DERMATOLOGY and OPTHALMOLGY

Question 1

Vitiligo tX

Answer 1

Limited disease: topical corticosteroids
Extensive/unresponsive disease: oral corticosteroids, topical calcineurin inhibitors, PUVA

Question 2

UR Dx and define it
and ur Mx

Answer 2

Senile purpura (solar or actinic purpura) is a noninflammatory disorder that is most common in the elderly but can also be seen in middle-aged patients with extensive sunlight exposure. It is caused by loss of elastic fibers in perivascular connective tissue.

not a dangerous condition and requires no further investigation.

Question 3

Blisters, bullae, scarring, hypopigmentation/hyperpigmentation on sun exposed skin (eg, back of hands, forearms, face)
Scarring & calcification similar to scleroderma
UR dx

Answer 3

Porphyria cutanea tarda

Question 4

porphyria cutaneous tarda in early vs late enzyme defficiencies

remember triggered by ingestion of certain substances (eg, ethanol, estrogens) and is most common in patients with underlying hepatitis C.

Answer 4

early steps of porphyrin synthesis (eg, acute intermittent porphyria) cause abdominal pain and neuropsychiatric manifestations (eg, psychosis, neuropathy);
*** later steps (eg, PCT) lead to {photosensitivity }due to accumulation of porphyrinogens that react with oxygen on excitation by ultraviolet light
can be associated with hyperpigmintation

Question 5

hashimoto thyroditis is associated with which skin disorder

Answer 5

vitilligo

Question 6

Hair growth occurs in a cyclical pattern with 3 primary phases:

Anagen phase: Linear growth of the hair shaft associated with proliferation of hair follicle cells. At any given time, 80%-90% of follicles are in anagen phase, which lasts up to 5 years.
Catagen phase: Transition phase characterized by regression and apoptosis of follicular cells. The hair shaft may continue to be extruded from the follicle but is no longer growing. This phase lasts up to 2 weeks and typically accounts for <1% of follicles.
Telogen phase: Resting phase of variable duration. The hair shaft is shed during this phase in preparation for growth of a new hair.
just review it

Answer 6

read it again saw uuuuu

Question 7

chemotheraputic agents can affect which phase and causes ———
but guess what its temporary, reversible

Answer 7

Impaired cellular reproduction can lead to cessation of hair growth and rapid shedding of hair shafts (anagen effluvium).

Question 8

recall male and female hair loss patterns and Mx for both

Answer 8

Men: vertex, frontal hairline, temporal areas
Women: vertex, center of scalp (sparing of hairline)

Management
Men: minoxidil, finasteride
Women: minoxidil

Question 9

urDX and Mx

Answer 9

alopecia areata
Mild/moderate hair loss: topical or intralesional corticosteroids{trimicnollone }
Extensive hair loss: topical immunotherapy (eg, diphenylcyclopropenone), oral corticosteroids

Question 10

Loss of function in filaggrin gene
lead to —————charcterized by
ur Mx 3 and remeber the drugs

Answer 10

Ichthyosis vulgaris
1-Impaired epidermal barrier
2-Reduced skin moisturization

Therapy

Long baths to remove scales
Moisturization
Keratolytics (eg, urea,** alpha-hydroxy acid, salicylic acid)
palmerhype linearity is also common

Question 11

ur DX

Question 12

Acute, diffuse, noninflammatory hair loss
Scalp & hair fibers appear normal
Hair shafts easily pulled out (hair pull test)
ACUTE while tinia capitis more in children and its has more slow onset of time

so whats ur Mx

Answer 12

Telogen effluvium

Address underlying cause
Reassurance (self-limited disorder

Question 13

uwrold fked up idea
ur Dx

Answer 13

can also occur on the scalp, hands, and trunk (eg, gluteal cleft) as small plaques.

Question 14

Tetracyclines are an important cause of phototoxic drug eruptions.
give ex—–

Answer 14

doxycycline :>)
but remember its more common than benzyol peroxide to cause phototoxicity

Question 15

common skin manifestations of lupus

Answer 15

discoid erythema

Question 16

drug induced acne revise
remember normal drugs of acne dnt have any effect its worthless like ur brain <:)

Answer 16

read it again

Question 17

Mild manifestations of a drug allergy (eg, urticaria and pruritus without systemic symptoms) Tx
while epniphrine is reserved for more severe anaphalctic reactions

Answer 17

e usually treated with antihistamines and discontinuation of the offending drug.

Question 18

acute, painless, monocular vision disturbance accompanied by flashes of light and/or floaters.
ur DX

Answer 18

Retinal detachment
Commonly begins in the periphery, affecting peripheral vision first. Ophthalmoscopic examination typically shows an area of gray, elevated retina, often with a wrinkled appearance.

Question 19

Anterior uveitis VS CONJUCTIVITIS
JUST ——–2 words

Answer 19

iritis and iridocyclitis) is characterized by a painful, red eye with tearing and decreased{ visual acuity. }

Question 20

acute eye pain, headache, and nausea. Signs include conjunctival erythema, corneal opacification, and a mid-dilated pupil in eldery with no HX of trauma viral
ur Dx
gold standard test and best initial

Answer 20

acute angle closure glucoma \
Gonioscopy is the gold standard for diagnosis
tonometry if opthalmologist consultant isnt available

Question 21

revise infectious keratitis
and remember cmv is painless with fluffy or granular retinal lesions near the vasculature as well as retinal hemorrhages

Answer 21

while the rest are painful
watery discharge its HSV
Central round infiltrate: This lesion is typically seen in bacterial keratitis (eg, Pseudomonas aeruginosa, Staphylococcus aureus)
Multiple ulcers with feathery margins: These findings are typical of fungal (eg, Candida) keratitis

Question 22

angiofibroma is the hallmark of the disease ++++seizures
brain MRI is required to evaluate for associated CNS lesions (eg, hamartomas). Brain hamartomas can cause seizures (as seen in this patient’s mother) or manifest more subtly with behavioral/cognitive disorders (eg, attention-deficit hyperactivity disorder, intellectual disability), as seen in this patient. Diagnosis can be confirmed by genetic testing.

Answer 22

ash leaf spot

Question 23

ur Dx
ur Mx remeber its an oldy disease

Answer 23

suberroickeratosis
stuck on appeareance
no Tx is required

Question 24

ur Dx
Mx
Tx

Answer 24

bcc
punch r excisional biopsy
First-line:
Surgical excision with 4-mm margins
Mohs micrographic surgery (face/high-risk tumors)
Second-line:
Topical fluorouracil, topical imiquimod, C&E (low-risk tumors only)

Question 25

ur Dx

Answer 25

Herpetic whitlow is a viral infection of the hand caused by herpes simplex virus. Most adult infections are acquired from contact with genital herpetic lesions or infected orotracheal secretions. Spontaneous resolution is the norm but recurrences are common.

Question 26

ur Dx
usually on lower limbs associated with trauma and insect bites

Answer 26

dermatofibroma
Treatment (cryosurgery or shave excision) is usually not required unless the lesion is symptomatic, bleeds, or changes in color or size.