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Dermatology+ENT+Opthal (passmed) Flashcards

(57 cards)

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1
Q

Pellagra?

A

Presents with 4 D’s:
-Diarrhoea
-Dermatitis
-Dementia
-Death

NB: Isoniazid(TB medication) is known to induce Pellagra.

Is caused by Nicotinic acid (Vitamin B3, Deficiency(niacin)

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2
Q

Erythema Nodosum presentation:

A
  • Painful red bruises on shins and forearm; is an inflammation of the subcutaneous fat.
  • Can also be associated with systemic diseases like: Sarcoidosis, Inflammatory Bowel Disease, Streptococcal Infection
  • usually resolves within 6 weeks

ddx: ITP (however bruises are NOT painful in this)

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3
Q

Burns: for what type of burn is IV fluids required?

A
  • Only give IV fluids for second/third degree burns that cover 15% of body surface or more for eg. For second degree(superficial DERMAL, partial thickness and more severe), NB: IV fluids are not required for first degree burns.
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4
Q

SLE skin manifestations:

A

-photosensitive butterfly rash
-discoid lupus
-alopecia
-livedo reticularis (net-like rash)

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5
Q

Sebborhoeic dermatitis complications:

A
  • Otitis Externa (causes inflammation- redness and swelling to external ear canal; is also referred as swimmer’s ear)
    -Blepharitis (inflammation along edge of eyelids)
  • Associated conditions include: HIV, Parkinson’s Disease

-1st line mx: Topical Ketoconazole

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6
Q

Erythema Multiforme:

A
  • Giant NON-ITCHY target lesions on forearm
    = The name of target lesions comes from the fact they have three concentric colour zones, a darker centre with a blister, a ring around this that is paler pink and raised due to oedema and a bright red outermost ring.

Most common medication causes:
- Aminopenicillins (such as co-amoxiclav), sulfonamides, carbamazepine, allopurinol, NSAIDs and oral contraceptive pill.

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7
Q

Psoriasis exacerbating factors:

A
  • beta blockers for eg. Atenolol, lithium, NSAIDs, ACE-i
  • trauma
    -alcohol
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8
Q

Pathogen to trigger Guttate psoriasis:

A

Streptococcal infection

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9
Q

Rosacea acne triggers:

A
  • Alcohol
  • spicy food
  • Hot drinks

Presents with: on nose, cheek, forehead with flushing, erythema, telangiectasia(papules and pustules)
- sunlight can worsen symptoms, if ocular involvement= Blepharitis( swollen, itchy eyelids)
Mx: 1st line- Topical Ivermectin +/- oral doxycycline. alternatives: Topical metronidazole/azelaic acid
-Simple: high factor sunscreen
- Topical Brimonidine gel
- can consider laser therapy if patient has prominent telangiectasia

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10
Q

Lichen Sclerosus:

A

Presents with: white patches affecting genitalia that may scar+ itch
Mx: topical emollients and steroids
- happens in elderly females
- clinical diagnosis can be made

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11
Q

Erythema ag igne:

A

happens due to application of hot water bottle on an area for a period of time.
- presents with an area of erythema

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12
Q

Acanthosis Nigricans:

A
  • Skin with: dark, thickened patches of skin that appears on axilla
  • Velvety, hyperpigmented rash
  • is an early sign of Type 2 Diabetes

Ddx: Hidradenitis suppurativa: but this has painful lumps and more prone to recurrent abscesses under the skin.

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13
Q

Allergic Rhinitis:

A

Presents: Symptoms come on same time each year
- Bilateral nasal obstruction, cough at night, clear nasal discharge, post-nasal drip, sneezing, nasal pruritus

Mx: avoid allergen triggers
- oral/intranasal antihistamines
-severe: intranasal corticosteroids

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14
Q

Erythema Nodosum:

A

Presents:
- Painful red bumps under skin of SHIN
- can occur in pregnancy due to hormonal changes AND infection with strep.= common cause.

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15
Q

Sudden loss of vision + diabetes

A

Vitreous Haemorrhage: presents with= red hue to the vision
Also presents with:
- dark spots obscuring vision/complete of vision if bleed is big enough

Ddx: Retinal detachment

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16
Q

Central retinal artery occlusion:

A
  • Sudden unilateral loss of vision in absence of pain
  • O/E: RAPD (relative afferent pupillary defect) + fundoscopy: pale retina with cherry-red dot at macula.
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17
Q

Optic Neuritis other disease association: (Neuro)

A

-Multiple Sclerosis

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18
Q

Optic Neuritis:

A
  • Pain on movement of the eye and often pain behind eye, funny colour, RAPD, reduced colour vision (red desaturation)
  • Mx: high dose steroids, recovery usually takes 4-6 weeks
    -Inv: MRI of brain; is usually diagnostic
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19
Q

Anterior Uveitis association disease:

A
  • Ankylosing Spondylitis
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20
Q

Difference between: Anterior Uveitis vs. Acute angle closure glaucoma=

A

Glaucoma= severe pain, haloes, ‘semi-dilated’ pupil

Uveitis= small, fixed oval pupil, ciliary flush/congestion, often presents with nausea and vomiting, blurred vision+ sudden onset severe ocular pain.

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21
Q

Anterior Uveitis (same are Iritis):

A
  • Presents with: unilateral eye pain, photophobia (often intense) , ciliary congestion
  • Mx: Treated with steroid+ cycloplegic (mydriatic) drops
  • Crohn’s Disease is associated with the condition
  • Also needs URGENT review by ophthalmology
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22
Q

Episcleritis vs. Scleritis:

A

Episcleritis: PAINLESS red eye, injected vessels=mobile when gentle pressure is applied on sclera
-classically painless
-Mx: conservative, artificial tears may be used.

Scleritis: vessels are deeper and hence do not move

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23
Q

Managements for varying ophthalmology conditions:

Study These Flashcards
A
  • Bacterial conjunctivitis: Abx drops
  • Allergic conjunctivitis: Antihistamine drops
  • Episcleritis: Topical NSAID drops
  • Acute closed angle glaucoma: Pilocarpine and beta blocker drops
  • Corneal Ulcer: pain, reduction in visual acuity; is a sight-threatening condition that requires immediate management.
24
Q

Retinal detachment:

Study These Flashcards
A
  • Cause of sudden, painless loss of vision
  • presents with= dense shadow starting peripherally and then progressing centrally
  • history of myopia= big risk factor
  • Mx: urgent corrective surgery
25
Persistent mouth ulcer? what diagnosis:
Squamous Cell Carcinoma: Persistent, unexplained mouth ulcer for 4 weeks = should raise suspicion of oral cancer - therefore mx: refer to secondary care under 2 week wait referral.
26
Acute glaucoma: what to do next?
- Refer immediately to hospital and admit immediately
27
Orbital Cellulitis:
- Is an emergency and requires admitting to hospital for IV antibiotics: due to high risk of cavernous sinus thrombosis - Presents with: facial swelling and eye swelling and erythema and pain on eye movement. - Risk factors: childhood, previous sinus infection, lack of Hib vaccination
28
Any patient with new onset flashes and floaters: management?
Referred urgently (less than 24 hours) to ophthal for assessment: with slit lamp to rule out vitreous haemorrhage and retinal detachment
29
Periorbital Cellulitis vs. Orbital cellulitis?
- Periorbital: absence of pain on eye movement -Orbital: infection of orbit, Painful eye movements, visual disturbance, proptosis(also known as Exophthalmos) - Investigation: need to do a CT scan with contrast of the orbits, sinuses and brain to assess posterior spread of infection.
30
Scleritis:
- Presents with a painful tender red eye with bluish hue - often in patients who already have SLE/rheumatoid arthritis (autoimmune conditions) - Presents with a gradual decrease in vision. - is an eye emergency and patient needs urgent ophthalmology review -1st line management: oral NSAIDs, for more severe presentations: oral glucocorticoid
31
Anterior Uveitis Management:
-Treated with: steroid+ cycloplegic (mydriatic) drops
32
Cellulitis management: if pregnant patient allergic to penicillin
Erythromycin: is first line that is also not harmful in pregnancy
33
Central Scotoma is a feature of which eye condition?
Optic Neuritis
34
Diabetic Retinopathy: complication of management(PRP)=
PRP (Pan-retinal Photocoagulation) - commonly used technique in treatment of diabetic retinopathy - side effect= causes a DECREASE in NIGHT vision. (Because: rods are responsible and majority is found in peripheral retina)
35
Diabetic retinopathy:
- Cotton wool spots: which represents areas of retinal infarction - 2 types: Non-proliferative and proliferative
36
Differentiating between Optic Neuritis vs. Anterior Uveitis:
- Optic Neuritis: Subacute unilateral visual loss+ eye pain worse on movements (is a classical sign), colour vision ('red desaturation') is also affected - Anterior Uveitis: causes red, painful eye with BLURRED vision, photophobia and watering of eye. O/E: would have a red eye with unreactive/distorted pupil.
37
Acute angle-closure glaucoma: inv to do?
- Tonometry (test that measures intraocular pressure) - Gonioscopy (special eye test that checks for glaucoma)
38
Scabies presentation:
- widespread pruritus (particularly at night), linear erythematous lesions between fingers - is highly contagious and can spread easily through physical contact/sharing items. - Mx: Permethrin= 1st line, Malathion= 2nd line
39
Features of Acne Vulgaris?
- will have: Open and closed comedones, pustules and nodules = all characteristic of acne vulgaris
40
What pathogen causes: Eczema Herpeticum?
- Herpes Simplex Virus 1
41
what cancer is associated with renal transplant patients?
- Squamous Cell Carcinoma
42
1st line medication for Cellulitis?
- Oral Flucloxacillin, if allergic then Oral Clindamycin
43
Guttate psoriasis presentation?
Tear drop papules on trunk and limbs, preceding streptococcal infection (ie sore throat) -Mx: Self-limiting (resolves after around 6 weeks), most cases resolve spontaneously within 2-3 months, topical agents as per psoriasis.
44
Classical presentation of SCC (squamous cell carcinoma)
- Non-healing painless ulcer associated with a chronic scar - Risk factors: immunosuppression following renal transplant, HIV, smoking
45
What is a side effect that topical corticosteroids could have in darker skin?
- Small patches of pale skin - Clobetasone: is a corticosteroid
46
Cellulitis in pregnancy mx?
- if allergic to penicillin= Erythromycin NB: Clindamycin is contraindicated in pregnancy - NB: Cellulitis is a clinical diagnosis, therefore 1st step= is to start oral antibiotics
47
Acute Urticaria Mx?
Cetirizine (non-sedating antihistamines) - has distinctive wheals: which appear as red, raised lesions with surrounding redness - NB: Chlorphenamine is a Sedating antihistamine. - if Severe: need to add Oral Prednisolone for 5 days to Cetirizine for 6 weeks.
48
Management of Acne Vulgaris? + In pregnancy
- Use Oral Erythromycin if need antibiotic, don't use Amoxicillin
49
psoriasis long term control?
- Calcipotriol (vitamin D analogue) - NOT to give Topical betamethasone as should not use corticosteroids long term, only to give short term!
50
acne mx in males?
if not pregnant, no need for erythromycin= give tetracyclines (doxycycline)
51
what is the most aggresive type of melanoma? (4 types in total)
Nodular: invades aggressively and metastasises early
52
for treatment of acne, can you use topical and oral abx that are separate?
No. - can consider a COCP.
53
Pyogenic granuloma?
Trauma is a common precipitant of pyogenic granuloma and contact bleeding and ulceration are common.
54
Molluscum Contagiosum?
The lesions have a pearly, flesh-coloured appearance, and some show central depressions. cause: by a Pox virus.
55
Primary herpes simplex infection, caused by the Herpes Simplex Virus (HSV), can lead to a what derm condition?
Erythema multiforme.
56
Common causes of the different types of Erythma?
Erythema ab igne - Over exposure to infrared radiation Erythema Nodosum - Sarcoidosis, IBD, TB Erythema chronicum migrans - Lyme Disease Erythema Marginatum - Rheumatic Fever Erythema Multiforme - HSV
57
if involves nasolabial fold?
is likely rosacea NOT SLE

Finals (38 decks)

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