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Finals Revision > Derm > Flashcards

Derm Flashcards

1
Q

What is the management of acne?

A

1st line = topical retinoids/benzoyl peroxide
2nd line = Oral tetracycline/erythromycin + topical retinoid/benzoyl peroxide
3rd line = oral isotretinoin (must be prescribed by derm)

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2
Q

Describe eczema herpeticum?

A

An area of rapidly worsening painful eczema. Lesions may be fluid filled/blood stained with a central umbilication
Mx = admit for urgent IV aciclovir

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3
Q

Describe erythema multiforme?

A

A hypersensitivity reaction e.g. to penicillins or infection
Sx = target lesions on the hands/feet which spread to the torso. No or mild itch

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4
Q

Describe granulomatosis with polyangitis?

A

Haemoptysis, cough wheeze, epistaxis, crusty nasal secretions, sinusitis, saddle shaped nose, hearing loss and glomerulonephritis.

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5
Q

Describe goodpasture’s syndrome?

A

Haemoptysis, glomerulonephritis and rapidly deteriorating kidney function

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6
Q

Describe Henoch-Scholein Purpura?

A

In children post-infection
Purpuric rash over the buttocks and extensor surfaces of the legs, abdo pain and polyarthritis

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7
Q

Describe Polyarteritis Nodosa?

A

Vasculitic rash and malaise with weight loss and joint pain. Seen in those with a Hx of Hep B infection

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8
Q

Name 4 causes of erythema nodosum?

A

TB, Sarcoidosis, Infection and Pregnancy

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9
Q

What is the most common cancer seen in those who have had a renal transplant?

A

Squamous cell carcinoma

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10
Q

What is the management of chronic plaque psoriasis?

A

Potent topical corticosteroids (e.g. beclametasone) and vitamin D analogues (e.g calcipotriene)

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11
Q

What is normal ABPI? What does an abnormal result indicate?

A

Normal = 0.9-1.2
<0.9 = arterial disease

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12
Q

What is the most common causative organism in fungal toe infection?

A

Trichophyton Rubrum

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13
Q

Sx, Ix and Mx of fungal toe infection?

A

Sx = thickened, rough or opaque nails
Ix = nail clippings/scrapings
Mx = amorolfine 5% nail lacquer. If unsuccessful or extensive infection give oral terbinafine

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14
Q

Describe Guttate Psoriasis?

A

Tear drop scaly papules on the trunk and limbs. Occurs 2-4 weeks after a strep sore throat and lasts 2-3 months.

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15
Q

Describe Pityriasis Rosea?

A

Herald patch followed 1-2 weeks later by multiple erythematous raised oval lesions with a fine scale. Follows URTI and lasts 6-12 weeks

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16
Q

Describe Erythema ab Igne?

A

Reticulated erythematous patches with hyperpigmentation and telangiectasia secondary to heat (e.g. hot water bottle or fire).
If untreated may lead to squamous cell skin cancer

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17
Q

Describe the appearance of plaque psoriasis?

A

Erythematous papules covered with a silvery-white scale. If the skin is removed a red membrane with bleeding may be seen

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18
Q

Describe seborrheic dermatitis?

A

A fungal skin infection causing eczematous lesions of the scalp/eyebrows, and periorbital/auricular/nasolabial folds

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19
Q

Mx of seborrheic dermatitis?

A

Scalp = Head and shoulders and T-gel
Face/Body = Topical ketoconazole

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20
Q

How do you manage urticaria?

A

1st line = non-sedating anti-histamines
If severe give oral prednisolone

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21
Q

What is Tinea Capitis? How do you treat it?

A

A fungal infection causing scarring alopecia in children
Mx = oral terbinafine and topical ketoconazole

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22
Q

How do we manage ringworm?

A

Oral fluconazole

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23
Q

What is Pompholyx?

A

Eczema of the hands and feet. It is intensely itchy and burning with blisters on the palms/soles. The rash is exacerbated by humidity and high temperatures

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24
Q

What is the most important prognostic factor in melanoma?

A

The invasion depth of the tumour

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25
Q

When can we use oral steroids to treat pain in shingles?

A

If <2 weeks since symptom onset and there is severe pain which is not relieved by simple analgesia or neuropathic analgesia

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26
Q

How can burns cause oedema?

A

They can cause hypoalbuminaemia which leads to oedema

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27
Q

What is the gold standard for TB diagnosis?

A

Sputum culture

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28
Q

What condition can serum ACE help us diagnose?

A

Sarcoidosis

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29
Q

Name the drug causes of erythema nodosum?

A

Penicillins, COCP and Sulphonamides

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30
Q

What findings are seen in acne vulgaris?

A

Comedones (whitehead if top is closed, blackhead if top is open), papules and pustules

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31
Q

What should you do with healthworkers who are not immune to VZV?

A

Vaccinate them

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32
Q

What are the complications of toxic epidermal necrolysis?

A

Fluid loss and electrolyte derrangement

33
Q

True or false, iron deficiency anaemia can cause pruritis?

A

True

34
Q

True or false palmar erythema may be seen in liver disease?

A

True

35
Q

Sx of Polycythaemia?

A

Pruritits after a hot bath, ruddy complexion, splenomegaly, HTN, hyperviscostity, bleeding, gout and peptic ulcer disease

36
Q

Describe dermatofibromas?

A

Benign skin lesions which occur secondary to injury, no Mx is needed

37
Q

Nail changes in psoriasis?

A

Pitting, onycholysis, subungual hyperkeratosis and loss of nail

38
Q

How much of a break should we aim for between courses of topical steroids in psoirasis?

A

At least 4 weeks

39
Q

Mx of Scabies?

A

Permethrin 5% applied to the whole body, leave to dry for 8-12 hours then remove. Repeat 7 days late.
Do this in all close contacts.
Malathion 1% is second line

40
Q

What is it called when you have fine unpigmented hair? What can it be associated with?

A

Lanugo hair, associated with chronic malnutrition

41
Q

What should you do with all children presenting with new onset purpura?

A

Refer to hospital to exclude ALL and meningococcal disease

42
Q

Shingles Mx?

A

PO antivirals and advise that they are infectious until all lesions have crusted over (5-7 days)

43
Q

Describe atopic eruption of pregnancy?

A

Most common skin condition of pregnancy, Eczematous itchy red rash
No Mx neededd

44
Q

Describe polymorphic eruption of pregnancy?

A

Seen in the 3rd trimester it is an itchy lesion 1st appearing in the abdominal striae. Mx = emollients or steroids (topical or PO depending on the severity)

45
Q

Describe Pemphigoid Gestationis?

A

Seen in the 2nd/3rd trimester is a pruritic blistering lesion which starts peri-umbilical and then spreads to the trunk, back, buttocks and arms
Mx = PO steroids

46
Q

Describe 1st degree burns?

A

Superficial epidermal
Red, painful and dry with no blisters

47
Q

Describe 2nd degree burns?

A

Partial thickness (superficial dermal) = pale pink, painful, blistered with a slow capillary refill
Partial thickness (deep dermal) = white, may have patches of non-blanching erythema, reduced sensation and pain only to deep pressure

48
Q

Describe 3rd degree burns?

A

Full thickness
White (waxy)/brown (leathery)/black. No blisters, no pain

49
Q

Describe salmon patches?

A

Small, flat patches of red/pink skin with poorly defined borders. Resolve by 18 months

50
Q

Mx of scalp psoriasis?

A

Potent topical corticosteroids. If no resolution of symptoms by 8 weeks give topical vitamin D analogues

51
Q

What is the Koebner phenomenom?

A

New skin lesions occur at the site of cutaneous injury
Seen in psoriasis and vitiligo

52
Q

Describe seborrheic keratoses?

A

Benign epidermal skin lesions seen in older people. Have a stuck on appearance and may vary in colour
No Mx required

53
Q

How do we manage facial hirsutism?

A

Eflomithine

54
Q

Where are arterial and venous ulcers typically found?

A

Venous ulcers = above the medial malleolus
Arterial ulcers = above the lateral malleolus

55
Q

When do we use a skin patch vs skin prick test to diagnose hypersensitivity reactions?

A

Skin patch to diagnose skin reactions e.g. nickel
Skin prick to diagnose systemic reaction e.g. nuts

56
Q

Where are venous ulcers typically found? How do you investigate and treat?

A

They are typically seen above the medial malleolus
Ix with ABPI to assess arterial flow
Mx = compression bandaging +/- oral pentoxifylline

57
Q

Mx impetigo?

A

1st line = hydrogen peroxide 1%
2nd line = topical fusidic aid, use mupirocin if resistance e.g. in MRSA
School exclusion until all lesions are crusted over and healed or 48 hrs after starting Abx treatment

58
Q

What happens to dermatofibromas when you pinch them?

A

They dimple

59
Q

Describe lichen scleorisis?

A

Itchy white patches on the vulva of elderly women.
In men it may cause a tight white ring around the tip of the foreskin leading to phimosis

60
Q

Sx and Mx of Rosacea?

A

Facial flushing, telangiectasia, erythema with papules and pustules along side thickening of the skin e.g. over the nose
Mx = high factor sun cream
If only erythema and flushing = TOP brimonidine gel
If mild/moderate papules/pustules = TOP ivermectin
If mode/severe papules/pustules = TOP ivermectin + PO doxycycline
If these fail you can offer laser therapy for telangiectasia

61
Q

What is a lipoma?

A

A smooth, mobile and painless lump found in the s/c tissue
If >5cm, growing, painful or in a deep anatomical location US to exclude lipoma

62
Q

What is an important complication of ketoconazole?

A

Gynaecomastia

63
Q

What is Molluscum Contagiosum?

A

A viral lesion seen in childhood associated with Koebner’s phenomenon (lesions seen at the site of injury)

64
Q

Mx of lichen sclerosis?

A

TOP strong steroids (e.g. clobetasol propionate) and emollients

65
Q

What is dermatitis herpetiformis?

A

Chronic itchy blister clusters seen in those with coeliac’s disease (they may also be malnurished)

66
Q

What is a pyogenic granuloma?

A

Over growth of blood vessels leading to red nodules at the site of trauma - these will often bleed

67
Q

Describe Keratoacanthomas?

A

Friable (will bleed/come away when touching) lesions seen in older people. They look like a volcano (have a smooth dome but the crater is filled with keratin). They will slough off on their own but lead to scarring.
2WW these patients to exclude squamous cell carcinomas

68
Q

Describe Buerger’s Disease?

A

Limb claudication, absent foot pulses and tortuos corkscrew collateral veins seen in smokers

69
Q

Describe Takayasu’s arteritis?

A

Upper limb claudication, absent upper limb pulses and raised ESR in young women

70
Q

What is an important complication of psoriatic arthritis?

A

Cardiovascular disease

71
Q

What is Nikolysky’s sign?

A

Gentle pressure on normal skin will cause the damaged area of skin and sloughing to extend. This is seen in toxic epidermal necrolysis

72
Q

What is the commonest form of pneumonia in alcoholics?

A

Klebsiella

73
Q

Describe Pyoderma Gangrenosum?

A

Very painful areas of rapidly enlarging skin ulceration following minor injury. The lesions will have undefined borders and are typically found on the lower leg
Mx = oral steroids

74
Q

Which conditions can Pyoderma Gangrenosum be associated with?

A

RA, SLE, UC, Crohn’s, PBC, lymphoma and AML/CML

75
Q

What is the most accurate way to assess burns?

A

Lund Browder chart

76
Q

Mx of plantar warts (verruca’s)?

A

Salicylic acid

77
Q

What are actinic keratoses?

A

Dry scaly patches of skin which have been damaged by the sun
Mx = cryosurgery or TOP fluorouracil

78
Q

Which neurological condition is associated with seborrheic dermatitis?

A

Parkinson’s

Finals Revision (23 decks)

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