random factoids Flashcards
(124 cards)
1
Q
bullous pemphogoid has a problem with…
A
hemidesmosomes
2
Q
pemphigus vulgaris has a problem with …
A
desmoglein-3
3
Q
drop like lesions
A
guttate psoriasis
4
Q
derm feature of endocarditis
A
finger clubbing
5
Q
asteatotic eczema patient presentation
A
elderly patietns in the winter months with dry legs
6
Q
removal of melanoma rules
A
first removed with 2mm excisional biopsy then breslows value is added
7
Q
onion skin appearanc
A
ewings sarcoma
8
Q
sunburst pattern
A
osteosarcoma
9
Q
does erythema blanche?
A
no
10
Q
what is petechia?
A
> 2mm of flat purpura
11
Q
is a nodule bigger than a papule?
A
yes
12
Q
does roseace have comedones?
A
no
13
Q
at what size does a skin lesion become concering?
A
> 6mm
14
Q
what are the symptoms of ramsay hunt?
A
shingles in ear
15
Q
pemphigus nikolsky sign
A
positive
16
Q
pemphigoid nikolsky sign
A
negative
17
Q
what is koebner phenomenon?
A
psoriasis / vitiligo on trauma areas
18
Q
what sort of deramtitis is gloves?
A
allergic
19
Q
what sort of dermatitis is soap
A
irritant
20
Q
what cells are found in the granular layer and what do they contain?
A
large keratohyaline granules
which contain filagrin adn involcurin proteins
- odland bodies
21
Q
which layer are the nuclei lost?
A
granular layer
22
Q
which cells are found in the prickle layer?
A
langerhan cells
23
Q
which layer is mainly composed of fibroblasts?
A
dermis
24
Q
what do panician nerves sense?
A
pressure
25
what do meissener nerves sense?
vibration
26
aprocine sweat glands
armpits
| oily + odourous fluid
27
eccrine sweat glands
palm and soles
28
what are the 2 dendritic cells in the dermis?
dermal DC - involved in Ag presenting and secreting cytokines
plasma DC - produce INFa (found in psoriasis)
29
pathway of vitamin D
| what converts it?
stored at hydrocholecalciferol in the liver and changes to 1,25dihydroxycholecalciferol in the kindey
converted by 290nm UV light
30
T2 hypersensitivity examples
haemolytic disease of the newborn
| blood transfusion recipients
31
T3 hypersensitivity examples
skin resting in arthurs reaction
32
T5 hypersensitivity examples
tuberculin reaction
contact allergy
delayed (1-2 days after contact)
33
deficiency in PCT
uroporphyrinogen decorbxylase --> increased uroporphyrinogen 3
34
symptoms of PCT
```
blistering in sun exposed areas
milla
hyperpigmentation
hypertrichosis
solari urticaria
morphoea
```
35
peak for PCT
617mm
36
urine colour for PCT
red
37
deficiency for EP
ferrochelatase --> increase in protopyrin IX
38
symptoms of EP
```
erythema
swelling
itching
burning
pain
```
39
peak for EP
634mm
40
treatment for EP
antioxidants
41
deficiency for ATP
porphobillinogen deaminase --> increased PBG
42
symptoms of ATP
abdominal pain
urinary symptoms
psychiatric symptoms
proximal muscle weakness
43
treatment for ATP
hermatin + haema arginate (in acute attack)
44
which drug / base combo is the best for skin?
lipophilic drug + hydrophilic base / vehicle
45
3 modes of action of topical corticosteroids?
vasoconstrictive
antiinflammatory
antiproliferative
46
20-30g of topical corticosteroids =
1 fingertip = 2 hand areas
47
side effects of topical corticosteroid use
skin thinning
purpura
stretch marks
sudden removal - risk of rebound pustular psoriasis
48
what do calcineural inhibitors do
suppress lymphocyte activatoin
| - used in atopic eczema
49
hyperkeratosis
increased thickness of keratin layer
50
parakeratosis
persitence of nuclei in the keratin laer
51
acanthosiss
increased thickness of epithelium
52
papillomatosis
irregular epithelial thickening
53
spongiosis
oedema fluid between squames appears to increase prominence of intercellular prickles
54
pathophysiology behind lichenoid disorders?
damage to basal epidermis eg lichen planus
55
pathophysiology behind pemphigus?
IgG antibodies made against desmoglein3
56
pathophysiology behind pemphigoid?
IgG reacts with hemidesmosomes which anchor basal cells to basement membrane
57
halotype of dermatitis herpetiform
HLA DQ2
58
how to treat a small area of ring worm?
comitrazole cream
59
how to treat a large area of ring worm?
terfinabine orally
60
how to treat candida
clotimazole
61
what is shingle for >4 weeks called
post hepatic neuralgia
62
when shingles is latent where does it sti
dorsal sensory root
63
where do adults get shingles
thoacic and lumbar nerves
64
where do cihldren get shingles
cervical and sacral nerves
65
what is ramsay hunt syndrome
VSV in 7th + 8th CN
vesicles + pain in auditory canal + throat
faical palsy
deafness, vertigo, irritation
66
what is the mechanism of acyclovir?
guanoside analogue
67
symptoms of erythema multiform
target lesions
68
molluscum contagiosum
fleshy firm unbilicated nodiles (1-2m in diameter)
children / sexually transmitted
treatment - liquid nitrogen
69
HPV types for genital warts
6+11
70
HPV types for cervical cancer
16+18
71
cause of herpangina
coxsackie / echo virus
72
cause of hand foot and mouth
coxsackie
73
cause of slapped cheek / erytheam infectiniosum
parovirus 19
74
primary infection of syphilus
chancre (painless ulcer at site of entry)
75
secondary infection of syphillus
red rash over body
prominent on soles of feet and palms
mucous membrane 'snail track' ucler
76
cause of syphillus
sexually transmitted bacterium troponaema pallidum
77
pruriceptive itch
somethign in skin triggers itch eg insect bite / lichen plnus
78
neuropathic itch
damage to nerves causing itch
79
neurogenic itch
no damage to CNS but itch caused by opiate effects on CNS receptors
80
psychogenic
psychologic cause with no CNS damage eg delusion of infestation
81
which secondary infection is common in atopic eczema?
staph aureus
| crusting is characteristc
82
pomphylax eczema?
spongiotic vesicles
83
drug related eczema
eosinophils involved
84
lichen simplex eczema
due to scratching
85
stasis dermatitis
RBCs infiltration into extracellular compartment
86
symptoms of tuberous sclerosis
```
periungual fibroma
longitudinal ridging
infantile serizures (corical tuberous and/or calcification of falk cerebri)
ash leaf macule (earliest sign)
harmatomas
shagreen patches
enamel pitting
```
87
genetics of tuberous scelorsis
autosomal domiant
| TSC1 (tuberin) + TSC2 (hamaratin) = tumour suppressor genes
88
types of epidermolysis bullosa
1. simples - epidermis
2. junctional - junction
3. dystrophic (dermis)
89
features of neurofibromatosis 1
cafe au lait macules (>5 = abnormal)
neurofibromats
axillary freckling
optic glioma
90
what does a fillagrin mutation cause
itchythosis vulgaris
91
what is a malignant melanoma
found in basal layer
| migrate into skin from neurla crest
92
what is a melanoma in situ called?
letingo maligna
93
what are the 2 types of malignant melanoma?
superficial - horizontal then vertical
nodular - vertical first (faster at progressing)
94
which genes mutate in malignant melanoma?
CDK2NA
CDK4
BRAF mutation
95
treatment for malignant melanoma
vemurafenib (targets RAF/RAS pathway)
| transemitibin (targets MEK pathway)
96
what are some features of BCC
```
75% of all skin cancers
painless
slow growing
pearly/ translucent
visible blood vessels
>40
```
97
which mutation is involved in BCC?
PTHC1 (drosphila gene pathced) - key component in the hedgehog pathway
98
what are some features of squamous cell carcinoma?
```
20% of all skin cancers
warty/ crusted
sun damaged skin
can travel in nerves (merkel)
poor prognosis + can met
```
99
what are SCC precursor lesions?
```
actinic keratosis (elongated rete ridges)
bowens disease (scaly, erythematous plaques, irregular bored)
```
100
what are the high risk sites for SCC
ear
scalp
lip
101
what is UVA
- 320-400mm
- indirect oxidant damage
- penetrates further into skin than UBV
- penetrates through glass
102
in UVA, what are the pyramid dimers inbetween bases caused by?
oxidation of DNA bases eg deoxyguanosine
103
what os UVB
290-320nm
causes direct DNA damage
more damaging than UVA
104
what are acitninc lentinges?
age/liver spots
epidermis elongated riges
increased melanin and basal melanocytes
105
what are the 4 types of malenocytic naevi?
congenital
acquired
dysplastic naevus
rare naevi
106
describe congenital melanocytic naevi?
small <2cm
| large >20 - risk of melanoma
107
describe aquired melanocytic naevi?
common during infancy
| melanocyte : keratinocyte ratio breaks down
108
describe dyspalsic naevi?
>6cm in dimaeter
asymmetric
sporadic or familial
109
what are the 3 types of rare naevi?
halo - depigmented peripheral halo, overrun by lymphocytes
blue - dermal, pigement rich dendritic spindle cells
spitz - <20 years, large
110
what are the 4 types of malignant melanoma?
superficial
acral / mucosal - heels fingers toes nails
lentino maligna
nodular
111
what are seborrheic keratosis?
benign (version of BCC)
face and trunk
stuck on apperance (greasy)
112
what is a malignant sign of seborrheic keratitis?
lesser treat
113
what are the results of ABPI?
```
1 = normal
0.8-1.3 = compression
<0.8 = vascular disease
>1.5 = calcification
```
114
decribe an arterial ulcer?
pressure areas eg feet toes
deep, punched out, not weepy, necrotic base
swings legs off bed
115
describe a venous ulcer?
medial and lateral malleolus most common
knee to foot
pain
116
which cells carry out vitamin D metabolism?
keratinocytes
117
type 2 hypersensitivity
direct cell killling
118
type 3 hypersensitivity
immune complex mediated
119
which inheritance pattern is tuberous scelrosis
autosomal dominnat
120
which numbers of HIV are for warts / verucas
1-4
121
which symptom is present months before bullous pemphigoid?
itch
122
what is the treatment for roseaca?
metronidazole gel
| 2. oral tetracycline
123
what is the definition of breslows thickness
the depth from the granular layer of the epidermis to the deepest melanoma cells
124
which surgery technique gives the best outcome?
an elliptical excision with the scalpal cutting at 90 degrees to the surface of the skin
