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MSRA > Dermatology/ENT > Flashcards

Dermatology/ENT Flashcards

1
Q

Pellagra

A

Dermatitis
Diarrhoea
Dementia

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2
Q

Pregnant lady with acne - tx options

A

Topical benzyl peroxide
Oral erythromycin

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3
Q

Single nodule
- one dimples when pressed
- one doesn’t dimple when pressed
Diagnosis?

A

Dimple - dermatofibroma
Not dimple - amelanocytic melanoma

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4
Q

Erythema multiforme Vs Erythema Marginatum

A

Multiforme Causes
viruses: herpes simplex virus (the most common cause), Orf*
idiopathic
bacteria: Mycoplasma, Streptococcus
drugs: penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, oral contraceptive pill, nevirapine
connective tissue disease e.g. Systemic lupus erythematosus
sarcoidosis
malignancy

Marginatum: rheumatic fever (Group A strep)

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5
Q

Difference in appearance between necrobiosis lipoidica diabeticum (NLD) and pre-tibial myxoedema

A

NLD - both shins but often asymmetrical and with irregular shaped patches, more prone to ulcerate, prominent blood vessels

PD: more diffuse swelling and lumpiness caused by deposition of glycosaminoglycans in dermal layer, more prone to THICKENING (rather than ulcerating), discolouration and with promiment HAIR FOLLICLES which give the ‘orange peel’ texture

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6
Q

Management of alopecia areata

A

watchful waiting (self-limiting)
intralesional steroid injections
topical steroid creams
minoxidil 5% solution

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7
Q

Treatment options for scabies

A

permethrin cream - 1st line
malathion cream - 2nd line

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8
Q

severity stages of eczema

A

Clear: no evidence of eczema
Mild: areas of dry skin with infrequent itching, +/- small erythematous patches of skin
Moderate: areas of dry skin with frequent itching, erythematous area of skin and excoriations
Severe: widespread area of dry skin, continuous itching, bleeding, oozing, skin thickening, altered skin pigmentation

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9
Q

Treatment of eczema

A

Topical emollient
Moderately potent topical steroid (betamethasone valerate 0.025% or clobetasone butyrate 0.05%)
Oral abx if infected

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10
Q

treatment of lichen planus

A

topical clobetasone butyrate

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11
Q

what can be prescribed to aid healing of ulcers?

A

pentoxifylline

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12
Q

how to treat psoriasis

A

dithranol or anthraline (anthracene derivative)

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13
Q

candidiasis VS leukoplakia VS lichen planus

A

Lesions that cannot be wiped away: leukoplakia and lichen planus

Lesion that can be wiped away: candidiasis

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14
Q

treatment of lichen planus

A

topical steroids
immunomodulators

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15
Q

Criteria for 2WW dermatology

A

Any lesion scoring 3points or more / features of melanoma.

Scoring:
Major (2 points each): change in size, irregular shape or border, irregular colour
Minor (1 point each): >7mm greatest diameter, inflammation, oozing or crusting, change in sensation including itch

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16
Q

cause of :
- blue nails
- opaque nails
- green nails

A

Blue: chloroquine
Opaque: diabetes mellitus, cardiac failure, psoriasis
Green: pseudomonas spp infection

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17
Q

what disease is psoriatic patients most at risk of?

A

cardiovascular disease
non-alcoholic fatty liver disease
hyperlipidaemia
type 2 diabetes
hypertension

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18
Q

common side effect of lymecycline

A

photosensitivity
(PS: lymecycline is used to treat acne)

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19
Q

which medical condition would deteriorate in pregnancy?

A

SLE
herpes simplex
acne rosaecea

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20
Q

Cowden’s syndrome

A

multiple haemartoma syndrome
autosomal dominant
variable expression
young adults
increasing number of hair follicles tumours, a cobblestone appearance of the oral epithelium, oral papillomas, multiple skin tags
associated with high risk of breast, thyroid, GI carcinomas

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21
Q

where can you find scabies?

A
  1. burrow on hands and feet
  2. skin of axillae, thighs, umbilicus
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22
Q

difference between scrofuloderma and lupus vulgaris?

A

scrofuloderma - breakdown of skin overelying the tuberculous focus usually at a lymph node bus also occur in skin over infected bones or joints

Lupus vulgaris: painful cutaneous tuberculous skin lesions with nodular appearance. usually over face around nose, eye lids, lids, cheeks and ears. sharply marginated, red-brown papules of gelatinous consistency (apple-jelly nodules) that slowly evolve by peripheral extension and central atrophy into large plaques.

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23
Q

treatment of post-herpetic neuralgia

A

amitryptiline
gabapentin
topical capsaicin 0.075%
topical lidocaine

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24
Q

young child. swelling at lateral aspect of eyebrow/

?diagnosis

A

dermoid cyst

-cystic teratoma contains mature skin with hair follicles, sweat glands and often pockets of sebum, blood, fat, bone, nails, teeth, eyes, cartilage, thyroid tissue

25
Q

what is seberrhoiec keratoses?

A

localised proliferation of basal layer of epidermis
AKA basal cell papillomas
tx is rarely necessary - if required, superficial cryotherapy

26
Q

androgenetic alopecia VS alopecia areata VS alopecia effluvium

A

androgenetic: male pattern baldness

areata: non-scarring and ?autoimmune

effluvium: chemotherapy/immunosuppression / radiotherapy causes rapid hair loss.

27
Q

telogen effluvium VS anagen effluvium

A

telogen: at the ‘dormant phase’ so that hair thins out due to physiological (eg infection) or psychological (tension) cause.

anagen: at the hair growing phase

28
Q

furunculosis - what is it?

A

infection of hair follicle & in distal part of auditory meatus
- caused by staphylococcus
- resolve by itself in 4-10days
- pain at site of lesion usualyl exacerbated by pressure of the tragus and movement of pinna. may be slight deafness.

29
Q

Acne vulgaris - what is it?

A

androgen driven increase in sebum production

Things that make it worse:
- POP
- hormonal changes around the period
- thick or greasy makeup
- picking/squeezing
- sweating/humid
- tight slothes
- phenytoin, steroids (anabolic/creams)

30
Q

dermovate - is it a strong or weak topicalsteroids?

A
  • more potent
    • this contains 0.05% clobetasol propionate!
31
Q

treatment of keloid scar

A

most effective: intralesional steroids

32
Q

keratoacanthoma - what is it?

A

benign epithelial tumour. They are more common with advancing age and rare in young people.

Features - said to look like a volcano or crater
initially a smooth dome-shaped papule
rapidly grows to become a crater centrally-filled with keratin

tx: surgical removal

33
Q

what is the name of the classification for cellulitis?

A

Eron

1: no systemic signs or uncontrolled comorbidities
2: systemically unwell or well with comorbidity (peripheral artery disease, venous insifficiency, obese_
3: significant systemic upset or life threatening infection due to vascular compromise
4: sepsis or severe life threatening infection such as necrotizing fasciitis

34
Q

treatment of cellulitis

A

depends on which class it is!

urgent hospital admission for class 3-4 OR vulnerable patients OR facial cellulitis OR susppected orbital or periorbital cellulitis

class 2: short term hospitalisation and discharge with OPAT

class 1: GP managed with PO fluclox or co-amox

35
Q

give ONE diagnosis for the following scenarios where complain of pain, watering, blepharospasm and photophobia of these patients:

  • welder
  • climbers/skiers
  • sunbed users
A

keratitis
(due to exposure to ultraviolet light & if they don’t use protective goggles)

36
Q

common organisms causing these infections:
- pinna cellulitis
- pinna perichondritis

A

celulitis: staph aureus
perichondritis: pseudomonas

37
Q

why does ear wax cause tinnitus, vertigo, dizzyness, hearing loss, ear discomfort of cough?

A

stimulating the branch of vagus nerve that supplies the outer ear

38
Q

nasal polyps can be associated with what other diseases?

A

cystic fibrosis
asthma
hayfever

39
Q

what is samter’s triad?

A

CF
nasal polyps
aspirin hypersensitivity

40
Q

molluscum contagiosum - what is it?

A

clusters of small shiny papules with umbilicated centre - can be inflammed and crusty.

common in flexural skin area.

caused by poxvirus

no tx needed usually. OR molludab (5% potassium hydroxide) for <2yo OR cryotherapy OR curettage for histology

41
Q

presenting complaint of scabies

A

severe itch, greyish-white linear burrows and papules around the finger webs, wrists, upper and lower limbs, and belt area

tx: permethrin, melathion

42
Q

presenting complaint of lichen planus

A

itchy, purple, flat-topped papules with interspersed lacy white lines on wrists, genitalia or mucous membranes

Tx: systemic antihistamines, weak coal tar preparations, 1-2% menthol in calamine lotion and topical steroids

43
Q

treatment of onychomycosis (fungal nail)

A

amorolfine 5% nail lacquer (for mild/superficial)
oral terbinafine 1st line (6weeks to 3 months for fingernails and 3-6months for toenails)
oral itraconazole 2nd line

AKA tinea unguium
affects toenails more than fingernails (4:1)
fungi responsible: trichophyton rubrum OR yeasts : candida

44
Q

difference in presentation between acne rosaecea and seborrhoiec dermatitis

A

AR spare the nasolabial folds
SD affects the folds

45
Q

seborrhoiec dermatitis

A

due to yeast malassezia ovale aka pityrosporum ovale

tx: antifungal shampoo

45
Q

tx of acne rosacea

A

topical brimonidine gel (alpha agonist)
topical ivermectin (reduce inflammation)
topical metronidazole
systemic antibiotics eg oxytetracycline
sunscreen
camouflage creams
laser therapy for patients with prominent telangiectasia

46
Q

organism causing erysipelas

A

strep pyogenes

47
Q

tx of erythema ab igne

A

topical tretinoin or laser

48
Q

another name for otitis media with effusion

A

glue ear - NO inflammation/infection

49
Q

differentiate these acne!
- acne vulgaris
- acne rosacea
- acne conglobata
- acne fulminans
- acne keloidalis nuchae
- acneiform eruptions

A

acne vulgaris: obstruction of the pilosebaceous follicles with keratin plugs which results in comedones, inflammation and pustules.

acne rosacea: flushing is often first symptom, telangiectasia, later develops into persistent erythema with papules and pustules, rhinophyma, ocular involvement: blepharitis, sunlight may exacerbate symptom

acne conglobata: a rare and severe form of acne found mostly in men that presents with extensive inflammatory papules, suppurative nodules (that may coalesce to form sinuses) and cysts on the trunk. also associated with hydradenitis suppurativa.

acne fulminans: rare skin disorder presenting as an acute, painful, ulcerating, and hemorrhagic clinical form of acne.

acne keloidalis nuchae: firm, dome-shaped, inflammatory papules and pustules over the nape of the neck.

acneiform eruptions: like acne vulgaris but caused by drugs

50
Q

1yo with soft transilluminable mass in the posterior triangle

?diagnosis

A

cystic hygroma

51
Q

16yo with longstanding, solitary, painless mass on the lateral side of the neck

A

brachial cyst
- it may become swollen intermittent with tenderness during URTI
- discharge may be reported if lesion is associated with a sinus tract

52
Q

2 weeks widespread rash started in abdomen. O/E multiple discrete pink-red flat and slightly raised circular and oval lesions (multiple small ones and one large lesion)

?diagnosis

A

pityriasis rosea

tx: supportive (will resolve 2-3months)
emollient or topical steroids can be used if itchy

53
Q

very itchy, coin shaped papules - may be vesicular or crusted. occur in the limbs first.

?diagnosis

A

discoid eczema

54
Q

chronically dry skin with widespread coin-shaped lesions. begin as itchy patches of vesicles and papules - later ooze serum and crust over. lesions are most prominent on extensor surface of extremities and buttocks.

?diagnosis

A

discoid eczema
AKA nummular dermatitis

55
Q

tx of acute tonsillitis

A

phenoxybenzylpenicillin for 10/7

56
Q

what is the first line of investigation for tinnitus?

A

audiogram

OR otoacoustic emission testing

57
Q

presbyacusis - what type of hearing loss is this?

A

sensorineural hearing loss

58
Q

treatment of allergic rhinitis
- mild to moderate intermittent OR mild persistent
- moderate to severe persistent

A
  • intranasal or oral antihistamines
  • Intranasal beclomethasone

MSRA (21 decks)

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