Skin COPY Flashcards
1
Q
ISOTRETINOIN MHRA WARNINGS?
A
NO WAXING/LASER DURING AND 6 MONTHS LATER. AVOID UV SUNLIGHT Report low mood/behaviour changes PPP
2
Q
ISOTRETINOIN CONTRACEPTION ADVICE?
A
CONTRACEPTION 1 MONTH BEFORE, DURING AND AFTER!1 HIGHLY EFFECTIVE (IUD) OR 2 COMPLEMENTARY (COC+BARRIER)PROGESTOGEN-ONLY- not rated!
3
Q
What is this?
A
Chicken pox
4
Q
What is this?
A
Acne
5
Q
What is this?
A
Atopic Dermatitis
6
Q
What is this?
A
Cold Sores
7
Q
What is this?
A
Cradle Cap
8
Q
What is this?
A
Dandruff
9
Q
What is this?
A
Fungal Nail Infection
10
Q
What is this?
A
Hand Foot and Mouth
11
Q
What is this?
A
Impetigo
12
Q
What is this?
A
Measles
13
Q
What is this?
A
Meningitis- rash that does not fade when glass rolled over
stiff neck
fever
14
Q
What is this?
A
Mumps- swollen glands
:0o
15
Q
What is this?
A
Nappy Rash
16
Q
What is this?
A
Psoriasis- silver scales, red patches of skin
17
Q
What is this?
A
Rubella- red/pink/spotty rash, all over body
18
Q
What is this?
A
Scarlet Fever- sunburn red rash, sandpaper
red lines folds of skin
flushed face
strawberry tongue
19
Q
What is this?
A
Slapped Cheek Syndrome- red rash on both cheeks
20
Q
What is this?
A
Tinea Capitis (fungal infection of the scalp)
21
Q
What is this?
A
Tinea Corporis (fungal infection of the body) scaly, ring shaped area- trunk, legs raised, expanding rings
22
Q
What is this?
A
Jock itch
23
Q
What is this?
A
Tinea Pedis (Athlete’s foot)
24
Q
What is this?
A
Wart / Verruca
25
As well as runny nose, cough and a high fever, what is another symptom of measles?
Conjunctivitis
26
Do you refer measles to the GP?
Yes - advise the patient to phone first to reduce risk of spreading the infection
27
What is the advice for patients with measles, mumps or rubella?
To stay hydrated
28
How long after symptoms disappear should a child stay off school with measles, mumps or rubella?
Measles - 4 days
Mumps - 5 days
Rubella - 6 days
29
Which over the counter products can be given to patients with measles, mumps or rubella?
Paracetamol and Ibuprofen
30
As well as fever, headache and malaise, what is another symptom of mumps?
Swelling of one or both glands which shows at the sides of the face
31
As well as fever, headache and malaise, what is another symptom of rubella?
Swelling of glands which shows up at the back of the neck
32
What are the 3 OTC treatments for chicken pox?
1. Calamine lotion
2. Cooling gels
3. Paracetamol
33
What are the two pieces of lifestyle advice given to patients with chicken pox?
1. Stay hydrated
| 2. Cut nails short to avoid scratching
34
Flu-like symptoms, nausea, vomiting, lethargy and muscle ache are non-specific signs of meningitis. What are the specific signs? (7)
1. Severe headache
2. Stiff neck
3. Altered mental state
4. Non-blanching rash
5. Photophobia
6. Seizures
7. Unconsciousness
35
As well as Olive Oil BP and gently brushing flakes away, which shampoo can be used in the treatment of cradle cap?
Ketoconazole 2% Shampoo
36
What are the referral criteria for nappy rash? (5)
1. Yellow/weeping (infection)
2. Broken skin
3. Symptoms for over 2 weeks
4. Concomittant genital / oral thrush
5. Rash in other areas of the body
37
What are the treatment options for nappy rash? (5)
1. Clotrimazole 1% cream
2. Dimeticone
3. Zinc
4. Lanolin
5. Castor oil/Cod liver oil (creates a water resistant barrier)
38
What are the referral criteria for eczema/atopic dermatitis?
1. Yellow/Weeping (infection)
2. Sever symptoms (cracked/bleeding)
3. Treatment failure
4. Not previously diagnosed / No identifiable cause
5. Symptoms for over 2 weeks
39
What are the two types of topical treatment used in atopic dermatitis?
1. Emolients
| 2. Corticosteroids
40
Which two corticosteroids can be used in atopic dermatitis?
1. Hydrocortisone
| 2. Clobetasone
41
What is the minimum age can hydrocortisone cream be sold for OTC?
10
42
What is the minimum age that clobetasone can be sold for OTC?
12
43
As well as moisturising creams, when else can emolients be applied to treat atopic dermatitis?
In the shower/bath as a soap substitute
44
What is the maximum duration of treatment for OTC hydrocortisone and clobetasone cream?
7 days
45
Which drugs can cause acne as an adverse effect? (5)
1. Lithium
2. Phenytoin
3. Progestogens
4. Levonorgesterol
5. Norethistrone
46
When treating acne OTC, after how long do you refer if unresponsive?
8 weeks
47
Which OTC product is used to treat acne?
Benzylperoxide: 2.5%, 5% or 10%
48
Especially during the initial stages of treatment with benzoyl peroxide, which side effects can patients experience?
1. Drying
2. Stinging
3. Soreness
4. Peeling
49
What are the counselling points for OTC acne treatment with benzyol peroxide? (4)
1. Regular use is required
2. Might take a while to work
3. Avoid greasy, oil-based cosmetics
4. Sunglight is helpful
50
Occuring 6-24hrs before, what is the prodomal symptom of cold sores?
Tingling and irritation
51
How long do most cold sores take to heal?
1 week
52
What are the referral criteria for cold sores? (5)
1. Painless lesions (may be cancerous)
2. Babies/young children
3. Sore and lasting for over 2 weeks
4. Affecting the eyes
5. Immunocompromised patients
53
Which antiviral can be used topically to treat cold sores?
Aciclovir
54
To treat cold sores, how many times a day should aciclovir be applied?
5 times a day
55
When treating cold sores, when should patients start using topical aciclovir to maximise effectiveness?
During the prodromal phase
56
As well as topical aciclovir, what can be sold OTC for the treatment of cold sores?
Hydrocolloid patches - promote wound healing
57
What is the duration of treatment for cold sores using OTC Zovirax cream?
At least 4 days, up to 10 days
58
How long does it usually take for warts and verrucas to disappear on their own?
6 months - 2 years
59
What are the referral criteria for warts and verrucae? (8)
1. Facial warts
2. Change in size/shape
3. Bleeding
4. Itching
5. On the genitals
6. Immunocompromised patients
7. No improvement after 3 months with OTC treatment
8. Diabetes
60
What are the 2 OTC treatment options for warts and verrucae?
1. Salicylic acid
| 2. Cryotherapy
61
Counselling patients with warts: what should they do before applying treatment?
Soak their hands/feet in warm water for 5-10mins
62
Counselling patients with warts: what should they do once a week?
Remove dead skin with pumice stone
63
When should you refer someone who presents with dandruff?
If you suspect it might be psoriasis
64
What is the first line treatment for dandruff?
Ketoconazole 2% shampoo
65
How often should ketoconazole 2% shampoo be applied when treating dandruff?
Twice a week for the first 2-4 weeks then,
Weekly/Fortnightly thereafter
66
After ketoconazole 2% shampoo, what is the other OTC treatment option for treating dandruff?
Selenium Sulphide 2% Shampoo
67
What is the least effective OTC treatment for dandruff but is still used?
Coal tar
68
How long does it take to see improvement of dandruff after starting OTC treatment?
12 weeks
69
When using shampoos to treat dandruff OTC, what counselling advice should you give patients?
Leave it on for 5 minutes before rinsing off
70
Which skin condition can be trigger by stress?
Psoriasis
71
What are the referral criteria for psoriasis? (2)
1. No previous diagnosis
| 2. Moderate - Severe (may need dermatologist)
72
What is the only OTC option to treat psoriasis?
Emollients
73
Athelete's Foot, Jock Itch, Tinea Capitis and Tinea Corporis are all caused by which type of infection?
Fungal
74
What is Tinea Corporis better known as?
Ringworm
75
What are the referral criteria for fungal infections? (5)
1. Spreading of symptoms
2. Signs of bacterial infection
3. Diabetics
4. Immunocompromised
5. Unresponsive to treatment
76
What is the referral criteria for someone presenting with athlete's foot?
If the toenail is also affected
77
Which 3 topical antifungals can be used to treat fungal "tinea" infections?
1. Clotrimazole
2. Ketoconazole 2% (Daktarin Gold)
3. Miconazole (Daktarin)
78
How long after symptoms subside should patients continue to treat fungal "tinea" infections?
7 days
79
As well as antifungal creams, what are other OTC treatment options for fungal "tinea" infections? (2)
1. Combination products (Antifungal and Corticosteroid) - e.g. Daktacord
2. Terbinafine
80
Should you refer impetigo?
Yes
81
Which recent POM to P OTC product is used for the treatment of fungal nail infections?
Amorolfine 5% nail laquer
82
What is the specific indication for OTC amorolfine 5% nail lacquer use?
No more than 2 nails affects
Only beneath the tips or sides of nails
83
Is amorolfine 5% nail lacquer used in the OTC treatment of fungal nail infections licensed for use in patients of all ages?
No, over 18 only
84
How often should amorolfine 5% nail lacquer be applied when treating fungal nail infections OTC?
once a week
85
What should the patient do before applying amorolfine 5% nail lacquer for the OTC treatment of fungal nail infections?
File down the nail, cleanse and degrease
86
How long is treatment duration for amorolfine 5% nail lacquer for the OTC treatment of fungal nail infections? TOES
9-12 months
87
How long is treatment duration for amorolfine 5% nail lacquer for the OTC treatment of fungal nail infections? FINGERNAILS
6 months
88
Should you refer a baby with slapped cheek syndrome?
No
89
A self-limiting disease, how long does it take for slapped cheek syndrom to heal?
2 weeks
90
Should you refer someone with shingles?
Yes, GP
91
Can you catch shingles from someone with chicken pox?
No
92
Can you catch chicken pox from someone with chicken pox?
Yes
93
Should you refer a baby with hand foot and mouth disease?
If no improvement after 7-10 days
94
Often with swollen tonsils, after which infection does scarlet fever usually develop from?
Throat
95
Should you refer someone with scarlet fever?
Yes, to the GP
96
SKIN INFECTIONS
| SCABIES VISUAL SYMPTOM?
Red spot with silverly interlinking lines- webbing of fingers/toes
97
SCABIES TREATMENT & COUNSELLING?
APPLY MALATHION & PERMETHRIN TWICE, 1 week apart
APPLY TO WHOLE BODY- scalp/neck/face/ears
TREAT ALL MEMBERS OF THE FAMILY
AVOID PHYSICAL CONTACT WITH OTHER PEEPS
REAPPLY TO WASHED HANDS!
98
SCABIES- BENZYL BENZOATE POINTERS?
Less effective
Irritant, avoid in children
Up to 3 consecutive days
99
HEADLICE TREATMENT
WET COMBING?
DRUGS?
NOT RECOMMENDED?
MHRA WARNING?
WET COMBING? Comb for 30mins, 4 day intervals, no lice for 3 sessions (3 weeks)
DRUGS?
Dimeticone- apply for 8hrs, dry naturally- repeat after 7 days
Malathion- apply for 12hrs, dry naturally- repeat after 7 days (AVOID IN SEVERE ECZEMA/ASTHMA cos alcohol, astags)
NOT RECOMMENDED? Benzyl benzoate/permethrin
MHRA WARNING? SOME PREPS ARE FLAMMABLE, FIYAAAAAAAAAA
100
ECZEMA- dry, flaky skin- small red spots
| DD FROM PSORIASIS?
PSORIASIS- silvery scales, bingo!
101
TYPES OF ECZEMA?
IRRITANT
ALLERGIC CONTACT
ATOPIC
102
ECZEMA TREATMENT
EMOLLIENTS?
TOPICAL CORTICOSTEROIDS?
ANTIHISTAMINES?
EMOLLIENTS? Apply as bath/shower emollients. Avoid aqueous cream due to high risk of skin infections
TOPICAL CORTICOSTEROIDS? Mild- face & genitals
ANTIHISTAMINES? NOT in atopic dermatitis
103
ECZEMA DRUG TREATMENT
MILD-MODERATE?
MODERATE-SEVERE?
MILD-MODERATE? Pimecrolimus
| MODERATE-SEVERE? Tacrolimus
104
SEVERE REFRACTORY ECZEMA TREATMENT? systemic G
CICLOSPORIN
AZATHIOPRINE
MYCOPHENOLATE MOFETIL
MONOCLONAL ANTIBODIES- tocilizumab?
105
PSORIASIS
| VISUAL SYMPTOM?
Skin thickening
| Silvery white scaling/raised/larger patches/plaques
106
PSORIASIS- systemic, immune-mediated inflammatory skin disease (joints too)-> psoriatic arthritis
107
PSORIASIS TREATMENT?
EMOLLIENTS
TOPICAL CORTICOSTEROIDS
COAL TAR PREPS
VITAMIN D (topical/analogue)
108
PSORIASIS TREATMENT- TOPICAL an L?
PHOTOTHERAPY- UVA/UVB through trained professional
SYSTEMIC- methotrexate/ciclosporin/acitretin (second-line)
OK then mate
109
```
TOPICAL CORTICOSTEROIDS
MILD?
MODERATE?
POTENT?
VER POTENT? (solo)
COUNSELLING?
```
```
MILD? Hydrocortisone
MODERATE? Clobetasone
POTENT? Betamethasone
VER POTENT? Clobetasol (solo)
COUNSELLING?
prolonged use- skin thinning, OTC hydrocortisone 1%, 7 days
apply thinly- fingertip unit hand? ok
do not apply to broken skin
```
110
ACNE- FIRST-LINE TREATMENT OPTIONS?
```
ADAPALENE
BENZOYL PEROXIDE
CLINDAMYCIN
LYME/DOXYCYCLINE
ERYTHROMYCIN
```
111
SEVERE ACNE- ISOTRETINOIN
| MHRA WARNING & ADVICE? PEN
PPP (pregnancy prevention programme)- take contraceptive 1 month before+after, 30 days supply treatment
ED/decreased libido- rare
Neuropsychiatric reactions- seek medical attention, mood change
AVOID UV LIGHT/LASER SKIN TREATMENT/DERMABRASION/EPILATION
112
```
SCALP & HAIR CONDITIONS
DANDRUFF TREATMENT
MILD?
PERSISTENT/SEVERE?
PSORIASIS OF SCALP?
```
MILD? Shampoos containing antimicrobials- pyrithione zinc/selenium/tar extracts
PERSISTENT/SEVERE? Ketoconazole shampoo
PSORIASIS OF SCALP? Coal tar & salicylic acid
113
HIRSUTISM TREATMENT? (hormonal/cos of drugs- minoxidil, corticosteroids, progestogens, phenytoin)
Weight loss Laser therapy Eflornithine Co-cyprindiol
114
ALOPECIA TREATMENT?
FINASTERIDE
OR
MINOXIDIL
