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Derm Flashcards

1
Q

What does the keratin layer consist of

A

keratinocytes -> corneocytes which are then shed off

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2
Q

what is included in the keratin layer include

A

involucrin, filaggrin, keratin

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3
Q

filaggrin is what

A

skin barrier gene - filament aggregating protein

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4
Q

what do keratinocytes do

A

sense pathogens and mediate immune system

produce AMPs, cytokines, chemokines

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5
Q

T cells in epidermis T cells in dermis

A 
CD8 in epidermis 
CD4 and CD8 in dermis 
CD4 - Th1 - psoriasis 
Th2 - atopic dermis 
Th17 - psoriasis, atopic derm
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6
Q

two types of dendritic cells

A 
dendritic DCs - AG presentation and secrete chemo and cytokines
plasmacytoid DC (pDC) releases IFM gamma and is found in diseased skin
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7
Q 
chromosome 6 class 1
chromosome 6 class 2
A 
class 1 - present on all cells, presents to CD8 cells, endogenous AG
Class 2 - present on only APCs, presents to D4 cells, exogenous AG
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8
Q

immunologically mediated drug reactions - allergic or non allergic - dose dependant or not?
non immunologically mediated drug reactions - allergic or non allergic - dose dependant or not?

A

allergic. not dose dependant

non allergic, can be dose dependent

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9
Q

types(4) of allergic drug reactions

A

type 1 - direct - urticaria
type 2 - cytotoxic - phemphigoid/phemphigous
type 3 - immune complex mediated - purpura/rash
type 4 - T cell mediated

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10
Q

AGEP
SJS
TEN
DRESS

A

acute generalised exanthematous pustules - rare
steven johnson syndrome - minor form of toxic epidermal necrolysis
TEN - >30% of epidermal detachment
DRESS - drug reaction with eosinophilia and systemic symptoms

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11
Q

clingfilm helps what

A

topical drug absorption

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12
Q

investigation for PCT

A

woods lamp

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13
Q

drug causes of bullous pemphigoid

A

furosemide, ACEI, penicillin

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14
Q

linear IgA disease drug cause

A

vancomycin

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15
Q

fixed drug eruption causes

A

tetracycline, doxycycline, paracetamol, NSAIDs, carbamazapene

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16
Q

causes of itch

A

pruriceptive - something on skin - asthma
neuropathic - damage to CNS fibres - shingles
neurogenic - no damage to CNS fibres but affect on them - thyroid disease, bile duct disease, liver disease
psychogenic

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17
Q

Type 1 allergy - how can you catch it
stages
investigation

A

skin contact, injection, ingestion, inhalation
urticaria, angiooedema, asthma/wheezing, anaphylaxis
skin prick if negative - challenge test

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18
Q

Type 4 allergy - how

ix

A

airborne, skin contact, injection

patch testing - 48 hours then check after 96 hours

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19
Q

psoriasis phototherapy treatment

A

narrowband UVB and PUVA

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20
Q

what do retinoids do

A

decrease skin turnover

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21
Q

open comedones

closed comedones

A

open - blackheads

closed - whiteheads

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22
Q

demadox mite

A

rosacea

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23
Q

pompholyx eczema

A

spongiotic vesicles

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24
Q

Tuberose sclerosis - autosomal what

symptoms/signs

A

dominant
infantile seizures, ash leaf macule, depigmented macule, preiungual fibromas, facial angiofibromas, haemartomas, bone cysts, shagreen patches, enamel pitting

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25
Q

Epidermolysis bullosa types

A

simplex - epidermis
junctional
dystrophic - dermis

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26
Q

cafe au lait macules

A

asymp coffee colours flat macule
1-2 are normal
>5 - NF?

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27
Q

NF1

A

cafe au lait, neurofibromas (soft neural tumours), plexiform neuroma, axillary or inguinal freckling, 2 or more lisch nodules, bony lesions

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28
Q

what do you need derm protection for

A

group a strep
MRSA
scabies

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29
Q

what is acicilovir an analogue of

A

guanine

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30
Q

what is the melanocyte: basal keratinocyte ratio

A

1:5 - 1:10

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31
Q

breslow - how is it measured

melanoma - 5 year survival

A

from granular layer to deepest point of invasion

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32
Q

different skin types

A 
type 1 always burns, never tans
2 usually burns, can tans
3 can burn, usually tans 
4 never burns, always tans 
5 brown 
6 black
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33
Q

what does a childhood skin burn lead to

A

a 4x increased likelyhoood of melanoma

34
Q

what are the three genetic conditions that lead to an increase risk for skin cancer

A

xeroderma pigmentosum
albinism
nevoid basal cell carcinoma (gorlins syndrome)

35
Q

what is xeroderma pigmentosum
median age onset
defect in what

A

photosensitivity, skin cancer on UV exposed sites
8
one of 7 nucleotides
neurological degeneration

36
Q

what autosomal is gorlins syndrome

A

dominant

37
Q

what UV is more damaging than the other

A

UVC most
UVB
UVA least damaging

38
Q

what type of melanin is better at absorbing UV light

A

eumelanin is better than phaemelanin

39
Q

layers of SCALP

A 
skin
connective tissue 
aponeurosis 
loose connective tissue 
periosteum
40
Q

Functions of the skin

A

thermoregulation, immune, UV protection, endocrine function (UV -> vit D), sensory, barrier, fluid and electrolyte balance

41
Q

what kind of epithelium does skin have

A

stratified keratinising squamous epithelium

42
Q

what type of collagen is in the dermis

what are the 2 layers of the dermis

A

type 1 and 2
papillary - thin and beneath epidermis
reticular - thicker bundles of type 1 collagen - contained appendages

43
Q

inflame skin diseases (4)

A

spongiotic - intraepidermal oedema - eczema
psoriaform - elongation of rate ridges - psoriasis
lichenoid - basal layer damage - lichen planus
vesicolubullous - blistering - pemphigoid

44
Q

immunflurescnce of bullous pemphigoid shows what

A

linear IgA

45
Q

what AB is in derm herpeitform and what HLA

A

IgA AB target is gliadin

HLA DQ2 haplotype

46
Q

dome shaped vascular papule

A

spitz naeuvus

47
Q 
phytotoxic drug reactions: amiodarone
thiazides 
CCBs
psoralen and UV
halo dixic acid
A

immediate prickling with delayed erythema
exaggerated sunburn
exposed telengectasia
delayed (3-5days) erythema and pigmentation
increased skin fragility

48
Q

What happens in UV induced immunosuppression

A

dendritic cells lose the ability to present antigens

T cells switch from helper to suppressor

49
Q

what antibodies does pemphigoid and phemphigois have

A

goid hemidesmosome ABs

gous desmoglein 3 (more serious)

50
Q

HSV 16+18
6+11
1-4

A

cervical cancer
genital warts
warts/verucas

51
Q

gardisil vaccination

cervarix vaccination

A

16, 18, 6 +11

only 16 +18 - only cervical cancer

52
Q

what is arthus reaction

A

skin testing testing in type 3 hypersensitivity

slower than type 1 but faster than type 4

53
Q

what are gene changed in tuberose sclerosis and what inhibitor partially corrects it

A

TSC1 or TSC2

MTOR inhibitors

54
Q

what is NF1 responsible for

A

switching off cell cycle

55
Q

what are auispitz signs

A

in psoriasis

bleeding sports where psoriatic scales have been scraped off

56
Q

what is the signature DNA mutation in UV light

A

pyrimidine dimer mutation

57
Q

list the precursors of SSC

and the treatment

A

bowens
actinic keratosis
viral - HPV

cryotherapy, sola raze, 5 FV, imiquiomod, resurfacing

58
Q

Treatment for SCC and BCC

A

surgery

5% imiquimod cream

59
Q

ulcer that has a shallow edge and is around the malleolus

high cliff like edges and that is punched out and is on pressure points

A

venous

arterial

60
Q

non adherent dressing for venus ulcers

A

absorption - hydrocollides

anti bacterial - silver nitrate/manuka honey

61
Q

where is latina melanoma derived from and where does it occur

A

lentigo maligna

chronically sun damaged skin

62
Q

pigmented lesions on an elderly persons palms/soles/nails

pigment extends into his nails

A

acralantigous melanoma

63
Q

what does an amelanotic melanoma look like

A

decreased or no pigment

64
Q

what may lead to a dermatofibroma and what do they look like

A

insect bites

firm, increased pigment around rim, deep (dermal), brown/grey

65
Q

why do naevi happen

A

due to melanocytes that have failed to migrate or unigrate in utero

66
Q

peripheral halo of depigmentation and overrun by lymphocytes

A

halo naevi

67
Q

dermal naevi. blue

A

blue naevus

68
Q

large spindle and or epithelial cells

A

spitz naevus

69
Q

plaque - stuck on appearance - greasy - brown/black - on trunk
what is it and the cause

A

seborreohiec keratosis

bengin proliferation of epidermal keratinocytes

70
Q

bulli that burst to form erosions

bulli that burst to form raw marks

A

pemphigoid

pemphigus

71
Q

bulli either in one area or widespread over his trunk and prox limbs
bulli on scalp, axilla and groin
bulli on elbows and knees symmetrical and they itch

A

pemphigoid
pemphigus
dermatitis herpetiformis

72
Q

itchy rash in fingerwebs, wrists and genital area

A

scabies

73
Q

thick crusted skin in elderly or immunocompromised

A

Norwegian scabies

74
Q

red moist skin with ragged peeling edge and papule/pustules/erythema on the edges

A

candida

75
Q

where does candida intertigro occur

A

in skin folds where area is warm and moist

76
Q

bulls eye target lesions

A

erythema multiforme

77
Q

child

fresh firm umbiilcated nod that is 1-2 mm in dm

A

mallocusum contagious
can be sexually transmitted
self limiting
liquid nitrogen

78
Q

blistering rash at the back of the mouth

A

herpengioma
enterocci
swab. stool sample
self limiting

79
Q

what is hand foot and mouth disease caused by

A

enterovirus

80
Q 
primary syphilis 
secondary 
tertiary 
ix
rx
A 
painless ulcer
rash all over body - snail track ulcers
CNS, CVS etc.
blood test, swab of ulcer
injections of penicillin

2 (25 decks)

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