Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

phase 2a mine > derm top tier > Flashcards

derm top tier Flashcards

1
Q

acne treatment

A

Advice

  • Avoid over washing
  • Don’t pick
  • Healthy diet

Mild

  • Benzoyl peroxide
  • – Increases skin turnover
  • – Clears pores and reduces bacteria count
  • – Dry
  • Retinoid (tretinoin)
  • – Topical
  • – Inhibit formation and reduce microcomedomes
  • Antibiotics
  • – Topical

Moderate

  • Antibiotics
  • – Doxycline
  • – Minocycline
  • Combined oral contraceptive
  • – Hormones suppress sebum production

Severe

  • Retinoid (isotretinoin)
  • –Decreases sebum production
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

acne investigations

A

Clinical
Skin swabs - microscopy and culture
Hormonal tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

acne complications

A

scarring

psychological / social

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what is a comedom

A

in hair follicle but hair not there, instead dead skin and bacteria

open = black head
closed = whitehead (skin)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

acne symptoms

- different severities

A

Mild

  • Blackheads = open comedones
  • Whiteheads = closed comedones
  • No scarring

moderate

  • Papules - small red bumps
  • Pustules - white/yellow spots
  • No scarring

Moderately severe

  • Inflammatory papules
  • Some scarring

Severe

  • Nodules - large red bumps
  • Severe scarring
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

acne pathophysiology

A
  • Chronic
  • Hypercornification = corneodesmosomes block entrance to hair follicles, resulting in narrowing of the hair follicle
  • Causes increased sebum production → greasy skin
  • Sebum becomes trapped in narrow hair follicles. Stagnates at bottom of pit - it is anaerobic here, allowing propionibacterium acnes bacteria to multiply in stagnant sebum
  • This results in irritation and inflammation (neutrophils attracted), so pus is formed and further inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what emotion may worsen/ trigger/ cause acne

inc pathophysiology

A

Psychological stress → increased cortisol → increased sebum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

is acne vulgaris a particularly severe form of acne?

A

no. vulgaris means common. this is the medical term for acne

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

complications of eczema

A

Broken skin may become infected (secondarily)

  • Staph aureus
  • –Crusted
  • –Weeping
  • Herpes simplex
  • –Multiple small blisters

Depression, anxiety

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatments for more severe/ non responsive eczema

A
  • Oral immune -modulators (cyclosporine, azathioprine)
  • Oral steroids (prednisolone)
  • Antibiotics (flucloxacillin)
  • Phototherapy - UV A
  • Antihistamines (chlorphenamine) –No clinical effect, but they sedate patient for better rest
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

first and second line pharmacological treatment for eczema

A

First line =Topical corticosteroids (hydrocortisone, clobetasol)

  • Different levels for different severities
  • Inhibit proinflammatory cytokines

Second line = topical calcineurin inhibitors (pimecrolimus, tacrolimus)

  • Less effective but less side effects - may be good for especially sensitive areas
  • calcineurin induces transcription factors for interleukins which activate T helper cells and cytokine production. so this medicine inhibits this so reduces inflammation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

non pharmacological management of eczema

A

Hydration
- Inc emollients – artificially restore skin barrier, traps moisture

bandages

Minimising exposure to allergens
- Bath soap substitutes

Minimizing itching

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

eczema investigations

A 
Clinical 
Bloods -- High serum IgE
Must have itchy skin in past 6 months
Patch testing- identifies suspected allergens
Skin prick test
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

where is eczema often (on the body)

A 
Elbows
Knees
Ankles
Wrist
Neck
Cheeks in infants - before spreading to rest of body
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

describe eczema appearance

A 
Red
Itchy
Scaly
hyper/hypopigmented 
Dry 
Weeping/ exudation/ vesicles - if very acute
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what conditions is eczema sometimes associated with

A

atopic triad =
Asthma
Allergic rhinitis
atopic dermatitis

Depression
Anxiety

17
Q

dermatitis vs eczema

A

same thing

18
Q

eczema pathophysiology

A
  • Inflammatory skin disease with vesicles (when acute), redness, oedema, oozing, scaling and usually pruritus (itch)
  • Skin breakdown due to stratum corneum thinning - so increased risk of inflammation
  • Filaggrin is a skin barrier protein. It is damaged allowing allergens to invade more easily and hence inflammation more likely
19
Q

eczema exacerbated by…

A 
Chemicals
Detergents
Woolen clothes
Infection 
Sweat 
Scratching / rubbing
cats/ dogs
Cigarette smoke
Stress
Weather changes
20
Q

is eczema more common in children or adults

A

children

but common in both

21
Q

types of eczema

causes/ risk factors

A

Endogenous - atopic

  • Hypersensitivity
  • Asthma , food allergy

Exogenous

  • Precipitated by chemicals, sweat and abrasives over a period of time
  • Sensitization of T lymphocytes
  • Itching and dermatitis upon re-exposure to antigen

family history also a risk factor/ cause – faulty gene that codes for filaggrin (skin barrier protein)

22
Q

psoriasis managment
advice
1st, 2nd, 3 rd line

A

Advice

  • Avoid irritants
  • Emollients

First line= topical therapy

  • Vitamin D analogues (calcitriol)
  • Corticosteroids
  • Retinoids (vit A agonist) (tazarotene)

Second line

  • Photherapy with UV A (induces damage in keratinocytes)
  • DMARD (methotrexate) (+ folic acid supplements)

Third line = biologics

  • TNF alpha inhibitors
  • Monoclonal antibodies
23
Q

Erythrodermic and pustular psoriasis presentation

A

Most severe
Widespread inflammation
Extremely itchy fire red scales that may fall off
Malaise, pyrexia, circulatory disturbances

24
Q

palmoplantar psoriasis presentation

A

Red, tender, thickening of palms and soles

25
guttate psoriasis presentation and age
Generalised, concentrating on trunk and upper arms/legs Explosive eruption of very small circular/ oval (raindrop-like) plaques Following streptococcal sore throat children and young adults
26
flexural psoriasis presentation and age
Well demarcated red, glazed plaques. No scaling Confined to flexures - groin, natal cleft, submammary (underboob) later in life
27
chronic plaque psoriasis presentation
Most common Well demarcated disc shaped, salmon pink silvery plaques Thickened Scalp common, hair margin, elbows, knees, limbs or at skin trauma sites
28
general psoriasis symtpoms where skin nail
Where? - Lower back - Scalp - Elbows - Knees Skin - Thickening - Itchy - Painful - Red - Scaly Nail changes - Pitting (dents) - Onycholysis (separation of nail from bed) - Yellow-brown discolouration - Thickening
29
psoriasis pathophysiology
Chronic T lymphocyte driven hyperproliferation of keratinocytes → thickened plaques (opposite of eczema which has skin breakdown) Inflammatory cell infiltration
30
psoriasis risk factors
``` Polygenic- family history Group a strep infection Drugs eg lithium UV light High alcohol consumption Stress ```
31
psoriasis epidemiology gender age -- inc age for guttate and flexural psoriasis
m=f rare in children Peak in early adulthood. Second less big peak 50-60y Guttate psoriasis - children and young adults Flexural psoriasis - later in life
32
risk factors for Squamous cell carcinoma (SCC) Basal cell carcinoma (SCC) Malignant melanoma (MM)
Squamous cell carcinoma (SCC) - UV exposure - Chronic inflammation eg wound scars, immunosuppression Basal cell carcinoma (BCC) - UV exposure - Skin type 1 (burns doesn't tan) - Ageing ``` Malignant melanoma (MM) - UV exposure - Alcohol drinking - Affluence - Red hair - High density freckles - Skin type 1 (burns doesn't tan) - -Atypical moles - Sun sensitivity Pale skin - Family history - Immunosuppression ```
33
squamous cell carcinoma (scc) - presents when - presents how - tumour of? - features inc how aggressive - commonness
- Present later in life - Locally invasive, malignant tumour of squamous keratinocytes (outermost bit of epidermis) - More aggressive than BCC as has higher metastatic potential - particularly to lymph nodes (but still rare to metastasise) - 2nd most common (to BCC) - On sun exposed sites - Ill defined nodules - May ulcerate - Grow rapidly
34
basal cell carcinoma (bcc) - presents when - presents where - presents how - tumour of? - features inc how aggressive - commonness
- Tumour of basal keratinocytes (deepest bit of epidermis) - Most common malignant skin cancer - Non pigmented mostly. If pigmented, can resemble melanoma - Majority in elderly - Majority head and neck - May ulcerate (=rodent lesion) - Border of ulcerated lesion is raised with pearly appearance - Shiny nodule - Non pigmented mainly - Bleeds following minor trauma and does not heal - less aggressive and metastatic than SCC-- slow growing, slowly causing local tissue destruction
35
malignant melanoma (mm) - tumour of? - presents when - presents where - presents how - prognosis inc bad prognosis signs - features inc how aggressive - commonness - types (4)
- Most malignant --- Tumour of melanocytes in basal layer of epidermis ---Produce melanin ---Absorbs UV (protective) - rarest out of MM, SCC, BCC - younger patients - Often fatal - Bad prognosis signs --- Thick lesions --- Over 60 y --- Male --- Ulceration of lesion --- On trunk - Men - back/chest Women - lower legs - Most lesions have dark colour, almost black in parts Types - Superficial spreading (SSMM- large, flat (laterally growth not vertical)) - Nodular (most aggressive) - Lentigo maligna (face, slow growing) - Acral (palms/soles)
36
skin cancer investigations
``` A- asymmetrical shape B- border irregularity C- colour irregularity D- diameter >6mm E- elevation, ``` ``` Major = Change / evolution is key -- Size, shape, colour (usually darkening) Minor = -- Inflammation -- Crusting -- Bleeding -- Sensory change- inc itching ``` Feel lymph nodes
37
skin cancer management
Surgical excision - wide borders (minimal 5mm) and histology Radiotherapy (esp if non resectable/ not fit for surgery) Superficial ones (esp BCC) - --Cryotherapy - --Photodynamic therapy Metastatic (esp MM) - --Remove regional lymph nodes - --Radiotherapy - --Immunotherapy - --Chemotherapy - --Isolated limb perfusion - limb circulation temporarily disconnected from body. External pump includes chemo that circulates to only particular limb

phase 2a mine (38 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions