clinical Flashcards
(123 cards)
1
Q
acne vulgaris symptoms and signs
A
Open and closed comedones inflammation papules pustules nodules cysts pseudocysts
2
Q
acne vulgaris treatment
A
Topical retinoids benzoyl peroxide topical antibiotics azelaic acid antibiotics tablets combined oral contraception Isotretinoin tablet
3
Q
acne fulminans symptoms and signs
A
Cystic acne nodular suppurative systemic fever arthralgia myalgia hepatosplenomegaly
4
Q
Rosacea symptoms and signs
A
Polymorphic facial centrally vascular changes episodic flushing erythema, burning pustules oedema, fibrosis, glandular hyperplasia recurrent blush telangiectasia deeper red colour, deep cystic nodules papules ocular dryness, tearing, pain, chalazia and corneal damage
5
Q
rosacea treatment
A
Avoid irritants metronidazole azelaic acid cream ivermectin cream tetracyclines surgery for rhinophymas
6
Q
erythroderma signs
A
> 90-95% skin inflamed
7
Q
erythroderma treatment
A
Fluid balance nutrition temperature regulation emollients oral and eye care treat infection manage itch remove offending drugs
8
Q
SJS symptoms and signs
A
Fever, malaise, arthralgia, rash, blisters, maculopapular, erosions, mouth ulceration, haemorrhagic crusting
9
Q
SJS treatment
A
Stop culprit drug and supportive therapy
10
Q
toxic epidermal necrolysis symptoms and signs
A
Prodromal febrile illness, ulceration of mucous membranes, rash blistering, then confluent with desquamation. + nikolsky sign
11
Q
toxic epidermal necrolysis and SJS complication
A
Pigmentation changes eye disease blindness nail and hair loss joint contractures
12
Q
erythema multiforme symptoms and signs
A
Distal to proximal stating in palms and soles
pink blistering macules
13
Q
erythema multiforme treatment
A
Self-limiting, treat symptoms and underlying cause.
14
Q
Drug reaction with eosinophilia and systemic symptoms - symptoms and signs
A
Eosinophilia
deranged liver function
fever
rash
15
Q
Drug reaction with eosinophilia and systemic symptoms - treatment
A
Stop drug
symptomatic support
systemic steroids
use of immunosuppression
16
Q
pemphigus symptoms and signs
A
Flaccid blisters face, axillae, groin \+ nikolsky sign mucousal erosion erosive stomatitis
17
Q
pemphigus treatment
A
Systemic steroids, dress erosions, supportive therapy
18
Q
pemphigoid symptoms and signs
A
Intact epidermis forms roof of blister
intact and tense
19
Q
pemphigoid treatment
A
Topical steroids, may require systemic if diffuse
20
Q
erythrodermic psoriasis and pustular psoriasis symptoms and signs
A
Rapid generalised erythema with clusters of pustules
fever, elevated WCC
red man syndrome
21
Q
erythrodermic psoriasis and pustular psoriasis treatment
A
Avoid steroids, initiate systemic therapy.
thick greasy emollients
bloods
fluid balance
22
Q
eczema herperticum symptoms and signs
A
Monomorphic blisters punched out erosions, painful. Fever and lethargy
23
Q
eczema herperticum treatment
A
Treatment dose of aciclovir
mild topical steroid
24
Q
staphylococcal scalded skin syndrome symptoms and signs
A
Prominent in flexures blistering desquamation fever irritability erythema rash with tenderness
25
staphylococcal scalded skin syndrome and treatment
IV antibiotics
| resolves 5-7 days with treatment
26
urticaria symptoms and signs
Erythema and swelling. Dermal oedema. Itching, burning
27
urticaria treatment acute
Oral anti-histamines
short course of oral steroids
avoid opiate + painkillers
28
urticaria treatment chronically
chronically; anti-histamine, anti-leukotrine, tranexamic acid for angioedema and finally cyclosporin, omalizumab
29
seborrheic keratoses symptoms and signs
Variable warty growths. Looks stuck on, patients often have multiple with cherry angiomas
30
seborrheic keratoses treatment
Cryotherapy
| curettage
31
leser trelat symptoms and signs
Abrupt onset of widespread seborrheic keratosis
32
leser trelat complications
GI adenocarcinoma
33
viral warts cause
HPV
34
viral warts symptoms and sign
Rough hyperkeratotic surface
pain
discomfort
clusters from mosaics
35
viral warts treatment
Self-limiting
cryotherapy
curette
salicylic acid
36
cysts symptoms and signs
Encapsulated lesion containing fluid or semi fluid material
| firm and fluctuant
37
cysts treatment
Excision
inflammation treat with antibiotics
intralesional steroids
incision and drain
38
dermatofibroma symptoms and signs
Fibrous nodule
firm, tethered to skin, mobile over fat. Pale, pink/brown. Dimple sign positive. Can be itchy or tender but often asymptomatic
39
lipoma signs and symptoms
Smooth rubbery subcutaneous mass
| asymptomatic
40
angioma signs and symptoms
Bleed
cherry
spider naevi
venous lakes
41
angioma treatment
excision and laser
42
pyogenic granuloma signs and symptoms
Rapidly growing red raw granuloma, bleeds easily. Found on head and hands
43
pyogenic granuloma treatment
curettage and cautery
44
actinic keratoses signs
rough scaly patches
45
actinic keratoses treatment
Cryotherapy
imiquimod
diclofenac gel
curettage
46
bowen's disease symptoms and signs
Dysplasia
| irregular scaly erythematous plaque
47
bowen's disease treatment
Cryotherapy, curettage,
photodynamic therapy
imiquimod
48
eczema atopic dermatitis signs
```
Itchy skin past 12 months +
Flexural involvement
<2yrs old
dry skin
atopic disease
family history
```
49
eczema atopic dermatitis symptoms
erythema, scale, papules, vesciles, exudate, crusting excoriation acute
chronic – plaques, lichenification, fissuring
50
chronic eczema dermatitis symptoms
chronic – plaques, lichenification, fissuring
51
eczema dermatitis diagnostic criteria
Modified Hanifin and Rajka criteria
52
eczema dermatitis causes/pathophysiology
Filaggrin gene
atopic family history
epidermal barrier dysfunction
environmental factors
inflammation, acanthosis, spongiosis
53
treatment for eczema atopic dermatitis
```
Emollients
soap substitutes
removal of causitive factors
intermittent topical steroids
antihistamines
antimicrobials
calcineurin inhibitors
Severe- UV + azathioprine
ciclosporin
mycophenolate-mofetil
methotrexate
```
54
allergic contact dermatitis test
patch testing
55
seborrheic dermatitis signs and symptoms
Pattern – rad sharp margined lesions, greasy scales
scalp
proximal features
dandruff
56
seborrheic dermatitis cause
malassezia yeast
57
treatment for seborrheic dermatitis
ketoconazole topical anti-yeast
58
additional investigation for seborrheic dermatitis
HIV testing
59
pompholyx/vesicular eczema signs and symptoms
```
Palms and soles
itchy
<40
crops of vesicles
desquamation
```
60
asteatosis eczema
Very dry skin, cracked scales, shins, excessive soap exposure
61
asteatosis eczema cause
loss of oil barrier
62
venous eczema treatment
compression stocking
63
acanthosis symptoms and treatments
```
Flexural
hyperkeratosis
hyperpigmentation
papules
velvety
weight loss
lip involvement
```
64
acanthosis complications
GI adenocarcinoma
65
psoriasis symptoms and signs
```
Sharply demarcated erythroderma
micaceous scale
acanthosis
pustules
onycholysis, pitting, oil spots on nails, scalp, Koebner phenomenon
Woronoff’s ring
```
66
psoriasis investigations and indexes
Skin biopsy if atypical
psoriasis area severity index
QOL index
67
psoriasis treatment
```
Emollients
soap substitutes
vitamin D3 analogues
topical steroids
salicylic acid
coal tar creams
UVB sun bed
retinoid
methotrexate
ciclosporin
biologics
```
68
carcinoid syndrome symptoms
Episodic flushing
facial telangiectasia
no sweating
69
carcinoid syndrome may reflect what underling conditions
Liver metastatic
| bronchial, ovarian cancer
70
erythema gyratum repens symptoms and signs
Concentric erythematous lesions
71
acquired hypertrichosis lanuginose symptoms and signs
Acute onset of lanugo hairs at face and body
72
acquired hypertrichosis lanuginose complications
colorectal, lung, breast
73
bazex syndrome symptoms and signs
Hyperkeratosis of extremities
| resembles psoriasis
74
bazex syndrome underlying cancers
SCC, bronchial, oropharyngeal, GI, gastric, colon, biliary, adenocarcinoma
75
Paget's disease symptoms and signs
Extension of ductal adenocarcinoma
| eczema plaque at nipple
76
Paget's disease underlying cancer
bladder, colon, adenocarcinoma
77
dermatomyositis symptoms and signs
```
Inflammatory myopathy + rash
periorbital heliotrope rash
gottron’s papules over bony prominences
shawl sign
photosensitive poikiloderma
scalp erythema
```
78
treatment for hypothermia
Insulate
slow rewarming with blanket
internal rewarming with hot drink
fast rewarming with water immersion and extracorporeal circulation
79
treatment for heat exhaustion
```
Cool environment
remove clothing
tepid water
fan
give fluids oral or IV
```
80
basal cell carcinoma symptoms and signs
Slow growing
locally invasive
telangiectasia
arborizing vessels
81
investigation for basal cell carcinoma
dermoscopy
82
basal cell carcinoma treatment
Excision
if not possible then curettage
if not RT or surgery then Vismodegib
83
SSC symptoms and signs
Fast growing
tender
scaly
ulceration
84
SSC treatment
excision and RT
85
melanoma symptoms and signs
```
Change in size
shape
colour
>5mm
oozing/bleeding
mild itch, altered sensation
```
86
melanoma investigations
dermoscopy
| lymph node biopsy
87
melanoma treatment
Surgical excision
chemo
immunotherapy
88
mycosis fungoides symptoms and signs
Patch; flat red dry oval lesion, itchy
plaques; thick, itchy
tumour; irregular ulcerating lumps
89
mycosis fungoides and sezary syndrome investigation
blood for sezary cells and CT
90
mycosis fungoides and sezary syndrome treatment
```
Topical steroids
P-UVA
localised RT
interferon
bexarotene
low dose methotrexate
chemo
skin electron beam therapy
extracorporeal photopheresis
bone marrow transplant
```
91
sezary syndrome symptoms and signs
```
Red man syndrome
itchy
thickened skin
scaly
red
lymph node involvement
```
92
impetigo signs and symptoms
Children
| Macule-vesicle – erosion with yellow crust
93
impetigo treatment
Topical wound care
| topical antibiotics
94
folliculitis treatment
Antibacterial wash
| antibacterial ointment
95
folliculitis investigation
bacterial culture
96
erysipelas signs and symptoms
Young, debilitated, old, cutaneous ulcers
erythema with well-defined margins
hot, tense, indurated, face + lower extremities, chills, fever, malaise, nausea
97
erysipelas investigation
leukocyte count shift left
98
erysipelas treatment
10-14 days penicillin
99
cellulitis signs and symptoms
```
Rubor
Calor
dolor
tumour
non-palpable borders
child; head and neck
adult; distal
```
100
cellulitis treatment
antibiotics
101
syphilis stages and symptoms
1- Painless ulcer
2 – widespread rash, flue, red papules, patches, palms and soles
3 – granulomatous lesion gumma
102
syphilis investigations
Non-specific non-treponemal antibody test
| specific anti-treponemal antibody test
103
syphilis treatment
penicillin
104
HSV symptoms an signs
Orolabial or genital infection
erythema
vesicles and ulceration
105
HSV treatment
anti-virals
106
chicken pox signs and symptoms
Red macules-vesicles, pustules – crusts, fever malaise, dew drops on a rose petal, facial then centrally
107
chicken pox treatment
calamine lotion
108
shingle symptoms and sign s
Localised blistering and painful rash
| dermatomal distribution
109
singles treatment
infection, prevention, pain relief
110
shingles complication
post herpertic neuralgia
111
molloscum contagiosum signs and symptoms
<10
warm climates
firm umbilicated pearly papules, waxy surface in skinfolds
112
molloscum contagiosum treatment
Liquid nitrogen
curettage
chemovesicants
113
molloscum contagiosum cause
pox virus
114
dermatophytosis symptoms and signs
Post pubertal
nail, groin, scalp, foot
waves with clear centres, dead skin and dry skin, loss of hair
115
candida symptoms and signs
Erythematous patches
satellite pustules
inguinal creases
116
pityriasis versicolour symptoms and signs
Excessive sweating, high temperature oily skin, multiple oval patches with mild scale, red, brown, white
117
pityriasis versicolour cause
malassezia
118
pityriasis versicolour treatment
topical antimycotic
119
scabies signs and symptoms
Close contact
overcrowding
passionate itch disturbing sleep
irregular tracks
120
scabies cause
Sarcoptes scabiei
121
head lice symptoms and signs
Itch irritation
| behind neck and ears, red brown spots
122
scabies treatment
anti-scabietic topical cream
123
head lice treatment
2 applications of insecticide, physical methods. Treat all family and school
