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FINALS > Derm > Flashcards

Derm Flashcards

1
Q

4 causes of burns

A
  • thermal
  • electrical
  • Contact
  • chemical
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2
Q

pathology and complications of burns

A
  • haemolysis
  • leakage of plasma into interstitial space
  • extravasation and hypovolaemic shock
  • protein loss
  • secondary infection
  • ARDS
  • compartment syndrome
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3
Q

general burns mx

A
  • IV morphine
  • IX = ECG, CXR, fluid balance chart
  • wound dressings
  • limit hypothermia
  • aggressive fluids and UO monitoring
  • nutrition
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4
Q

Fluid resus calculation in burns

A
  • Adults = initial 24hrs 4ml x weight x % TBSA
  • children = 3ml x weight x % TBSA
  • 50% of the fluid calculated given in first 8 hours, remaining in 16hrs
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5
Q

TBSA means

A
  • total body surface area burned
  • extent and depth
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6
Q

most accurate method to measure burns

A

lund and browder chart

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7
Q

Superficial burn

A
  • epidermis deepest later involved
  • dry, blanching, erythema
  • painful
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8
Q

superficial partial thickness burn

A
  • Upper epidermis
  • blisters, wet, blanching, erythema
  • painful
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9
Q

deep partial thickness burn

A
  • lower dermis
  • yellow or white, dry, non blanching
  • decreased sensation
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10
Q

full thickness burn

A
  • subcutaneous tissue
  • leather, white, non blanching, dry
  • painless
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11
Q

assessing rashes - distribution

A
  • Acral = hands and feet
  • Extensor = elbows, extensor surfaces
  • Flexural = axilla
  • Follicular = face, sebaceous glands
  • Dermatomal
  • Seborrhoeic = scalp
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12
Q

assessing rashes = configuration

A
  • Discrete = separated lesions
  • Confluent = merged
  • Linear
  • Discoid = same colour
  • Target
  • Annular = colour change
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13
Q

Assessing rashes - colour

A
  • erythematous = red, blanches
  • purpuric/ petechia = caused bysmall bleeds
  • hyperpigmented = darker skin
  • hypopigmented = lighter skin
  • depigmented = white
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14
Q

assessing rashes - morphology

A
  • macule = flat altered colour
  • papule = solid raised lesion
  • vesicle = clear fluid
  • pustule = pus filled
  • wheal - oedematous papule or plaque
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15
Q

A-E dermatology

A
  • Asymmetry
  • Border
  • Colour
  • Diameter
  • Evolving
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16
Q

S+S acne

A
  • Open (blackheads) and closed (whiteheads) comedones
  • pustules
  • nodules
  • face, chest, back
  • Mild = <30, mod = 30-125, severe >125
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17
Q

Mx acne

A
  • hygeine etc
  • topical benzoyl peroxide 1st line
  • topical abx if infected = clindamycin
  • oral abx
  • isotrenitoin
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18
Q

cellulitis common organisms

A
  • staph aureus
  • strep pyogenes
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19
Q

Mx cellulitis

A
  • flucloxacillin or erythromycin
  • analgesia
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20
Q

exogenous eczema

A
  • external factor or skin insult causes
  • allergic contact dermatitis
  • photosensitive
  • post traumatic
  • drugs
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21
Q

endogenous eczema

A
  • atopic
  • seborrheic
  • discoid
  • lichen simplex
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22
Q

brief patho of eczema

A
  • breakdwon of skins natural barrier
  • subsequent IgE mediated response
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23
Q

S+S eczema

A
  • flexor surfaces
  • pruritus
  • dry skin
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24
Q

mx atopic eczema

A
  • emollients
  • topical corticosteroids
  • topical calcineurin inhibitors (tacrolimus)
  • bandages
  • oral steroids
  • antiseptics
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25
Q

SE topical steroids

A
  • burning/stinging
  • thinning
  • striae
  • acne
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26
Q

HSP background

A
  • small vessel vasculitis
  • caused by deposition of IgA complexes in small arteries –> complement activation
  • hx recent UTRI
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27
Q

S+S HSP

A
  • purpuric lesions on skin
  • extensors
  • symmetrical
  • colicky abdo pain
  • joint swelling
  • glomerulonephritis
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28
Q

Ix HSP

A
  • urinalysis = proteinuria, haematuria
  • Normal platelets
  • ESR raised
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29
Q

Mx HSP

A
  • analgesia
  • steroids = pred 1mg/kg
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30
Q

Impetigo most commonly caused by

A
  • staph aureus
  • highly infectious
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31
Q

S+S impetigo

A
  • recent damage to skin
  • pustules that pop and crust = yellow
  • itchy
  • clinical dx
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32
Q

Mx impetigo

A
  • 5 days hydrogen peroxide 1%
  • topical abx = mupirocin
  • keep off school until lesions dried
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33
Q

Where is lichen planus most commonly found

A
  • flexor surfaces and mucous membranes
  • t cell mediated autoimmune disorder
34
Q

S+S lichen planus

A
  • genitals and inside vagina
  • palms, soles and flexor arms
  • acute px
  • purpuric papular lesions
  • white lace like in mouth
35
Q

Mx lichen planus

A
  • topical steroids like clobetasone butyrate
36
Q

histology lichen planus

A
  • saw tooth patterns of epidermal hyperplasia
  • t cell infiltration of dermis
  • reduced malanocytes
37
Q

lichen sclerosis

A
  • small well demarcated white plaques
  • external genitals, not inside
  • itchy
38
Q

psoriasis appearance

A
  • well demarcated white/red erythematous plaques
  • silver scale
  • extensor surfaces
  • nails = pitting, ridging, oncholysis
39
Q

psoriasis mx

A
  • emollients and moisturisers
    1. potent corticostteroid OD and Vit D analogue 4w
    2. Vit D analogue BD
    3. Corticosteroids BD and coal tar
  • Short acting dithranol
  • retinoids
  • phototherapy
  • systemic = methotrexate, ciclosporin, biologica
40
Q

psoriasis background

A
  • T cell mediated abnormal immune response
  • T cells release cytokines = keratinocyte proliferation
41
Q

mx rosacea

A
  • sun protection
  • avoid oil based products
  • topical metronidazole cream/ ivermectin
  • oral abx = doxy
  • no steroids
42
Q

mx scabies

A
  • permethrin 5% before bed, wash off in morning, 7 days
43
Q

RF malignant melanoma

A
  • age
  • UV
  • skin type
    -FHx
44
Q

background MM

A
  • proliferation of atypical melanocytes with potential for dermal invasion and metastasis
45
Q

S+S melanoma

A
  • asymmetrical, irregular, large, evolving lesion
46
Q

Mx melanoma

A
  • excision with extended margins
  • chemotherapy if spread
47
Q

squamous cell carcinoma clinical features

A
  • Speedy SCC - grow weeks -months
  • enlarging scaly or crusty lumps
  • may ulcerate
  • tender and painful
  • sun exposed sites
48
Q

precursor to scc is

A

actinic keratosis

49
Q

mx SCC

A
  • surgical excision with extended margins, Mohs
  • 5-fluorouracil 4 weeks
  • imiquimoid 6 weeks
50
Q

features BCC

A
  • slowly growing plaque/nodule
  • skin pigmented
  • shiny/pearly
  • rolled edges
  • telangiectasia
  • central ulceration
  • spontaneous bleeding
  • asymmetry
51
Q

biopsy of BCC shows

A
  • apoptotic cells
  • peripheral palisading of nuclei
  • clefts of tumour tissue
  • basophilic aggregations of basaloid keratinocytes with large nuclei and scant cytoplasm
52
Q

Mx bcc

A
  • surgery
  • mohs if ill defined
  • radiotherapy
53
Q

tinea is caused by

A

dermatophyte fungus

54
Q

4 types of tinea?

A
  • capitis = scalp
  • pedis = feet = athletes foot
  • cruris = groin
  • corporis = any other skin site
55
Q

S+S tinea

A
  • itchy and inflamed
  • acute onset
  • ring like lesion with scaly edge
56
Q

mx tinea

A
  • topical terbinafine 1%
  • econazole
57
Q

eczema herpeticum is

A

complication of atopic with HSV infection

58
Q

S+S herpeticum

A
  • Malaise, fever
  • itchy, painful lesions
  • crusted papules
  • gritty eyes
  • LN
59
Q

Mx herpeticum

A
  • urgent derm referral
  • aciclovir
60
Q

erythroderma caused by

A

rapid epidermal cell turnover

61
Q

S+S erythroderma

A
  • red hot itchy skin
  • hot
  • desquamation - malaise
62
Q

Meds that cause SJS/TEN

A
  • allopurinol
  • anti epileptics
  • sulfonamides
  • salicylates
  • imidazole
63
Q

S+S SJS/TEN

A
  • flu like prodrome
  • painful rash starts on trunk
  • macular rash blisters and desquamates
64
Q

differentiate SJS and TEN

A
  • SJS = <10% body coverage
  • TEN = >30%
65
Q

venous ulcers morphology

A
  • irregular borders
  • yellow fibrinous base
66
Q

venous ulcers surrounding skin

A
  • yellow brown to brown
  • pinpoint petechiae
  • lipodermatosclerosis
67
Q

venous uclers often found

A

medial malleolar region

68
Q

arterial ulcers usually found

A

pressure sites, distal points

69
Q

morphology arterial ulcers

A
  • dry necrotic base
  • wel demarcated = punched out
70
Q

surrounding skin arterial

A
  • shiny atrophic skin
71
Q

other findings in arterial ulcers

A
  • weak peripheral pulses
  • prolonged cap refill time
72
Q

Molluscum contagiosum

A
  • Pink or pearly whyte papules
  • Central umbilication (dimpling) 5mm in diameter
  • Anywhere apart from hands and feet soles
  • Self limiting
73
Q

Seborrhoeic dermatitis adults

A
  • Eczematous lesions on sebum rich areas
  • Otitis externa and blepharitis may develop
  • Scalp = ketoconazole shampoo
  • topical = ketoconazole
74
Q

Urticaria

A
  • Pale pink raised skin
    1. Non sedating AH = cetirizine (up to 6w)
    2. Pred
75
Q

drugs that induce TEN

A
  • Phenytoin
  • Penicillins
  • Carbamazepine
  • Allopurinol
  • NSAIDs
  • Sulfonamides
76
Q

what might exacerbate psoriasis

A
  • trauma
  • alcohol
  • BB
  • Lithium
  • NSAIDs
  • ACEi
  • Antimalarials
  • Withdrawal systemic steroids
77
Q

dermatitis herpetiformis

A
  • coeliac disease
  • itchy vesicular
  • extensor surfaces
78
Q

actinic keratoses mx

A
  • sun protection
  • fluorouracil cream
  • topical diclofenac
  • cryotherapy
  • currettage
79
Q

Mx venous ulcers

A
  • Compression bandaging
  • Oral pentoxifylline
80
Q

Mild acne mx

A
  • 12 w course topical combo therapy = trenitoin + clindamycin or BP + clindamycin
81
Q

Mx mod-severe acne

A
  • ## 12 w of topical combo or topical + abx oral
82
Q

SCC features

A
  • sun exposed sites
  • rapidly expanding, painless, ulcerated nodules
  • cauliflower appearance
  • may bleed

FINALS (31 decks)

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