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Pre-Reg November Exam '24 > Skin > Flashcards

Skin Flashcards

1
Q

What are the signs and symptoms of eczema (dermatitis)?

A
  1. Itching
  2. Vague an poorly defined borders
  3. Can be chronic inflammatory condition, but may be due to irritant… remove triggers!
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2
Q

What are the RED FLAGS for eczema (dermatitis)?

A
  1. Treatment failure
  2. Lesions on face (think difigurement)
  3. Widespread or severe

Signs of infection
* Bacterial- crusting skin? (oozing, yellow/green)
* Viral- blisters and bubbles (colourless weeping)
* Fungal- Flaking/circular lesions?

Bacterial complication of dermatitis
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3
Q

What is the treatment goal for eczema (deramtitis)?

A

Hydrate/ reduce imflammation where possible

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4
Q

What are the treatment options for eczema (dermatitis)?

In order of treatment steps

A
  1. Emollients, applied liberally e.g. hydromol
  2. Hydrocortisone 1%, applied sparingly BD for 7 days (aged >10)
  3. Clobetasone 0.05%, applied sparingly BD for 7 days (aged >12) e.g. EUMOVATE
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5
Q

Are the treatments available for eczema (dermatitis) safe for use in pregnancy?

A

Inadequate evidence of safety in human pregnancy. Topical corticosteroid use in animals is shown to cause abnormalities of foetal development, including cleft palate

Dermacort (hydrocortisone) should not be used in pregnancy

IF RTS, advise patient speak with GP

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6
Q

Important safety advice for treatment options for eczema (dermatitis)

A
  1. Do NOT apply to cracked or broken skin
  2. Do NOT supply if patient taking oral steroids e.g. prednisolone
  3. Ensure 45 minute gap between applying agents
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7
Q

What are the signs and symptoms of headlice?

and how would you definitively diagnose?

A
  1. Itching
  2. Sighting of shells and/or bodies

Only definitive diagnosis is through direct visual confirmation

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8
Q

What can

What are the treatment options for headlice?

A

Dimeticone lotion or spray e.g. Hedrin Once

  • Treat whole head of hair and leave on overnight for 8 hours
  • Wash off in morning
  • Treat AGAIN in 2 WEEKS (imperitive as dimeticone only kills live lice)

Effectively suffocates (live louse) and lice can’t develp resistance to

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9
Q

What are the signs and symptoms of seborrheic dermatitis?

A
  • Red, flaky and itchy rash on skin
  • Affects greasier areas of skin e.g. face, scalp and chest
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10
Q

What is cradle cap?

A

Form of seborrheic dermatitis affecting babies scalps

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11
Q

What are the treatment options for cradle cap?

In order of treatment steps

A
  1. Topical emollient- to loosen scales, and brush off with shampoo
  2. Topical imidazole cream
    * Clotrimazole 1% cream- apply BD-TDS for up to 4 weeks
    * Miconazole 2% cream- apply BD up to 4 weeks

If symptoms persist longer than 4 weeks with treatment- seek specialist help

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12
Q

What are the treatment options for dandruff?

A
  • Coal tar shampoo (Neutrogena Therapeutic shampoo)
  • Zinc pyrithione
  • Ketoconazole (Nizoral)

Leave in hair for a few minutes before washing off

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13
Q

What are the signs and symptoms of psoriasis?

A
  • Areas of inflamed skin with scaly skin
  • Commonly found on elbows, knees, forehead and less often on the back

Scales can help differentiate from dermatitis

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14
Q

What are the RED FLAGS for acne?

A
  • Treatment failure
  • Widespread or severe (e.g. cysts or nodules)
  • Signs of infection
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15
Q

What are the treatment options for acne?

A
  • Benzoyl peroxide (acnecide)- apply sparingly BD (avoid UV etc)
  • Nicotinamide (Freederm 4% gel)- Apply sparingly BD

S/E can be drying of skin- reduce to OD if necessary

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16
Q

What are the signs and symptoms of scabies?

A
  • Features very similar to eczema or psoriasis (difficult to diagnose)
  • Commonly found in finger webs , under arms or other bodily crevices
  • Intense itching
17
Q

What are the RED FLAGS for scabies?

A
  • Widespread or severe
  • Signs of infection
18
Q

What are the treatment options for scabies?

A
  • Premethrine (e.g. Lyclear 5% cream)- apply once weekly for 2 doses over whole body and leave overnight. Wash off in morning
  • Malathion (e.g. Derbac- M 0.5% liquid)- same as above
19
Q

Where are each of these fungal infections found?

  1. *Tinea curis
  2. Tinea corporis
  3. Tinea pedis
  4. Tinea capitis*
A
  1. Groin
  2. General body
  3. Foot
  4. Head
20
Q

What are the signs and symptoms of ring worm?

A
  • Circular, flaky skin
  • Can cause itching
21
Q

What are the RED FLAGS for ring work/ fungal infections?

A
  • Treatment failure
  • Lesions on face
  • Widespread or severe
  • Signs of infection
22
Q

What are the treatment options for fungal infections?

A
  • Ketoconazole- apply BD (foot), OD/BD (non-foot)
  • Clotrimazole 1%- apply BD/TDS
  • Miconazole (e.g. Daktarin)- apply BD/TDS
    For all ages
  • Terbinafine- apply cream OD/BD up to two weeks. Oral- 250mg OD for 2-4 weeks
    Aged > 16

Continue treatment for up to 1 week after clearance of lesion

23
Q

What are the treatment options for fungal nail infection?

When would you refer to GP?

A
  • Amorolfine 5%- apply 1-2 times weekly for 6 months. Allow to dry for approx. 3 mins
    File and clean nails before administration
    Aged > 18

Referral:
* > 2 nails affected
* Diabetes
* Pregnancy
* Treatment Failure

> 2 nails affected here
24
Q

What are the RED FLAGS for warts, corns and verucas?

A
  • Treatment failure
  • Lesions on face
  • Widespread or severe
  • Diabetics/ immunocompromised patients
  • Corns causing pain when walking (best reviewed by GP or podiatrist)
  • Signs of infection
25
Q

What are the treatment options for warts, corns and verucas

A
  • Silver nitrate pencil- apply moistened pencil tip every 24 hours. for up to 3 applications (warts) or 6 applications (verucas)
  • Salicylic acid (e.g. Salactol)- apply daily, ma need to for up to 3 months

All ages

26
Q

Which Herpes simplex virus causes coldsores and which causes genital herpes?

A
  • HSV1- coldsores
  • HSV2- genital herpes
27
Q

What are the RED FLAGS for coldsores?

A
  • Repeat infections
  • Diabetic/ immunocompromised patients
  • Lesions lasting > 14 days
  • Severe or widespread
  • Secondary infection

Can also spread to the eyes!

28
Q

What are the treatment options for coldsores?

A

Aciclovir 5%- apply 5 times daily for 5 days

Avoid contact with eyes

29
Q

What are SCC, BCC and MM?

A
  • SCC- Squamous cell carcinoma
  • BCC- Basal cell carcinoma
  • MM- Melanoma skin cancer

Beware of complacency
Can also mimic other conditions

30
Q

What are the RED FLAGS for skin lesions (Cancerous etc)?

A

A: asymmetrical?
B: Border jagged?
C: colour variation?
D: Diameter? Larger than a pencil rubber (6 mm)?
E: Evolving? Is this lesion different or changing?

  • New lesion in patient > 60
  • Immunocompromised patients

All referral criteria for assessment

31
Q

Best methods to prevent skin lesions

A

PREVENTION!

  • Suncream > SPF 30
  • stay out of mid-day sun (10:00-14:00)
32
Q

What are the signs and symptoms of chickenpox?

A
  • Fever
  • Headache
  • Fatigue
  • Red spots first appear on chest, face and back
  • Decreased appetite
  • Spots turn to itchy blisters
33
Q

What are the treatment options for chickenpox?

A
  • Oral antihistamines
  • Paracetamol
  • Calamine lotion or zinc oxide creams

Keep nails short!

34
Q

What are the signs and symptoms of measles?

A
  • Fever
  • Red, inflamed eyes
  • Runny nose
  • Hacking cough and sore throat
  • Kopliks spots inside the mouth
  • Red, blotchy rash first appears on forehead

NOTE: the rash is often the LAST SIGN of measles

Pre-Reg November Exam '24 (10 decks)

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