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FINALS: PASSMED/QUESMED > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the management of extensive fungal nail infection by dermatophytes?

A
  • Oral terbinafine
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2
Q

How should a child with new-onset purpura be managed?

A

Immediate referral to secondary care to exclude ALL

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3
Q

Where are keloid scars most common?

A

Sternum

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4
Q

What is the management of athletes foot?

A
  • Topical miconazole
  • terbinafine
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5
Q

What medications exacerbate plaque psoriasis?

A

Beta blockers, lithium, antimalarias, NSAIDS and ACE

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6
Q

What should be used for long-term psoriasis?

A

Calcipotriol

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7
Q

What is pemphigoid gestationis?

A

Pruritic blistering lesions which in the peri-umbilical region and can then spread to trunk, back buttocks and arms in the 2nd/3rd trimester

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8
Q

When does pemphigoid gestationis present?

A

In the second/third pregnancy

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9
Q

How is pemphigoid gestationis managed?

A

Oral corticosteroids

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10
Q

What can make perioral dermatitis worse?

A

Topical steroids

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11
Q

What is the first line management of venous ulcers?

A

Compression bandaging

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12
Q

What is a rare side effects of penicllins?

A

Toxic epidermal necrolysis

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13
Q

What is the most common malignancy associated with acanthosis nigricans?

A

gastrointestinal adenocarcinoma

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14
Q

What are some causes of acanthosis nigricans?

A
  • T2DM
  • PCOS
  • Obesity
  • Cushing’s disease
  • Acromegaly
  • COCP
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15
Q

purple, polygonal, pruritic papules suggest what?

A

Lichen planus

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16
Q

What is a port wine stain?

A

A vascular birthmark: deep red or purple colour usually over the cheek

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17
Q

What is a strawberry naevus?

A

A soft raised vascular swelling which is bright red in colour

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18
Q

What is a salmon patch?

A

A flat dull-red area usually on the face and neck, usually in the midline which causes no symptoms

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19
Q

What derm feature is associated with Sturge Webber syndrome?

A

Port wine stain

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20
Q

What is pityriasis versicolor?

A

A superficial fungal (Malassezia) infection which affects the trunk causing pink/brown patches, sometimes after a suntan

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21
Q

What is the management of pityriasis versicolor?

A

Topical antifungal: ketoconazole

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22
Q

Salmon patch vs port wine stain?

A

Salmon patch will usually self resolve

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23
Q

What is toxic epidermal necrolysis?

A

A emergency scaled skin appearance usually secondary to a drug reaction

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24
Q

How does toxic epidermal necrolysis present?

A
  • Systemically unwell patient
  • Positive Nikolsky sign: epidermis separates with mild lateral pressure
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25
Q

What drugs are known to induce toxic epidermal necrolysis?

A
  • Phenytoin
  • Allopurinol
  • Penicillins
  • NSAIDs
  • Carbamazepine
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26
Q

How is toxic epidermal necrolysis managed?

A
  • Stop trigger
  • Supportive care: fluid loss and electrolyte derangements are complications
  • IV immunoglobulins are first line
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27
Q

What is pityriasis rosea?

A

An acute self limiting rash which affects younger people

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28
Q

How does pityriasis rosea present?

A
  • Herald patch on trunk
  • Followed by smaller red macules
  • Lethargy
  • Christmas tree distribution as on upper parts of arms and legs
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29
Q

Bowens vs SCC?

A

SCC will ulcerate, grow over weeks-months and may bleed

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30
Q

What is the management of Bowens?

A

Topical 5-fluorouracil

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31
Q

A rapidly progressing painful rash in children with atopic eczema suggests what?

A

Eczema herpeticum

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32
Q

How is eczema herpeticum managed?

A

Admission for IV aciclovir with urgent derm and opthal review

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33
Q

What are causes of erythema nodosum?

A

NO cause
Drugs
OCP
Sarcoidosis
UC and Crohns
Microorganisms such as TB, Strep and Chlamydia

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34
Q

What is erythema ab igne?

A

A skin disorder associated with over exposure to infrared radiation: hot water bottles or open fires

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35
Q

How should patients with moderate/severe papules in rosacea be managed?

A

Topical ivermectin and oral doxycycline

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36
Q

What is the management of refractory pain in shingles?

A

Prednisolone

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37
Q

What can iron deficiency anaemia cause?

A

Pruritus

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38
Q

What is the management of athletes foot?

A
  • Topical imidazole
  • Terbinafine
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39
Q

What is a complication of burns?

A

Curlings ulcers - acute gastric ulcers which develop in response to physiological stress: usually present with vomiting blood

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40
Q

What pathogen causes eczema herpeticum?

A

Herpes simplex 1/2

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41
Q

When to use skin patch vs skin prick test?

A

Skin patch - used for contact dermatitis
Skin prick - used for immediate hypersensitivity reactions e.g. food and resp allergies

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42
Q

Skin infection occurring 2-4 weeks after a strep infection?

A

Guttate psoriasis

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43
Q

‘tear drop papule on the trunk and limb’

A

Guttate psoriasis

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44
Q

What is livedo reticularis?

A
  • A non-blanching, reticulated rash caused by obstruction of the capillaries
  • Can be idiopathic or part of SLE, Ehlers-Danlos
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45
Q

non-healing painless ulcer associated with a chronic scar

A

Squamous cell carcinoma

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46
Q

How long will people with shingles be infectious?

A

Until the vesicles have crusted over - 5-7 days after onset

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47
Q

Steroid treatment in psoriasis?

A

Aim for 4 week break in between courses

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48
Q

What is the main reason for using antivirals for shingles?

A

Reduce post herpetic neuralgia

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49
Q

What phenomenon does psoriasis exhibit?

A

Koebner phenomenon - new skin lesions form at the site of cutaneous injury

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50
Q

What is the most important prognostic factor with malignant melanoma?

A

Depth of the lesion

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51
Q

intensely pruritic rash on the palms and soles

A

pomphlyx eczema

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52
Q

What term condition can isoniazid cause?

A

Pellagra - dermatitis, diarrhoea and dementia

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53
Q

How is rosacea managed?

A

Predominant flushing: topical brimonidine
Mild-moderate papules: topical ivermectin
Moderate-severe papules: tropical ivermictin + oral doxycycline

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54
Q

single well-demarcated, erythematous circular patch with a raised edge and central hypopigmentation

A

tinea corpis

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55
Q

Management of severe urticaria?

A

Short course of oral steroids plus anti-histamine

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56
Q

What should be screened for before starting isotretinoin?

A

Mental health conditions/Pregnany

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57
Q

What is a wheal?

A

Transient, raised lesions due to underlying dermal oedema -> urticaria

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58
Q

What does histology of eczema show?

A

IgE mediated response
- Epidermal acanthosis
- Hyperkeratosis
- Parakeratosis

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59
Q

red scaling plaques in sun exposed areas of skin

A

Discoid lupus

60
Q

Actinic keratosis vs sebhorreic keratosis?

A

AK - lesions lighter in colour + more in line with the skin, SK - lesions will be much darker + stuck on appearance

61
Q

What can be used for patients with severe childhood eczema?

A

Wet wrapping

62
Q

Flu-illness, dry cough, target shaped lesions + anaemia

A

Erythema multiforme caused by Mycoplasma pneumonia

63
Q

Which organisms cause necrotising fasciitis?

A

Type 1 - mixed
Type 2 - strep pyogenes

64
Q

What are risk factors for malignant melanoma?

A
  • Fair complexion
  • FH
  • Sunburn
  • Sun exposure
65
Q

What are sites where malignant melanoma can occur?

A
  • Choroid of the eye
  • CNS
  • GI tract
  • Neck
66
Q

What are features of BCC?

A
  • Small, pearly white lesion
  • Rolled edge
  • Central ulcer
  • Can be pigmented
67
Q

What surgical technique can be used for BCC?

A

Mohs micrographic surgery

68
Q

What is the pathophysiology of acne?

A

Increased sebum production leads to the pilosebaceous follicles becoming blocked and infected

69
Q

Which bacteria is involved with acne?

A

Propionbacterium acnes

70
Q

What are S/E of isotretinoin?

A

Dry skin, dry eyes, depression, migraine, muscle aches

71
Q

What is the name for SCC carcinoma in situ?

A

Bowens

72
Q

What anatomical sites on head and neck give worst prognosis for SCC?

A

Ear and lip

73
Q

What is the management of lichen sclerosus?

A

Topical steroids and emollients

74
Q

What does lichen sclerosus increase the risk of

A

Vulval cancer

75
Q

Most common organism for cellulitis?

A

Strep pyogenes then staph aureus

76
Q

Incredibly itchy blisters + papules in someone with coeliac?

A

Dermatitis herpetiformis

77
Q

What classification system is used for patients with cellulitis?

A

Eron

78
Q

What is the Abx of choice for severe cellulitis?

A

Co-Amox / Clindamycin

79
Q

Target lesions on back of hands/feet spreading to limbs?

A

Erythema multiforme

80
Q

What is erythema nodosum?

A

Painful inflammation of the sub cut fat more common in females

81
Q

Lichen planus vs lichen sclerosus

A

Planus - can affect inside the vagina, Sclerosus will only affect the external genitals
Planus - purpuric papular lesions, Sclerosus - small, white plaques

82
Q

‘saw tooth pattern of epidermal hyperplasia, T-cell infiltration and reduced melanocytes’

A

Lichen planus

83
Q

Round, pearly papules in crops in children?

A

Think Molluscum - no treatment needed

84
Q

Erythema multiforme vs pityriasis vericolor?

A

Pityriasis - white/brown patches with dry scaly skin usually on trunk
Erythema - red, round lesions

85
Q

Papular rash around abdomen/wrist/inner thigh which itches worse at night?

A

Scabies - treat with Permethrin for all household members

86
Q

Flaky rash on face/scalp/trunk which is not itchy?

A

Seborrheic Dermatitis

87
Q

Which fungus causes seborrheic dermatitis?

A

Malassezia furfur

88
Q

What conditions are associated with seborrheic dermatitis?

A

Parkinsons / HIV

89
Q

What are common complications of seborrheic dermatitis?

A

Otitis externa / Blepharitis

90
Q

Most common and most aggressive form of melanoma?

A

Common - superficial spreading
Aggressive - Nodular

91
Q

What is the management of actinic keratoses?

A
  • Avoid sun
  • Fluorouracil cream
92
Q

What is erythroderma?

A

Complex process leading to rapid epidermal cell turnover -> large desquamated area which is red and painful

93
Q

What is the management of erythroderma?

A

Urgent derm referral with admission to burns unit for emollients, fluids and wet balances

94
Q

What can often cause erythroderma?

A

Drugs like sulphonylureas, isoniazid and sulphonamides

95
Q

Which antibiotic causes red man syndrome?

A

Vancomycin

96
Q

Signs of psoriasis on nails?

A
  • Nail pitting
  • Oncholysis
  • Oil drop sign
97
Q

What sign in psoriasis where pinpoint bleeding occurs when scales are scraped?

A

Auspitz sign

98
Q

What are the ABCDE of lesions?

A

Asymmetry
Border
Colour change
Diameter > 6mm
Evolving lesion

99
Q

What are cardinal signs of inflammation?

A

Dolor
Calor
Rubor
Tumour
Loss of function

100
Q

What autoimmune diseases are associated with dermatitis herpetiformis?

A
  • Coeliac
  • Vitiligo
  • Addisons
  • T1DM
101
Q

What are skin manifestations of liver disease?

A
  • Flushing
  • Hyperpigmentation
  • Palmar erythema
  • Jaundice
  • Spider naevi
102
Q

What are nail manifestations of liver disease?

A
  • Clubbing
  • Koilonychia
  • Leukonychia
103
Q

What is seborrheic keratosis?

A

Benign warty epidermal growths which occur in older patients - can be removed by cryotherapy/curettage

104
Q

What is folliculitis?

A

Inflammatory condition of hair follicles caused by Staph aureus

105
Q

Crusty lesion which may bleed easily when bumped or scratched?

A

SCC

106
Q

What type of hypersensitivity reaction is scabies?

A

delayed type IV

107
Q

How long can pruritus persist for with scabies?

A

6 weeks

108
Q

Red or black lump, oozes or bleeds, sun-exposed skin

A

Nodular melanoma

109
Q

Acute onset of tear-drop scaly papules on trunk and limbs

A

Guttate psoriasis

110
Q

Afro-Carribean with nodule not on sun exposed area?

A

Think acral lentiginous melanoma

111
Q

How often should people with scabies be treated?

A

Twice with treatments one week apart

112
Q

PUVA therapy is associated with what?

A

SCC

113
Q

Hard swelling near the umbilicus?

A

Think Sister Mary Joseph nodule - gastric cancer

114
Q

Rash improving with sunlight?

A

Psoriasis

115
Q

Small lower limb ulcer which develops into deep ulcer following minor trauma?

A

Think pyoderma gangrenosum - treat with prednisolone

116
Q

What is pyoderma gangrenosum associated with?

A
  • Diabetes
  • IBD
  • GPA
  • Sarcoidosis
  • Thyroid disorders
117
Q

widespread raised papules with a central umbilication on his trunk, face, hands, legs and feet

A

Molluscum contagiosum

118
Q

What can persistent molluscum be a sign of?

A

Immunocompromise -> HIV testing needed

119
Q

Layers of the skin?

A
  • Epidermis
  • Dermis
  • Subcut tissue
120
Q

Topical corticosteroids can cause what?

A

Skin depigmentation in patients with darker skin

121
Q

Bullous pemphigoid vs pemphigus vulgaris?

A

BP - elderly patient with deep blisters and no mucosal involvement -> treat with topical steroids
PV - middle aged patient with superficial blisters, mucousal involvement -> treat with oral steroids/immunosuppression

122
Q

pruritic wheals?

A

Urticaria

123
Q

red, scaly rash on the face and scalp which is itchy

A

Sebhorreic dermatitis

124
Q

What is the most common infection which cause erythema multiforme?

A

Herpes simplex virus

125
Q

What is vitiligo?

A

Loss of melanocytes in the skin’s epidermis

126
Q

What causes erythroderma?

A
  • Dermatitis
  • Psoriasis
  • Drug allergies
  • Idiopathic
127
Q

What is the management of keratoacanthomas?

A

Surgical excision

128
Q

purpura, abdominal pain, and arthritis

A

Henoch-Schonlein Purpura - IgA mediated vasculitis triggered by infection

129
Q

coin-shaped lesions that are well-demarcated, with exudates and crusting

A

Discoid eczema

130
Q

Steroid makes a rash worse?

A

Think fungal causes

131
Q

Deep pustular ulcer on leg which is very painful?

A

Think pyoderma gangrenosum

132
Q

When to do wide local excision vs Mohs micrographic surgery?

A

Mohs used for lesions where tissue loss should be minimised e.g. face

133
Q

Bullous pemphigoid has antibodies against what?

A

Epithelial basement membrane

134
Q

Actinic keratosis is a precursor for what?

A

Squamous cell carcinoma

135
Q

Sebhorreic keratosis is associated with what?

A

Gastric/Colorectal adenocarcinoma

136
Q

Most common cause of erythroderma?

A

Skin condition such as psoriasis or eczema

137
Q

Staph scalded skin vs TEN

A

TEN will have mucosal involvement - usually oral

138
Q

What is the management of scalded skin?

A

IV Flucloxacillin

139
Q

Withdrawal of steroids can be a trigger for what?

A

Psoriasis

140
Q

Butterfly rash + ashleef macules + shagreen patch

A

Tuberous sclerosis

141
Q

Management of molluscum

A

Watch and wait

142
Q

Blistrs which cover most of the skin following an injury/graze?

A

Staph scalded skin

143
Q

Skin prick vs patch testing?

A

Prick - T1 Hypersensitivity reactions
Patch - T4 Hypersensitivity

144
Q

What is the most common type of BCC?

A

Nodular

145
Q

Round/firm lesion following minor trauma?

A

Dermatofibroma

146
Q

Hypopigmented skin on face/limbs/face with sensory loss in a traveller?

A

Leprosy -> treat with rifampicin, dapsone

FINALS: PASSMED/QUESMED (22 decks)

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