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1
Q

Mng Rosacea

A

General: Avoid trigers, minimise irriation, minimise sun exposure, avoid topical corticosteroids.

For rosacea with flushing, erythema, telangiectasia = brimonidine tartrate
For rosacea with inflammatory pustules and papules = ivermectin, metronidazole, azelaic acid +- doxycycline, erythromycin
For hyperplasia of skin, refer for consideration of surgery
Ocular rosacea= ocular lubricant, daily eyelid hygiene, firm eyelid massage

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2
Q

polymorphic eruption of pregnancy

A

. PEP most commonly occurs in the third trimester and is characterised by pruritic papules and plaques that initially arise within abdominal striae, sparing the periumbilical region. The rash can then spread to the buttocks and thighs and does not usually affect the face. The absence of blistering or mucosal involvement further supports PEP over other dermatoses.

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3
Q

Polymorphic eruption of pregnancy is not associated with

A

blistering

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4
Q

Skin disorders associated with pregnancy

A

Atopic eruption of pregnancy
Polymorphic eruption of pregnancy
Pemphigoid gestationis

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5
Q

eczema herpeticum

A

disseminated viral infection characterised by fever and clusters of itchy blisters or punched-out erosions. It is most often seen as a complication of atopic dermatitis/eczema. Most cases of eczema herpeticum are due to herpes simplex type 1 or 2. It is a dermatological emergency and requires prompt treatment with an anti-viral such as aciclovir or valacyclovir.

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6
Q

What organism is implicated in eczrma herpeticum

A

HSV 1 or 2

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7
Q

CLin f of eczema herpeticum

A

It is more commonly seen in children with atopic eczema and often presents as a rapidly progressing painful rash.

On examination, monomorphic punched-out erosions (circular, depressed, ulcerated lesions) usually 1-3 mm in diameter are typically seen.

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8
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd050.jpg

A

eczema herpeticum

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9
Q

differnetials for puritis

A

Liver disease- hx ETOH excess, stgmata of CLD, evidence of decompentation like ascites, jaundice, encephalopathy
IDA- pollor, koilonychia, atrophic glossitis, webs, stomatitis
Polycythemia- puritis after warm bath, ruddy complexion, gout, peptic ulcer disease
CKD- lethargy, pallor, edema, weight gain, HTN
Lymphoma - night sweats, lymphadenopathy, hepatosplenomegaly, fatigue
Hyper/hypothyroidism
diabetes
pregnancy
senile puritis
urticaria
skin disorders: eczema, scabies, psoriasis, pityriasis rosea

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10
Q

Cause of edema in contxt of burn

A

hypoabumineamia

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11
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd966.jpg

A

seborrhoeic keratosis

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12
Q

what is the most common malignancy secondary to immunosupression

A

squamous cell carcinoma of the ski

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13
Q

dermatitis herpetiformis

A

Dermatitis herpetiformis is an autoimmune blistering skin disorder associated with coeliac disease. It is caused by deposition of IgA in the dermis. More than 90% of patients exhibit small bowel biopsy findings consistent with some degree of gluten-sensitive enteropathy.
itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

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14
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd955b.jpg

A

dermatitis herpetiformis

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15
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/dsx053.jpg

A

dermatitis herpetiformis

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16
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd956b.jpg

A

dermatitis herpetiformis

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17
Q

Mng of dermatitis herpetiformis

A

Gluten free diet
Dapsone weaned used initally to control blistering lesions (before starting r/o G6PD def and order FBC- regular bloods are needed when on dapsone)

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18
Q

Which site is venous ulceration most characteristically seen at

A

Medial malleolus- This is due to the fact that this region is particularly susceptible to venous hypertension, a key pathophysiological factor in the development of venous ulcers. The high pressure in the veins causes fluid and blood cells to leak out into the surrounding tissue, leading to inflammation and eventually ulceration.

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19
Q

Which site is arterial ulceration most characteristically seen at

A

Lateral malleolus. Ulcerations in this area are more likely to be due to arterial insufficiency rather than venous. Arterial ulcers tend to occur on the outer parts of the leg and foot where there is less muscle and fat to cushion the arteries against pressure from outside.

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20
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd030.jpg

A

vitiligo

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21
Q

https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/dsx041.jpg

A

Bullous pemphigoid

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22
Q

Bullous pemphigoid

A

Bullous pemphigoid is an autoimmune condition causing sub-epidermal blistering of the skin. This is secondary to the development of antibodies against hemidesmosomal proteins BP180 and BP230.

Bullous pemphigoid is more common in elderly patients. Features include
itchy, tense blisters typically around flexures
the blisters usually heal without scarring
there is stereotypically no mucosal involvement (i.e. the mouth is spared)
in reality around 10-50% of patients have a degree of mucosal involvement. It would, however, be unusual for an exam question to mention mucosal involvement as it is seen as a classic differentiating feature between pemphigoid and pemphigus.

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23
Q

bullous pemphigoid mng

A

etg

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24
Q

types of Vasculitides

Study These Flashcards
A

Large vessel
temporal arteritis
Takayasu’s arteritis

Medium vessel
polyarteritis nodosa
Kawasaki disease

Small vessel
ANCA-associated vasculitides
granulomatosis with polyangiitis (Wegener’s granulomatosis)
eosinophilic granulomatosis with polyangiitis (Churg-Strauss syndrome)
microscopic polyangiitis
immune complex small-vessel vasculitis
Henoch-Schonlein purpura
Goodpasture’s syndrome (anti-glomerular basement membrane disease)
cryoglobulinaemic vasculitis
hypocomplementemic urticarial vasculitis (anti-C1q vasculitis)

Wegeners granulomatosis
Polyarteritis nodosa
Giant cell arteritis
Takayasu's arteritis
Buergers disease
25
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd953.jpg
dermatofibroma
26
initial presentaiton of pityriassi rosea
herald patch
27
Pityriasis rosea features
Features in the majority of patients there is no prodrome, but a minority may give a history of a recent viral infection herald patch (usually on trunk) followed by erythematous, oval, scaly patches which follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a 'fir-tree' appearance
28
perioral dermatitis can be made worse by
topical steroids
29
mng of Periorificial dermatitis
cease topical steroids treat as rosacea
30
mng of pityriasis rosea
self limiting - disappears after 6-12weeks
31
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/dsd011.jpg
acanthosis nigricans
32
Hereditary haemorrhagic telangiectasia
There are 4 main diagnostic criteria. If the patient has 2 then they are said to have a possible diagnosis of HHT. If they meet 3 or more of the criteria they are said to have a definite diagnosis of HHT: epistaxis : spontaneous, recurrent nosebleeds telangiectases: multiple at characteristic sites (lips, oral cavity, fingers, nose) visceral lesions: for example gastrointestinal telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM family history: a first-degree relative with HHT
33
Strawberry naevus
Strawberry naevi (capillary haemangioma) are usually not present at birth but may develop rapidly in the first month of life. They appear as erythematous, raised and multilobed tumours. Typically they increase in size until around 6-9 months before regressing over the next few years (around 95% resolve before 10 years of age). Common sites include the face, scalp and back. Rarely they may be present in the upper respiratory tract leading to potential airway obstruction If treatment is required (e.g. Visual field obstruction) then propranolol is increasingly replacing systemic steroids as the treatment of choice. Topical beta-blockers such as timolol are also sometimes used.
34
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd935b.jpg
severe acne
35
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd965.jpg
Seborrhoeic keratoses
36
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd027.jpg
oral leukoplakia
37
the bacteria that contributes to the development of acne
Propionibacterium acnes
38
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd959.jpg
Pyoderma gangrenosum
39
Guttate psoriasis
Guttate psoriasis is more common in children and adolescents. It may be precipitated by a streptococcal infection 2-4 weeks prior to the lesions appearing. Features tear drop papules on the trunk and limbs gutta is Latin for drop pink, scaly patches or plques of psoriasis tends to be acute onset over days
40
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd942.jpg
erythema multiforme
41
erythema multiforme
Erythema multiforme is a reaction pattern, not a primary disease. It is characterised by round to oval triphasic iris-like (target) lesions, usually on the face, and hands or feet. True erythema multiforme is rare, and common causes are herpes simplex virus reactivation, Mycoplasma pneumoniae and drugs (eg nonsteroid anti-inflammatory drugs [NSAIDs], penicillins, phenytoin, barbiturates, sodium valproate). Erythema multiforme is most commonly misdiagnosed as annular urticaria.
42
mng of erythema multiforme
Remove triggers Apply emollient with topical corticosteroid (betamethasone)
43
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd057.jpg
actinic keratoses
44
causes of acanthosis nigricans
obesity type 2 diabetes mellitus polycystic ovary syndrome Cushing's syndrome acromegaly hypothyroidism familial Prader-Willi syndrome gastrointestinal cancer drugs combined oral contraceptive pill nicotinic acid
45
Procedures in primary care dermatology
https://www.racgp.org.au/getattachment/380a44ec-4527-4309-92c6-a9c115c3a50f/attachment.aspx
46
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/dsx061.jpg
spider naevi
47
which medication is associated with the development of spider naevi
COCP
48
Pellagra
Pellagra is a caused by nicotinic acid (niacin) deficiency. The classical features are the 3 D's - dermatitis, diarrhoea and dementia. Pellagra may occur as a consequence of isoniazid therapy (isoniazid inhibits the conversion of tryptophan to niacin) and it is more common in alcoholics. Features dermatitis (brown scaly rash on sun-exposed sites - termed Casal's necklace if around neck) diarrhoea dementia, depression death if not treated
49
One of the main clinical features of polymorphic eruption in pregnancy
periumbilical sparing
50
Which skin condition does TB cause
erythema nodosum
51
examples of non sedating antihistamines
loratidine cetirizine
52
examples of sedating antihistamines
chlorphenamine
53
https://d32xxyeh8kfs8k.cloudfront.net/images_Passmedicine/ddd020.jpg
pemphigoid gestationis
54
which skin cancer does psoralen + ultraviolet A light therapy increase risk of
Squamous cell cancer
55
Seborrhoeic dermatitis mng
etg
56
description of lichen planus
violaceous, polygonal papules and plaques with overlying white scale
57
first line treatment for lichen planus
potent topical steroids
58
milia vs infantile acne
Milia - benign, 1-2mm white or yellow papules caused by retention of keratin within the epidermis. They commonly present on the nose, chin, and cheeks of neonates, affecting up to 50% of newborns. These lesions are completely harmless and typically resolve spontaneously within the first few weeks to months of life without requiring any treatment. Infantile acne typically presents later, usually between 3-6 months of age, and consists of inflammatory papules, pustules, and occasionally nodules. The lesions are red rather than white and are more widespread across the face.

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