Derm Passmed

Question 1

What Drug Induced lupus?

Answer 1

Not all typical feature of SLE

Feature: Anti-histone antibodies + ANA +VE

Question 2

Which drugs induce lupus?

Answer 2

Most common causes; procainamide, hydralazine
Less common causes; isoniazid, minocycline
phenytoin

Question 3

Whta is shingles?

Answer 3

Painful dermatomal rash caused by HZV.

Question 4

Presentation of shingles?

Answer 4

Acute,
Unilateral,
Painful blistering rash caused by reactivation of the varicella-zoster virus (VZV)
Often dormant for decades in the dorsal root ganglion nerves.
Reactivate due to several causes e.g. immunosuppression.

Question 5

RF of shingles?

Answer 5

Increasing age >50 yo. 
Immunocompromised conditions 
Transplant patient = immunocompromised 
Autoimmune condition 
Female genre

Question 6

Herpes zoster ophthalmicus

Answer 6

involving the eye

Question 7

Herpes Zoster Oticus

Answer 7

infection of the ears (w/ facial paralysis)

Question 8

What does psoriasis histologically demonstrate?

Answer 8

neutrophil infiltration into the stratum corneum.

Question 9

Presentation of psoriasis?

Answer 9

Presents with red, scaly patches on the skin = have INCREASED risk of arthritis (psoriatic) + Cardio disease.

Worsened by lithium.

Question 10

Destruction of Desmoglein 1 ?

Answer 10

Pemphigus Vulgaris

Question 11

Destruction of Hemidesmosomes ?

Answer 11

Bullous Pemphigoid

Question 12

What is Erysipelas ?

Answer 12

is bacterial infection in the superficial upper layer of the skin.

caused by s. pyogenes but can be cause by s. aureus.

Question 13

1st degree burn ?

Answer 13

In the superficial epidermal = appear red + painful.

Question 14

2nd degree ?

superficial dermal

Answer 14

partial thickness = appear pale pink, painful, blistering

Question 15

2rd degree ?

deep dermal

Answer 15

partial thickness = appear white but patches of non-blanching erythema. Reduced sensation.

Question 16

3rd degree ?

Answer 16

Full thickness = appear white / brown/ black non blistering, no pain.

Question 17

Pathogenesis of burns ?

Answer 17

Local response with progressive tissue loss + release of inflammatory cytokines.

Reduced CO due to fluid loss + sequestration of fluid into the 3rd space (interstitial compartment)

Question 18

What is Acanthosis Nigricans ?

Answer 18

dry, dark patches of skin that usually appear in the armpits, neck or groin.

Question 19

Is AN due to an underlying condition?

Answer 19

Yes! 
Obesity 
T2D
Polycystic ovarian syndrome
Acromegaly
Cushing's disease
Hypothyroidism
Familial
Prader-Willi syndrome
Drugs: oral contraceptive pill, nicotinic acid
GI cancer

Question 20

Pathophysiology of AN ?

Answer 20

Insulin resistance → hyperinsulinemia → stimulation of keratinocytes + dermal fibroblast proliferation via interaction with insulin-like growth factor receptor-1 (IGFR1).

Question 21

What is Pityriasis Rosea ?

Answer 21

Temporary skin condition = erythematous, oval, scaly patches which follow a characteristic distribution

‘fir-tree’ appearance.

Question 22

Toxic Epidermal Necrolysis ?

Answer 22

Life-threatening skin disorder that is most commonly seen secondary to a drug reaction.

Systemically unwell e.g. pyrexia, tachycardic + - positive Nikolsky’s sign

Question 23

Steven-Johnson syndrome ?

Answer 23

Similar but involves less than 10% of body surfaces.

Question 24

Complications of S-JS + TEN:

Answer 24

Volume loss
Electrolyte derangement
Hypothermia
Secondary infection

Question 25

What are scabies ?

Answer 25

caused by mite Sarcoptes scabiei + is spread by prolonged skin contact. It typically affects children + young adults.

Question 26

Where does scabies lay its eggs?

Answer 26

Stratum Corneum | Can cause intense purities = assoc. w/ delayed T4 Hypersensitivity.

Question 27

Treatment of choice for scabies

Answer 27

Permethrin 5% cream | Malathion is an insecticide lotion which is used second-line for scabies

Question 28

Treatment for pyoderma ganggrenosum

Answer 28

Oral prednisolone

Question 29

Pathophysiology pyoerma gangrenosum

Answer 29

Classified as a neutrophilic dermatosis Neurophilic dermatoses are skin conditions characterised by dense infiltration of neutrophils in the affected tissue and this is often seen on biopsy

Question 30

What are the 6 Ps in lichen planus

Answer 30

polygonal, purple, pruritic, papules, plaques, planar (flat topped)

Question 31

Most common type of melanoma?

Answer 31

Superficial spreading melanoma

Question 32

Drugs known to induce Toxic Epidermal Necrolysis ?

Answer 32

``` phenytoin sulphonamides allopurinol penicillins carbamazepine NSAIDs ```

Question 33

What type of melanoma is common in darker skinned individuals?

Answer 33

Acral lentiginous melanoma

Question 34

Describe Tinea Corporis?

Answer 34

well-demarcated, erythematous circular patch with a raised edge and central hypo-pigmentation.