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RACP Written Exam Cram Series > Derm Cram > Flashcards

Derm Cram Flashcards

1
Q

Immune cells found in erythema toxicum?

A

Eosinophilia

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2
Q

Pathogenesis of acne?

A

Abnormal keratinisation
Increased sebaceous gland production
P Acnes
Inflammation

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3
Q

Mechanism & indication for isotretinoin (Accutane)?

A

Severe nodulocystic acne
Reduces size and secretion of sea glands, normalises keratinisation
Course of 4-5 months
HIGHLY TERATOGENIC
Causes liver dysfunction (contraindication)

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4
Q

Treatment of allergic contact dermatitis?

A

Avoidance of trigger
Topical corticosteroids
Topical calcineurin inhibitors
Systemic corticosteroids indicated if >20% BSA or if affect the face, hands, feet or genitalia

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5
Q

Treatment of irritant contact dermatitis?

A

Increase emollient use
Topical corticosteroids
Gloves
Systemic corticosteroids are not indicated

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6
Q

Pathogen related to seborrheic dermatitis?

A

Pityrosporum ovale yeast

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7
Q

Treatment of seborrheic dermatitis?

A

If scalp - medicated shampoo, wet compresses +/- topical antifungals
If not scalp - topical corticosteroids +/- antifungals
Consider pimecrolimus in severe disease

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8
Q

Yellow-gold on wood’s lamp exam

KOH preparation shows groups of thick walled spores, short angular hyper resembling spaghetti and meatballs

A

Tinea/Pityriasis Versicolour

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9
Q

Preferred topical anti fungal agent?

When systemic therapy indicated?

A

Terbinafine
If chronic/resistant infection or scalp/nail involvement use systemic therapy
Baseline ALT/AST required prior to systemic therapy

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10
Q

Indications for treatment of haemangiomas?

A

If large/rapidly growing
Periorbital
Airway (beard distribution) / liver / GIT lesion
If ulcerating

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11
Q

> 5 haemangiomas?

A

Needs liver USS to investigate for liver haemangioma

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12
Q

Thrombocytopenia/coagulopathy with large haemangioma?

A

Kasabach-Merritt phenomenon

platelet trapping in vascular tumour

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13
Q

Segmental haemangioma on face/head?

A 
PHACE
Posterior fossa brain malformation
Haemangioma
Arterial anomaly
Cardiac/coarctation
Eye and endocrine
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14
Q

Segmental haemangioma on lumbosacral region?

A

Assoc myelopathy
Spinal and genitourinary anomalies
Needs MRI as investigation

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15
Q

Beard hameangioma

A

Airway haemangioma

Risk of airway sx at 6-12 weeks when haemangioma proliferation is rapid

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16
Q

SEs of propranolol?

A

Low BP and HR (peaks 2hrs post)
Wheeze & bronchospasm
Hyperkalaemia
Diarrhoea
Masks low BGL symptoms except sweating - parents need to be aware
Infants <2mths admitted for observation with first doses

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17
Q

When not to use propranolol in haemangiomas?

A

Sinus brady/1st degree heart block
Bronchial asthma
Hypersensitivity to BBs
Prem infant aged <5 weeks

PHACE with cervical stenosis/coractation
Drop in BP -> ischaemia

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18
Q

Itchy worse at night with tracks between fingers

A

Scabies

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19
Q

Treatment for scabies?

A

Ivermectin/permethrin

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20
Q

Flat, non-blanching red rash not crossing midline
Growing with child
Management?

A

Port Wine Stain/Naevus Flammeus

Pulsed dye laser - lightens without causing scarring

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21
Q

Associations with port wine stain?

A

Glaucoma
Spinal dyraohism
Stoft tissue/bony overgrowth

22
Q

Port wine stain V1/V2 trigeminal distribution
Leptomeningeal angiomatosis
Glaucoma

A

Sturge Weber Syndrome

23
Q

Port wine stain on limb
Venous/lymphatic malformation
Soft tissue/bone hypertrophy

A

Kippel-Trenaunay Syndrome

24
Q

Port wine stain limb
AV shunts with CCF
AVM

A

Parkes-Weber Syndrome

25
Q

Newborn with raised brown lesion with irregular margin

Biopsy shows nevus cells in lower reticular dermis

A

Congenital melanocytic naevi

26
Q

Risk of malignant transformation in congenital melanocytes naevus?

A

5%

Risk proportional to size

27
Q

Melanocytic nevus on biopsy shows atypical intraepidermal melanocytes +/- angiogenesis?

A

Atypical Melanocytic Naevi

28
Q

Risk factors for paediatric melanoma?

A

Atypical mole/melanoma syndrome
Xeroderma pigmentosum
Acquired melanocytic naevi/atypical naevi

29
Q

Hairless, red, dome shaped naevus

A

Spitz Naevus

30
Q

Patchy skin pigmentation following lines of Blashko?

A

McCune Albright

31
Q

Conditions presenting with lentigines?

Lentigines = small round dark brown macule like freckles/moles

A

LAMB syndrome
LEOPARD syndrome
Puetz Jeghers

32
Q

Conditions presenting with cafe au last macule?

A 
NF
Tuberous sclerosis
Turner's 
Fanconi Anaemia
Russell-SIlver
McCune Albright (Blashko)
Bloom 
Cowden
33
Q

Absent/reduced pigment in hair, skin, eyes?

A

Oculocutaneous albinism

34
Q

Rash begins on face

Koplik spots

A

Measles

35
Q

Rosy cheeks developing into lacy rash which spares the palms and soles

A

Parvovirus

36
Q

Small raised erythematous lesions beginning on trunk and spreading to limbs

A

Roseola Infantatum

HHV6,7

37
Q

Nonpruritic rash beginning on face and spreading downwards

A

Rubella

38
Q

Umbilicated epidermal papules

A

Molluscum

In immune competent 50% have cleared within 12 months

39
Q

HPV assoc w genital warts and respiratory papillomatosis?

A

HPV 6 and 11
11 more severe and more common
Treat with laser, cidofivir or interferon

40
Q

HPV assoc w cervical Ca?

A

16, 18

Detected in 70% of Cervical Ca

41
Q

RF for staph scalded skin?

A

Neonates - renal excretion of staph toxin reduced

42
Q

Unwell infant week 1 of life with fever
Blistering skin which heals without scars
Nikolsky sign positive
Mucus membranes not involved

A

Staph scalded skin

43
Q

Differentiation between staph scalded skin and TENS/SJS?

A

Staph scalded skin = intraepidermal cleavage and NO mucosal involvement
TEN = sub epidermal cleavage and necrosis and vast mucosal involvement

44
Q

Scaling on extensor surfaces, flexural surfaces spared
Keratosis pillars
Hyperkeratosis of palms and soles

A

Icthyosis Vulgaris
Most common disorder or keratinisation
AD - fillagrin mutation
Treat with moisturiser and salicylic acid

45
Q

Harlequin Ichthyosis treatment?

A

Oral retinoids
Now 80% survive beyond infancy
ABA12 mutation

46
Q

Alopecia
Unilateral yellow, waxy, scaling
Hemidysaplsia
Limb defects

A

CHILD syndrome

Congenital Hemidysplasia with Ichthyosiform erythroderma and Limb Defects

47
Q

Baby presents with unilateral facial swelling over a period of weeks-months
Painless mass that can be transilluminated
Sudden increase in size, accompanied by fever

A

Lymphatic malformation
50% head/neck
50% at birth and rest develop prior to age 2
Rapid enlargement can be due to bleed or infection

48
Q

Skin thickening and tethering to underlying tissue

Renal failure

A

Nephrogenic systemic fibrosis

49
Q

Most common superinfectioms in VZV?

A

Strep pyogenes

Staph Aureus

50
Q

Erythematous macules in infancy with increasing wheals/dermatographism which touched

A

Urticaria pigmentosa

RACP Written Exam Cram Series (19 decks)

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