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Year 5 > Derm > Flashcards

Derm Flashcards

1
Q

which glands produce sebum?

A

pilosebaceous follicles in response to androgens

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2
Q

describe to pathophysiology of acne

A

increased androgen sensitivity. excess sebum production. obstruction of outlfow of sebum, leakage into surrounding dermis, colonisation with propionibacterium acnes

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3
Q

what is an open comedone?

A

blackhead

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4
Q

what is a closed comedone?

A

whitehead

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5
Q

what suggests moderate/ severe acne?

A

scarring, affecting trunk and lots of comedones

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6
Q

conservative management for acne

A

washing BD with soap, sunlight ?beneficial, OTC benzyl peroxide

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7
Q

what are first line treatments for acne vulgaris?

A

topical antibiotics (not alone as increased risk of resistance)
topical retinoids
benzoyl peroxide

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8
Q

what is a side effect of benzoyl peroxide?

A

dry/ irritated skin, start lowest strength e.g. 2.5% and persevere

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9
Q

which topical antibiotics can be used for acne?

A

clindamycin/ erythromycin

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10
Q

how long can systemic treatments for acne take to work?

A

allow 4 months to assess effects

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11
Q

which oral antibiotics can be used for acne?

A

tetracyclines- limacycline/ doxycycline

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12
Q

give an example of an oral retinoid?

A

isotretinion

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13
Q

give 3 side effects of isotretinoin

A

teratogenic
dry skin
myalgia (exercise related)

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14
Q

what are contraindications to isotretinoin?

A

tetracycline use- risk of benign intracranial HTN

POP (reduces effectiveness)

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15
Q

what treatment for acne can be used in F?

A

anti-androgens e.g. COCP

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16
Q

treatment for fungal nail infection

A

oral terbinafine

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17
Q

young adult with an abdominal herald patch, followed by erythematous, oval, scaly patches in a ‘fir-tree’ distribution

A

pityriasis rosea

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18
Q

what is RAST?

A

radioallergosorbent test- identifies IgE to specific antigens in eczema

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19
Q

pearly papules with central punctum

A

molluscum contagiosum

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20
Q

systemically unwell, extensive papules and blisters. history of eczcema

A

eczema herpeticum

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21
Q

what is the pathophysiology of ezcema?

A

IgE mediated T call autoimmune response

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22
Q

what bacteria most commonly causes secondary infection of eczema?

A

staph aureus

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23
Q

what are the 3 steps of emollient?

A

cream< lotion< ointment

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24
Q

name mild corticosteroids

A

1% hydrocortisone (<2 weeks/ 5 days on face)

if no effect eumvate

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25
Q

name potent corticosteroids

A

betnovate

dermovate (not on face, good if lichenification)

26
Q

side effects of topical steroids

A

skin thinning
striae formation
telangectasia
cushings (rare)

27
Q

what is Auspitz sign?

A

sctratch of scale causes capillary bleed, +ve for psoriasis

28
Q

2 nail changes in psoriasis

A

pitting

onycholysis

29
Q

pathophysiology of psoriasis?

A

t cell mediated- release cytokines resulting in keratinocyte proliferation

30
Q

multiple small discoid plaques, scaly, following strep tonsillitis

A

guttate psoriasis

31
Q

5 drugs that can precipitate psoriasis

A 
BB
Li
anti malarials
NSAIDs
ACE-Is
32
Q

4 extra-dermal manifestations of psoriasis

A

arthritis
IBD
uveitis
metabolic syndrome (DM-II, HTN, CVD)

33
Q

what should always be co-prescribed with steroids in psoriasis?

A

vitamin D analogues e.g. calcitriol/ calciprotriol

34
Q

True or false: in psoriasis start with least potent agent and titrate up

A

false: start with most potent agent

35
Q

name 3 other topical treatments for psoriasis other than emollients/ steroids/ vit D analogues

A

coal tar preparations
salicylic acid (keratolytics)
retinoids

36
Q

what can be used in secondary care for psoriasis?

A

phototherapy (UVB>UVA>PUVA)
retinoids
immunosuppression- methotrexate
biologics- infliximab

37
Q

First line for psoriasis

A

Vit. D analogues +/- topical steroids + tar or salicylic acid ± UVB

38
Q

what % of skin coverage in psoriasis warrants referral to secondary care?

A

> 10%

39
Q

seborrhheic keratosis

A

flat topped/ warty, dark lesions in sun-exposed areas. reassure

40
Q

what causes plantar warts (verruca)

A

HPV

41
Q

treatment for verrucas

A

first line OTC salicylic acid

then: cryotherapy

42
Q

slow growing tumour, rarely spreads

A

BCC

43
Q

pearly nodule with a raised, red, edge. May be scaly. Often on the face.

A

BCC

44
Q

treatment of solar keratosis

A

cryotherapy/ effudix

45
Q

management of BCC

A

Medical- effidux

surgical- cryotherapy/ curretage/ cautery/ Moh’s

46
Q

what do solar keratoses predispose to?

A

SCC

47
Q

Solitary papule / nodule, often eroded at the centre, or crusty, purulent or bleeding

A

SCC

48
Q

what name is given to SCC in situ

A

Bowen’s disease

49
Q

management of SCC

A

edical- effidux (rare as no histology)

surgical- cryotherapy/ curretage/ cautery/ Moh’s

50
Q

what checklist is used for melanoma

A

Glasgow 7 point checkilst

51
Q

what mnemonic can be used for melanoma diagnosis?

A 
ABCDE
Assymetry
Border- irregulr
Colour
Diameter >7mm
Evolving
52
Q

on biopsy of melanoma what predicts outccome?

A

Breslow thickness, >1mm indicates high risk of metastasis and need for sentinal node biopsy

53
Q

how many naevi increase risk of developing melanoma

A

> 50 normal/ >2 atypical

54
Q

Kaposi sarcoma

A

immunosuppression + HPV infection-> multiple purple plaques/ patches on skin + mucous membrane

55
Q

what signs around a leg ulcer suggests a venous cause?

A 
varicose veins
oedema
venous eczema
haemosiderin deposition
atrophie blanche
56
Q

where are venous ulcers typically located?

A

around malleoli

57
Q

where are arterial ulcers typically located?

A

areas of poor blood supply e.g. tibia/ toes

58
Q

large, shallow ulcer, irregular border, pain reduced on elevation

A

venous ulcer

59
Q

deep, punched out ulcer. Pain relieved by hanging leg over edge of bed

A

arterial ulcer

60
Q

initially a smooth dome-shaped papule

rapidly grows to become a crater centrally-filled with keratin

A

keratoacanthoma

61
Q

scabies management

A

permethrin 5%

Year 5 (12 decks)

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