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Medicine Year 5 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

how do you measure the extent of a burn

A

wallaces rule of 9’s

  • head & neck - each arm - each anterior leg - each posterior leg - anterior chest - posterior chest - anterior abo - posterior abdo
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2
Q

what is the most accurate method of measuring the extent of a burn

A

lund and browden chart

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3
Q

red and painful burn which is dry with no blisters

A

superficial epidermal (1st)

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4
Q

pale pink burn which is painful, blistered and has a slow capillary refill

A

superficial dermal (2nd)

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5
Q

white burn with patches of non-blanching erythema, reduced sensation and pain on deep pressure

A

deep dermal (2nd)

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6
Q

white waxy, brown leathery or black burn with no blisters and no pain

A

full thickness (3rd)

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7
Q

give some initial management for burns

A

first aid
ANALGESIA
early intubation if burns to face/inhalation injuries
urinary catheter
IV fluids

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8
Q

management of superficial epidermal

A

analgesia and emollients

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9
Q

management of superficial dermal

A

no emollients, non-adherent dressing to keep the blister intact

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10
Q

management of severe full thicknesss burns

A

escharotomies

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11
Q

where are deep dermal, full thickness, superficial dermal more than 3% in adults or 2% in paeds, inhalational injuries, electrical or chemical burns managed

A

secondary care

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12
Q

burns more than 10% in adult or 5% in child or complex burn

A

burns unit

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13
Q

what causes oedema weeks after a burn

A

loss of plasma proteins

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14
Q

what is the formula for IV fluid calculation in burns patients

A

PARKLAND FORMULA

% SA of the burn x weight x 4

give half in first 8 hours and half in next 16

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15
Q

skin cancer presenting as a painless bleeding ulcer on sun exposed skin with RF of sunlight, smoking, leg ulcers, genetics, bowens disease, actinic keratosis

A

squamous cell carcinoma

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16
Q

management of skin cancers

A

surgery with wide excision

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17
Q

what factors contribute towards a poor prognosis in skin cancer

A

deep/large diameter or patient immunosuppressed

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18
Q

precancerous dermatosis
slow growing red scaly patches in sun exposed areas
managed with topical flurouracil

A

bowen’s disease (-> SCC)

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19
Q

premalignant condition with small crusty, scaly and itchy lesions in the sun
managed with topical flurouracil, diclofenac or surgery

A

actinic keratosis

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20
Q

benign tumour similar to an SCC
dome crater filled with keratin

A

keratocanthoma

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21
Q

skin cancer with a pearly white edge

A

BCC

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22
Q

most common BCC raised translucent papule on face with local destruction

A

nodular BCC

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23
Q

what are the 4 other BCC types

A

superficial: trunk in 50’s
morpheaform: flat irregular plaque
cystic: clear blue-grey
basosquamous: very invasive

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24
Q

most common type of malignant melanoma presenting as a slow growing mole in a young person

A

superficial spreading malignant melonoma

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25
Q

second most common malignant melanoma presenting as a red/black bleeding lump in sun exposed areas of middle aged which metastasises early

A

nodular malignant melanoma

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26
Q

least common malignant melanoma presenting as a growing mole in elderly

A

lentigo maligna

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27
Q

rare form of malignant melanoma in the nails, palms or soles of darker skinned individuals which exhibits hutchinsons sign

A

acral lentiginous

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28
Q

what are the surgical margins of malignant melanoma based on

A

breslow thickness

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29
Q

premalignant condition in smokers presenting with white hard spots on the mucous membranes of the mouth

A

leucoplakia

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30
Q

what are the two types of dermatitis

A

irritant: non allergic on hands from cleaning/cement
allergic: T4 hypersensitivity with weeping eczema

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31
Q

management of allergic dermatitis

A

patch test and steroid

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32
Q

20-45 year old woman presenting with clusters n the perioral region which worsen with steroids and are treated with ABx

A

perioral dermatitis

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33
Q

dermatitis around the anus

A

zinc deficiency

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34
Q

eczematous rash on the face associated with otitis externa and blepharitis treated with ketoconazole/steroids

A

seborrheic dermatitis

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35
Q

SE of ketoconazole

A

gynaecomastia

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36
Q

autoimmune condition causing IgA deposits in coeliac disease presenting with itchy vesicular lesions on extensors treated by removing gluten or dapsone

A

dermatitis herpetiformis

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37
Q

antibodies against desmosomes causing mucosal ulcers and skin blisters
managed with steroids and immunosuppressants

A

pemphigus vulgaris

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38
Q

blistering skin in the elderly treated with steroids

A

bullous pemphigold

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39
Q

pathophysiology of vitiligo

A

reduced melanocytes causes well demarcated depigmented skin
precipitated by trauma

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40
Q

management of vitiligo

A

suncream, make up, tacrolimus, steroids, phototherapy

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41
Q

what must you test for in patients who have been diagnosed with vitiligo or alopecta acreta

A

other autoimmune diseases

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42
Q

which organism causes impetigo

A

staph aureus/pyrogens

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43
Q

presentation of impetigo

A

golden crusted lesions

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44
Q

treatment of impetigo

A

hydrogen peroxide

(or fusidic acid/oral fluclox/eryth if extensive)

45
Q

school exlcusion for impetigo

A

until lesions crusted or 48 hours after abx as contagious

46
Q

pink pearly white papules with central umbilication on the trunk and flexors which self-resovle in 18m

A

molluscum contagiosum

47
Q

virus which causes molluscum contagiosum

A

pox

48
Q

widespread pruritis and linear burrows which are spread by skin to skin contact

A

scabies

49
Q

management for scabies

A

2 doses of PERMETHRIN at least 1 week apart for the whole family

50
Q

how long can the itch last after successful therapy for scabies

A

4-6w

51
Q

management of verruca

A

salicyclic acid

52
Q

management of headlice

A

malathion

53
Q

management of hyperhidrosis

A

topical aluminium chloride

54
Q

most common site for keloid scars

A

sternum

55
Q

where are sebaceous cysts commonly found

A

scalp
central punctum

56
Q

common eczematous itchy rash in pregnancy

A

atopic eruption of pregnancy

57
Q

pruritis in abdominal striae which spares the peri umbilicus in the 3rd trimester
management

A

polymorphic eruption of pregnancy
emollient / steroid

58
Q

pruritic blistering lesions around the umbilicus in the 2nd/3rd trimester
management

A

pemphigoid gestationis
oral steroid

59
Q

itchy white spots on the vulva of elderly women
management

A

lichen sclerosis
potent topical steroid (clobetasol)

60
Q

Purple Pruritic Papular Polygonal rash on flexor surfaces, genitals and palms with oral involvement, Wickham’s striae and koebner phenomenon
management

A

Lichen planus

potent topical steroid (clobetasol) or benzylamine mouthwash

61
Q

inflammation of the SC fat causing tender, red and nodular lesions on shins associated with strep, TB, sarcoidosis, pregnancy, malignancy, COCP and penicillin

management

A

erythema nodosum

self resolves in 6w

62
Q

hypersensitivity reaction triggered by herpes, SLE, malignancy, penicillin, NSAID, sulph, carbamazepine, COCP, allopurinol causing TARGET LESIONS

A

erythema multiforme

63
Q

requirement of erythema multiforme major

A

mucosal involvement

64
Q

severe end of the spectrum which causes erythema multiforme to stevens johnson syndrome
patients are systemically unwell with positive nikolyskys

A

toxic epidermal necrolysis

65
Q

management of toxic epidermal necrolysis

A

ICU - Fluids - Immunoglobulin - Immunosuppression

66
Q

chronic and painful inflammatory skin condition in women under 40 years with DM, PCOS or smoking presenting with red nodules in the axilla which can rupture and cause rope like scarring

A

hidradenitis suppurativa

67
Q

management of hidradenitis suppurativa

A

good hygiene, weight loss, stop smoking, steroid, flucloxacillin

68
Q

complications of hidradenitis suppurative

A

sinus tracts, fistula, comedomes, lymphatic obstruction

69
Q

rare condition causing skin ulceration, fever and myalgia assoaciated with IBD, RA, SLE, biliary cirrhosis, lymphoma and myeloproliferative disorders

treated with steroids and immunosuppression

A

pyoderma gangrenosum

70
Q

surgery with pyoderma gangrenosum

A

postpone

71
Q

benign small red spot which can bleed/ulcer associated with trauma, pregnancy, crohns, UC and treated with steroids or surgery

A

pyogenic granuloma

72
Q

which virus causes shingles

A

herpes zoster

73
Q

how does shingles present

A

prodrome: fever, lethargy, headache, burning pain
rash: red and macular in T1-L2

74
Q

management of shingles

A

aciclovir in 72 hours to prevent post herpetic neuralgia
steroids NSAID paracetamol if severe pain

75
Q

3 risk factors for shingles

A

age HIV immunosuppression

76
Q

which bacteria causes acne

A

propionibacterium acnes

77
Q

classification and treatment of acne

A

mild-moderate-severe

stepwise
1. topical retinoids/benzylperoxide
2. oral ABx (tetracyclines) or COCP
3. Isotrenitoin

78
Q

how do you initiate isotrenitoin

A

under specialist treatment
if scarring

79
Q

main side effect of isotretinoin

A

dry skin

80
Q

which medications do you need to avoid when managing acne in pregnancy

A

retinoids
tetracyclines
isotrenitoin

81
Q

herpes simplex or coxsackie virus causing a rapidly progressive painful rash in children with ‘monomorphic punched out erosions’

A

eczema herpeticum

82
Q

treatment of eczema herpeticum

A

IV aciclovir

83
Q

which type of eczema presents as small puritic blisters on the palms and soles in humidity or high temperatures

A

pompholyx eczema

84
Q

management of pompholyx eczema

A

cool compress, emollients, steroids

85
Q

flushing and telangiectasia of the face exacerbated by sunlight associated with papules and pustules and BLEPHARITIS

A

rosacea

86
Q

management of rosacea

A

suncream/hats
laser therapy for telangiectasia

topical metronidazole/brimodine
tetracyclines if severe

87
Q

what does trauma (koebner phenomenon), alcohol, withdrawal of systemic steroids, BB, NSAID, ACEi, infliximab and anti-malarials exacerbate

A

psoriasis

88
Q

3 main medications in the management of psoriasis

A

emollients, topical steroid, vitamin D analogue

89
Q

how should you use steroids in psoriasis

A

4 week break between steroid doses

if you’ve been on strong steroids for 8 weeks then vitamin D analogue only

90
Q

which therapy for psoriasis can predispose SCC

A

PUVA light therapy

91
Q

which medication can be used in psoriasis to reduce the number of long term flares

A

calcipotriol

92
Q

tear drop scaly patches on the trunk and limbs 2-3 weeks after strep throat infection which resolves in 2-3 months (can use steroid or UVB)

A

guttate psoriasis

93
Q

herald patch then multiple red raised oval lesions 1-2w later with a fir tree appearance which resolves in 6w
sometimes associated with resp infection

A

pityriasis rosea

94
Q

superficial fungal infection affecting the trunk causing hypopigmented lesions after sun exposure

A

pityriasis versicolour

95
Q

management of pityriasis versicolour

A

ketoconazole shampoo

96
Q

management of onychomycosis (fungal nail infection)

A

nail clipping or scraping
oral terbinafine

97
Q

RF for onychomycosis (fungal nail infection)

A

DM

98
Q

itchy peeling skin on the feet
management

A

tinea pedis
topical terbinafine

99
Q

what is tinea corporis
managment

A

ringworm
oral fluconazole

100
Q

fungal infection of the scalp caused by trichophyton which glows green under woods lamp and treated with oral terbinafine or ketoconazole shampoo

A

tinea capitis

101
Q

symmetrical brown, velvet plaques on the neck axilla and groin associated with T2DM, GI cancer, COCP, PCOS, cushings, obesity, thyroid and acromegaly

A

acanthosis nigricans

102
Q

vascular birthmark which self resolves

A

salmon patch

103
Q

management of a strawberry naevis

A

propranolol if large and bleeding

104
Q

management of a child with new onset purpura

A

immediate referral for ALL or meningococcal disease

105
Q

management of healthcare workers who are not naturally immune to varicella

A

vaccinate

106
Q

management of facial hirsitism

A

topical eflornithine

107
Q

management of severe urticaria

A

ST oral steroid and antihistamine

108
Q

side effect of steroids in darker pigmented skin

A

patchy depigmentation

109
Q

what is a curlings ulcer

A

stress ulcer in burns patients causing haematemesis

Medicine Year 5 (27 decks)

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