Dermatology

Question 1

What virus is thought to play a role in pityriasis rosea?

Answer 1

Herpes hominis virus 7

Question 2

What is the treatment for actinic keratosis?

Answer 2

Fluorouracil cream
Topical diclofenac
Topical imiquimod
crytotherapy

Question 3

What does immunofluoresence of bullous pemphigoid show?

Answer 3

IgG and C3 at the dermo-epidermal junction

Question 4

What type of hypersensitivity reactions are stephens johnsons syndrome and Toxic Epidermal Necrosis ?

Answer 4

Type 4

Question 5

What type of hypersensitivity reaction is allergic contact dermatitis?

Answer 5

Type 4

Question 6

What is the inheritance pattern of hereditary haemorrhagic telangiectasia?

Answer 6

Autosomal dominant

Question 7

What are the symptoms of hereditary haemorrhagic telangiectasia?

Answer 7

1. Epistaxis
2. Telangiectasia
3. Visceral lesions eg pulmonary AVM. hepatic AVM, cerebral AVM
4. Family history

(If they meet 3 or more of these criteria then this is a definitive diagnosis)

Question 8

What treatment can be given for guttate psoriasis?

Answer 8

UVB phototherapy 
(most cases resolve spontaneously)

Question 9

What is pellagra?

Answer 9

Niacin deficiency. Presents are the triple combination of dementia, diarrhoea and dermatitis (photosensitive, pigmented dermatitis)

Question 10

What is the treatment for psoriasis?

Answer 10

1. Topical corticosteroid + vitamin D analogue once daily
2. Vitamin D analogue twice daily
3. Potent corticosteroid twice daily + a coal tar preparation. Short acting dithranol

Secondary care

1. UV B light therapy
2. psoralen + PUVA
3. Oral methotrexate
4. Ciclosporin
5. Systemic retinoids
6. Biologics - infiximab, etanercept, adalimumab

Question 11

How do vitamin D analogues work in psoriasis?

Answer 11

Decreasing cell division and differentiation which then decreases epidermal proliferation

Question 12

What is the first line treatment for lichen planus?

Answer 12

Potent topical steroids

Benzydamine mouthwash

Question 13

What investigations are required for porphyria cutanea tarda?

Answer 13

Urine - elevated uroporphyrinogen and pink fluorescence of urine under woods lamp
Serum iron ferritin level

Question 14

What is the management of porphyria cutanea tarda?

Answer 14

Chloroquine

Venesection if ferritin above 600

Question 15

What medications exacarbate plaque psoriasis

Answer 15

Beta blockers 
Lithium 
Antimalarials 
NSAIDS 
ACEi
Infliximab