24 November #2 Flashcards
What are features of lichens pplanus?
Itchy, flat topped papular lesions
Found on flexor surfaces, palms, soles and mucous embraines
Wickhams striae- white lines can occur
What are some skin signs of dermatomyostis?
Heliotropic rash
Macular rash over back and shoulders- shawl sign
Red papules over knuckles- got tons of papulesW
What is erythema ab igne?
Looks like mottling
Common in elderly- sitting in front of fire or use of hot water bottles
What is Bowens disease?
Slow growing red scaly plaque
SCC in situ
Treated with cryrotherapy or topical 5flurouracil cream
What investigation is used in tinea capatis?
Woods lamp- bright green to yellow fluorescence of infected hairs
Treat with oral antifungals- terbinafine for trichophyton and griseofulvin for microsporum infections
What is the management of psoriasis?
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
What are side effects of oral retinoids?
Hair loss
Nose bleeds
Sore lips
Dry mucous membranes
Teratogenic
What are clinical features of pagets?
Disease of increased osteoclastic activity
Older male with bone pain and isolated high ALP
Bone pain- skull, pelvis, vertebra, femur
What are complications of Pagets disease?
Deafness
Bone sarcoma
Fractures
Skill thickening
Cardiac failure
What is the management of bradycardia?
if haemodynamically unstable
Atropine 500mcg up till 3mg
Transcutaneous pacing (1st line if stable, specialist advice if unstable
Isoprenaline/adrenaline infusion titration
what are symptoms of Diptheria?
Sore throat
Grey appearance on pharyngeal wall
Bulky cervical lymphadenopathy
Neuritis
Heart block
What is the management of Paget disease of the bone?
Bisphosphates
What antibodies indicate chronic hep B infection?
HbsAg positive- acute or chronic infection
Anti-HBc IgG= chronic
If both positive means chronic infection
What does positive anti HBs show in (hepatitis B infection)
Immunisation to Hep B
How can anion gap be calculated?
Sodium+potassium -bicarbonate +chloride
Normal result 8-14
What are causes of normal anion gap metabolic acidosis?
Diarrhoea/vomiting
Renal tubular acidosis
Addisions disease
Drugs e.g. acetazolamide
What are causes of raised anion gap acidosis?
Lactate- shock/hypoxia
DKA
Alcohol
Renal failure
Salicylate over dose
Methanol overdose
What are the features of tetrology of fallot?
VSD
Right ventricular hypertrophy
Right ventricular outflow obstruction- pulmonary stenosis
overriding aorta
What is Argyll-roberston Pupil?
Associated with neurosyphilis
Pupils small and irregular shaped
They accomodate
No reaction to ligh
What is Holmes-Adie pupil?
One or both pupils large
Slow or absent reactions to light
Normal accomodation
What abs should be given in event of animal bite?
Co-amoxiclav
If pen allergic then doxy and metro
What are the grades of hypertensive retinopathy?
1- Arteriolar narrowing/tortuosity, silver wiring
2- AV nipping
3- Cotton wall exudates, flame and blod haemorrhages
4- papilloedema
What are features of roseola infantum?
High fever lasting few days
Followed by maculopapular rash
Febrile convulsions
Diarrhoea and cough
What are features of eczema herpeticum?
Seen in children with atopic eczema
Presents as rapidly progressing painful rash
Admit for IV aciclovir
