Tiêu đề HY Dermatology.pdf ✅

MEHLMANMEDICAL HY DERMATOLOGY
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MEHLMANMEDICAL.COM MEHLMANMEDICAL.COM 3 HY Dermatology This document is not designed to be a long-winded, 350-page dermatology textbook that caters to superfluous details that will never be tested. The focus here is to be as concise as possible with HY factoids in order to increase your score on the USMLE. - Student Q showed 10M with scalp lesion similar to below, then the Q asked for the treatment: o Answer = oral griseofulvin for patient only (also on FM NBME form); wrong answer = “oral griseofulvin for patient and classmates”; Dx is tinea capitis; note alopecia and circular/scaly appearance of lesion; cause is dermatophytes (i.e., Microsporum; Trichophyton). o Q on different NBME asks how to prevent; answer = “avoidance of sharing of hats”; “use of medicated shampoo” is wrong answer. - 24M + itchy patches and greasy scales along the hairline; Q asks for the diagnosis: o Answer = seborrheic dermatitis (dandruff); treatment = topical selenium or ketoconazole shampoo; does not cause circular area of alopecia as with tinea capitis; more common in adults (tinea capitis more common in children); cause is inflammatory response to over- colonization with Malassezia yeast. o High prevalence in HIV patients; sudden onset in MSM à answer = do HIV test.
MEHLMANMEDICAL.COM MEHLMANMEDICAL.COM 4 - 46F + has three dogs at home; the following lesion from her forearm is shown; Q asks treatment: o Answer = topical miconazole or clotrimazole; diagnosis = tinea corporis (ringworm); Q will often mention dogs or use of yoga mats at the gym. - 35F + BMI of 55 + type II diabetes + red, moist 8x12-cm ellipse under right breast; Q asks biggest risk factor for her condition? à answer = insulin resistance; obesity is wrong answer; diagnosis is cutaneous Candida; treat with oral fluconazole. - 27F + white, cheese-like discharge per vaginum; Q asks what oral treatment she needs; answer = fluconazole; some students say, “Wait, I thought we use topical nystatin” à either oral fluconazole or topical nystatin can be used; there’s an NBME Q for Step 1 where they specify “oral” treatment; fluconazole is correct and nystatin isn’t listed. - 32M + fever 101 F + red, itchy, scaly area between his 1st and 2nd toes + the redness/scaling extends up dorsum of foot and onto ankle; Q asks most likely causal organism for his fever; answer = Staph aureus; Trichophyton is wrong answer; diagnosis is Staph cellulitis superinfection over tinea pedis; Staph can cause the fever; unlikely for tinea pedis in isolation to cause fever. o Tx for tinea pedis on USMLE is topical terbinafine or -azole (i.e., clotrimazole/miconazole). - 40F + diabetic foot ulcer; sterile probe to base of lesion is likely to show what? à correct answer on new NBME exam = “polymicrobial”; wrong answers are Staph aureus and Pseudomonas. This is an extremely important Q from NBME because people have long debated Staph vs Pseudomonas for diabetic foot ulcers. - 6M + puncture wound on foot 3 weeks ago + continues to have warmth, redness, and pain on palpation; Q asks most likely organism (polymicrobial not listed) à answer = Pseudomonas on new CMS Peds form; Staph aureus is wrong. Apparently implication is osteomyelitis has occurred due to