conditions

Question 1

what does varicella zoster cause?

Answer 1

chickenpox - childhood

shingles - reactivation. elderly and immunocompromised

Question 2

distribution of shingles

Answer 2

dermatomal

Question 3

type of pain in shingles

Answer 3

neuralgic

Question 4

what is Ramsay-Hunt syndrome

“geniculate/otic herpes zoster”

Answer 4

reactivation of herpes zoster of geniculate ganglion of facial nerve
vesicles and pain in auditory canal and throat
facial palsy

Question 5

fleshy, firm pearlescent nodules

age group?
treatment?
can it be sexually transmitted

Answer 5

molluscum contagiosum
common in kids
local application of liquid nitrogen

yes

Question 6

warts are due to which type of infection?

Answer 6

HPV

Question 7

herpangina
caused by what?
Ix?

Answer 7

blistering rash at back of mouth
caused by enteroviruses e.g. coxsackie, echovirus
Ix: swab of lesion, sample of stool for PCR

Question 8

Parvovirus B19
complications?
testing?

Answer 8

spontaneous abortion, aplastic crisis, chronic anaemia

parvovirus B19 IgM test

Question 9

treponema pallidum

Answer 9

syphillis

Question 10

treatment for syphillis

Answer 10

injections of penicillin

Question 11

borellia burgdoferri

Answer 11

lyme disease

Question 12

bulls eye rash

Answer 12

lyme disease

Question 13

erythema migrans

Answer 13

lyme disease

Question 14

what might tuberose sclerosis present as

Answer 14

infantile seizures

Question 15

earliest cutaneous sign of tuberose sclerosis

also, ??? patches and ???? pitting

Answer 15

ash leaf macule

shagreen patches
enamel pitting

Question 16

tuberose sclerosis

aut dom or aut rec?

Answer 16

aut dom

multi gene disorder

Question 17

treatment for tuberose sclerosis

Answer 17

mTOR inhibitors

Question 18

what is disrupted in junctional epidermolysis bullosa (EB)

Answer 18

DEJ

Question 19

what is EB aquisita?

Answer 19

rare autoimmune condition that can mimic dystrophic EB

Question 20

most common form of EB

Answer 20

simplex

Question 21

worst type of EB

Answer 21

junctional

Question 22

more than ? cafe au lait macules suggests genetic disease

Answer 22

5

Question 23

optic glioma, lisch nodules

Answer 23

NF1

Question 24

acne treatments

Answer 24

mild 
- benzyl peroxide - keratolytic, antibacterial 
- azelaic acid
- abx - clinadmycin 
moderate 
- doxycycline 
- topical retinoid - adalpene/isotretinoin 
severe 
- isotretinoin 1st choice 
- co-cyprindiol

Question 25

comedones in acne rosacea?

Answer 25

none

Question 26

what exacerbates rosacea

Answer 26

alcohol
sudden change in temperature
spicy foods

Question 27

rosacea treatment

Answer 27

AVOID topical steroids
abx
- topical metronidazole
- oral tetracycline

isotretinoin low dose if severe

Question 28

malignant melanoma more common in M or F ?

Answer 28

F, 2x more common

Question 29

by adulthood, naevi are entirely ?

Answer 29

dermal

Question 30

colour of spitz naevus

Answer 30

pink

Question 31

what does MC1R do
what does 1 defective copy of MC1R cause?
2 defective copies?

Answer 31

MC1r turns phaeomelanin > eumelanin
1 defective copy > freckling
2 .. > red hair and freckles

Question 32

most common form of cutaneous T cell lymphoma

Answer 32

mycosis fungoides

Question 33

actinic lentigines
related to ?
distribution?

Answer 33

liver spots
related to UV exposure
face, forearms, dorsal hands

Question 34

who gets lentigo maligna?

what is it?

Answer 34

elderly people with sun damaged skin

neoplastic naevus along the basal layer which then may become invasive

Question 35

brown/black greasy lesions found on the trunk of older caucasians
what is leser trelat?

Answer 35

seborrheic keratoses

leser trelat is eruptive appearance of many lesions which may indicate internal malignancy

Question 36

coeliac has a strong association with this condition

Answer 36

dermatitis herpetiformis

Question 37

dermatitis herpetiformis - assoc with which haplotype?

Answer 37

HLA-DQ2

Question 38

hallmark of dermatitis herpetiformis

deposits of ?? in dermal papillae

Answer 38

papillary dermal micro abscesses

deposits of IgA in dermal papillae

Question 39

areas affected by dermatitis hepetiformis

Answer 39

elbows, buttocks, knees

Question 40

bullous pemphigoid

• flaccid or tense bullae?
• scarring?
• nikolsky sign +/-?
• what is deposited around the BM?
• treatment?

Answer 40

large tense bullae that burst to leave erosions
no scarring
nikolsky sign negative
IgG and complement deposited around the BM
rx: tetracycline, nicotinamide

Question 41

pemphigus vulgaris

• flaccid or tense bullae?
• risk of what when bullae burst?
• involvement of ?? very common
• IgG auto ab against ??
• nikolsky sign +/-?
• mortality high or low?
• treatment?

Answer 41

flaccid bullae, thin roofed that rupture to leave raw areas 
infection risk 
mucosal involvement very common 
IgG auto ab against desmoglein 3
nikolsky sign POSITIVE 
mortality high if untreated
rx: 
emollients, topical steroids
systemic steroids
azathioprine, ciclosporin, mycophenolate

Question 42

where do venous leg ulcers usually develop

Answer 42

around the malleoli

Question 43

treating venous ulcers

what must be done first?

Answer 43

DOPPLER FIRST TO EXCLUDE ARTERIAL DISEASE 
- ensure ABPI > 0.8 
non adherent dressing 
de sloughing agent e.g. honey, hydrogel 
4 layer compression bandaging 
elevation

Question 44

defining a leg ulcer

any break in the skin of the lower leg present more than ? weeks

Answer 44

4

Question 45

when should an ulcer be investigated further?

Answer 45

if it hasn’t healed within 3 months

Question 46

ABPI results
normal?
vascular disease?
calcification?

Answer 46

normal - 0.8-1.3

vascular disease = 1.5