08/23/2017

INDIAN pg entrance exam/mci screening test subject DERMATOLOGY high yield

By Live Dr - Tue Jan 27, 9:32 pm

DERMATOLOGY

1.      Seborrheic Dermatitis Red skin with greasy scales, worse in winter & when under stress, Se or Tar soap

2.      Psoriasis HLA-B27, Similiar sx to RA but w/ neg RF, Silvery scaled plaques w/ sharp demarcations, Pitted fingernails

3.      Pilonidal Cyst Hair lined tract in sacral area = “Jeep Seat”

4.      Actinic Keratoses Firm, yellow scale, Due to sun exposure, can lead to squamous cell CA

5.      Skin CA Basal Cell > Squamous; Basal Cell = pearly papule w/ dilated blood vessels and central depression; Squamous Cell: Red papule w/ crusted surface, later nodular and ulcerated, rarely mets; Assoc w/ sun exposure

6.      Malignant Melanoma Change in size, shape or color of a mole, Usually superficial spreading, Mets incr. as invasion goes deeper than 0.76 mm; itchy & ulcerated

7.      Contact Dermatitis 1o = irritant contact – direct injury, all w/ contact affected, Occurs w/ 1st exposure

8.      Allergic = type IV hypersensitivity, T cell medicated, Never 1st exposure

9.      Carbuncle Abscess of skin caused by several boils coming together

10.  Dermatopytoses TINEA CORPORIS: ring worm of body (round lesion w/ raised borders, spreads peripherally w/ central clearing) TINEA CRURIS: Jock Itch; TINEA PEDIS: Athletes Foot; TINEA UNGUIUM : Toenails; TINEA CAPITIS: ring worm of scalp;

11.  NEVI PIGMENTED: (Benign) sun exposed areas in children & adolescents

12.  DYSPLASTIC: 2-12 mm, more irregular, unexposed areas, Multiple dysplastic Nevi = familial incr. risk of melanoma

13.  Hemangiomas NEVUS FLAMMEUS: Port wine stain – flat, purple, does not fade

14.  CAPILLARY: strawberry mark, raised, bright red, regress spontaneously by age 5

15.  CAVERNOUS: Raised red or purple, enlarged vascular spaces

16.  MUSCULOSKELETAL & CONNECTIVE TISSUE

17.  Osteoarthritis incr. morning stiffness, bone spurs, osteophytes, DIP = heberdon’s nodes, PIP = Bouchard’s nodes, also affects hips, knees, spine

18.  Rheumatoid Arthritis Symmetric, PIP & MCP joints NOT DIP, Subcutaneous nodules, 70% +RF

19.  Gout Affects big toe (Podagra), pinna of ear; Negatively birefringent crystals; Sodium urate; Colchicine or NASIDS for acute attacks

20.  Pseudo Gout Calcium pyrophosphate dihydrate; Knee most affected; Positively birefringent

21.  Phocomelia Hands & feet attached to trunk, Thalidomide

22.  Slipped Capital Femoral Epiphysis Overweight Teens; stiffness=>weakness=>pain radiating down anteromed thigh to knee, ext rot of leg; avascular necrosis

23.  Lyme Disease Borrelia burgdorfi, Ixodes tick, arthralgias, Rash w/ central clearing = erythema chronicum migrans, CNS chgs 1 month after exposure

24.  Osteoporosis decr. mass of bone; hip & wrist fx most common; decr. estrogen, Ca & Phos normal; Risk factors = post menopause, Caucasian, Asian, smoking, alcohol, corticosteroids, Cushings, hyperparathyroid, hyperthyroid; Etidronate – inhibits osteoclast activity, used for men & women who can’t take estrogen

25.  Systemic Lupus Erythematosus Malar (butterfly) rash, arthralgias (raynauds), ANA sensitive; Anti dsDNA specific; Neuro = HA, psychosis, seizures, aseptic meningitis; Check for hemolytic anemia w/ Coombs; Renal = incr. BUN incr. Cr, + protein = immune complex glomerulonephritis

26.  Polymyositis & Dermatomyositis inflammation of skeletal muscles; violet discoloration of eyelids (heliotrope rash), elevated muscle enzymes (CPK, SGOT, SGPT, LDH) symetric proximal muscle weakness; hips & shoulders 1st

27.  Ankylosing Spondylitis “Bamboo shoots” = vertebral squaring w/ bony outgrowths, paraspinal lig. Calcifications on xray; sacroiliac involvement is diagnostic; HLA-B27; incr. ESR

28.  Shoulder Hand Syndrome Pain, stiffness, swelling in hand and shoulder; Occurs 1 month after MI or other acute disease

29.  Bone Mets from Primary breast, lung, prostate, kidney, thyroid

30.  Paget’s Disease Osteolytic => osteoblastic; Frontal “bosing” (enlarged skull with rounded forehead) bow legs and shortened spine; incr. alk phos, Ca & phosphorus levels normal; “Cotton Wool” appearance on skull xray; high output cardiac failure

31.  Congenital Hip Femoral head partially or completely dislocated from acetabulum; BARLOWS: dislocates hip when abducted and decr. pressure; ORTOLANI’S: reduces dislocation by abduction and flexion

32.  Osteochondritis Inflammation of bone & cartilage; Osgood Schlaters – teens, tibial tubercle, pain& swelling at the insertion of the patellar tendon

33.  Osteomyelitis Bone infection; Local or hemtogenous spread; Prepuberty infection is in metaphysis; Salmonella – sicklers; S. aureus; pseudomonas; incr. ESR; incr. WBC; Radionucleotide bone scan w/ in 72 hrs; 4-6 wks organism specific antibiotics

34.  Septic Arthritis S, aureus = most common; N. Gon most common sexually active; synovial fluid = incr. WBC and + culture; Ceftriaxone NG infection; Nafcillin for others

35.  Degenerative Disk Nucleus Pulposa herniates post or postlat.; Lumbosacral = sciatics = L3L4; + pain on straight leg raise;

36.  CaudaEquina Syndrome Lg midline post. Hemorrhage compressing C.E. Urinary and bowel incontinence; bilateral leg weakness

37.  Polymyalgia Rheumatica older women; assoc w/ temporal arteritis; Morning stiffness; swelling 1-2 joints; no weakness; incr. ESR; neg. Rheum factor; steroid response immediate

38.  Fibromyalgia “Trigger Points” reduce pain, IBS, depression, anxiety

39.  Osteosarcoma teenage boys, distal femur & proximal tibia; mets to lungs

40.  Eosinophillic Granuloma 20-40; granuloma w/ histiocytes, eosinophilic infiltrate & fibrosis; multifocal = poor prognosis

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