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Flashcards in Derm/Ophthalmology/ENT Deck (89)
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1

What are some specific symptoms you should ask about any skin lesion or rash?

Pain, itch, bleeding, discharge/crusting (also remember to ask about systemic symptoms)

2

What are some risk factors that it is important to ask about in a dermatological history?

Sun exposure, sunbed use, skin type, previous sunburn (particularly blistering)

3

If a patient presents with a generalised skin condition, what are some other areas that it is useful to examine?

Nails, scalp and mucus membranes

4

What two terms can be used to describe a flat area of skin of altered colour? What is the difference between these terms?

Macule and patch - a macule is < 1cm diameter and a patch is > 1cm diameter

5

What two terms can be used to describe a solid, raised, palpable lesion? What is the difference between these terms?

Papule and nodule - a papule is < 0.5cm diameter and a nodule is > 0.5cm diameter

6

What term is used to describe a lesion with raised edges and a flat surface > 1cm diameter?

Plaque

7

What two terms can be used to describe a raised, clear, fluid filled lesion? What is the difference between these terms?

Vesicle and bulla - a vesicle is < 0.5cm diameter and a bulla is > 0.5cm diameter

8

What term is used to describe a pus containing lesion of < 0.5cm diameter?

Pustule

9

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under general inspection?

Isolated/widespread/generalised? Where is the lesion? If there are multiple- comment on symmetry/asymmetry and discrete/confluent

10

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under morphology?

Size and shape of the lesion? Raised or not? Fluid filled or not? Then come up with appropriate terminology to describe the lesion.

11

When describing a rash or non-pigmented lesion, it is best to work through general inspection, morphology and any additional features. What things should you comment on under additional features?

Colour? Border? Additional things e.g. crusting, bleeding, weeping?

12

What things should you comment on before going on to use the ABCDE approach to describing a pigmented skin lesion?

Isolated/widespread/generalised? Where is the lesion?

13

Describe what is meant by the ABCDE approach to describing a pigmented skin lesion?

Asymmetry, border, colour, diameter, elevation

14

If you suspected a bacterial skin lesion, what type of investigation should you do?

Bacterial swab (blue) for microscopy, culture and sensitivity

15

If you suspected a viral skin lesion, what type of investigation should you do?

Viral swab (red) for PCR

16

What is the most likely investigation to do for a skin lesion where malignancy is suspected or a non-infective rash where diagnosis is required?

Biopsy for histopathology

17

What investigations are required for immediate IgE mediated allergic skin reactions?

RAST IgE levels and skin prick test

18

What investigation is used for delayed type allergic skin reactions?

Patch testing

19

Ideally, where should skin scrapings be taken from?

The periphery of the affected area

20

What type of scalpel should be used to take skin scrapings?

A rounded scalpel, e.g. number 15

21

If you suspect a fungal skin lesion, what type of investigation should you do?

Skin scrapings for mycology (microscopy and culture)

22

If you suspect an infestation related skin lesion, what type of investigation should you do?

Skin scrapings for microscopy

23

What specific symptoms should you ask about in an ophthalmic history?

Visual changes, red eye, eye pain/photophobia, discharge, headaches

24

What additional questions should you ask in the past medical history of someone with an eye problem?

Have they ever had any problems with their vision or eye? Do they use glasses/contact lenses?

25

Should patients wear glasses/contact lenses during assessment of visual acuity?

Yes

26

If visual acuity is not 6/6, what should you do next? What is the purpose of this?

Repeat the examination using pinholes- if this improves the visual acuity, this suggests that a refractive error is likely the cause

27

What should you do next if a patient is unable to read a Snellen chart, even with the pinholes?

1. Repeat at 3m, 2. Repeat at 1m, 3. Assess hand movements, 4. Assess light response

28

What two questions should you ask before performing a visual field exam to ensure that gross vision is normal?

Can you see my whole face? Can you see both my hands?

29

What are all of the different aspects of eye examination?

General inspection, visual acuity, visual fields, colour vision, pupillary reflexes, fundoscopy, eye movements

30

What are the three aspects of visual field examination that you can test?

Movements of fingers in quadrants, moving a pin in from quadrants, blind spot testing