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Y2 > Derm > Flashcards

Derm Flashcards

1
Q

Main cell type in epidermis

A

Keratinocytes

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2
Q

Epidermis layers

A 
Stratum:
Germinativum
Spinosum
Granulosum
Lucidum(palms/soles)
Corneum
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3
Q

What is the dermis mainly made of

A

Collagen(fibroblasts)

Immune cells

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4
Q

Afferent nerves

A

Merkel cell(epidermis): light touch, pressure

Meissner’s corpuscle: light touch, vibration
Ruffini corpuscle: stretch
Pacinian corpuscle: pressure/vibration

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5
Q

Psoriasis pathology

A

Chronic, immune-mediated

Stressed keratinocytes release DNA
Immune complexes form
Cytokine release
Inflammation

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6
Q

Psoriasis symptoms

A

Extensor surface erythematous plaques

Psoriatic arthritis

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7
Q

Psoriasis management

A

Vit D analogues
Topical corticosteroids
Phototherapy

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8
Q

Atopic eczema pathology

A

Intensely pruritic chronic inflammation

Impaired protection against microbes

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9
Q

Eczema symptoms

A

Flexor surface erythematous plaques that itch

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10
Q

Eczema management

A

Emollients
Topical corticosteroids
Phototherapy
Biological therapy

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11
Q

Lupus skin symptoms

A

Red scaly patches

Butterfly rash on face

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12
Q

What to do if an infant has red rash

A

Test ECG in case infant has neonatal lupus(50% have heart block)

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13
Q

Dermatomyositis skin symptoms

A

Photodistributed rash:
Heliotrope rash(eyes)
Shawl sign(upper chest)
Gottron’s papules

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14
Q

Dermatomyositis antibodies

A

Anti-p155: malignancy

Anti-MDA5: digital ulcers->interstitial lung disease

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15
Q

Dermatomyositis investigations

A

Antinuclear antibodies
Creatinine kinase
LFT: ALT raised
Biopsy

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16
Q

Vasculitis presentations

A

GI bleed
Abdominal pain
Macular purpura

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17
Q

What is sarcoidosis and features

A

Granulomas, commonly lungs
Highly variable presentation
Diagnosis of exclusion
Lupus pernio

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18
Q

Graft vs host disease symptoms

A

Face involvement
Acral involvement
Diarrhoea

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19
Q

DRESS syndrome/SJSTEN causes

A

Antibiotics
Anticonvulsants
NSAIDs

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20
Q

DRESS syndrome presentations

A

Head/neck oedema
Rash
Fever
Lymphadenopathy

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21
Q

Result of itching

A

Nodular prurigo

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22
Q

Causes of itch without rash

A 
Uraemia
Cholestasis
Iron deficiency/overload
HIV
Cancer
Drugs
Psychogenic
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23
Q

Scurvy presentations

A

Spongy gingivae
Corkscrew hair
Petechiae

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24
Q

Kwashiorkor presentations

A

Hepatomegaly
Loss of muscle mass
Soft, thin nails

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25
Q

Vit B3 deficiency presentations

A

Photodistributed erythema

Casal’s necklace

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26
Q

Steven-Johnson-Syndrome/Toxic Epidermal Necrolysis classification

A

BSA detachment:
<10% -> SJS
10-30% -> SJS/TEN
>30% -> TEN

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27
Q

SJSTEN pathology

A

Emergency

Flu like symptoms followed by skin lesions->blisters emerge->skin detaches

28
Q

CKD cutaneous presentations

A

Prurigo
Xerosis(dryness)
Half and half nails
Calciphylaxis

29
Q

Liver disease presentations(derm)

A

Jaundice
Muerhcke’s lines(nails)
Terry’s nails
Clubbing

30
Q

S. Aures infections

A 
Folliculitis
Cellulitis
Impetiginisation
SSSS, toxic shock syndrome
Blistering distal dactylitis
Erysipelas
Necrotising fasciitis
31
Q

S. Pyogenes infections

A 
Cellulitis
Ecthyma
Blistering distal dactylitis
Erysipelas
Scarlet fever
Necrotising fasciitis
32
Q

Pseudomonas aeruginosa infections

A

Folliculitis

Ecthyma gangrenosum

33
Q

Animal-related infections

A

Erysipeloid: raw fish/meat
Borreliosis(Lyme): tick bite
Tularaemia: handling animals, tick/deerfly bites

34
Q

What is a carbuncle

A

Furuncle(deep follicular abscess) affecting adjacent follicles

35
Q

Which part of skin affected in cellulitis

A

Lower dermis and subcutaneous tissue

36
Q

Oedema causing infections

A

Cellulitis

Erysipeloid

37
Q

Necrotising fasciitis management

A

Prompt diagnosis
Broad spectrum antibiotics and surgical debridement
Blood/tissue culture

38
Q

Borreliosis presentations

A

1-30 days: fever, headache, secondary lesion

Neuroborreliosis: facial palsy, aseptic meningitis

39
Q

Syphilis primary presentation and treatment

A

Chancre: painless ulcer, firm border

Painless lymphadenopathy

40
Q

Syphilis progression

A

Secondary:
Malaise, fever, pruritus
Lues maligna(if immunosuppressed)

Tertiary:
Gumma skin lesions
Neurosyphilis

41
Q

Leprosy types

A

Lepromatous leprosy: multiple lesions, sensation&sweating normal

Tuberculoid leprosy: few lesions, anhidrotic&numb

42
Q

Herpes simplex virus types

A

HSV-1: saliva and secretions

HSV-2: sexual contact

43
Q

HSV presentations

A

Burning/tingling-> urinary retention
Lymphadenopathy, malaise
Painful vesicles on erythematous base

44
Q

What is roseola infantum

A

6th disease
HHV6
Commonly children

45
Q

Most common fungal infection

A

Trichophyton rubrum

46
Q

Scabies presentations

A

Flesh-coloured pruritic papules

Burrow of fine white scale

47
Q

Types of lice

A

Head louse: pediculous humanus capitis
Body louse: pediculous humanus corporis
Pubic louse: crabs

48
Q

Infestation treatment

A

Permethrin

Ivermectin

49
Q

Melanoma pathology

A 
Most common skin cancer
Melanocyte malignancy
MAPK pathway
CDKN2A loss of function
CTLA-4 inhibits costimulatory signal for CD8 T cell to kill tumour cell
50
Q

Melanoma subtypes

A

Superficial spreading: horizontal&vertical
Nodular: only vertical growth
Lentigo maligna: commonly face
Acral lentiginous: commonly palms/soles

51
Q

Melanoma diagnosis(ABCDE)

A 
A: asymmetry
B: border irregularity
C: colour variation
D: diameter >5mm
E: evolving
52
Q

Melanoma management and major prognostic factor for metastasis

A

Primary excision, 2mm peripheral margin
Sentinel lymph node biopsy
LDH: major prognostic factor(metastasis)

Immunotherapy: CTLA-4 or PDL-1 inhibition
Oncogene: BRAF or MAPK inhibition

53
Q

Types of keratinocyte dysplasia

A

Basal cell carcinoma
Squamous cell carcinoma
Actinic keratoses
Bowen’s disease

54
Q

Basal cell carcinoma pathology

A

Loss of function mutation->sonic hedgehog signalling pathway
p53 mutation
Almost never metastasises

55
Q

Basal cell carcinoma treatment

A

Standard excision
Radiotherapy
Vismodegib->inhibits SHH pathway

56
Q

Squamous cell carcinoma features

A

CDKN2A, p53 mutations

Rapidly growing

57
Q

Squamous cell carcinoma treatment

A

Excision

Radiotherapy

58
Q

Keratoacanthoma

A

Rapidly growing papule that resolves after months
Neck snd sun exposed areas
Difficult to distinguish from SCC

59
Q

Types of cutaneous T cell lymphoma

A

Mycosis fungoides

Sezary syndrome

60
Q

Mycosis fungoides features and treatment

A

Common
Takes years to diagnose

Topical corticosteroids, phototherapy, radiotherapy
Chemotherapy if advanced

61
Q

Sezary syndrome triad of symptoms and treatment

A

Triad of: erythroderma, generalised lymphadenopathy, neoplastic T cells

Extracorporeal photophoresis
Topical corticosteroids

62
Q

Kaposi sarcoma virus

A

HHV8

63
Q

Merkel cell carcinoma virus and treatment

A

Polyomavirus

Treat with surgery, radiotherapy
Anti PDL1

64
Q

PVL S. Aureus features

A

Painful
More than 1 site
Recurrent
Present in close contacts

Higher morbidity, mortality, transmissibility

65
Q

Viral infections derm

A 
HSV
Varicella zoster virus
HFMD(coxsackievirus)
Erythema infectiosum(parvovirus B19)
Rosella infantum(6th disease)
Orf(parapoxvirus sheep/goats)
Warts(HPV)
66
Q

Sarcoidosis

A

Systemic granulomatous disorder(lungs common)
Diagnosis of exclusion
Lupus pernio

67
Q

Carcinoid syndrome

A

Metastasis of malignant carcinoid tumour
Flushing, wheezing, diarrhoea, dizziness
5-HT secretion

Y2 (10 decks)

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