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Focused 3 > Dermatology/ENT > Flashcards

Dermatology/ENT Flashcards

(59 cards)

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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

Study These Flashcards
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
what is seberrhoiec keratoses?
localised proliferation of basal layer of epidermis AKA basal cell papillomas tx is rarely necessary - if required, superficial cryotherapy
26
androgenetic alopecia VS alopecia areata VS alopecia effluvium
androgenetic: male pattern baldness areata: non-scarring and ?autoimmune effluvium: chemotherapy/immunosuppression / radiotherapy causes rapid hair loss.
27
telogen effluvium VS anagen effluvium
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
furunculosis - what is it?
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
Acne vulgaris - what is it?
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
dermovate - is it a strong or weak topicalsteroids?
- more potent - - this contains 0.05% clobetasol propionate!
31
treatment of keloid scar
most effective: intralesional steroids
32
keratoacanthoma - what is it?
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
what is the name of the classification for cellulitis?
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
treatment of cellulitis
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
give ONE diagnosis for the following scenarios where complain of pain, watering, blepharospasm and photophobia of these patients: - welder - climbers/skiers - sunbed users
keratitis (due to exposure to ultraviolet light & if they don't use protective goggles)
36
common organisms causing these infections: - pinna cellulitis - pinna perichondritis
celulitis: staph aureus perichondritis: pseudomonas
37
why does ear wax cause tinnitus, vertigo, dizzyness, hearing loss, ear discomfort of cough?
stimulating the branch of vagus nerve that supplies the outer ear
38
nasal polyps can be associated with what other diseases?
cystic fibrosis asthma hayfever
39
what is samter's triad?
CF nasal polyps aspirin hypersensitivity
40
molluscum contagiosum - what is it?
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
presenting complaint of scabies
severe itch, greyish-white linear burrows and papules around the finger webs, wrists, upper and lower limbs, and belt area tx: permethrin, melathion
42
presenting complaint of lichen planus
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
treatment of onychomycosis (fungal nail)
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
difference in presentation between acne rosaecea and seborrhoiec dermatitis
AR spare the nasolabial folds SD affects the folds
45
tx of acne rosacea
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
organism causing erysipelas
strep pyogenes
47
tx of erythema ab igne
topical tretinoin or laser
48
another name for otitis media with effusion
glue ear - NO inflammation/infection
49
differentiate these acne! - acne vulgaris - acne rosacea - acne conglobata - acne fulminans - acne keloidalis nuchae - acneiform eruptions
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
1yo with soft transilluminable mass in the posterior triangle ?diagnosis
cystic hygroma
51
16yo with longstanding, solitary, painless mass on the lateral side of the neck
brachial cyst - it may become swollen intermittent with tenderness during URTI - discharge may be reported if lesion is associated with a sinus tract
52
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
pityriasis rosea tx: supportive (will resolve 2-3months) emollient or topical steroids can be used if itchy
53
very itchy, coin shaped papules - may be vesicular or crusted. occur in the limbs first. ?diagnosis
discoid eczema
54
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
discoid eczema AKA nummular dermatitis
55
tx of acute tonsillitis
phenoxybenzylpenicillin for 10/7
56
what is the first line of investigation for tinnitus?
audiogram OR otoacoustic emission testing
57
presbyacusis - what type of hearing loss is this?
sensorineural hearing loss
58
treatment of allergic rhinitis - mild to moderate intermittent OR mild persistent - moderate to severe persistent
- intranasal or oral antihistamines - Intranasal beclomethasone
59
seborrhoiec dermatitis
due to yeast malassezia ovale aka pityrosporum ovale tx: antifungal shampoo

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