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Dermatology SB > Diseases > Flashcards

Diseases Flashcards

(100 cards)

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1
Q

what is hyperkeratosis

A

increased thickness of keratin layer

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2
Q

what is parakeratosis

A

persistence of nuclei in the keratin layer

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3
Q

what is acanthosis

A

increase thickness of epidermis

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4
Q

what is seen in warts

A

papillomatosis

irregular epithelial thickening

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5
Q

what is the pathology seen commonly in eczema

A

spongiosis - oedema between keratinocytes

inflammatory cell infiltrate

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6
Q

what is the common description of eczema

A

itchy, ill-defined, erythematous and scaly

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7
Q

what is acute presentation of eczema

A

papulovesicular
erthematous lesions
oedema
scaling/crusting

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8
Q

what is chronic phase of eczema

A

lichenification
elevated plaques
excoriation
increased scaling

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9
Q

what are common substances causing contact allergic dermatitis

A

nickel
topic therapies
chemicals

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10
Q

what is the immunopathology of contact allergic dermatitis

A 
1 - langerhans cells process antigen
2 - present to Th cells in dermis
3 - migrate to lymphatics 
4 - subsequent antigen challenge
5 - specifically sensitised T-cells proliferate and migrate to and infiltrate skin. Dermatitis
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11
Q

what investigation is done for contact allergic dermatitis

A

patch testing

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12
Q

how is irritant dermatitis different from contact allergic dermatitis

A

Non-specific physical irritation rather than a specific allergic reaction
e.g. nappy rash

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13
Q

what complications does irritant dermatitis have

A

implications for occupation i.e. problem with latex

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14
Q

what is the common description of atopic eczema

A 
Itch
Ill-defined erythema & scaling
Generalised dry skin
Flexural distribution 
Associated with other atopic diseases - asthma, allergic rhinitis, food allergy
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15
Q

what must be present in atopic eczema

A

itch

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16
Q

where are the flexor areas affected in eczema

A 
back of knees
inside of wrists
inside of elbows
front of ankle 
neck/eyes/genitals (less common)
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17
Q

what organisms commonly infects eczema

A

staph aureus

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18
Q

what is characterised by monomorphic punched-out lesions

A

eczema herpecticum

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19
Q

what virus causes eczema herpecticum

A

Herpes Simplex Virus

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20
Q

what gene has been linked to atopic eczema

A

filaggrin

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21
Q

what eczema can be caused by being immobile

A

stasis eczema

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22
Q

what is stasis eczema secondary to

A

hydrostatic pressure
oedema
red cell extravasation

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23
Q

Sx and Tx of Lichen Simplex

A

Can be due to scratching skin - seen on wrists, forearms, ankles and leg. White areas can be seen in the inner mouth.

Purple
Pruritic (itchy)
Poly-angular
Papules

tx - potent Topical steroid

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24
Q

what virus causes chickenpox and shingles

A

Varicella Zoster Virus

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25
what does Varicella cause
Chickenpox
26
what does Zoster cause
Shingles
27
what are possible complications of chickenpox
``` secondary bacterial pneumonitis haemorrhagic scarring, absent or minor encephalitis ```
28
when can chickenpox being aggressive
in immunocompromised adult
29
what is neonatal VZV
Secondary to chickenpox in mother in late pregnancy Higher mortality Prevention with Varicella Zoster Immune Globulin in susceptible women in contact
30
what is shingles
reactivation VZV
31
how is shingles different from chickenpox
dermatomal distribution
32
who gets shingles
elderly and immunocompromised
33
presentation of shingles
tingling/pain erthyema vesicles crusting
34
what disease classical presents with Vesicles and pain in auditory canal and throat
Ramsay-Hunt Syndrome
35
what nerves is affected in Ramsay-Hunt Syndrome and what complications can arise
(Always affected) CNVII - causes facial palsy (secondary ) CNVIII - causes deafness/vertigo/tinnitus
36
pre-school child with primary gingivostomatitis - what causes this?
HSV
37
characteristics of HSV
primary gingivostomatitis extensive ulceration in and around mouth blistering rash at vermillion border can spread
38
where can HSV spread
finger or eczema e.g. herpetic whitlow OR eczema herpeticum (LIFE THREATENING)
39
what does HSV type 1 cause
main cause of oral lesions causes half of genital herpes causes encephalitis
40
what does HSV type 2 cause
rare cause of oral lesions causes half of genital cases encephalitis / disseminated infection (particularly in neonates)
41
what is used to treat VZV and HSV
Aciclovir
42
Aciclovir eliminated latent virus - true or false
false | it does not
43
what infections trigger erythema multiform
HSV | Mycoplasma pneumonia
44
what characterises erythema multiforme
target lesions with erythema
45
what is common in children and are self limiting
molluscum contagiosum
46
what is the typical appearance of molluscum contagiosum
Fleshy, firm, umbilicated, pearlescent nodules
47
what causes warts and possible tx
Human papilloma virus | self limiting but topical salicylic acid can be used
48
what HPV causes cervical cancer
HPV types 16 and 18
49
what does HPV 6 and 11 cause
Genital warts
50
what HPV causes warts/verrucas
HPV 1 and 4
51
disease that causes blistering rash in back of mouth
herpangina
52
what causes herpangina
enterovirus | e.g. coxsackie virus, echovirus
53
what causes hand, foot and mouth disease
coxsackie virus | i.e. enteroviruses
54
what is a.k.a slapped cheek disease and what causes it
erythema infectiosum | parvovirus B19
55
what are complications of parvovirus B19
spontaneous abortion aplastic crises (drop in haemoglobin, short RBC life span) chronic anaemia
56
how does Orf classical present
Firm, fleshy nodule on hands of farmers
57
what is the primary infection of syphilis
chancre - painless ulcer typically in genitals
58
what is the secondary phase of syphilis
red rash over body | particularly on soles of feet and palms of hands
59
typically seen in secondary phase of syphilis
mucous membrane 'snail track ulcers"
60
what causes syphilis
treponema pallidum
61
what is tertiary syphilis
when is affects CNS, CV
62
how is syphillis treated and diagnosed
Dx - blood test or PCR swab of chancre | Tx - injections of penicillin
63
what bacteria causes lyme disease
borrelia burgdorferi
64
early classic presentation of lyme disease and later complications
early - erythema migrans | late - nerve palsies, arthritis, heart block
65
tx of lyme disease
doxycyline or amoxicillin
66
what is the most common type of psoriasis
psoriasis vulgaris | i.e. chronic plaque psoriasis
67
what are key features of psoriasis
symmetrical | Sharply demarcated, scaly, erythematous plaques
68
areas of trauma developing psoriasis - name?
Koebner phenomenon
69
psoriatic nail changes
onycholysis nail pitting dystrophy subungal hyperkeratosis
70
what is Acne vulgaris
Chronic inflammatory disease of the pilosebaceous unit.
71
what is the pathogenesis of Acne
Poral occlusion Bacterial colonisation of duct Dermal inflammation Increased sebum production
72
which areas does acne affect
related to sites with most sebaceous glands | Face, upper back, anterior chest
73
acne grading
Mild- scattered papules and pustules, comedones Moderate - numerous papules, pustules & mild atrophic scarring Severe - as above, cysts, nodules and significant scarring
74
what is rosacea
Prominent facial flushing exacerbated by sudden change in temperature , alcohol & spicy food
75
what areas does rosacea affect
nose, chin, cheeks, forehead
76
tx of rosacea
reduce aggravating factors topical metronidazole oral tetracycline
77
what can treat telangiectasia
vascular laser
78
Bullous pemphigoiD
split is Deeper | through DEJ
79
pemphiguS vulgaris
split more Superficial | intra-epidermal
80
who gets Bullous pemphigoid
elderly
81
what is characteristics of bullous pemphigoid
localized to one area, or widespread on the trunk and proximal limbs large tense bullae on normal skin or erythematous base blisters burst to leave erosions
82
Nikolsky sign is positive in bullous pemphigoid - true or false
false | it is negative
83
where does pemphigus vulgaris affect
scalp, face, axillae, groin
84
symptoms/signs of pemphigus vulgaris
Flaccid vesicles/bullae – thin roofed Lesions rupture to leave raw areas - Increased infection risk Nikolsky sign positive Mucosal involvement (eyes, genitals) : very common
85
Bullous pemphigoid vs pemphigus vulgaris - mortality
Pemphigus very high mortality if untreated | Pemphigoid up to 20% mortality I year treated
86
Bullous pemphigoid and pemphigus vulgaris - Ix
Pemphigoid - Skin biopsy +ve immunofluorescence; linear IgG and C3 along basement membrane Pemphigus - +ve immunofluorescence; intracellular IgG giving a crazy paving effect
87
Bullous pemphigoid and pemphigus vulgaris - Tx
Pemphigoid - Clobetasol cream up to 40g/day Pemphigus - Prednisolone 60-80mg. Can continue onto Rituximab.
88
what Tx is used specifically in pemphigoid
tetracycline antibiotics, nicotinamide
89
clinical presentation of type 1 hypersensitivity reaction
urticaria (hives/wheals) angioedema wheezing/asthma Anaphylaxis
90
what is tested during anaphylaxis
tryptase levels
91
what test are used to identify allergen
Specific IgE (RAST) Skin prick Challenge test
92
Mx of allergy
avoidance anti-histamines corticosteroids adrenaline autoinjector
93
amount of adrenaline in auto injector
300µg adults | 150µg children
94
onset of reaction in Type IV allergy
24-48 hours
95
how is Type IV investigated
patch testing
96
what are the 4 causes of itch
Pruitoceptive Neuropathic Neurogenic Psychogenic
97
what causes Pruritoceptive itch
something (usually associated with inflammation or dryness) in skin that triggers itch
98
what causes Neuropathic itch
damage of any sort to central or peripheral nerves causing itch
99
what causes Neurogenic itch
no evident damage in CNS, but itch caused by, e.g., opiate effects on CNS receptors
100
primary biliary cirrhosis is associated with itch - true or false
true

Dermatology SB (11 decks)

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