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Dermatology (P4) > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What does ABCDE refer to with pigmented lesions?

A

Indications of melanoma:

Asymmetry 
Border (irregular)
Colour 2+
Diameter: >6mm
Evolution: rapid change
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2
Q

What is pruritis?

A

Itching

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3
Q

What is a comedone?

A

A plug in a sebaceous follicle containing sebum and debris (open = blackheads / closed = whiteheads).

[present in acne]

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4
Q

What is Koebner phenomenon?

A

When a skin disorder is triggered by skin trauma e.g. psoriasis.

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5
Q

What is a macule?

A

A flat, small area of altered colour e.g. freckles.

If its large its called a patch e.g. port wine stain.

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6
Q

What is a papule?

A

A solid, raised lesion <0.5cm in diameter e.g. xanthomata.

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7
Q

What is a nodule?

A

A solid, raised, lesion >0.5cm in diameter.

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8
Q

What is a vesicle?

A

A raised, clear fluid filled lesion <0.5cm in diameter e.g. eczema or chicken pox.

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9
Q

What is a bulla?

A

Raised, clear fluid filled lesion >0.5cm in diameter

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10
Q

What are striae?

A

Linear areas which progress from purple to pink to white e.g. stretch marks of pregnancy or cushings.

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11
Q

What is koilonychia, give a cause?

A

Spooning of the nails.
Iron deficiency anaemia
GI malignancy
Coeliacs

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12
Q

Give a cause of clubbing

A

Lung cancer
Heart failure
Inflammatory bowel disease

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13
Q

Give two functions of skin

A

Temperature regulation
Protective barrier
Sensation
Vit D synthesis

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14
Q

What are the 4 main types of cells in the epidermis?

A

Keratinocytes

Melanocytes

Langerhans (immune response)

Merkels (nerve sensation)

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15
Q

What are the 4 layers of the epidermis from inner to outer?

A

Stratum basale
Stratum spinosum
Stratum granulosum
Stratum corneum

(Skin regenerates every 30 days from inner to outer)

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16
Q

What are the 4 stages of wound healing?

A

Haemostasis: Vasoconstriction + clot formation

Inflammation:
Vasodilation, neutrophil migration and phagocytosis.

Proliferation:
Granulation, angiogenesis, and re-epithelialisation.

Remodelling:
Collagen reorganisation and scar maturation.

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17
Q

What is erythema multiforme? How does it differ from Stevens Johnson Syndrome and Toxic Epidermal Necrosis?

A

Inflammatory condition often caused by HSV presenting with target lesions.

[Only one mucosal surface max is affected]

SJS is more extreme with multiple mucosal surfaces involved (often drug caused).

TEN is the most extreme form, often caused by drug reaction with full thickness epidermal necrosis.

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18
Q

What is erythema nodosum?

A

A mild hypersensitivity reaction to various bacteria or chronic health conditions such as cancer. Presents as tender nodules on the shins especially.

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19
Q

How quickly should contacts of a patient with meningococcal septicaemia be treated with prophylactic antibiotics?

A

Within 14 days of exposure

[Rifampicin]

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20
Q

What is the most common cause of meningococcal septicaemia?

A

Neisseria Meningitidis

[G-ve diplococcus]

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21
Q

Give three symptoms of meningitis

A 
Headache
Fever
Myalgia
Non-blanching rash
Photophobia
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22
Q

What is erythroderma?

A

AKA ‘Red skin’

Widespread ~90% of skin surface becomes inflamed, oedematous and scaly (exfoliative). Caused by existing skin conditon e.g. eczema, psoriasis or drug reaction.

Treatment: Emollients, Topical steroids, Treat underlying cause.

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23
Q

What is the cause and treatment for eczema herpeticum?

A

Cause: HSV

Treatment: Antivirals and antibiotics to prevent secondary infection.

[Tend to be systemically unwell]

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24
Q

What is the common cause of necrotising fasciitis?

A

Group A haemolytic strep

[76% mortality!]

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25
Q

What is the difference between Erysipelas and Cellulitis?

A

Erysipelas is a superficial form of cellulitis involving only the dermis and upper subcutaneous tissue.

Cellulitis affects the deep subcutaneous tissue.

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26
Q

What are the two common causes of cellulitis?

A

Strep pyogenes

Staph aureus

27
Q

What antibiotic would you use to treat cellulitis?

A

Flucloxacillin

Benzylpenicillin

28
Q

A child presents with pearly, papules over their back and trunk. What do you suspect?

A

Molluscum Contagiosum

29
Q

What is the cause of bullous pemphigoid?

A

Autoimmune where IGG/E attacks the basement membrane causing tense fluid filled bullae.

30
Q

What is the treatment for bullous pemphigoid?

A

Potent topical steroids

Emollient e.g. diprobase

Immune suppression e.g. azathioprine.

31
Q

What is the difference between bullous pemphigoid and pemphigus vulgaris?

A

BP is deeper (at the dermo-epidermal junction and therefore the blisters are tense).

PV is more superficial so the blisters rupture more easily.

32
Q

Name two skin conditions sensitive to UV light

A

Psoriasis
Eczema
Rosacea
SLE

33
Q

What is Rosacea?

A

Red/flushing of the face in older people 30-60yo. Particularly affects celtic people.

[Rhinophyma = the bulbous nose commonly seen]

34
Q

What is the treatment for atopic eczema?

A

Topical emollient
Mild corticosteroid
Antihistamine
Alternative soap e.g. dermol

35
Q

What is the difference between contact dermatitis and eczema?

A

Contact dermatitis is eczema caused by direct skin contact with the allergen.

36
Q

Which is the stronger topical steroid. eumovate or dermovate?

A

Dermovate. Only used for severe cases.

37
Q

A patient with a history of eczema presents as systemically unwell with punched out lesions and fever, what do you suspect?

A

Eczema Herpeticum

Caused by HSV 1 or 2.

38
Q

What are the 4 types of psoriasis?

A

Plaques (most common)

Guttate (small red spots)

Erythrodermic (like severe burns)

Pustular (multiple white pustules)

39
Q

How is psoriasis treated?

A 
Emollients
Vitamin D
Corticosteroids
Coal Tar
Immune suppression e.g. methotrexate
40
Q

What is the treatment of pressure sores?

A

Mobilisation (prevention)

Warm the area (perfusion)

Antibiotics

Surgical debridement

Negative pressure wound vac

Skin grafts

41
Q

How do arterial and venous ulcers differ?

A

Arterial ulcers:

  • Pale
  • Cold to touch
  • Absent periph pulses
  • Punched out
  • Typically on toes

Venous:

  • Swollen
  • Red
  • Irregular border
  • Typically lower leg
42
Q

How do you treat venous ulcers?

A

Elevate legs

Debridement (chemical/magots)

Grafts

Compression devices

43
Q

How do you treat/prevent arterial ulcers?

A 
Surgical revascularisation
Avoid cold
Analgesia
Exercise
Diabetic control 
Stop smoking
44
Q

Give two risk factors for malignant melanoma

A

[MRISK]

Moles [>50 atypical]
Red hair
Inability to tan
Sunburn 
Kin [Fhx]
45
Q

What is the first line treatment for SCC?

A

Initial biopsy (incisional) then wide excision.

[Radiotherapy and photodynamic therapy is also an option]

46
Q

What is Bowen’s disease?

A

A superficial keratinocytic dysplasia and precursor to SCC.

Actinic keratosis –> Bowen’s –> SCC [if untreated]

47
Q

Which is more invasive BCC or SCC?

A

SCC is more invasive and spreads via the lymphatic system.

48
Q

What is a dermatofibroma?

A

A non cancerous raised lump that resembles an insect bite.

Biopsy and if confirmed can remove (cryotherapy) or leave.

49
Q

Describe two observable features of a BCC

A

Pearly surface
Telangiectasia
Non pigmented

50
Q

How is BCC treated?

A

Excision with 3-4mm margin

51
Q

What is anaphylaxis?

A

Acute, severe hypersensitivity reaction [Type 1 - IgE mediated]

Rapid Mast cell degranulation.

52
Q

Give two common causes of anaphylaxis

A 
Latex
Food allergy
Hair dyes
Drugs
Insect stings/bites
53
Q

What is the treatment for anaphylaxis?

A

IM adrenaline 1 in 1000
(1mg in 1ml)

IM/IV Chlorphenamine
IM/IV Hydrocortisone
Salbutamol if breathing problems.

54
Q

Why is it important to monitor patients following anaphylaxis for at least 12 hours?

A

5-10% get a Biphasic reaction where they have a second occurrence within 12 hours.

55
Q

What enzyme is diagnostic of anaphylaxis? How many samples are needed?

A

Mast Cell Tryptase

3 samples:

  • Immediately
  • 1-2 hrs post onset of symptoms
  • > 24hrs post symptoms
56
Q

What is the difference between anaphylaxis and anaphyactoid?

A

Anaphylaxis is IgE mediated.

Anaphylactoid is non-IgE mediated i.e. caused by direct Mast cell degranulation e.g. opiates, contrast, heat etc.

57
Q

What is the first line treatment for acne vulgaris?

A

Benzoyl peroxide [1st line]

Topical Retinoid

Oral antibiotics e.g. doxycycline or lymecycline.

COCP

[NB: Steroids are not NICE recommended]

58
Q

How is actinic keratosis aka solar keratosis treated?

A 
Cryotherapy 
Shave
Curettage
Electrocautery 
Excision
Diclofenac
5-Fluorouracil 
Imiquimod
Photodynamic therapy
59
Q

What is the treatment for tinea pedis (athlete’s foot)?

A

Imidazole / Clotrimazole / Miconazole

Whitfield ointment (Benzoid acid, Salicylic acid)

Tipical steroid

Antibiotics if infected.

60
Q

How would you treat asymptomatic carriers of tinea capitis?

A

Antifungal shampoo

61
Q

How woul dyou investigate tinea capitis?

A

Skin scrapings must be analysed in a lab before treatment.

62
Q

What are the three tinea infections?

A 
Tinea capitis (head)
Tinea corporis (body)
Tinea pedis (foot)
63
Q

What are seborrhoeic keratoses?

A 
Benign
Warty plaques
Occur commonly with age
Cobble-stone surface. 
(Start as flat)

Can be removed (shaved, curettage, cautery etc) or left alone.

Unknown cause

Dermatology (P4) (1 decks)

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