Dermatology Medicine 💆🏽✅

Question 1

Tx for high risk BCC

Answer 1

Surgical removal

Question 2

Tx for low risk BCC

Answer 2

Cutterage

Question 3

Tx options for BCC

Answer 3

Sx, cutterage, cryotherapy, topical imiquimod/FU, radiotherapy

Question 4

Best Tx for most SCC

Answer 4

Mohs Surgery

Question 5

SCC less than 20 mm, do what Sx

Answer 5

Mohs Sx, with 4mm margins

Question 6

SCC more than 20 mm, do what Sx

Answer 6

Mohs Sx, with 6mm margins

Question 7

Aggressive Bowens lesion, Tx

Answer 7

Mohs excision and chemo

Question 8

Therapy given to all Bowen lesion patients

Answer 8

Topical FU BD for 4 weeks (give CSs if patient gets Inflamation from it).

Question 9

When is cryotherapy or excision used for Bowen lesions Tx

Answer 9

Low risk cases (will still receive the FU topically)

Question 10

How to Dx melanoma and it’s importance

Answer 10

excisional Skin biopsy with 1-3 mm margins. Get Breslow thickness

Question 11

Worse Px areas to get melanoma

Answer 11

TANS (thorax, upper arm, scalp)

Question 12

Breslow stage I melanoma Mx (consider the safety margin)

Answer 12

1cm

Question 13

Breslow stage II melanoma Mx (consider the safety margin)

Answer 13

1-2 cm

Question 14

Breslow stage III melanoma Mx (consider the safety margin)

Answer 14

2cm

Question 15

Breslow stage IV melanoma Mx (consider the safety margin)

Answer 15

2cm

Question 16

Insitu melanoma Mx (consider the safety margin)

Answer 16

Removal with 0.5-1cm margin

Question 17

Main management for Kaposi’s sarcoma

Answer 17

A.R.T

Question 18

Investigations for astinic keratosis

Answer 18

Clinical, but still do biopsy to rule out SCC

Question 19

Management for all actinic keratosis

Answer 19

Sun avoidance, topical FU and CS, (rest depends on severity

Question 20

Add-ons for mild actinic keratosis

Answer 20

Topical diclofenac (being a dic spending too long in the sun). Add to FU

Question 21

Add-ons for more severe actinic keratosis

Answer 21

Topical imiquimod (imi joke)

Question 22

What is acne fulminans

Answer 22

Severe acne with systemic symptoms

Question 23

Mx of acne fulminans

Answer 23

Admit and PO steroids

Question 24

Three types/stages of acne

Answer 24

Question 25

Inflammatory acne:.. always add what Tx

Answer 25

Abx

Question 26

Mild acne Tx

Answer 26

Topical retinoids +- benzylperoxide +- topical Abx

Question 27

Moderate Acne mx

Answer 27

Topical retinoids +- benzylperoxide +- oral Abx

Question 28

Severe acne Mx

Answer 28

PO ISOtretinoin + PO CS +- PO Abx

Question 29

For women who have hornonal Acne, give what?

Answer 29

COCP

Question 30

IDd acne with propionobac… can Tx how?

Answer 30

3mo Abx

Question 31

Topical Abx choices for Acne

Answer 31

Clinda, erythro, dapsone

Question 32

Oral Abx for acne, options

Answer 32

Doxy, iymecycline

Question 33

Main worry in cellulitis patients

Answer 33

Sepsis

Question 34

Eron classification

Answer 34

How to Mx cellulitis

Question 35

Patient with cellulitis: there are no signs of systemic toxicity and patient has no comorbidities. Eron classification class and management

Answer 35

Class one. Give oral flucloxacillin, or clarithromycin if allergic, erythromycins pregnant

Question 36

Patient with cellulitis: Patient systemically unwell (not in shock) or well but has a comorbidity. How to manage and what stage

Answer 36

Class two. IV antibiotics and monitor, may need admission

Question 37

Patient with cellulitis: Person is systemically unwell, such as confusion tachycardia, tachypnoea, hypotension. Or has life-threatening vascular compromise. What class is this and how would you manage

Answer 37

Class three, admit patient and give IV antibiotics. Co Amoxiclav Or clindamycin for cephtrioxane

Question 38

Patient with cellulitis: Patient has sepsis necrotising fasciitis. How to manage, and what class is this

Answer 38

Class 4. Admit patient and give IV antibiotics

Question 39

Indications to admit a patient with cellulitis

Answer 39

ERON class 3 or four, rapidly deteriorating, frail, less than one year old, immuno compromised, lymphoedema, facial cellulitis

Question 40

Aside from ERON class treatment for cellulitis, what support of therapy should be given to all patients

Answer 40

Fluids, heparin, wound management, analgesia, elevate limb, draw around lesion, treat lymphoedema

Question 41

Drugs responsible for causing Steven Johnson syndrome

Answer 41

Penicillin, sulphurs, lamotrigine , carbamazepine, phenytoin, allopurinol, NSAID, OCP

Question 42

Difference between Steven Johnson and TEN

Answer 42

Steven Johnson involves less than 10% of skin, TEN involves more than 30%

Question 43

Aside from usual investigations, two investigations which are crucial for Steven Johnson syndrome

Answer 43

Skin biopsy (definitive diagnosis) and blood cultures to ruled out toxic shock/scalded skin syndrome.

Question 44

Overview of management for Steven Johnson

Answer 44

Urgent admission, ABCD approach, withdraw causative agent (very important), fluid intake orally/IV ringers or isotonic saline. Immuno suppressants are not great

Question 45

Treatment for Urticaria. And if severe?

Answer 45

Oral antihistamine second generation. If severe give PO prednisolone. If chronic with eosinophilia give Omalizumab

Question 46

Management of a patient with urticaria and airway Involvement

Answer 46

Adrenaline, airway protection, IV antihistamine

Question 47

First line treatment for eczema

Answer 47

Emollience plus or minus topical corticosteroids. Can add antibiotics if infected

Question 48

How to admin medication for eczema

Answer 48

Emollient, wait for 30 minutes, steroid. Or can do wet wrapping

Question 49

If severe eczema what medication can you give

Answer 49

Oral cyclosporine (eczyclosporine)

Question 50

First line treatment for plaque psoriasis

Answer 50

Topical corticosteroids and topical vitamin di analogues (calcipotriol) once daily for four weeks.

Question 51

Step up, second line, for plaque psoriasis

Answer 51

Vitamin di analog twice daily

Question 52

Third line step up for plaque psoriasis

Answer 52

Corticosteroids twice daily

Question 53

Aside from steroids/vitamin D analogues what 4 other medications are good for plaque psoriasis

Answer 53

Coal Tar, UVB, Tacrolimus Good for face and skinfolds

Question 54

If patient has plaque psoriasis involving the face this is a strong indication to start what medication

Answer 54

Topical corticosteroids

Question 55

Patient with plaque psoriasis and arthritis, medication first line

Answer 55

Methotrexate

Question 56

Indications for systemic therapy in psoriasis

Answer 56

Pustular, topical has failed, hospitalised, elderly, extensive, arthritis

Question 57

Treatment for dermatomyositis and polymyositis

Answer 57

High-dose corticosteroids and the taper until symptoms improve

Question 58

Main treatment for Henoch schoelein Purpura

Answer 58

Analgesia (paracetamol), hydration, rest, monitor

Question 59

Henoch Sholan purpura, treatment for mild nephritis

Answer 59

Oral corticosteroids, consider ACEi

Question 60

Henoch Sholan purpura, treatment for moderate nephritis

Answer 60

Oral oral IV steroids and Consider ACEI

Question 61

Henoch Sholan purpura, treatment for severe nephritis

Answer 61

IV Cyclophosphamide and consider ACEI. Patient may need transplant

Question 62

When to hospitalise an HSP patient

Answer 62

Need IV fluids, GI bleed, severe abdominal pain, AMS, severe arthritis, severe renal disease

Question 63

macule, patch, vs papule, vs plaque

Answer 63

Question 64

what is purpura

Answer 64

Purpura is a condition of red or purple discoloured spots that do not blanch under pressure. The spots are usually caused by bleeding underneath the skin, secondary to platelet disorders, vascular disorders, coagulation disorders, etc