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Y2 DERMATOLOGY > big derm document > Flashcards

big derm document Flashcards

1
Q

acanthosis

A

thickening of the epithelium

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2
Q

acantholysis

A

seperation of individual keratinocytes

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3
Q

hyperkeratosis

A

increased thickness in keratin layer

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4
Q

parakeratosis

A

persistence of nuclei in keratin layer

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5
Q

papillomatosis

A

irregular thickening of the epithelium

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6
Q

spongiosis

A

intercellular oedema in the epidermis

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7
Q

what are features of topical steroids

A

anti-inflammatory
anti-proliferative
vasoconstrictive

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8
Q

examples of topical steroids and their potencies

A

Mild: hydrocortisone 1%

Moderate: Eumovate (clobetasone butyrate 0.05%)

Potent: Betnovate (betamethasone valerate 0.1%).

Very potent: Dermovate (clobetasol proprionate 0.05%).

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9
Q

side effects of topical steroids

A 
skin thinning 
immunosuppression 
stretch marks 
purpura 
steroid rosacea 
systemic absorption - adrenal suppression, cushings syndrome 
flare up of conditions:psoriasis
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10
Q

when would you use topical steroids

A

eczema (dermatitis)
psoriasis
lichen planus
keloid scars

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11
Q

what is the function of emoillients

A

rehydrate the skin - used in all dry/scaly conditions especially eczema - 300-500g weekly

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12
Q

examples of emollients

A

cream = Diprobase, E45
ointments = epiderm
wet wraps - very dry skin

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13
Q

what is the function of calicneurin inhibitors and give examples

A

suppress lymphocyte activation - ‘Calcineurin inhibitor’ means that they work with the immune system by blocking one of the chemicals that can contribute to the flaring of atopic eczema

topical treatment of atopic eczema

examples = tacrolimus, pimecromilus

can cause burning sensation on application

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14
Q

what is the antiviral for shingles/eczema herpeticum

A

acyclorvir

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15
Q

when are keratolytics used

A

soften keratin

used for viral warts and hyperkeratotic eczema and psoriasis

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16
Q

embryologically what is the dermis derived from

A

ectoderm

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17
Q

embryologically what is the epidermis derived from

A

mesoderm

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18
Q

embryologically what are melanocytes derived from

A

neural crest

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19
Q

main function of keratinocytes

A
  • production of keratin
  • synthesis of vitamin D
  • variety of immune functions
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20
Q

what are the layers of the epidermis

A
  1. keratin layer
  2. granular layer
  3. prickle cell layer
  4. basal cell layer
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21
Q

describe the basal layer

A
  • deepest layer

- contains stem cells, merkel cells, melanocytes, keratin, and a single layer of small cuboidal keratinocytes

22
Q

describe the prickle cell layer

A
  • sits above the basal layer

- polyhedral keratinocytes

23
Q

describe the granular layer

A
  • 2-3 layers of flattened keratinocytes and langerhans cells
  • function = to produce the cornified envelope by producing keratin and additional proteins such as Filaggrin and Involucrin
  • lack of nuclei
  • high lipid content
  • odland bodies
24
Q

describe the keratin layer

A

AKA stratum corneum

function = waterproof barrier

composed of = corneocytes, keratin, lipids, filaggrin

25
Q

where do melanocytes migrate from and what is their function

A

migrate from neural crest

function = producing melanin from tyrosine

26
Q

what are langerhan cells and where are they found

A

found: prickle cell layer
function: dendritic cells that present antigens to the T cells
distinguishing: Birckbeck granules (rod shaped)

27
Q

where are merkel cells found and what is their function

A

found: basal layer
function: mechanoreception

28
Q

what is the dermo-epidermal junction

A

avascular zone that acts as the interface between the dermis and the epidermis

29
Q

what do diseases that alter the dermo-epidermal junction result in

A

bullae

30
Q

what are functions of the dermo-epidermal junction

A
  • semi permeable membrane that acts as a barrier to filtration
  • support, anchorage and adhesion of epidermal cells
31
Q

what are the layers of the dermo-epidermal junction

A
  1. hemi desmosomes
  2. lamina lucida
  3. lamina densa
  4. sub lamina densa
32
Q

what is the function of the dermis

A

cushion and support the epidermis

33
Q

what does the dermis consist of

A

mainly connective tissue:

  • collagen
  • elastin
  • ground substances, which is the gel like substance composed of glycoaminoglycans
34
Q

what are cells found in the dermis

A 
Mast cells 
Fibroblasts 
Macrophages 
Lymphocytes 
Langerhans cells
35
Q

function of sebaceous glands

A

produce sebum in a hormone sensitive manner, with the sebum acting to prevent moisture loss and protect against infection

face, chest, back

36
Q

function of apocrine glands

A

produced scented, oily fluid

found deep in dermis, project up towards and open out into the hair follicle (axilla and perineum)

37
Q

function of eccrine glands

A

sweat glands and open directly onto the skin
found everywhere especially palms, soles and axillae

function = thermoregulation and are under control of autonomic nervous system

38
Q

what are the nerves of the skin

A

Meissners corpuslces: sensory nerves found high in the dermis and respond to light touch and vibration

Pancinian corpuscles: sensory nerves found deeper in the dermis and respond to heavy, deep pressure

39
Q

what are the 3 types of hair

A

Terminal: course hair found on the scalp, beard and pubic region.

Vellus: fine hair found on the face of women and in pre pubertal children.

Lanago: soft hair found in new borns.

40
Q

what are the phases of the hair cycle

A

Anagen: period of active growth.

Catagen: period of no active growth but with involution of the hair.

Telogen: resting phase of the cycle when the hair falls out.

41
Q

what is a type 1 antibody mediated reaction

A

anaphylaxis and or urticaria

42
Q

what is type 2 cytotoxic reactions

A

blistering reaction - pemphigus and pemphigoid

43
Q

what’s a type 3 immune complex mediated reaction

A

purpura/vasculitis/rash

44
Q

what is a type 4 cell mediated delayed hypersensitivity reaction

A

T cell mediated. erythema and rash

45
Q

what is an exanthematous drug eruption

A
  • most common
  • type 4 reaction
  • widespread symmetrical rash
  • mucous membrane usually spared
  • itch and fever common
46
Q

what drugs cause exanthematous drug eruptions

A
  • penicillins
  • sulphonamides
  • erythromycin
  • strepyomycin
  • allopurinol
  • anti epileptics (carbamazepine, phenytoin)
  • NSAIDs
47
Q

what are urticarial drug reactions

A

usually immediate IgE mediated hypersensitivity reaction (type 1) after rechallenge with drug

direct release of inflammatory mediators from mast cells on first exposure

48
Q

what drugs cause urticarial drug reactions

A
  • aspirin
  • opiates
  • NSAIDs
  • muscle relaxants
  • vancomycin
  • quinolones
49
Q

what drugs cause drug induced bullies pemphigoid

A

ACE inhibitors
Penicillin
Furosemide

50
Q

what are fixed drug eruptions

A

= well demarcated round/ovoid plaques

  • red and painful
  • hands genetalia lips
  • resolves with persistent pigmentation when drug stopped
  • can re occur at same site on re-exposure
51
Q

what are drugs associated with fixed drug reactions

A
  • tetracycline, doxycycline
  • paracetamol
  • NSAIDs
  • Carbamazepine

Y2 DERMATOLOGY (21 decks)

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