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MRCP PART 1 > Derm > Flashcards

Derm Flashcards

1
Q

Linear crusted leisons a few milimeters in length and intense itching pathognomic of? Usual locations? Rx

A

Scabies
Webbing of fingers / toes and nipples
Permethrin

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2
Q

Single very itchy area with serpiginous (wavey) tracks? Caused by? Most common body part?

A

Cutaneous Lava migrans

Hookworm

Foot

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3
Q

BCC prognosis post excision?

A

100% -
[Usually takes over 5 years to met]

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4
Q

Most common skin Ca? What does it look like

A

BCC
-Ulcer with a rolled edge
-Prominent fine blood vessels around edge
- Pearly / waxy nodule on skin

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5
Q

Suspected BCC referral speed?

A

Can be routine rather than usual urgent for Ca

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6
Q

What is Imiquimod?

A

Topical Rx option for BCCs

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7
Q

What is Vismodegib used for?>

A

Used for Rx of metastatic BCCs
[Targets hedgehog pathway signaling]

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8
Q

Surgery for BCC called

A

Mohs - Gets complete margin control

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9
Q

Tense itchy blisters in pregnancy? Basic Ix rx

A

Pemphigoid of pregnancy

Skin biopsies + immunofluorescence
Oral pred if bad

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10
Q

Urticated and plaques which are very itchy in pregnancy and SPARING umbilicus

A

Polymorphic eruption of pregnancy

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11
Q

Bullos pemphigoid description? Antibodies? Usual Ix/Rx? If bad?

A

Tense blisters
IgG Hemidesmomosal [BP180/BP230]

Biopsy + immunofluorescence

Oral pred
[Add Azathioprine / cyclosporin /mycophenolate]

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11
Q

Bullos pemphigoid description? Antibodies? Usual Ix/Rx? If bad?

A

Tense blisters
IgG Hemidesmomosal [BP180/BP230]
Biopsy + imunoflourescence [and blood imunoflourescence] will show IgG/C3 deposition
Oral pred [Add Azathioprine / cyclosporin / mycophenolate]

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12
Q

Cafe-au-lait patches + armpit freckles ? chromosome? When do these lesions get more pronounced and why?

A

Neurofibromatosis type 1
Chromosome 17 - Dominant inheritance
In pregnancy as usually oestrogen responsive

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13
Q

How is NF2 different to NF1? Characteristic finding? Chromosome

A

NF2 usually has CNS Lesions eg. swhanomas / meningiomas
Bilateral acoustic neuromas -> Tinnitus/deafness/vertigo
Chromosome 22 [for NF2]

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14
Q

Facial angiofibromas, periungual (toe/finger nail) fibromas and ‘ash leaf spots’?
How to see these best?

A

Tuberous sclerosis
Woods ultraviolet lamp

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15
Q

Small brown nodules on iris seen in what? called?

A

NF1
Lisch nodules - seen on slit lamp

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16
Q

Excoriated symmetrical papules on extensor surfaces of knees elbows, buttocks and back?
Commonly associated with?
Gene?
Diagnostic tests?
Rx?

A

Dermatitis herpetiformis [nothing to do with herpes]

Coeliac. Both are due to a gliardin [gluten] allergy
HLA DQ2, HLA DQ8

TTG antigen + skin biopsy [will show microabscesses in dermal papillae, granular IgA deposits]
[Can use endomysial antibody if TTG weakly positive]

Gluten free diet
Oral dapsone

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17
Q

Dematitis herpetiformis and don’t stick to gluten free diet risk developing?

A

Non Hodgkin lymphoma

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18
Q

Most common antibody in SLE? 2 others that are more specific but less sensitive?

A

Anti nuclear antibody

Anti-Ds DNA
Anti Sm

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19
Q

Anti-ccp antibody

A

Rheumatoid arthritis
[Present in 50-75%, indicates more agressive disease]

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20
Q

An anti-mitochondrial antibody found in?

A

Primary biliary cholangitis (90%)
Also found in SLE, though less frequent

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21
Q

Anti-smooth muscle antibody? other thing found in this condition?

A

Autoimmune hepatitis
IgG predominant polyclonal HyperGammaGlobulinaemia [found in 85%]

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22
Q

Rx rosacea

A

Topical metronidazole / azeliac acid
[can use oral tetracycline
Resistant cases may need isotrenatoin]

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23
Q

Bromonidine gel used for

A

Severe rosacea

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24
Q

Anti-ribosomal P antibodies in?

A

Cerebral SLE

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25
Q

cANCA ? common features with this

A

Granulomatosis with polyangitis

Sinusitis, renal vasculitis, mononeritis
Pulm haemorrhage later in disease

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26
Q

Super common DMARD in SLE arthritis

A

Hydroxychloriquine

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27
Q

Recurrent arterial / venous thrombosis + fetal loss

A

Antiphospholipid syndrome

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28
Q

Endocarditis / focal neurological lesions in lupus usually have which antibody

A

Anti-phospholipid

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29
Q

In SLE what does low C3/C4 levels indicate

A

Lupus nephritis

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30
Q

SLE with vital organ involvement Rx ? If refractory disease?

A

Steroids + immunosupression
[Azathioprine / methotrexate]

Plasma exchange + ritixumab

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31
Q

Yellow papules on skin [usually on neck]- looks like a plucked chicken?CV findings? Were else does it affect?

A

Pseudoxanthoma elasticum
Skin, Eyes, Cardiac
[Does sometimes give GI bleeding too!]

Mitral valve prolapse
Premature CV disease Eg CAD/claudication

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32
Q

What might you see in eyes of someone with Pseudoxanthoma elasticum? skin ?

A

Angiod streaks [dark red streaks by retinal vessles]
-> visual loss

Skin looks yellow and like plucked chicken

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33
Q

Symmetrical skin pigmentation on cheeks in women is called and usually seen in?

A

Melasma
Pregnancy

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34
Q

Target lesions (concentric rings) ? most commonly seen in?

A

Erythema multiform

Infection - Herpes/mycoplasma most common
[Also seen as a drug reaction some times - eg valproate, penicillin]

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34
Q

Target lesions (concentric rings) ? most commonly seen in?

A

Erythema multiform

Infection - Herpes/mycoplasma most common
[Also seen as a drug reaction some times - eg valproate, penicillin]

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35
Q

Pathogen causing a red, tender skin leison with induration and a sharply defined, rapidly progressing border

A

Strep pyogenes
Group A Beta haemolytic strep

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36
Q

ANIMALS in history -> Bald patch on scalp increasing in size caused by?
If no animals in history?

Rx of tinea capits?

A

Microsporum canis

Trichophyton tonsurans
[Both fungal infections causing tinea capitis]

Systemic antifungals

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37
Q

Microsporum canis characteristic finding on woods lamp?

A

Bright green fluroescence

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38
Q

What is Onychomycosis

A

fungal infection of nail

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39
Q

Key Ix if people have recurrent fungal infections

A

GTT
- as often the presentation of diabetes

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40
Q

pulmonary infiltrates + Halo sign on CT

A

Aspergillous

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41
Q

Cryptococcal meningitis. Staining on CSF?

A

India staining

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42
Q

Annular erythematous lesion with overlying scaling seen in?

A

Tinea Corporis

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43
Q

Recurrent skin infections usually mean s. aureus is producing what?

A

PVL

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44
Q

Staph aureus produces what in rapid bad food poisoning?

A

Enterotoxin

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45
Q

Toxic shock syndrome means s. aureus is producing what?

A

TSST-1

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46
Q

S Aureus producing these things usually leads to what?

1- PVL
2- Enterotoxin
3- TSST-1

A

1- PVL - recurrent skin infections
2- Enterotoxin - food poisoning
3- TSST-1 - toxic shock

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47
Q

Sandfly bite -> which infection? Usually presents as? Rx?

A

Leishmaniasis
Solitary ulcer
Sodium Stibogluconate

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48
Q

visceral leishmaniasis always has what?

A

Hepatosplenomegaly

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49
Q

Itchy flat topped papular rash on wrists and ankles. White ‘lacy’ or lined pattern of rash [often in mouth] is called what?. What is koebner phenonomen?

A

Lichen plannus
Whickam’s striae
Where rash colonises site of trauma a few days later

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50
Q

Vesicular eczema which affects soles, palms and fingers

A

pompholyx

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51
Q

Management of lichen planus

A

Topical steroids / tacrolimus

Oral steroids if bad
->UVB phototherapy / dmards

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52
Q

Plum coloured skin lesions [usually in haem onc]

A

Sweet’s syndrome

[sweet plums]

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53
Q

What is bowens disease

A

Slow growing scaly erythematous patches related to long term sun exposure
[may progress to SCC]

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54
Q

What are actinic keratosis

A

rough patches often itchy related to sun exposure

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55
Q

What is 5-flurorouracil cream used for

A

actinic keratosis or bowens

[Usually just cut them out if needed / cryotherapy]

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56
Q

Melanoma found on sole of the foot / pam ?

A

Acral lentiginous melanoma

[ACRA i just stood on something]

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57
Q

Most common melanoma

A

superficial spreading

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58
Q

Dark pigmented melanoma? found where ?

A

Nodular
Usually agressive and fast growing
Usually on legs/ trunk

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59
Q

Slowly expanding irregularly pigmented macule usually found in older people

A

Lentigo maligna melanoma

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60
Q

How does melanoma metastasise

A

through lymph

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61
Q

What determines prognosis of melanoma

A

breslow thickess

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62
Q

Lesions which usually found on legs start as papules/pustules which then breakdown into painful necrotic ulcers

A

Pyoderma gangrenosum

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63
Q

Bar legs where is a common place to get pyoderma gangrenosum

A

By stoma sites in pts with IBD

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64
Q

Differentiate PBC and PSC

A

Both have obstructive LFTs

PBC - anti-mitochondrial antibodies

PSC - link to IBD

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65
Q

PBC, how to confirm diagnosiss? initial therapy?

A

Liver biopsy (+anti-mitochondrial antibody)
ursodeoxychoic acid
[can add obeticholic acid if not working]

May need liver transplant in long run

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66
Q

clustered pearly papules with a central umbilicus. Often found in kids and immunocompromised? caused by? Usual Rx

A

Molluscum contagosum

pox virus

No treatment in immunocompetent

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67
Q

Photosensitive dermatitis, diarrhoea and dementia=? Cause?
What is the common cause of the cause?
Rx?

A

Pellagra
Due to niacin (vit D3) deficiency [DDD due to D3 deficiency]

Carconoid syndrome
[Serotonin production -> negative feedback on D3 production]

Niacin replacement
Rx of carcinoid eg somatostatin analogue Eg ocretide

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68
Q

Dermatitis lesions which appear overnight. Especially if Hx of self harm or psychiatric

A

Dermatitis artefacta

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69
Q

Viral infection -> large scaly oval patch -> similar smaller patches

A

Pityriasis rosea

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70
Q

Purpuric rash on buttocks and lower legs. Abdominal pain and vomiting (+/- GI bleed)? Usual age? Any other features? Management?

A

Henoch-schonlein-purpura
Usally 15-19 years old

Usually get renal involvement (nephritis / nephrotic syndrome)
Usually triggered by a respiratory infection

Usually supportive but may need pred

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71
Q

What is deposited in affected organs and raised in HSP?

A

IgA

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72
Q

Purpuric rash in HSP - what are the platelets saying?

A

Normal. Purpuric rash is not due to thrombocytopenia

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73
Q

Drug for dermatitis herpetiforms

A

Dapsone

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74
Q

3 classes of drug that exacerbate psoriasis

A

B blockers
Antimalarials
Lithium

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75
Q

Streptococcal infection leads to which classical rash

A

Guttate psoriasis

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76
Q

What does pustular psoriasis look like? Key association with pustuar psoriasis on palms / soles?

A

Sheets of small yellow pustules on a red background

Smoking

77
Q

What does guttate psoriasis look like? Key association?

A

Acute eruption of drop like leisons

Streptococca infection

78
Q

What happens to psoriasis during preg and post partum?

A

Gets better in pregnancy
Worse post partum

79
Q

Name a few topical options for psoriasis

A

Coal tar - useful for thick plaque psoriasis

Dithranol

Vit D analogues

Taraztoene - Retinoid (think TARAtogenic)

Steroids

80
Q

Vid D analogue name

A

Calcipotriol

81
Q

What is second line (after topical) for Rx of psoriasis?
When is it recommended first line?

A

Phototherapy

If >10% BSA, Nail bed psoriasis, or general high stress Eg question mentions someone going wild as they’ve got psoriasis face

82
Q

First line DMARD for psoriasis? What do you have to monitor 3 monthly?

DMARD if for short term or need rapid control?

A

Methotrexate (Blocks DNA synthesis)
P3NP - Used to monitor liver fibrosis
[Psoriasis3NonthlyPlease]

Ciclosporin (inhibits t-lymphocyte transcription of IL-2)

83
Q

Key side effects of ciclosporin

A

Renal toxicity
Hypertension

84
Q

Odd thing to monitor with retanoids Eg acitretin? Another common side effect

A

Triglyceride levels

Mucocutaneous side effects

85
Q

Biologics are 3rd line psoriasis. name a -mab that is given as an infusion? Sub cut? how to they work?

A

INFliximab - INFusion
Adalibumab - Sub cut

TNFa inhibitors

86
Q

How does etanercept work?

A

Human protein fusion of the TNF receptor
Binds to TNFa and blocks it
[given sub-cut]

87
Q

Name a couple key associations with psoriasis longer term….

A

CV - Eg MI / Stroke / Venous thromboembolism

Athropathy

Gout

Lymphoma

Skin Ca (not melanoma)

Malabsorbtion - UC / Crohns

88
Q

Nails have a green discolouration means what infection?

A

Pseudomonas

89
Q

What is Onycholysis? Key associations?

A

Nail separates from nail bed

Psoriasis
Fungal

90
Q

Nail Onycholysis, pustual, hyperkeratosis =

A

psoriasis

91
Q

Nail onycholysis, discolouration, thickening =

A

Fungal

92
Q

Nail thinning, longitudinal depressions

A

Lichen planus

93
Q

Nail pitting, thickening and ridging (sandpaper nail)

A

Alopecia areata

94
Q

Nail onycholysis, coarse pits, cross-ridging

A

Dermatitis

95
Q

Name 3 things that cause koebner phenomenon

A

Psoriasis
Lichen planus
vitiligo
warts
Molluscum contagiosum

95
Q

Name 3 things that cause koebner phenomenon. what is it?

A

Psoriasis
Lichen planus
vitiligo
warts
Molluscum contagiosum

These things develop over areas of trauma

96
Q

What is erythroderma

A

Severe skin inflammation covering most of body

97
Q

Itchy small blisters. Biopsy shows IgA immunoflourescene =

A

Dermatitis herpetiformis

98
Q

Monitoring with dapsone ?Used for

A

Can cause polyneuropathy, haemolysis + liver issues

Monitor bloods + LFTs

Dermatitis herpetiformis

99
Q

General pathology of inflam plaque in psoriasis

A

Activated T-Lymphocytes into the epidermis
->Activate keratinocytes
-Get upregulation of TNFa, IL-2 and Interferon gamma

100
Q

Which IL key in psoriasis? Gout / Stills?

A

IL-17 / IL-22- psoriasis
[Don’t forget TNFa of course]

IL-1 - gout and stills

101
Q

Key risks for amiodarone>?

A

Photosensitive
Hepatic / pulm fibrosis
Thyroid disorders

102
Q

3 parts of melanoma that actually change prognosis

A

Thickness
Ulceration
Lymph node micrometastisis

103
Q

Red / violaceous [violet] periorbital rash
Papules over knuckles
Nail fold inflammation
Proximal myopathy [rarely involuntary muscles Eg swallowing]

=?
Which antibody is diagnostic?
Common association? Drug association?

A

Dermatomyositis
Anti-Mi-2 [ONLY found in 30%)

Many have an underlying Ca
Penicilliamine

104
Q

Anti-jo-1 found in? Key association?

A

Polymyositis

Pulmonary fibrosis

105
Q

Rx dermatomyositis

A

Pred
Aza/ciclo if not repsponding

106
Q

What is cheiroathropathy ?

A

Arthropathy associated with long-term diabetes and microvascular complications

-> Frozen shoulder / carpal tunnel
->Thickened swollen skin over fingers

107
Q

Questions mentions decades history diabetes and thick skin

A

cheiroathropathy

108
Q

pencil-in-cup deformity on XR

A

Psoriatic athropathy

109
Q

2 most common causes of erythroderma ? What is it?

A

Psoriasis
Eczema
General term for any inflammatory skin condition which affects >90%

[Others include drug eruption / pityriasis rubra pilaris / cutaneous lymphoma]

110
Q

photosensitive blistering rash commonly triggered/ sustained by alcohol? Other triggers? Apart from avoiding sun/ using suncream what is the mainstay of Rx? drug you can sometimes use?

A

Porphyria cutanea tarda (PCT)

Oestrogen, HepC, HIV

Phlebotomy to avoid Porphyrin deposits in liver- guided by ferritin levels
Hydroxychloroquine

111
Q

Porphyria cutanea tarda (PCT) - how to spot the pathogenesis if in question

A

deficinecy of uroPORPHYIN decarboxylaze.

Ie the answer is there….
[Investigations also are for serum/urinary PROPHYRINs -these make urine red]

112
Q

first line (if Non topical) management of rosacea?

A

Oral tetracycline

113
Q

Erythema nodosum sometimes idiopathic… Name a few associations

A

IBD
Sarcoid
Strep/Tb infections
COCP / some Abx eg tetracycline / penicillin
Pregnancy
Malignancy

114
Q

Area of skin depigmentation, usually in hot countries and associated with areas that get sweaty / covered by clothes? Casued by? Rx?

A

pityriasis versicolor

Malassezia globosa

Topical antifungal

115
Q

What causes ring worm? rx?

A

Trichophyton Rubrum

Topical antifungal

116
Q

Herald red patch -> multiple others with no other Sx and normal blood =?

A

Pityriasis rosea
[treatment conservative and usually just clears by 12 weeks]

[Rosea for red patch ]

117
Q

Smooth circular patches of hair loss - may feel tingly?

Itchy scalp with patches of hair loss + scaling?

A

Alopecia acreta

Tinea capitis

118
Q

What is male hair loss pattern called

A

Androgenetic alopecia

119
Q

Drug Rx of alopecia acreta?

A

Topical steroids / minoxidil

120
Q

What is the term for generalised hair loss over scalp and usually occurs a couple months after high stress / malnutrition / child birth?

A

Telegen effluvium

121
Q

What white cell is raised in toxic epidermal necrolysis?

A

Eosinophils

122
Q

Score system for severity of SJS/TEN

A

SCORETEN

123
Q

Exclamation mark hairs

A

Alopecia areata

124
Q

Areas of depigmented skin patches often with little patches of hair loss? Assoc with? Important blood test?
Rx?

A

Vitiligo
Autoimmune conditions
Thyroid function tests

Usually just conservative
-Can use topical steroids / phototherapy however often just persists

125
Q

Lichen planus or lichen sclerosis in koebner phenomenon

A

P for P
Planus for phenomenon

126
Q

Depigmented itchy skin lesions with increased peripheral nerve growth and raised inflam markers

A

Mycobacterium leprae

127
Q

Itchy wheals (raised) lesions which keep coming up? Flare Rx? Long term? If that isn’t working?

A

Hives (urticaria)

Antihistamines +/- steroids for flare

Longer-term antihistamines usually at least 2 with an increased dose and then can add in an LRA (montelukast)
->ciclosporin / tacrolimus
->Finanlly omalizumab if all else fails (mab at IgE)

128
Q

Diagnosis of pseudoxanthoma (chicken skin)

A

Skin biopsy

129
Q

Diagnose Marfan’s

A

Fibrillin 1 gene testing

130
Q

Bar psoriasis and nail fungal infections what systemic disease causes onycholysis

A

Thyrotoxicosis

131
Q

Acanthosis nigrans is? associated with what ok and what bad thing?

A

Hyperpigmented velvety skin in skin folds

Insulin resistance

Gastric Ca

132
Q

Area of erythema which then rapidly develops into multiple pus-filled papules? Assoc with?

A

PLEVA

EBV (this if uni student) with sore throat / atypical lympcytes on blood film
Toxoplasmosis
HIV
CMV
Staph/strep

[AKA there will be a clue in question for which one it is causing it]

133
Q

Cancer + blistering rash = ? Antibodies associated?

A

Paraneoplastic pemphigus

anti-**plakin

134
Q

First line Rx early syphilis

A

single IM Ben pen 2.4g

135
Q

Eczema -> massive pustular eruption with yellow crusting (mostly in areas where eczema has prev been) =? Rx?

What if a localised reaction over eczema site?

A

Eczema herpeticum (herpes simplex / zoster)
Acyclovir

Staph -> fluclox

136
Q

90% fungal nails caused by

A

Tricophyton rubrum

137
Q

Pale atrophic plaques on vag =?
Rx?
If on penis tends to affect? Usually need?
Risk?

A

Lichen sclerosis
Topical steroids

Foreskin and glans (gets called balantis xerotica obliterans)
- circumsision

Small risk developing Squamous cell Ca

138
Q

Differentiate lichen planus and sclerosis on a vag?

A

Both can itch

Slcerosis can be pale and atrophic (like a scar)

Planus - more Painful and coloured (Purple)
PPP

139
Q

Fat - alcohol as trigger and rash in sun areas = ? Other trigger bar alcohol?

A

porphryia cutanea tarda
Oestrogen

140
Q

Usual Rx in porphryia cutanea tarda

A

Avoid sun / alcohol.
Stop COCP

Plebotomy if ferrin >600
Can use hydroxychloroquine if less and prefer [mobilised porphyrins from liver -> excreted in urine]

Needs HIV / HepC rx

141
Q

Diabetes, peripheral neuropathy. Large waxy yellow lesion on shin with ulceration

A

Necrobiosis lipoidica

142
Q

Which lymphoma usually on skin (especially men aged 60)? What are the 2 types?

A

Cutaenous T-cell lymphoma

Mycosis fungoities and sezary syndrome

143
Q

When are atypical lymphocytes with cerebriform nuclei seen?

A

Sezary syndrome (sezary cells)

144
Q

Intensley itchy rash on flexural surface eg wrist. Koeberners phenomenom. Violet papules with white streaks ? IxRx?

A

Lichen planus (purple papules)

Usually no Ix and no Rx and will just get better

145
Q

Red scaling rash in sun-exposed areas. Bald patches on the scalp. Scarring and pigmentation change =? Rx?

A

Discoid lupus
ANA = WILL BE NEGATIVE

Need sun protection
One of few indications for HIGH strength steroids for face
->Hydroxycloriquine / acretin

146
Q

Diabetes with small erythermatous papules which coalesce into an area of erythema

A

Granuloma annulare

147
Q

Which conditions are associated with pyoderma gangrenosum?

A

Necrotic ulcers are GRIMP

Granulomatous with polyangitis
Rhem A
IBD
Myeloproliferative disorders / lymphoma
PBC

148
Q

Differentiate pyoderma gangrenosum and erythema nodosum

A

Pyoderma - deep ulcerating necrotic ulcers. Demonstrate cribriform pattern of scarring

Erythema - Painful erythematous lumps
-Eg TB, sarcoid, strep, IBD

149
Q

Talk about pemphigus differences to pemphigoid

A

Pemphigus - oral lesions common,
Blisters may have all been scratched away as superficial and fragile.
Antidesmoglein antibodies

150
Q

First line Ix contact dermatitis? What type of hypersensitivity reaction is contact dermaitits

A

Patch testing

Type IV

151
Q

Whats most important Ix for Dx of NF1

A

Slit lamp of eye
Otherwise physical exam and FHx

152
Q

Australian. Painless lesion on penis which then turns into a heaped-up ulcer? The biopsy will show? Rx?

A

Granuloma inguinale
Donovan bodies

Doxy / co-trimoxazole

153
Q

Sore genital ulcers with ragged edges and painful swollen inguinal lymph nodes? Caused by which bug

A

Chancroid
Haemophilus ducreyi

154
Q

Which antihypertensive worsens psoriasis? Other drugs?

A

b blockers
Lithium
Antimalrials

155
Q

Diagnosis of leprosy? Stab at recognising Rx?

A

Skin biopsy
->Zheil neilson / Fite staining

Dapsone, rifampacin and clofazimine

156
Q

Strong family history. Warty lesions on chest / back / scalp. Nail dystrophy ? Rx if needed?

A

Dariers disease

acitretin if needed

157
Q

Presents as pemphigus but the mucosa are unaffected and blisters all crusted

A

Pemphigus foliaceus

158
Q

Bar Vit D3 (niacin) which other deficiency leads to dermatitis but without as predominant depression/dementia symptoms and more effects on nails.

A

Zinc

159
Q

T1DM. Symmetrical areas of hypopigmentation = ?

What if there was a textural change and asymetrical?

A

Vitiligo

Morphoea (may be hypo or hyper pigmented)

160
Q

Which drugs are known to trigger pemphigoid

A

Furosemide
ACEi
NSAIDS
Penicillamine

161
Q

post EBV now have a papular rash covering chest / Abdo. Rx?

A

Topical tacrolimus

[Ideally don’t use steroids over a large area in young people]

162
Q

Pemphigus biopsy

A

IgG / Complement deposits / antidesmoglein 1 and 3

163
Q

differentiate pemphigus Vulgaris and pemphigus follicularis on antibodies

A

Vulgaris - desmoglein 1 and 3
Follicularis - Desmoglein 2

164
Q

What is henna tattoo which causes allergic reaction

A

PPD

165
Q

Necrobiosis lipoidica Rx

A

Very poorly responsive to treatment - non-proven to work as it is due to small vessel damage and necrosis of dermal collagen

166
Q

What is positive nickolsky sign in SJS

A

Pressure on skin causes blistering within hours

167
Q

Acne flow chart Rx

A

Topical eg Benzyl perioxide then topical retinoid
Topical abx
Oral Abx x 2
Oral retiniod

168
Q

Dermatitis, dementia and diarrhoea =? If other extra symptoms eg raised aLT what might have caused it?

A

Vit B3 - Niacin
[There B3 D’s in this condition]

Carcinoid syndrome - tryptophan used to make serotonin and non left for conversion to Vit B3

169
Q

Which rash do 1/3 of people with new Ca present with

A

Dermatomyositis

170
Q

Lifestyle Rx of rosacea

A

Stopping drinking

171
Q

Acute intermittent porphyria
Inheritance of what?
Presentation?
Key biochem fidning?

A

Dominant inheritance of deficiency in porphrobilinogen

Neuropsychiatric / GI disturbance. Dark red urine (porphyrins)

Often SIADH

172
Q

Acute intermittent porphyria
Rx?
Prevention of cyclic attacks?

A

Dextrose oral / IV
IV haemin

Haem arginate
Can use GnRH analogues eg goserelin in women

173
Q

Acute intermittent porphyria monitoring? risk?

A

yearly uroporphyrins and LFTs
Liver US when >50 as risk of HCC

174
Q

Mucocutaneous leishmaniasis Rx

A

Sodium Stibogluconate

175
Q

2 main causes of angioedema in absence of urticaria

A

ACEi
C1esterase deficiency

176
Q

Rx hand eczema which is resistant to oral steroids and super potent topical steroids

A

Alitrenitoin

[Or ciclosporin if CI’d]

177
Q

Herald patch -> Christmas tree pattern of salmon pink rash

A

Pityriasis roseacea

178
Q

Which drug causes onchyolysis?

A

Tetracyclines Eg doxy

179
Q

eczema with erythema and pustule formation + yellow crusting Rx ? When would you suspect viral?

A

Topical Abx and continued topical corticosteroids

If herpeticum it would mention vesicles, not pustules

[So long as systemically well]

180
Q

Fat man with erythematous plaque and scaling border on inner thigh Dx?Ix? Rx?

A

Tinea Cruris
Skin scrapings
Topical antifungals

181
Q

When is the ink test used?

A

Scabies - ink onto hands then wipped off and it stays in the burrows

182
Q

Paraneoplastic pemphigus usually which Ca?

A

Non-hodgkins lymphoma

183
Q

Symmetrical maculopapular rash on trunk and limbs which is pale pink and not itchy. Mucosal erosions. Generalised muscle and joint pains/lymphadenopathy? What are the plaques which form in the flexures called?

A

Secondary syphilis

Condylomata lata

183
Q

Symmetrical maculopapular rash on trunk and limbs which is pale pink and not itchy. Mucosal erosions. Generalised muscle and joint pains/lymphadenopathy? What are the plaques which form in the flexures called?

A

Secondary syphilis

Condylomata lata

184
Q

Drugs causing photosensitivity

A

QR STAND

Q- Quinine, Quinolones, Quinidine
R- Retinoids
S- Sulphonamides, Sulfonylureas
T- Tetracyclines, Thiazides
A- Amiodarone
N- NSAID’S– Ibuprofen, naproxen, celecoxib
D- Dapsone

185
Q

When is a lesion melanoma until proven otherwise

A

Asymmetry
Border is irregular
Colour varies throughout
Diameter >6mm
Evolving / growing

186
Q

Most effective intervention for molluscum contagiousosum

A

Cryotherapy

187
Q

tender red nodules on shins in pregnant

A

eRYTHEMA NODOSUM

188
Q

Peri-stomal pyoderma Rx

A

Topical tacrolimus

189
Q

Velvity dark patch on lip and in neck folds? Key associations

A

Acanthosis nigrans
Cushings, acromegally or other insulin resistant
Gastric adenocarcinoma , Endometrial Ca

MRCP PART 1 (22 decks)

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