24 November #2

Question 1

What are features of lichens pplanus?

Answer 1

Itchy, flat topped papular lesions
Found on flexor surfaces, palms, soles and mucous embraines
Wickhams striae- white lines can occur

Question 2

What are some skin signs of dermatomyostis?

Answer 2

Heliotropic rash
Macular rash over back and shoulders- shawl sign
Red papules over knuckles- got tons of papulesW

Question 3

What is erythema ab igne?

Answer 3

Looks like mottling
Common in elderly- sitting in front of fire or use of hot water bottles

Question 4

What is Bowens disease?

Answer 4

Slow growing red scaly plaque
SCC in situ
Treated with cryrotherapy or topical 5flurouracil cream

Question 5

What investigation is used in tinea capatis?

Answer 5

Woods lamp- bright green to yellow fluorescence of infected hairs

Treat with oral antifungals- terbinafine for trichophyton and griseofulvin for microsporum infections

Question 6

What is the management of psoriasis?

Answer 6

Regular emollients
1) topical steroid and Vit D analogue daily (calcitriol)
2) No improvement after 8 weeksn then Vit D analogue BD
3) No improvement after 8-12 weeks then potent steroid BD or coal tar OD-BD

Question 7

What are side effects of oral retinoids?

Answer 7

Hair loss
Nose bleeds
Sore lips
Dry mucous membranes
Teratogenic

Question 8

What are clinical features of pagets?

Answer 8

Disease of increased osteoclastic activity

Older male with bone pain and isolated high ALP
Bone pain- skull, pelvis, vertebra, femur

Question 8

What are complications of Pagets disease?

Answer 8

Deafness
Bone sarcoma
Fractures
Skill thickening
Cardiac failure

Question 9

What is the management of bradycardia?

Answer 9

if haemodynamically unstable
Atropine 500mcg up till 3mg
Transcutaneous pacing (1st line if stable, specialist advice if unstable
Isoprenaline/adrenaline infusion titration

Question 10

what are symptoms of Diptheria?

Answer 10

Sore throat
Grey appearance on pharyngeal wall
Bulky cervical lymphadenopathy
Neuritis
Heart block

Question 11

What is the management of Paget disease of the bone?

Answer 11

Bisphosphates

Question 12

What antibodies indicate chronic hep B infection?

Answer 12

HbsAg positive- acute or chronic infection
Anti-HBc IgG= chronic

If both positive means chronic infection

Question 13

What does positive anti HBs show in (hepatitis B infection)

Answer 13

Immunisation to Hep B

Question 14

How can anion gap be calculated?

Answer 14

Sodium+potassium -bicarbonate +chloride

Normal result 8-14

Question 15

What are causes of normal anion gap metabolic acidosis?

Answer 15

Diarrhoea/vomiting
Renal tubular acidosis
Addisions disease
Drugs e.g. acetazolamide

Question 16

What are causes of raised anion gap acidosis?

Answer 16

Lactate- shock/hypoxia
DKA
Alcohol
Renal failure
Salicylate over dose
Methanol overdose

Question 17

What are the features of tetrology of fallot?

Answer 17

VSD
Right ventricular hypertrophy
Right ventricular outflow obstruction- pulmonary stenosis
overriding aorta

Question 18

What is Argyll-roberston Pupil?

Answer 18

Associated with neurosyphilis
Pupils small and irregular shaped
They accomodate
No reaction to ligh

Question 19

What is Holmes-Adie pupil?

Answer 19

One or both pupils large
Slow or absent reactions to light
Normal accomodation

Question 20

What abs should be given in event of animal bite?

Answer 20

Co-amoxiclav
If pen allergic then doxy and metro

Question 21

What are the grades of hypertensive retinopathy?

Answer 21

1- Arteriolar narrowing/tortuosity, silver wiring
2- AV nipping
3- Cotton wall exudates, flame and blod haemorrhages
4- papilloedema

Question 22

What are features of roseola infantum?

Answer 22

High fever lasting few days
Followed by maculopapular rash
Febrile convulsions
Diarrhoea and cough

Question 23

What are features of eczema herpeticum?

Answer 23

Seen in children with atopic eczema
Presents as rapidly progressing painful rash

Admit for IV aciclovir

Question 24

What markers are raised in anorexia?

Answer 24

GH
Cortisol
Cholesterol
Carotin

Rest are all low