Derm Week

Question 1

ALL CARDS MOVED TO ANKI

What is the commonest type of malignant melanoma? Give the 3 other types

Answer 1

ALL CARDS MOVED TO ANKI

Superficial spreading MM
Nodular
Acral lentiginuous melanoma (black nail)
Lentingo maligna melanoma (lentil bean shaped, on face)

Question 2

What sun protection advice would you give for MM ptx

Answer 2

Sun cream SPF>30 (UVB protection)
High UVA star rating
Protective clothing (long sleeves, hat, sunglasses)
Avoid sun 11-3pm

Question 3

Differential diagnoses for black nails?

Answer 3

acral lentiginous melanoma (MM)
trauma and subungual haemorrhage
fungal nail infection

Question 4

A patient comes in concerned about one of their moles. What is the medical term for a mole? How can you assess the mole? If your findings are normal what advice would you give?

Answer 4

Benign melanocytic naevus
ABCDE for MM
Reassure, self-surveillance ABCDE for MM, sun protection advice

Question 5

What are the three main types of skin condition caused by dermatophyte infections?

Answer 5

Tinea capis (scalp ringworm) 
Tine corporis (ringworm)
Tinea pedia (athlete's foot)

Question 6

What is the mangement of ringworm?

Answer 6

Topical or if severe oral terbinafine

Question 7

Which skin infections do the following viruses cause
HPV
VZV
HSV
Pox virus

Answer 7

HPV= genital warts
VZV= chicken pox/shingles
HSV= cold sores/ genital ulcers
Pox virus= molluscum contagiousm

Question 8

What skin lesion am i? example of cause?

I am raised, fluid-filled, fluid is clear, smaller than 5mm

Answer 8

vesicle e.g HSV

Question 9

What skin lesion am i?

I am flat and display only colour change

Answer 9

macule e.g freckle

Question 10

Give 3 examples of skin changes you may observe in a patient with DM?

Answer 10

neuropathic ulcers,
acanthosis nigricans
lipohypertrophy

Question 11

How is lyme disease transmitted?

Answer 11

tick bites

Question 12

How is lyme disease treated?

Answer 12

penicillin >2wks

Question 13

What is the commonest cause of erythema multiforme

Answer 13

idiopathic

others incl. HSV infection, SLE, UC, CA, sarcoidosis, pregnancy

Question 14

You examine a skin lesion, it is raised, solid and >5mm. What is it? Potential cause?

Answer 14

Nodule e.g wart

Question 15

You examine a skin lesion, it is raised, fluid-filled, clear fluid, over 5mm. What is it? Potential cause?

Answer 15

Bulla e.g burn blister

Question 16

You examine a skin lesion, it is raised, a solid flat disc shape. What is it? Potential cause?

Answer 16

plaque

psoriasis

Question 17

You examine a skin lesion, it is raised, solid, under 5mm, What is it? Potential cause?

Answer 17

papule

mole

Question 18

You examine a skin lesion, it is eroded. What is it? Potential cause?

Answer 18

ulcer

pressure ulcer

Question 19

You examine a skin lesion, it is raised, pus-filled. What is it? Potential cause?

Answer 19

pustule e.g acne

Question 20

What is the difference in evolution of SCC vs BCC

Answer 20

SCC= fast growing e.g <2mo 
BCC= slow-growing e.g up to 1 year

Question 21

Give an example of a skin condition which acts in the following distributions? 
Flexures 
Extensors 
Dermatomal 
Interiginious

Answer 21

Flexures= eczema
Extensors= psoriasis
Dermatomal= shingles
Interiginous (skin folds)= fungal

Question 22

Give an example of a skin condition which has the following configuration?
Linear 
Annular 
Discoid 
Cluster

Answer 22

Linear= Psoriasis (kobner phenomenon- follow skin injury/scars)
Annular= ringworm (round)
Discoid= discoid eczema 
Cluster= infections e.g HSV

Question 23

Give 3 physiological functions of skin?

Answer 23

Barrier/Protection
Thermoregulation
Sensation

Question 24

What are the layers of the epidermis from in to out?

Answer 24

Stratum corneum
Stratum granulosum
Straum spinosum
Statum basale

Question 25

A contagious superficial bacterial infection caused by staph aureus describes which condition?

Answer 25

Impetigo

Question 26

A patient presents with well-defined honey-crusting lesions around their mouth. Diagnosis? Treatment?

Answer 26

Impetigo | Topical fusidic acid, PO fluclox if severe

Question 27

What is the management of chicken pox?

Answer 27

Self-limiting, Paracetamol / calmomine lotion Aciclovir if severe

Question 28

Re-activation of _____ causes dermatomal skin lesions. This is called____ and is treated with ____

Answer 28

VZV, shingles, aciclovir

Question 29

What is the pathophysiology of shingles?

Answer 29

Re-activation of varicella zoster virus in posterior root ganglion

Question 30

What are the SEs of topical corticosteroid use?

Answer 30

Skin thinning (atrophy and striae) Easy bruising Telangiectasia Exacerbating existing skin conditions e.g Acne Increased susceptibility to skin infection (immunosuppressant) Allergy

Question 31

Which common skin condition is made worse by topical corticosteroid?

Answer 31

Acne

Question 32

Give example of different strengths of corticosteroid creams?

Answer 32

``` Hydrocortisone = mild Eumovatae= moderate Betnovate= potent Dermovate= very potent ``` "Hi, you bet derm"

Question 33

What type of hypersensitivity reaction is allergic contact dermatitis?

Answer 33

Type IV

Question 34

What is a skin fissure?

Answer 34

linear cleavage of skin e.g anal fissure

Question 35

Give several differentials for diffuse non-scarring hair loss?

Answer 35

male-pattern balding hypothyroidism hypopituitarism iron-deficiency

Question 36

Alopecia acreta, fungal infection and secondary syphilis are all differentials for what kind of alopecia?

Answer 36

localised non-scarring

Question 37

Give several causes of scarring alopecia?

Answer 37

burns, severe infection, lichen planus, SLE

Question 38

What are the 2 categories of excessive hair growth?

Answer 38

Hirsutism (females): androgen-dependent | Hypertrichosis (males/females): non-androgen dependent

Question 39

What are the differentials for hirsutism?

Answer 39

*PCOS, androgen-secreting tumour, cushing's, acromegaly, adrenal hyperplasia

Question 40

What is hirsutism?

Answer 40

development of male-pattern hair growth on females e.g face, chest, abdomen

Question 41

Hypertrichosis is a category of non-androgen dependent hair growth. Give 3 systemic disorders which may cause this?

Answer 41

CA, anorexia, malnutrition