgia?
Trigeminal and brachial plexus. Followed by thoracic and then LS areas with lower risks.
Other than location of lesion, what other things cause higher chance of post herpetic neuralgia?
Severity of lesions, intense prodrome, and age >80
What drugs are indicated on post herpetic neuralgia treatment?
Pregabalin (Lyrica) TCAs, (amitriptyline), Gabapentin
What is the Zoster Vaccine? And what population is it indicated for?
Live attenuated varicella zoster virus to protect elderly against Shingles. Indicated in adults >60
What happens at a cellular level with Psoriasis Vulgaris?
Accelerated mitosis and rapid cell turnover causes decreased skin maturation and keratinization
What is the Goeckerman regimen used for and what does it entail?
Psoriasis. UV light therapy with coal tar 2 times a day
Where is seborrheic Dermatitis noted?
Skin areas with high sebaceous glands. Ears, scalp, eyelid margins, nasolabial fold, upper trunk
Treatment for seborrheic dermatitis?
Low dose topical steroid during flare. Ketoconazole.
Surgical procedure for skin cancer removal?
Mohs micrographic surgery
How much compression should be on venous stasis ulcer?
What is urticaria?
Hive eruptions. Typically in response to allergen. Itchy, and raised.
What combination of symptoms is seen in anaphylaxis?
Wide spread urticaria, vasodilation, angioedema and bronchospasm
What virus causes verruca vulgaris warts?
HPV 1, 2, 4
What would you prescribe if you weren't sure if a skin infection was gram positive or gram negative or wanted to cover for both?
Bactrim plus add a beta lactam, such as a cephalosporin
What can mimic CA MRSA wound?
The spider bite of the brown recluse spider. It has more of a red, white, and blue. Red being halo. Blue being internal necrotic spot.
What is contained in the Dermis?
Blood vessels, sebaceous glands, and hair follicles
What is contained in the subcutaneous layer?
Fat, sweat glands, hair follicles
What happens on the epidermal layer?
Melanocytes are there, vitamin D synthesis occurs, top layer has keratinized cells
What is a xanthelasma and who might you see this in?
Deposit of cholesterol under skin of eyelid. Seen in those with hyperlipidemia.
Mask of pregnancy. Tan cheeks and forehead
Inherited skin disorder causing extremely dry skin
Extremely dry mouth
Extremely dry conjunctiva
Where would you note the Koebner Phenomenon?
Skin lesions occurring along traumatic areas, sometimes noted in psoriasis
What is an Auspitz sign?
If remove psoriatic plaque, will see punctate bleeding
What is Rhus Dermatitis?
Rash due to position ivy, oak, etc
What is noted in hidradenitis Suppurativa?
Staph aureus bacterial infection of sebaceous glands of axillae and groin with sinus tracts and scarring
Treatment for Hidradenitis Suppurativa?
Augmentin or dicloxacillin x 10 days
Another name for Stevens-Johnson's syndrome?
Erythema Multiform Major
What causes Stevens-Johnson's syndrome?
Sever hypersensitivity reaction to medications, viral or fungal infection or malignancies
What medications can cause Stevens-Johnson's syndrome?
Dilantin, PCNs, and Sulfas
What is characteristic lesions of Stevens-Johnson's syndrome?
Multiple lesions abruptly erupt, hives, blisters, bullae, petechiae, hemorrhagic lesions, with extensive mucosal surface involvement including airway.
What area of skin does dermatophytosis affect?
Superficial keratinized tissues of skin, nails, and hair
Rule of thumb about pruritic rashes that are worse at night?
Scabies until proven otherwise
What is a lesion covered in fine silvery scales called?
What is a herald patch and what is it associated with?
Christmas tree rash noted in Pityriasis Rosacea that then progresses to a diffuse exanthem rash.
What is an Exanthem?
A wide-spread rash
Another name for seborrheic dermatitis?
Cautions with oral antifungals?
Assess for hepatotoxicity with LFT checks. Careful of other CYP 450 3A4 enzymes.
What areas of body absorb the highest amount of topical medication?
Crust, Primary or secondary lesion?
Secondary. Crust forms after a primary lesion has opened and dried