Error when uploading: More than 7 items on line 1

[Yuanci]

When I copy and pasted the following in the upload page, this error came up: More than 7 items on line 1. Extra item: Picture 2
Is it because Text 1 isn't the first column? If so, is it possible for the other tags to be in the first column because I like it better (it makes more sense to me)?


Notes Category 1 Category 2 Text 1 Text 2 Text 3 Picture 1 Picture 2 Picture 3
01 10.11.15 Introduction to Dermatology I Information Functions of the Skin "Protection against:
- Fluid loss
- Microorganism entry
- Mechanical damage
Mediates sense of touch
Synthesize: Vit D, cytokines
Absorbing → allow for topical medications"
01 10.11.15 Introduction to Dermatology I Information "Raised bumps that are:
??? → < 1cm
??? → > 1 cm" "Raised bumps that are:
Papule → < 1cm
Nodule → > 1 cm"
01 10.11.15 Introduction to Dermatology I Information Pus-filled papule Pustule
01 10.11.15 Introduction to Dermatology I Information "Flat, non-palpable discolorations that are:
??? → < 1 cm
??? → > 1 cm" "Flat, non-palpable discolorations that are:
Macule → < 1 cm
Patch → > 1 cm"
01 10.11.15 Introduction to Dermatology I Information Discrete palpable elevation or depression or textural abnormality Plaque
01 10.11.15 Introduction to Dermatology I Information "Blisters that are:
??? → < 1 cm
??? → > 1 cm" "Blisters that are:
Vesicle → < 1 cm
Bulla → > 1 cm"
01 10.11.15 Introduction to Dermatology I Information Non-blanchable red/purple discoloration "Purpura
What does this mean?" Extravasated RBC
01 10.11.15 Introduction to Dermatology I Information Blanchable pink discoloration "Erythema
What does this mean?" Dilated capillaries
01 10.11.15 Introduction to Dermatology I Information Excessive hair Hypertrichosis
01 10.11.15 Introduction to Dermatology I Information ♂-pattern hypertrichosis Hirsutism
01 10.11.15 Introduction to Dermatology I Information Hair loss Alopecia
01 10.11.15 Introduction to Dermatology I Information "Deepness of an
Ulcer
~vs~
Erosion" "Ulcer is deeper → full thickness into the dermis
Erosion → only through epidermis"
01 10.11.15 Introduction to Dermatology I Information Circumscribed or diffuse hardening of the skin Sclerosis
01 10.11.15 Introduction to Dermatology I Information Thinning or diminution of epidermis and/or subcutaneous tissue Atrophy
01 10.11.15 Introduction to Dermatology I Information "Lesions that are:
??? → ring shaped, clear center
??? → coin shaped" "Discolorations that are:
Annular → ring shaped
Nummular → coin shaped"
01 10.11.15 Introduction to Dermatology I Information Lesion that is dermatomal, vesicular, and have erythematous base "Zosteriform
Commonly caused by…?" Commonly caused by Herpes zoster
01 10.11.15 Introduction to Dermatology I Information Lesion that is closely grouped, vesicular, with crusting "Herpetiform
Often found on…?
Commonly caused by…?" "Often found on the lip
Commonly caused by Herpes simples"
01 10.11.15 Introduction to Dermatology I Information "Bx used for superficial lesions
Instrument used" "Shave Bx → use scapel
What does it examine?" Epidermis and superficial dermis
01 10.11.15 Introduction to Dermatology I Information "Bx used for keeper inflammatory infiltrates and tumors
Instrument used" "Punch Bx → dermal punch
What does it examine?" "Epidermis, dermis, and subcutaneous fat
Useful for rash, skin carcinoma"
01 10.11.15 Introduction to Dermatology I Information What Bx used for melanoma Excisional, including peripheral and deep margins
01 10.11.15 Introduction to Dermatology I Information Potassium Hydroxide preparation (KOH) is useful for… "Superficial fungal skin infections
Procedure…?" "1. Scrape scale onto slide
2. Incubate in 10% KOH and applying gentle heat
3. Light microscope → see hyphae"
01 10.11.15 Introduction to Dermatology I Information Tzanck preparation is used for diagnosing… "Herpes simplex or varicella zoster
Procedure…?" "1. Scrape cells off a blister
2. Giemsa or Wright stain
3. Light microscope → multinucleate giant cells
4. Mineral oil → look for mites if infestation is suspected"
01 10.11.15 Introduction to Dermatology I Information Stages of acne "Comedone
* Early
-- Infundibulum: hyperkeratosis, comeocyte cohesiveness
-- Androgen stimulation of sebum secretion
* Later
-- Accumulation of shed keratin and sebum
-- Formation of whorled lamellar concretions
Inflammatory papule/pustule
* Propionibacterium acnes proliferation
* Sebaceous lobule regression
* Mild inflammation
Nodule/cyst
* Marked inflammation
* Scarring

Common age and risk factors" "* 85% people between ages 12-24
Risks:
* XYY ₢
* Polycystic ovarian syndrome
* Hyperandrogenism
* Hypercortisolism
* Precocious puberty"
01 10.11.15 Introduction to Dermatology I Information Drugs that cause acne "Anabolic steroids: classically cause new bad acne
Bromide/bromine (soda)
Lithium, corticosteroids

What occupational exposures cause acne?" "Petroleum products
Cutting/cooking oils
Chlorinated aromatic hydrocarbons
Coal tar derivatives
Friction from helmets and pads → hyperkeratosis (common in athletes)"
01 10.11.15 Introduction to Dermatology I Case "Acne - Comedones
Commonly seen in which age group?" Kids 01.01a.jpg 01.01b.jpg
01 10.11.15 Introduction to Dermatology I Case Acne - Cystic 01.02a.jpg 01.02b.jpg
01 10.11.15 Introduction to Dermatology I Case Acne - Scars 01.03a.jpg
01 10.11.15 Introduction to Dermatology I Case "Severe Acne
Eroding, tracking through skin surface" Post-Treatment 01.04a.jpg 01.04b.jpg
01 10.11.15 Introduction to Dermatology I Information Tests for evaluating endocrine abnormalities as cause of acne "DHEAS (dehydroepiandrosterone sulfate)
Free testosterone"
01 10.11.15 Introduction to Dermatology I Information Topical treatments for acne and uses "Used for Comedones and inflammatory papules

Topical antibiotics: benzoyl peroxide, clindamycin, erythromycin
Retinoids → what is the mechanism and some examples?" "Retinoids prevent comedone formation by normalizing follicular keratinization
Also comedolytic by opening the plugged follicular ostea
Examples:
- Tretinoin (Retin-A)
- Adapalene (Differin)
- Tazarotene (Tazorac)"
01 10.11.15 Introduction to Dermatology I Information Treatments for severe acne "Systemic therapy

Inflammatory papules → antibiotics
- Tetracycline, doxycycline, minocycline, erythromycin

Nodulo-cystic scarring acne
- Isotretinoin (Accutane)

What are mechanism and side effects?" "Antibiotics: ↓ bacterial colonization and anti-inflammatory effects

Isotretinoin: mechanism not well understood
- 70% cure of acne when used over 5-6 month period
- Liver damage: ↑ triglyceride, cholesterol, and transaminases
- Strong teratogen: absolute need for birth control
- Depression: need to question patients about mood and behavior"
01 10.11.15 Introduction to Dermatology I Case "Red itchy plaques with silvery scales on elbows and knees
- bleed easily when scratched
Itchy, flaky scalp
Thick, discolored, crumbling nails
25% Arthritis" "Psoriasis
Nail and finger tuft involvement are typical
What are possible treatments?
What drugs can exacerbate psoriasis?" "Topical treatments
- Corticosteroids
- Retinoids (tazarotene)
- Calcipotriene (Vit D)
- Anthralin
- Tar
- Need mild soap and frequent moisturization

Systemic treatments:
- NO systemic steroids (can cause pustular flare if tapered too quickly)
- UV therapy (UVB or UVA + psoralen)
- Methotrexate
- Acitretin (systemic retinoid)
- Cyclosporine
- Biologics: Antibodies to cd11a, cd2, IL12/23, TNF → inhibit T cell activation

Exacerbated by
- Li
- Beta-blockers; Ca channel blockers
- Antimalarials
- Captopril
- Glyburide
- NSAIDs" 01.05a.jpg 01.05b.jpg
01 10.11.15 Introduction to Dermatology I Case "Pustular Psoriasis
- Can be induced with quick systemic steroid taper
- Start with pustules, then pool togethter to lakes, then peel
- Cause same problem as skin failure
- If cover significant areas of body → life threatening: pulm capillary leak, high output cardiac failure, etc" 01.06a.jpg
01 10.11.15 Introduction to Dermatology I Case "Red itchy rash
- Early onset (infancy and childhood)
- Hx of allergies, asthma, dry skin
- Elevated IgE
- Also have food intolerance: milk, eggs, peanuts, soy" "Atopic Dermatitis
- Over 90% skin lesions colonized by S. aureus
- Skin is red and scaly from scratching → broken skin → infections
What are some treatments?" "Treatment:
- Mild soap
- Frequent moisturization
- Topical corticosteroid
- Systemic antibiotics if infection occurs

Refractory cases:
- Systemic immunosuppression: prednisone, mycophenolate mofetil, methotrexate, cyclosporin, azatioprine
- UV light" 01.07a.jpg
01 10.11.15 Introduction to Dermatology I Case "Red edematous skin with:
- Fissures
- Pruritus
- No arthritis
- Nails unaffected" "Eczema
Common causes" "* Contact dermatitis
* Atopic dermatitis
* Seborrheic dermatitis
* Asteototic dermatitis
* Venous stasis dermatitis" 01.08a.jpg
01 10.11.15 Introduction to Dermatology I Case "Fine, flaky, oily rash in
- Eyebrows
- Ears
- Naso-labial folds
- Scalp
Dx + common associations…?" "Seborrheic dermatitis
- Chronic → need ongoing treatment
Common in pts with
- Parkinson's and other neuro disorders
- HIV
Treatments…""" Low potency topical corticosteroid: hydrocortisone (1-2.5%)
01 10.11.15 Introduction to Dermatology I Case Eczema from excessive dryness of skin; often skin has cracked appearance (name?) "Asteototic dermatitis
Eczema craquele: cracked appearance of skin
Treatments…?" "Moisturizer ointments
Topical corticosteroid: triamcinalone 0.1%
AVOID cream bases because they lead to drying"
01 10.11.15 Introduction to Dermatology I Case "Eczema from lower leg verocosities and venous hypertension →
- Redness
- Pruritus
- Induration
- Occasional ulceration
Dx + pathogenesis…?" "Venous stasis dermatitis
- Platelet aggregation and release of pro-inflammatory cytokines
- ↑ endothelial cell adhesion molecules, influx of inflammatory cells
- Edema from sluggish flow and venous hypertension
Treatment…?" "Graded pressure stockings
Removal of varicose veins
Leg elevation
Topical corticosteroid: triamcinalone 0.1%"
02 10.11.15 Introduction to Dermatology II Information "↑ Redness, pain, yellow crusted plaques
- Hot
- Elevated WBC, CRP/ESR
- ± Pustules
- Often accompanied by Hx of dermatitis" "Impetigo
- S. aureus > Strep. Pyogenes
- Most common bacterial skin infection in kids
- Contagious
Treatments…?" "Clean it twice a day with topical antibiotic:
* Mupirocin ointment
* β-lactamase resistant penicillin
* First generation cephalosporin" 02.01a.jpg
02 10.11.15 Introduction to Dermatology II Information "Yellow, oozing, crusted plaque
- Can be washed off
- Under is erythematous and friable" "Impetigo
- Common in kids
- Anterior nose has a lot of staph" 02.02a.jpg

[Ernie]

Text 1-5, Sound 1-5, Picture 1-5...
One of these must be your first column.