Derm

Question 1

First-line management for hyperhidrosis?

Answer 1

Topical aluminium chloride

Question 2

Most accurate way of measuring TBSA for burns?

Answer 2

Lund and Browder chart

Question 3

Wallace’s rule of Nines

Answer 3

head + neck = 9%
each arm = 9%
each anterior leg = 9%
each posterior leg = 9%
anterior abdomen = 9%
posterior abdomen = 9%

Note: not accurate > 15% TBSA

Question 4

TBSA of palmar surface?

Answer 4

1%

Question 5

When would you refer burns to secondary care? (6)

Answer 5

• all deep dermal and full-thickness burns.
• superficial dermal burns of more than 3% TBSA in adults, or more than 2% TBSA in children
• superficial dermal burns involving the face, hands, feet, perineum, genitalia, or any flexure, or circumferential burns of the limbs, torso, or neck
• any inhalation injury
• any electrical or chemical burn injury
• suspicion of non-accidental injury

Question 6

Which rash is commonly associated with HSV?

Answer 6

Erythema multiforme

Question 7

Which drugs cause erythema multiforme?

Answer 7

penicillin
sulphonamides
carbamazepine
allopurinol
NSAIDs
oral contraceptive pill

Question 8

Which drug can exacerbate psoriasis?

Answer 8

Lithium

Question 9

Initial management of actinic keratoses?

Answer 9

Topical fluorouracil cream

Question 10

Strep throat then rash 2-4 weeks later?

Answer 10

Guttate psoriasis

Question 11

Appearance of pityriasis rosea v. guttate psoriasis?

Answer 11

PR –> herald-patch then fir tree, erythematous + scaly lesions

GP –> ‘tear drop’ papules on trunk + limbs

Question 12

When should IV fluids be given for burns?

Answer 12

Second/third degree > 15% (superficial dermal + partial thickness or more)

Question 13

Eczema herpeticum - management

Answer 13

Hospital for IV acyclovir

Question 14

Lichenoid drug eruptions caused by?

Answer 14

gold
quinine
thiazides

Question 15

Lichen planus - initial management?

Answer 15

Topical steroids

Question 16

Seborrheic dermatitis - first-line management?

Answer 16

OTC preparations containing zinc pyrithione + tar

Question 17

Rash - hypopigmented and more obvious after sun tanning

Answer 17

Pityriasis versicolor

Question 18

Formula to calculate volume of IV fluids needed in first 24 hour in burns?

Answer 18

Parkland formula

Question 19

Skin manifestations of SLE

Answer 19

photosensitive ‘butterfly’ rash
discoid lupus
alopecia
livedo reticularis: net-like rash

Question 20

Well-demarcated patch marks of hair loss in younger woman with peripheral “exclamation point” short broken hairs

Answer 20

Alopecia areata

Question 21

Lesion initially a smooth dome-shaped papule –> rapidly grows to become a crater centrally-filled with keratin

Diagnosis?

Answer 21

Keratoacanthoma

Question 22

Lichen sclerosus - initial management

Answer 22

topical clobetasol propionate

Question 23

Sounds like acne but wrong age group

Answer 23

Acne rosacea

Question 24

Acne rosacea, mild/moderate - management?

Answer 24

Topical metronidazole

Question 25

Acne rosacea, severe/resistant - management?

Answer 25

Oral tetracycline

Question 26

Bullous pemphigoid - management?

Answer 26

Oral corticosteroids

Question 27

Squamous cell carcinoma in an area with chronic inflammation?

Answer 27

Marjolin's ulcer

Question 28

Which derm cancer has increased risk in immunocompromised?

Answer 28

SCC

Question 29

Young girl (17) with lanugo - common cause?

Answer 29

Malnutrition

Question 30

Burns --> haematemesis + Shock

Answer 30

Curling's ulcer

Question 31

Severe hirsutism - management?

Answer 31

co-cyprindiol

Question 32

Erythema multiforme + mucosal involvement?

Answer 32

Erythema multiforme major

Question 33

What are the skin appendages?

Answer 33

Hair follicle, sebaceous gland, apocrine / eccrine sweat glands, nail

Question 34

What comprises the pilosebaceous unit?

Answer 34

Hair follicle, sebaceous gland, arrector pili muscle

Question 35

What cells are found in the epidermis?

Answer 35

Keratinocytes, melanocytes, Langerhans cells, Merkel cells

Question 36

Psoriasis is unresponsive to conventional treatment - next step of management?

Answer 36

Topical retinoids

Question 37

Causes of onycholysis

Answer 37

``` Skin disease Systemic disease Infection Trauma Idiopathic ```

Question 38

What is koilonychia?

Answer 38

Spooning of nails, seen in IDA

Question 39

Which drug can cause generalised alopecia?

Answer 39

Warfarin

Question 40

What type of HS is contact dermatitis?

Answer 40

Type IV

Question 41

Causes of pyoderma gangrenosum?

Answer 41

UC + Crohn's RA Idiopathic

Question 42

Management of pyoderma gangrenosum?

Answer 42

High dose steroids | Non-adherent dressings

Question 43

What condition is associated with lupus pernio?

Answer 43

Sarcoidosis

Question 44

What is pellagra?

Answer 44

From deficiency of B3 (niacin/nicotinic acid) Dermatitis, diarrhoea, dementia

Question 45

'apple jelly' nodules

Answer 45

lupus vulgaris cutaneous manifestation of TB

Question 46

Cause of molluscum contagiosum?

Answer 46

Pox virus

Question 47

Buzzwords - violaceous, polygonal, popular eruption on flexor aspects

Answer 47

Lichen planus

Question 48

Function of Apo C-II?

Answer 48

Co-factor of lipoprotein lipase

Question 49

Function of lipoprotein lipase?

Answer 49

Hydrolyses triglyceride in chylomicrons and VLDLs

Question 50

Consequence of apo C-II deficiency?

Answer 50

elevated chylomicrons and VLDL

Question 51

Bullous pemphigoid affects: ``` desmosome hemidesmosome zonula occludens zonula adherens gap junction ```

Answer 51

hemidesmosome

Question 52

Pemphigus vulgaris affects: ``` desmosome hemidesmosome zonula occludens zonula adherens gap junction ```

Answer 52

desmosome

Question 53

Erythematous rash on face + telangiectasia?

Answer 53

Pityriasis rosea