Mixed Deck — All CDT Topics Flashcards

The papillary dermis differs from the reticular dermis in that it contains:

Answer: Loose connective tissue and capillary loops

The papillary dermis is composed of loose connective tissue with capillary loops that nourish the avascular epidermis.

A patient scheduled for a full-face laser resurfacing asks if she needs antiviral prophylaxis. The CDT correctly explains that prophylaxis is indicated for patients with a history of:

Answer: Herpes simplex virus (HSV) infection

Antiviral prophylaxis is standard before laser resurfacing for patients with a history of HSV, as the procedure can trigger a widespread herpes outbreak across the treated area.

A wound with purulent drainage, periwound erythema extending more than 2 cm, warmth, and fever most likely indicates:

Answer: Wound infection

Purulent drainage combined with spreading erythema >2 cm, warmth, and systemic signs like fever indicates wound infection requiring treatment.

What is the mechanism of action of salicylic acid in dermatologic products?

Answer: Keratolytic — softens and removes excess keratin

Salicylic acid is a keratolytic beta-hydroxy acid that dissolves intercellular cement between skin cells, promoting shedding of dead skin and clearing clogged pores.

The Bloodborne Pathogens Standard (29 CFR 1910.1030) is enforced by which federal agency?

Answer: OSHA

OSHA enforces the Bloodborne Pathogens Standard, which mandates exposure control plans and protective measures for healthcare workers.

A patient with rosacea is most likely to report worsening symptoms after which trigger?

Answer: Spicy food consumption

Spicy foods are a common trigger for rosacea flares because they induce facial flushing and vasodilation.

Pityriasis rosea classically begins with which primary lesion?

Answer: A single large 'herald patch' on the trunk

Pityriasis rosea typically starts with a solitary 'herald patch' — a large oval scaly plaque — followed 1-2 weeks later by smaller daughter lesions in a Christmas tree distribution.

What is the Minimal Erythema Dose (MED) used to determine in phototherapy?

Answer: Safe starting UV dose for treatment

The MED is the lowest UV dose producing minimal redness at 24 hours, used to calculate a safe and individualized starting phototherapy dose.

The process by which wound edges contract and pull together during healing is primarily mediated by:

Answer: Myofibroblasts

Myofibroblasts are differentiated fibroblasts containing alpha-smooth muscle actin that enable wound contraction during the proliferative phase.

When is it appropriate to use a shave biopsy?

Answer: Superficial raised lesions like seborrheic keratoses or nevi above the skin plane

Shave biopsies are appropriate for superficial, raised lesions because they cleanly remove the elevated portion without requiring sutures.

A patient reports burning and stinging immediately after applying a topical corticosteroid to the face. The most appropriate first action is to:

Answer: Document and report the reaction to the provider

Burning and stinging after topical corticosteroid application should be documented and reported to the supervising provider, as it may indicate irritation or an adverse reaction.

Balsam of Peru is included in patch test panels primarily because it serves as a marker for sensitivity to:

Answer: Fragrances, spices, and aromatic compounds

Balsam of Peru is a natural resin that cross-reacts with many fragrances, spices, flavorings, and topical preparations containing similar aromatic compounds.

A patient with HIV presents with violaceous nodules on the lower extremities. Which diagnosis should be considered first?

Answer: Kaposi sarcoma

Kaposi sarcoma, associated with HHV-8, presents as violaceous macules, plaques, or nodules and is strongly linked to HIV/AIDS.

Which vitamin deficiency most directly impairs collagen cross-linking and is associated with poor wound healing?

Answer: Vitamin C

Vitamin C (ascorbic acid) is essential for hydroxylation of proline and lysine in collagen synthesis; deficiency causes impaired collagen cross-linking.

Under what circumstances should a biopsy specimen be divided and submitted in BOTH formalin and Michel's transport medium?

Answer: When both routine histology and direct immunofluorescence (DIF) studies are ordered

Michel's medium preserves immunoglobulins and complement for DIF testing, while formalin fixes tissue for routine H&E; dividing the specimen allows both studies.

What is the primary purpose of applying a coupling gel during an ultrasound-based skin tightening procedure such as Ultherapy?

Answer: To facilitate ultrasound wave transmission and skin contact

Coupling gel eliminates air gaps between the transducer and skin, allowing efficient ultrasound energy transmission to the target tissue depth.

Which hallmark sign is used to diagnose pemphigus vulgaris at the bedside, where lateral pressure on unblistered skin causes shearing of the epidermis?

Answer: Nikolsky sign

A positive Nikolsky sign, elicited by applying lateral shear pressure to normal-appearing skin to produce blistering, is characteristic of pemphigus vulgaris.

Which topical medication class is contraindicated near the eyes due to risk of increased intraocular pressure?

Answer: Topical corticosteroids

Topical corticosteroids used near the eyes can penetrate ocular tissues and elevate intraocular pressure, potentially causing steroid-induced glaucoma with chronic use.

Which dressing material is most appropriate for a dry, necrotic eschar on a heel without signs of infection?

Answer: Leave the dry eschar intact as a natural barrier

Dry, stable heel eschar in a non-infected wound should be left intact as it acts as a natural biological cover; debridement increases infection risk.

When counseling a patient about using a topical retinoid for the first time, which side effect should you specifically warn them to expect in the first 2–4 weeks?

Answer: Retinoid dermatitis (dryness, peeling, redness)

Retinoid dermatitis — dryness, peeling, and redness — is a common and expected initial reaction that typically subsides with continued use.