Derm2

Question 1

Name 3 examples of emollients

Answer 1

White soft paraffin and liquid paraffin
Aqueous cream
Emulsifying ointment

Question 2

How much topical steroid do you use?

Answer 2

A finger tip unit (length of finger) for the area of 2 hands

30g tube is enough to cover whole body once

Question 3

5 local SE to topical steroid cream

Answer 3

Skin atrophy
Striae
Telangiectasia
May mask/exacerbate skin infections
Acne

Question 4

Name 7 systemic SE to steroids

Answer 4

Cushing's
Immunosuppression
Hypertension
Diabetes
Osteoporosis
Cataracts
Steroid induced psychosis

Question 5

Name 2 sedating and 2 non sedating antihistamines

Answer 5

Sedating (chlorpromazine, hydroxyzine)
Non sedating (cetirizine, loratidine)

Question 6

Unwanted effects of older antihistamines

Answer 6

Sedation

Anticholinergic (dry mouth, urinary retention)

Question 7

Name 2 topical antibiotics

Answer 7

Fusidic acid

Mupirocin (bactroban)

Question 8

Name 2 antiseptics

Answer 8

Chlorhexidine

Povidone-iodine

Question 9

Name an oral retinoid

Answer 9

isotretinoin

Question 10

What are retinoids used for?

Answer 10

Acne
Psoriasis
Disorders of keratinisation

Question 11

SE of retinoids

Answer 11

Teratogenicity
Dry skin, eyes
Disordered liver function
Lipid profile

Question 12

Give 2 tips for topical steroids

Answer 12

Only for short term use (up to 2 weeks)

Only use 1% hydrocortisone for face

Question 13

Where are skin scrapes taken from?

Answer 13

Scaly lesions (suspected fungal infection)
Burrows in scabies)

Question 14

How do you do an ABPI?

Answer 14

BP at dorsalis pedis/posterior tibial
BP at brachial artery
Ratio, normally >0.8

Question 15

What do you never prescribe in psoriasis?

Answer 15

Oral steroids

Beta blockers

Question 16

What is scleroderma?

Answer 16

Fibrotic change
Probably autoimmune
Can affects joints (contractures)
Decreased blood supply-> ulcers
Can lead to systemic sclerosis

Question 17

8 causes of ulcers

Answer 17

Venous
Arterial
Vasculitis
Neuropathic
Infectious (TB, protazoa, herpes)
SCC
Drug induced (nicorandil, methotrexate)

Question 18

Steps towards skin cancer

Answer 18

Acitinic keratoses
Bowen’s
SCC

Question 19

What does Bowen’s look like?

Answer 19

Can look like patches of psoriasis
Inflammatory base
Disordered structure
Keratinisation
Fairly well defined border
Tiny regular clods of blood vessels

Question 20

Treatment of rosacea

Answer 20

Topical ivamectin/metronidazole

Oral antibiotics

Question 21

What is an epidermoid cyst?

Answer 21

Normal epidermis contained under skin
Produces skin
Can get infected and cause an abscess

Question 22

What is Breslow thickness?

Answer 22

> 1mm thickness of melanoma is likely to have spread

Other factors: mitotic rate, poorly differentiated

Question 23

Describe the progress of a mole

Answer 23

If acquired, it progresses from a junctional nevus (most common in children) to a compound nevus and eventually to an intradermal nevus

Question 24

What are the 6Ps of lichen planus?

Answer 24

Pruritic, purple, polygonal, planar papules and plaques

Question 25

Difference between varicella zoster and herpes zoster?

Answer 25

Varicella: chickenpox Herpes: shingles

Question 26

What is erysipelas? | What is cellulitis?

Answer 26

Erysipelas involves the superficial dermis and epidermis, often resulting in superficial blistering. Lymphangitis is common. Cellulitis involves the deep dermis and subcutaneous tissue.

Question 27

Function of langerhan cells

Answer 27

Antigen presenting cells

Question 28

What cells are involved in wound healing?

Answer 28

Neutrophils and macrophages phagocytose cellular debris and invading bacteria Fibroblasts form granulation tissue Epidermal cells proliferate and migrate (re-epithelialisation)

Question 29

Difference between Steven Johnson and TEN

Answer 29

SJ is mucosal, infection or drug induced | TEN is skin and mucosa, systemic toxicity, full thickness epidermal necrosis

Question 30

How can you tell it's erysipelas?

Answer 30

Inflammation Fever, malaise, rigors Well-defined red raised border

Question 31

Which antibiotics are used to treat Staph Scalded Skin Syndrome?

Answer 31

Fusidic acid Best lactamase resistance penicillin Erythromycin Cephalosporin

Question 32

Define tinea unguium

Answer 32

fungal tinea infection of the nail | Yellow, crumbly, thickened

Question 33

Define pityriasis versicolor

Answer 33

Scaly fungal pale brown patches that fail to tan | usually asymptomatic

Question 34

What is imiquimod cream used for?

Answer 34

Anogenital ulcers Actinic Keratosis Bowen's BCC

Question 35

3 types of melanoma and associations

Answer 35

``` Nodular (young and middle aged, intermittent high intensity Uv exposure) Lentigo maligna (elderly, face, cumulative UV) Acral (dark skinned, palms soles and nail beds, elderly) ```

Question 36

Genetic defect for eczema?

Answer 36

Fillagrin protein function | Skin barrier defect

Question 37

Name a topical immuno modulator

Answer 37

Tacrolimus

Question 38

Name the bacteria that causes acne

Answer 38

Proprionibacterium acnes

Question 39

Name 7 most common causes of blisters

Answer 39

``` Impetigo Herpes (zoster/simplex) Pompholyx eczema Contact dermatitis Burns Insect bites ```

Question 40

what features are associated with venous ulcers?

Answer 40

warm skin, normal pulses leg oedema haemosiderin deposits lipodermatosclerosis