Derm

Question 1

erythema multiforme looks like

Answer 1

target lesions with erythema

Question 2

erythema multiforme associated with

Answer 2

HSV
drug eruptions
mycoplasma pneumoniae

Question 3

herpangina

Answer 3

virus causing painful mouth blisters
common in kids
coxsackie & echovirus
resolves itself

Question 4

orf

Answer 4

parapoxvirus
caused by handling infected sheep
firm, fleshy nodule on hand commonly that can be red/blue
-> pustule -> crust over
cllears itself in 3-6weeks

Question 5

Primary syphilis infection

Answer 5

chancre (painless ulcer)
local non-tender lymphadenopathy

Question 6

secondary syphilis infection

Answer 6

systemic symptoms: fevers, lymphadenopathy
rash on trunk, palms and soles
buccal ‘snail track’ ulcers (30%)
condylomata lata (painless, warty lesions on the genitalia )

Question 7

tertiary syphilis infection

Answer 7

gummas (granulomatous lesions of the skin and bones)
ascending aortic aneurysms
general paralysis of the insane
tabes dorsalis
Argyll-Robertson pupil

Question 8

Investigations for syphilis

Answer 8

bloods
swab chancre for PCR

Question 9

treponoma pallidum

Answer 9

syphilis

Question 10

borrelia burgdorferi

Answer 10

lyme disease

Question 11

early + late signs lyme disease

Answer 11

early: erythema migrans
late: heart block, nerve palsies, arthritis

Question 12

necrotising fasciitis types

Answer 12

type 1 is caused by mixed anaerobes and aerobes (often occurs post-surgery in diabetics). This is the most common type
type 2 is caused by Streptococcus pyogenes

Question 13

tuberous sclerosis non-derm signs

Answer 13

epilepsy

Question 14

tuberous sclerosis tumours

Answer 14

periungal fibromas
facial angiofibromas
hamartomas aka angiomyolipomas
bone cysts

Question 15

tuberous sclerosis skin

Answer 15

ash-leaf macules
shagreen patches

Question 16

erythema infectiosum

Answer 16

slapped cheek, parvovirus b19

Question 17

investigation for parvovirus b19

Answer 17

antibody test for parvovirus b19 IgM

Question 18

NF1 tumours & skin

Answer 18

cafe-au-lait macuels
neurofibromas
azillary or inguinal freckling
optic glioma
lisch nodules

Question 19

NF1 non-derm sign

Answer 19

learning difficulty

Question 19

superficial melanoma site

Answer 19

trunk and limbs

Question 20

acral/mucosal lentiginous melanoma site

Answer 20

acral: soles of feet, hands and nailbeds

Question 21

lentigo maligna melanoma sites

Answer 21

sun damaged face/scalp/neck

Question 22

nodular melanoma sites

Answer 22

anywhere but often trunk

Question 23

most common sites for melanoma mets

Answer 23

lung
brain
liver

Question 24

melanoma types from most common to least

Answer 24

superficial spreading nodular lentigno maligna acral

Question 25

major criteria melanoma

Answer 25

change in size change in shape change in colour

Question 26

Secondary features (minor criteria) melanoma

Answer 26

Secondary features (minor criteria) Diameter >= 7mm Inflammation Oozing or bleeding Altered sensation

Question 27

margins for excision if breslow thickness 0-1mm thick

Answer 27

1cm

Question 28

margins for excision if breslow thickness 1-2mm thick

Answer 28

1-2cm

Question 29

margins for excision if breslow thickness 2-4mm thick

Answer 29

2-3cm

Question 30

margins for excision if breslow thickness >4mm thick

Answer 30

3cm

Question 31

5 year melanoma survival if breslow thickness < 0.75 mm

Answer 31

95-100%

Question 32

5 year melanoma survival if breslow thickness >4mm

Answer 32

50%

Question 33

BCC what skin layer

Answer 33

keratinocytes in basal layer of epidermis

Question 34

SCC what skin layer

Answer 34

keratinocytes in suprabasal layers

Question 35

keratoacanthama looks like and may be confused with

Answer 35

looks like fast growing papule with keratin plug may be confused with SCC

Question 36

Bowen's disease

Answer 36

RED SCALY patches often 10-15 mm in size slow-growing often occur on sun-exposed areas such as the head (e.g. temples) and neck, lower limbs

Question 37

Actinic keratosis

Answer 37

small, CRUSTY or scaly, lesions may be pink, red, brown or the same colour as the skin typically on sun-exposed areas e.g. temples of head multiple lesions may be present

Question 38

SCC excision margins

Answer 38

if <20mm - excision margin 4mm If >20mm - excision margin 6mm

Question 39

rodent ulcers

Answer 39

BCC

Question 40

Scabies treatment

Answer 40

permethrin 5% is first-line malathion 0.5% is second-line everyone in household do full body TWICE, 7 days apart

Question 41

pompholyx

Answer 41

hands and feet worse in sweaty and hot small blisters very itchy management: emollients and topical steroids

Question 42

Dermatitis in acral, peri-orificial and perianal distribution

Answer 42

→ ?zinc deficiency

Question 43

SCC poorer prognosis if

Answer 43

diameter >20mm and depth >4mm

Question 44

high-risk patients and in cosmetically important sites treatment for scc?

Answer 44

Mohs

Question 45

SCC in situ AKA

Answer 45

Bowen's disease

Question 46

SCC in situ AKA

Answer 46

Bowen's disease

Question 47

Positive non-treponemal test + positive treponemal test consistent with active syphilis infection

Answer 47

consistent with active syphilis infection

Question 48

Positive non-treponemal test + negative treponemal test

Answer 48

consistent with a false-positive syphilis result e.g. due to pregnancy or SLE

Question 49

Negative non-treponemal test + positive treponemal test

Answer 49

consistent with successfully treated syphilis

Question 50

RPR and VDRL are what type of syphilis tests

Answer 50

non-treponemal

Question 51

Syphilis management

Answer 51

IM Benzathine penicillin OR doxy if pen allergic then monitor non-treponemal levels: should decrease 4fold

Question 52

Fournier's gangrene

Answer 52

nec fasc of the perineum

Question 53

which DM drug is most associated with fourniers gangrene

Answer 53

SGLT2 i

Question 54

pain, swelling, erythema at the affected site often presents as rapidly worsening cellulitis with pain out of keeping with physical features extremely tender over infected tissue with hypoaesthesia to light touch skin necrosis and crepitus/gas gangrene are late signs

Answer 54

necrotising fasciitis