derm high yield

Question 1

most common place for a keloid scar

Answer 1

sternum

Question 2

what two conditions can seborrhoeic dermatitis cause

Answer 2

blepharitis and otitis externa

Question 3

Mx seborrhoeic dermatitis

Answer 3

ketoconazole
topical steroids for short periods

Question 4

Mx shingles

Answer 4

antivirals within 72 hours (unless <50 and mild)
pain relief
- paracetamol and NSAIDs
- then amitriptyline
- oral corticosteroids may be considered in first 2 weeks if still no response

Question 5

ABPI below 0.9, what ucler?

Answer 5

arterial

Question 6

where are venous ulcers normally seen

Answer 6

above the medial malleolus

Question 7

Mx venous ulcers

Answer 7

compression bandaging

Question 8

Mx rosacea

Answer 8

erythema/flushing = topical brimonidine
mild/mod = topical ivermectin
mod/severe = topical ivermectin and oral doxycycline

Question 9

is impetigo itchy

Answer 9

no

Question 10

cluster of vesicles on small area of eczema

Answer 10

eczema herpeticum

Question 11

features in chickenpox that indicate bacterial infection

Answer 11

• high grade pyrexia (above 39)
  erythema and tenderness around the
  -original chicken pox lesions
• leaks pus (thick discoloured)

Question 12

molluscum contagiosum Mx

Answer 12

reassure
- resolves in 6 - 24 months

Question 13

small raised pearly lesions in a child

Answer 13

molluscum contagiosum

Question 14

mild to moderate acne treatment

Answer 14

12 week course of topical combination therapy:
- topical benzoyl peroxide with topical clindamycin
- tretinoin with clindamycin
- adapalene with benzoyl peroxide

Question 15

moderate to severe acne Mx

Answer 15

12 week course of:
- a fixed combination of topical adapalene with topical benzoyl peroxide + either oral lymecycline or oral doxycycline
- a topical azelaic acid + either oral lymecycline or oral doxycycline

Question 16

rules about antibiotics in acne

Answer 16

• tetracyclines avoided in pregnant or breastfeeding women and children <12yrs
• erythromycin in preggers
• always co-prescribed with topical retinoid or benzoyl peroxide
• never use topical and oral antibiotics together

Question 17

eczema herpeticum Mx

Answer 17

IV aciclovir

Question 18

most common cause of cellulitis

Answer 18

strep pyogenes

Question 19

Mx cellulitis

Answer 19

1) fluclox
2) penicillin allergic: calrithromycin, erythromycin (in preggers) or doxy
3) if severe: oral/IV co-amox, clindamycin or ceftriaxone

Question 20

Ix of orbital cellulitis

Answer 20

CT with contrast

Question 21

Mx tinea corporis (ringworm)

Answer 21

oral fluconazole

Question 22

tinea capitis Mx

scalp ringworm

Answer 22

oral antifungal
ketoconazole shampoo

Question 23

how does dermatitis herpetiformis present

Answer 23

itchy vesicular skin lesions on extensor surfaces

Question 24

Ix dermatitis herpetiformis

Answer 24

skin biopsy

Question 25

impetigo mx

Answer 25

hydrogen peroxide topical fusidic acid oral fluclox/erythromycin if severe

Question 26

chronic plaque psoriasis Mx

Answer 26

1) potent corticosteroid OD + vitamin D analogue (up to 4 weeks) 2) no improvement after 8 weeks then: vitamin D analogue twice daily 3) no improvement after 8-12 weeks either: corticosteroid BD up to 4 weeks OR coal tar preparation OD

Question 27

how long between corticosteroids in psoriasis

Answer 27

4 week break

Question 28

bowen's disease Mx

Answer 28

topical 5-fluorouracil

Question 29

AK Mx

Answer 29

flourouracil cream

Question 30

what is erythema multiforme caused by

Answer 30

herpes simplex virus usually

Question 31

erythema multiforme presentation

Answer 31

target lesions - initially on hands/feet then spread to torso

Question 32

erythema nodosum causes

Answer 32

NODOSUM NO cause Drugs (antibiotics) Oral contraceptives Sarcoidosis/streptococcus Ulcerative colitis/Crohns Maternity/mycoplasm

Question 33

pityriasis rosea presentation

Answer 33

herald patch on trunk few days later fir tree rash all over trunk (longitudinal ovals)

Question 34

lichen planus Mx

Answer 34

potent topical steroids