Derm 3 Flashcards
True/false
Venous ulcer’s are more common on the lateral malleolus
False – they are more common on the medial malleolus
True/false
Venous ulcers have a necrotic base
False – arterial ulcers do; venous ulcers have a granulating base
True/false
Arterial ulcers are worse in bed at night
True – when the leg is raised the blood supply to the foot is less, so patients commonly dangle their foot from the end of the bed increase the blood supply and ease the pain.
True/false
Neuropathic ulcers are painful
False– they are painless
True/false
Dermatomyositis muscle involvement comes after cutaneous signs
False – Muscle involvement can occur concurrently, precede or may follow skin disease
True/false
A SCC arising from an area of Bowens disease is most likely to metastasise
True
True/false
Erythroderma is inflammatory skin disorder affecting >90% of skin
True
Which disease is most likely associated with intractable vasculitic ulcers A: Diabetes B: SLE C: Rheumatoid arthritis D: Leprosy
C: Rheumatoid arthritis
Which is the most likely malignancy in a long-standing ulcer A: SCC B : BCC C: Malignant melanoma D: Viral wart
SCC
Compression stockings contraindicated below which ABPI:- A: 1 B: 0.9 C: 0.8 D: 0.7
0.8
Which of these is NOT classically associated with pyoderma gangrenosum
A: IBD
B: Myeloma
C: Diabetes
D: Rheumatoid arthritis
diabetes
Erythema Nodosum is NOTassociated with:
A: OCP
B: Sarcoid
C: Vasculitis
D: Streptococcal infection
Vasculitis
Acanthosis Nigracans is associated with
A: Diabetes
B: Stomach cancer
C: Vasculitis
D: Obesity
Diabetes
Dermatomyositis is NOT associated with
A: Malignancy
B: Papules on the volar aspect of the IP joints
C: Photosensitive rash
D: Periorbital purple rash
B – they tend to involve the dorsal aspect of the IP joints
- Which of the following has the worst prognosis?
- Which is most common in Caucasians?
- Which most common in Orientals?
A: Lentigo Maligna Melanoma
B: Nodular melanoma
C: Acral lentiginous melanoma
D: Superficial spreading melanoma
- B
- D
- C
Which does NOT predict poorer prognosis in melanoma
A: Ulceration
B: Nodule
C: Amelanosis
D: Female sex
D Females have a better prognosis
When would you consider sentinel lymph node biopsy
A: >1mm depth
B: >2mm depth
C: >3mm depth
D: Melanoma of any depth
A
How would you initially stage a melanoma
A: Excision biopsy
B: Shave biopsy
C: Punch Biopsy
D: Sentinal node biopsy
A – an excision biopsy is preferred, including initially 1-2mm margin of all layers of skin and some subcutaneous fat to determine depth/extent of lesion. If suggestive lesion is in cosmetically sensitive site, incisional/punch biopsy may be apt. These should be taken from the most abnormal area of lesion.
What clearance do you require for excision of melanoma in situ
A: 0.5cm
B: 1cm
C: 2cm
D: 3cm
A
Which of these are first line for scabies infestation
A: Topical Steroids
B: Antihistamine
C: Permethrin
D: Malathione
C: Permethrin
What are the types of penicillin, how are they administered and what are they used for?
IV: Benzylpenicillin sodium (Penicillin G)
- streptococcal (including pneumococcal), gonococcal, and meningococcal infections and also for anthrax, diphtheria, gas-gangrene, and leptospirosis. Pneumococci, meningococci, and gonococci which have decreased sensitivity to penicillin have been isolated; benzylpenicillin sodium is no longer the drug of first choice for pneumococcal meningitis.
Oral: Phenoxymethylpenicillin (Penicillin V)
- not be used for serious infections because absorption can be unpredictable and plasma concentrations variable
- indicated principally for respiratory-tract infections in children, for streptococcal tonsillitis, and for continuing treatment after one or more injections of benzylpenicillin sodium when clinical response has begun
- It should not be used for meningococcal or gonococcal infections
- Phenoxymethylpenicillin is used for prophylaxis against streptococcal infections following rheumatic fever and against pneumococcal infections following splenectomy or in sickle-cell disease.
When is flucloxacillin used?
Most staphylococci are now resistant to benzylpenicillin because they produce penicillinases. Flucloxacillin, however, is not inactivated by these enzymes and is thus effective in infections caused by penicillin-resistant staphylococci, which is the sole indication for its use. Flucloxacillin is acid-stable and can, therefore, be given by mouth as well as by injection. Flucloxacillin is well absorbed from the gut.
