Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

5. Dermatology (Med) > Acute and Emergency Dermatology > Flashcards

Acute and Emergency Dermatology Flashcards

1
Q

What is the largest organ in the body?

A

Skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Consequences of skin failure relates to function, what does failure of the skin to be a mechanical barrier to infection cause?

A

Sepsis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Consequences of skin failure relates to function, what does failure of temperature regulation cause?

A

Hypo or hyper-thermia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Consequences of skin failure relates to function, what does failure of the skin to balance fluid and electrolytes lead to?

A

Protein and fluid loss

Renal impairment

Peripheral vasodilation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is erythroderma?

A

Descriptive term rather than a diagnosis:

  • “Any inflammatory skin disease affecting >90% of the total skin surface”
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are some causes of erthroderma?

A
  • Psoriasis
  • Eczema
  • Drugs
  • Cutaneous lymphoma
  • Hereditary disorders
  • Unknown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the principles of erythroderma management?

A
  • Remove any offending drugs
  • Fluid balance
  • Good nutrition
  • Temperature regulation
  • Oral and eye care
  • Anticipate and treat infection
  • Manage itch
  • Disease specific therapy, treat underlying cause
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is an example of a mild drug reaction?

A

Morbiliform exanthema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is morbiliform exanthema?

A

Rose-red flat (macular) or slightly elevated (maculopapular) eruption, showing circular or elliptical lesions varying in diameter from 1 to 3 mm, with healthy-looking skin intervening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are examples of severe drug reactions?

A
  • Erthroderma
  • Stevens Johnson Syndrome (SJS)
  • Toxic epidermal necrolysis (TEN)
  • DRESS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What does SJS stand for?

A

Stevens Johnson Syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What does TEN stand for?

A

Toxic epidermal necrolysis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs can SJS or TEN be secondary to?

A
  • Antibiotics
  • Anticonvulsants
  • Allopurinol
  • NSAIDs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What percentage of epidermal detachment occurs with SJS?

A

<10%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What percentage of epidermal detachment occurs with TEN?

A

30%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Which of SJS and TEN affects a larger surface area?

A

TEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the clinical features of SJS?

A
  • Fatigue, malaise, arthralgia (pain in a joint)
  • Rash
    • Maculopapular, target lesions, blisters
    • Erosions covering <10% of skin surface
  • Mouth ulceration
    • Greyish white membrane
    • Haemorrhagic crustings
  • Ulceration of other mucous membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the clinical features of TEN?

A
  • Often presents with prodromal febrile illness
  • Ulceration of mucous membranes
  • Rash
    • May start as macular, purpuric or blistering
    • Rapidly becomes confluent
    • Nikolsky’s sign may be positive
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the management of SJS/TEN?

A
  • Identify and stop culprit drug as soon as possible
  • Supportive therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the prognosis of SJS/TEN?

A

SJS - 10% mortality

TEN - 30% mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What scale is used to determine how severe SJS or TEN are?

A

SCORTEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What does a greater SCORTEN score increase?

A

Mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What does SCORTEN scale consider?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are some long term complications of SJS/TEN?

A
  • Pigmentary skin changes
  • Scarring
  • Eye disease and blindness
  • Nail and hair loss
  • Joint contractures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is erythema multiforme?
Hypersensitivity reaction usually triggered by infection
26
What infections is erthema multiforme most commonly associated with?
HSV then myoplasma pneumonia
27
What is the clinical presentation of erythema multiforme?
Abrupt onset of up to 100s of lesions over 24 hours: * Distal to proximal * Palms and soles * Mucosal surfaces * Evolve over 72 hours * Pink macules, become elevated and may blister
28
What is the treatment for erythema multiforme?
Self limiting and resolves over 2 weeks Symptomatic and treat underlying cause
29
What does DRESS stand for?
Drug reaction with eosinophilia and systemic symptoms
30
What is the mortality of DRESS?
Up to 10%
31
When does DRESS occur after the drug exposure?
Onset 2-8 weeks after drug exposure
32
What is the clinical presentation of DRESS?
Fever Widespread rash Eosinophilia Deranged liver function Lymphadenopathy Maybe other organ involvement
33
What is the treatment of DRESS?
* Stop causative drug * Symptomatic and supportive * Systemic steroids * With or without immunosuppression or immunoglobins
34
What is pemphigus?
Rare skin disorder characterized by blistering of your skin and mucous membranes Antibodies targeted at desmosomes
35
What is the clinical presentation of pemphigus?
Flaccid blisters that rupture very easily are seen in the skin Intact blisters may not be seen Nikolsky's sign may be present Commonly affects mucous membrane Ill defined erosions in mouth
36
Where does pemphigus commonly affect?
Face, axillar and groins
37
What is pemphigoid?
Rare autoimmune disorder that can develop at any age, including in kids, but that most often affects the elderly. Pemphigoid is caused by a malfunction of the immune system and results in skin rashes and blistering on the legs, arms, and abdomen
38
What is the clinical presentation of pemphigoid?
Intact epidermis forms roof of blister Blisters are usually tense and intact
39
In pemphigoid what are antibodies direct at?
Dermo-epidermal junction
40
Compare and contrast pemphigus and pemphigoid?
41
Which of pemphigus and pemphigoid is more common?
Pemphigoid
42
Which of pemphigus and pemphigoid affects older patients?
43
What is the treatment of pemphigus?
Systemic steroids Dress erosions Supportive therapies
44
What is the treatment of pemphigoid?
Topical steroids may be sufficient if localised Systemic usually required if diffuse
45
What are some different kinds of psoriasis?
Erythrodermic psoriasis Pustular psoriasis
46
What are common causes of erythrodermic and pustular psoriasis?
Infection Sudden withdrawal of oral steroids or potent topical steroid
47
What is the clinical presentation of erythrodermic and pustular psoriasis?
Rapid development of generalised erythema with or without clusters of pustules Fever Elevated WCC
48
What is the treatment of erythrodermic and pustular psoriasis?
Exclude underlying infection, bland emollient and avoid steroids Often require initiation of systemic therapy
49
What is eczema herpeticum?
Disseminated herpes virus infection on a background of poorly controlled eczema
50
What is the clinical presentation of eczema herpeticum?
Monomorphic blisters and "punched out" erosions Which are painful but not itchy Fever and lethargy
51
What is the treatment of eczema herpeticum?
* Dose of aciclovir * Mild topical steroid if required to treat eczema * Treat secondary infection * Ophalmology input if peri-ocular disease In adults consider underlying immunocompromised
52
What is staphylococcal scaled skin syndrome?
Staphylococcus aureus produces an exfoliative toxin that causes the outer layers of skin to blister and peel, as if they've been doused with a hot liquid
53
What does SSSS stand for?
Staphylococcal scaled skin syndrome
54
Who is commonly affected by staph scaled skin syndrome?
Children Can occur in immunocompromised adults
55
What is the clinical presentation of staph scaled skin syndrome?
* Diffuse erythematous rash with skin tenderness * More prominent in flexures * Blistering and desquamation follows * Staph procures toxin which targets desmoglein 1 * Fever and irritability
56
What is the treatment of staph scaled skin syndrome?
* Admission for IV antibiotics initially and supportive care * Generally resolves over 5-7 days with treatment
57
What is urticaria?
Raised, itchy rash that appears on the skin
58
What is urticaria also known as?
Also known as hives, weals, welts or nettle rash
59
What is the clinicla presentation of urticaria?
* Central swelling of variable size, surrounded by erythema * Dermal oedema * Itching, sometimes burning * Histamine release into dermis * Fleeting nature, duration is 1 to 24 hours * Angioedema * Deeper swelling of the skin or mucous membranes
60
When does acute urticaria become chronic?
After 6 weeks of history
61
What are causes of acute urticaria?
* Idiopathic 50% * Infection, usually viral 40% * Drugs, IgE mediated 9% * Food, IgE mediated 1%
62
What is the treatment of acute uticaria?
* Oral histamine * Taken continuously * Up to 4x dose * Short course of oral steroid may be of benefit if clear cause and this is removed * Avoid opiates and NSAIDs if possible (exacerbate urticarial)
63
What is the cause of chronic uticaria?
* Autoimmune/idiopathic 60% * Physical 35% * Vasculitic 5% * Rarely a type 1 hypersensitivity reaction
64
What is the treatment of chronic uticaria?
* Omalizumab * Monoclonal antibody to IgE

5. Dermatology (Med) (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions