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Pre-reg > Chapter 13- Skin > Flashcards

Chapter 13- Skin Flashcards

1
Q

What do emollients do and when are they indicated

A

Soothe, smooth and hydrate the skin

Indicated for all dry or scaling disorders

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2
Q

When are barrier preparations indicated

A 
They contain water repellent substances used on:
The skin around a stoma 
Bedsores 
Pressure areas 
Nappy rash
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3
Q

What’s the MHRA alert for emollients

A

Risk of severe and fatal burns

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4
Q

How long should local antifungal infection treatment be carried on for after signs are gone

A

1-2 weeks

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5
Q

What antibacterials are mainly used for skin infections

A 
Neomycin 
Metronidazole 
Polymyxins
Silver sulfadiazine 
Mapirocin
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6
Q

Which antifungals are mainly used for skin infections

A 
Imidazole: 
Clotrimazole 
Econazole 
Ketoconazole
Miconazole
Tioconazole

Other:
Amorolfine
Griseofulvin
Terbinafine

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7
Q

What’s used for viral skin infection

A

Aciclovir

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8
Q

Why might some emollients contain urea

A

To relieve itching and hydrate the skin

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9
Q

What steroid is available OTC and from what age

A

Hydrocortisone 1%

Aged 10 +

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10
Q

What is scabies caused by

A

Parasites

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11
Q

How long can local topical anaesthetics be used for

A

3 days

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12
Q

What skin condition should corticosteroids not be used in

A

Acne

Rosacea

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13
Q

What drugs can exacerbate psoriasis

A 
Lithium 
Chloroquine 
Hydroxychloroquine 
Beta blocker 
Nsaid 
ACEI
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14
Q

What’s important to caution with the use of oral retinoids (can be used in psoriasis)

A

Avoid pregnancy 1 month before and Atleast 2 years after treatment

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15
Q

Counselling point with benzyl peroxide (used for acne)

A

Avoid sunlight

Can stain clothes

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16
Q

Which topical antibiotics can be used for acne

A

Tetracycline
Erythromycin
Clindamycin

For 6 months

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17
Q

Side effect of retinoids

A 
Risk of benign intracranial hypertension 
Headache 
Nausea 
Vomiting 
Visual disturbances
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18
Q

What preparation is mild to moderate acne usually treated with

A

Topical preparations

Benzyl peroxide, topical retinoids or topical antibiotic

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19
Q

When is systemic treatment for acne used

A

Moderate to severe acne
Topical not tolerated
Hard to reach the site

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20
Q

Long term risk associated with acireitin (retinoid)

A

Skeletal hypertosis

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21
Q

Uses of co-cyprindol

A

Contraception

Acne (in women)

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22
Q

Drug in roaccutane and drug class

A

Isotretinoin (vit a)

Retinoid

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23
Q

Counselling for roaccutane

A

Seek help of psychiatric disorders develop

Avoid wax and laser During treatment and 6 months after

Avoid exposure to UV light

Use emollients form the start (lips too)

Possible nose bleeds and joint pain

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24
Q

What are warts caused by and how are they treated

A

HPV- treated by destroying the affected skin

First line: salicylic acid (OTC)
Cryotherapy equally effective but may cause pain and blistering

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25
Q

What do the different UV cause

A

UVA- tanning and long term skin damage

UVB- sunburn

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26
Q

How’s hydrogen peroxide used for skin cleaning

A

Disinfectant and deodorant for wounds

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27
Q

How can potassium permanganate be used for skin cleaning

A

Used for weeping eczema lesions (may stain the skin)

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28
Q

What’s used for many preparations of anti perspirant

A

Aluminium

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29
Q

What’s ointments

A

Greasy preparations form a more occlusive barrier over the skin

The most hydrating for chronic dry skin

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30
Q

What are creams

A

More cosmetically acceptable

Less greasy in comparison to ointments

Dries quicker than ointment so applied more frequently

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31
Q

What’s gels

A

Contains high water content, suitable for scalp and face application

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32
Q

What’s lotions

A

Have a cooling effect, preferred for applying over a large or hairy area

Can sting promenade skin

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33
Q

What’s a mild topical corticosteroid used

A

Hydrocortisone <2.5%

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34
Q

What’s a moderate topical corticosteroid used

A

Clobetasone (Eumovate)

Betamethasone 0.025% (Betnovate)

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35
Q

What’s a potent topical corticosteroid used

A

Betamethasone 0.1% (betnovate)

Hydrocortisone

Momentasone

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36
Q

What’s a very potent topical corticosteroid used

A

Clobetasol (Dermovate)

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37
Q

Counselling on how to apply steroids

A

Apply thinly to the affected area no more than twice a day

Avoid prolonged use especially to the face

Apply emollient first then the steroid cream 30 minutes after for maximum absorption

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38
Q

How is rosacea- facial redness treated

A

Brimonidine

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39
Q

What’s does the pregnancy prevention programme include for roaccutane

A

Exclude pregnancy with Atleast 2 negative tests

Rx valid for only 7 days with a max 30 day supply

Emergency supply can be given with w negative pregnancy test

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40
Q

When should roaccutane treatment be started

A

On the 2nd or 3rd day of me natural cycle

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41
Q

What contraception is not suitable when on roaccutane

A

Progesterone only contraceptives

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42
Q

Should antihistamines be given in eczema?

A

No as eczema is not histamine related

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43
Q

First line otc acne medication

A

Benzoyl peroxide

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44
Q

How can you identify psoriasis

A

Usually raised red patches of dry skin covered with silvery while scales or plaques

Occurs on the elbows knees and scalp

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45
Q

What meds can worsen psoriasis

A

Lithium
BB
ACEi
Anti malarial drugs

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46
Q

OTC treatment for dandruff

A

Ketoconazole 2% (nizoral)

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47
Q

What are warts caused by and Treatment of choice for warts

A

Virus

Salicylic acid

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48
Q

Treatment otc for ring worm

A

Imadazole (miconazole, ketoconazole, clotrimazole)

Terbineafine (over 16)

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49
Q

When should fungal nail infections be referred

A 
2 or more nails affected
Under 18
Pregnant/ diabetes 
Damage to the nail
Bottom of the nail affected
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50
Q

Treatment of choice otc for fungal nail infection and how long can it take to work

A

Amolorfine 5%

Can take 6 months

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51
Q

How do you treat a boil otc

A

Magnesium sulphate can draw out the inside
Abx may be needed

Refer to gp

52
Q

What Comorbidity should you usually refer with skin problems

A

Diabetes due to poor would healing

53
Q

What’s the key treatment in managing eczema

A

Emollient

If soap is an irritant substitute for an emollient wash

54
Q

What age can topical steroids be sold to the public from

A

10 and above hydrocortisone

12 and above clobetasone

55
Q

What should not be used in acne and why

A

Topical steroids

They can increase local hormone effect making the problem worse

56
Q

How can you avoid damaging healthy skin when removing warts and varrucas with salicylic acid

A

Apply vaseline on the healthy skin

57
Q

Scabies treatment

A

Permethrin (> 2 months)
or
malathion (>6 months)

One treatment for whole family then repeated after 7 days

58
Q

What’s the only product licensed to treat hair loss

A

Minoxidil

2% men and women
5% men only

59
Q

What otc treatment should you not used for psoriasis that can be used in eczema

A

Steroid

60
Q

What’s the duration of treatment for amorolfine

A

6 months fingernails

9-12 months toenails

61
Q

What antihistamine has a license for pruritis

A

Hydroxyzine

62
Q

What condition presents as a rash, can have blisters is the rash and and has a tingly sensation like pins and needles

A

Shingles

63
Q

What safety advice should you say to a patient if using a bath emollient?

A

Makes the skin and surface slippery so care is neededIf paraffin containing, also warn them of the fire risk

64
Q

What are borderline substances?

A

Regarded as drugs when prescribed in accordance with the advice of the Advisory Committee on Borderline Substances for the clinical conditions listed.

65
Q

The use of aqueous cream as a leave-on emollient may increase the risk of what?

A

Skin reactions - particularly in eczema

66
Q

Urea is used with other topical agents e.g. corticosteroids. What would be the reason for this?

A

To enhance penetration of the skin

67
Q

Diluted creams should be used within how many weeks of preparation?

A

Within 2 weeks

68
Q

Acute impetigo on small areas of the skin is treated with what?If the impetigo is extensive/cream has not worked, what can be used?

A

Short-term application of fusidic acid Flucloxacillin can be used (clarithromycin is penicillin allergic)

69
Q

Mupirocin ointment/ nasal ointment is used for what resistant bacterial strain?

A

MRSA

70
Q

What topical antibiotic is used for rosacea?

A

Metronidazole

71
Q

What is tinea capitis?

A

Ringworm of the scalp

72
Q

What is tinea corporis?

A

Ringworm of the body

73
Q

What is tinea cruris?

A

Fungal infection of groin

74
Q

What is tinea manuum?

A

Fungal infection of hands

75
Q

What is tinea pedis?

A

Athlete’s foot

76
Q

What is tinea unguium?

A

Fungal nail

77
Q

When would a combination cream of antifungal and steroid be used?

A

Fungal infection in the presence of inflammation

78
Q

What is the common name for labial herpes simplex infection?

A

Cold sore

79
Q

What is 1st line for scabies?What is 2nd line?

A

Permethrin

Malathion

80
Q

If a person with scabies lives with other people, what is recommended?

A

The whole household should be treated at the same time

81
Q

Where should scabies treatment be applied?

A

The whole body, including scalp, face, neck and ears

Particular attention should be paid to the webs of fingers and toes, and lotion should be brushed under the end of nails

82
Q

How often is it recommended that the permethrin and malathion is applied and how many times for scabies?

A

Applied twice to the whole body for the treatment of scabies

1 week apart

83
Q

Dimeticone treatment for headlice should be repeated after how many days?

A

7 days

84
Q

What is the MHRA warning regarding head lice products?

A

Risk of serious burns if treated hair is exposed to open flames or other sources of ignition

85
Q

How much contact time with the scalp is recommended in head lice lotions and liquid?

A

8-12 hours or overnight

86
Q

For the treatment of scabies with malathion lotion, after application, how long should it be left until washing off?

A

24 hours- when hands are washed within this time, this needs to be repeated

87
Q

With how many eczema flare ups a month would you consider a corticosteroid to prevent further flares?

A

2-3 a month

88
Q

In patients who require a corticosteroid to prevent flare ups, how often is application recommended?

A

To be applied on 2 consecutive days each week

89
Q

What drug classes can provoke psoriasis?

A

Lithium, chloroquine and hydroxychloroquine, beta-blockers, NSAIDs, and ACE inhibitors Psoriasis may not be seen until the drug has been taken for weeks or months.

90
Q

What is 1st line for scalp psoriasis?

A

Tar based shampoo

Salicylic acid can also be used if there is significant scaling

91
Q

What is first line for plaque psoriasis?

A

Vitamin D and its analogues

92
Q

What type of drug is acitretin and what skin condition is it used in?

A

Vitamin A derivative retinoid used in psoriasis

93
Q

The manufacturers of acitretin do not recommend continuous treatment for longer than how many months?

A

Longer than 6 months

94
Q

Topical corticosteroids should be applied no more than how many times a day?

A

No more than twice a day (often once a day is sufficient)

95
Q

What information should be included on a topical corticosteroid dispensing label?

A

Potency

96
Q

Lotriderm contains what?

A

Betamethasone and clotrimazole

97
Q

What is the difference in storage requirements for Daktacort cream vs ointment?

A

Cream you store in a fridge, whereas with the ointment you don’t

98
Q

What is azelaic acid used for?

A

Acne

99
Q

Maximum improvement for acne with antibacterial treatment usually occurs after how much time?

A

4-6 months

100
Q

What is the minimum number of weeks isotretinoin is usually given for in acne?

A

16 weeks

101
Q

What is the limit of number of days supply for isotretinoin under PPP?

A

30 days

102
Q

What does SPF 8 mean?

A

Should enable a person to remain 8 times longer in the sun without burning.

103
Q

For optimum protection, how often should suncream be applied?

A

Every 2 hours

104
Q

What skin condition is formaldehyde used for?

A

Warts

105
Q

Should you use corticosteroids in acne and rosacea?

A

No - can exacerbate these conditions

106
Q

If a patient needs to apply a steroid cream and emollient, how is this done?

A

Apply emollient then apply steroid 30 minutes after

107
Q

How much roughly is a finger tip unit of cream? (amount of cream from the tip of the finger to the first crease)

A

500mg

108
Q

What does 1 finger tip unit cover

A

2 palms

109
Q

Isotretinoin carries the risk of pancreatitis, especially in what case?

A

If triglycerides are above 9 mmol/L

110
Q

How should Oral thrush be treated?

A

1) Daktarin (Miconazole) oral gel
2) Nystatin solution
3) Oral fluconazole

111
Q

Urea is often present in many topical agents. What is its action?

A

Hydrating agent

112
Q

How is Nappy Rash managed?

A

1) Change Nappy more frequently2) Irritant case: Barrier cream e.g. Sudocreme, Drapolene, Zinc oxide3) Fungal cases: Clotrimazole cream BD- do not use barrier cream till infection settled

113
Q

How are insect bites and stings usually managed?

A

Antihistamine cream or short course of steroid cream if inflamed. DO NOT use calamine lotion- leaves itchy residues

114
Q

Topical local anaesthetics may be used for burns, wasp stings etc. These should be avoided in young children, and used for max __ days?

A

max 3 days Creams containing Benzocaine

115
Q

Hydrocortisone is a ___ steroidHydrocortisone + urea is a ____ steroidHydrocortisone Butyrate is a _____ steroid

A

Mild
Moderate
Potent

116
Q

First line treatment for seborrhoeic dermatitis?

A

Ketoconazole 2% shampoo

117
Q

What drugs, used for psoriasis and acne, are teratogenic?

A

Oral Retinoids: IsotretinoinAcitretin Alitretinoin These are similar to VITAMIN A/ RETINOL and this is also contra-indicated in pregnancy!

118
Q

Acetretin is especially teratogenic. When should pregnancy be avoided?

A

3 days before, every month whilst on it and at least 3 years after

119
Q

When should contraception be used with Isotretinoin?

A

1 month before and 1 month after (even with topical). Exclude pregnany 3 days before every month during treatment and 5 weeks after

120
Q

Which drugs used for acne may cause Benign Intercranial Hypertension?

A

Oral Retinoids: IsotretinoinAcitretin Alitretinoin Discontinue if severe headache, nausea, vomiting or visual disturbance occur

121
Q

How should cradle cap in infants be treated?

A

Olive oil or Arachic oil (nut oil) or coconut oil

122
Q

Preparations for Male pattern baldness include Finasteride and Minoxidil. Can these be prescribed on NHS Rx’s?

A

NO- all preps for male baldness not available on prescription

123
Q

What age can terbinafine- lamisil and lamisil once be sold otc

A

Lamisil 16+

Lamisil once 18+

124
Q

When should you return to work with impetigo

A

48 hours after abx started

125
Q

How long after can you return to work with scarlet fever

A

24hrs after abx started

1-2 weeks if no abx commenced

126
Q

When can people with scabies return to work

A

After the first treatment

127
Q

What cases of impetigo do you refer

A

All bullous impetigo

Pre-reg (27 decks)

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