Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

PLAB Dra. Sommerhalder > Dermatology > Flashcards

Dermatology Flashcards

(74 cards)

Start Studying
1
Q

Anti-dsDNA and Anti-smith

A

Systemic Lupus Erythematosus (SLE)

The initial test for SLE is ANA

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

Anti-histone

A

Drug induced lupus (hydralazine)

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

Anti-scl70

A

Systemic Sclerosis

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

Anti-centromere

A

Limited sclerosis/CREST syndrome

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

Anti-Jo1

A

Polymyositis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Anti-Ro, Anti-La

A

Sjogren’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Anti-mitochondrial

A

Primary biliary cirrhosis

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

Anti-smooth muscle

A

Autoimmune hepatitis

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

pANCA

A

Churg Strauss (Eosinophilic Granulomatosis with Polyangiitis)

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

cANCA

A

Wegener’s Granulomatosis (Granulomatosis with Polyangiitis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Anti-tissue transglutaminase and IgA, Anti-gliadin, Anti-endomysial

A

Celiac disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ANA

A

Rheumatoid Arthritis (RA), initial test for SLE, other auto-immune diseases.

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

What is cellulitis?

Typically due to…?

A

Inflammation of the skin and subcutaneous tissues.

G +ve like Streptococcus pyogenes and Staphylococcus aureus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Features of cellulitis

A

Commonly on the shins

Erythema, pain, swelling

May be associated with systemic upset such as fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Management of cellulitis

A

1st line Fucloxacillin

Allergic to penicillin> Clindamycin or Clarithromycin (clindamycin if failed to respond to flucloxacillin like MRSA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Severe cellulitis and MRSA skin infection management

A

Severe cellulitis> IV benzypenicillin + flucloxacillin

MRSA skin infeciton> Vancomycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

4Ps + F and LP for lichen planus

A 
Pruritic
Purple
Papular
Polygonal rash on the 
Flexor surfaces

White LACY PATTERN on the buccal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Management of lichen planus

A

topical steroids

Benzydamine mouthwash or spray is recommended for oral lichen planus

Extensive lichen planus may require oral steroids or immunosuppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

ABCDE of malignant melanoma (when to suspect?)

A

Asymmetry- the 2 halves of the mole look different in shape

Border- Irregular edges

Color- Different shades of black, brown and pink

Diameter- >6mm

Evolves- Enlarge, grows upwards, downwards, outwards as a flat lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Management of a benign mole?

A

A benign mole that does not bleed or interfere with life can be referred to a PRIVATE dermatology clinic.

NHS does not provide Cosmetic Services

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Depth of invasion is important as a …… factor for malignant melanoma

A

Prognosis

bad prognosis factor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is the most important prognostic factor indicator in a malignant melanoma that was excised?

A

Breslow thickness

The depth in mm

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Most common melanomas in the UK?

A

70% are superficial spreading melanomas.

More common in people with pale skin and freckles, less common in darker skinned people.

They initially grow outwards rather than downwards, so don’t pose a problem. If they grow downwards into deeper skin layers then they can spread to other parts of the body.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Melanomas that usually appear as a changing lump on the skin which might be black to red in colour.

A

Nodular melanomas, they develop faster and can quickly grow downwards into deeper layers of the skin if not removed.

They often grow on previously normal skin and most commonly occur on the head and neck, chest or back. Bleeding or oozing is a common symptom

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
What is SLE (systemic lupus erythematosus)
Multisystem autoimmune disorder. Presents early in adulthood and is more common in women and Afro-Caribbean origin.
26
General Features of SLE (systemic lupus erythematosus)
atigue, fever, lymphadenopathy Mouth ulcers (large, multiple and painful) Remitting and relapsing illness
27
Skin features of SLE (systemic lupus erythematosus)
Malar (butterfly) rash (*spares nasolabial folds*) Discoid rash- scaly, erythematous, well demarcated rash in sun-exposed areas. They may progress to become pigmented and hyperkeratotic before becoming atrophic Photosensitivity Raynaud's phenomenon (1/5th of the pxs but often mild)
28
Musculoskeletal, cardiovascular and respiratory features of SLE (systemic lupus erythematosus)
Arthralgia and non-erosive arthritis Pericarditis (the most common cardiac manifestation) and myocarditis Pleurisy and fibrosis alveolitis
29
Renal and neuropsychiatric features of SLE (systemic lupus erythematosus)
Proteinuria and glomerulonephritis (diffuse proliferative glomerulonephritis is the most common type) Anxiety and depression Psychosis Seizures
30
SLE immunology
99% is ANA positive (screening= sensitive but not specific) 20% are rheumatoid factor positive anti-dsDNA is highly specific (>99%) but less sensitive (70%) anti-Smith is the most specific (>99%) but very low sensitivity (30%)
31
The initial screening for SLE is ...? And the confirmatory test for SLE is...?
Anti-nuclear antibody (ANA) is the most sensitive Anti-dsDNA is the most specific (confirmatory)
32
Immunology in drug-induced lupus and drug examples
Anti-histone antibodies Hydralazine Procainamide Isoniazid (TB drug!)
33
Drug induced lupus is just like SLE | True or false?
FALSE Not all typical features are seen Renal and nervous system involvement is rare Resolves on its own after stopping the causative drug
34
Features of drug induced lupus
Arthralgia Myalgia Skin (malar rash) and pulmonary involvement (pleurisy) are common
35
Immunology of drug induced lupus
ANA positive in 100% dsDNA negative Anti-histone antibodies are found in 80-90% (usually the answer in exams)
36
Urticaria
Wheals (central itchy white papules or plaques surrounded by erythema) Variable in size and shape ± swelling of soft tissues (eyelids, tongue, lips) > angioedema Here today, gone tomorrow> come and go within a few minutes or hours
37
Acute and chronic urticaria
Acute <6 weeks Chronic >6 weeks
38
Why aspirin and opiates cause urticaria?
Aspirin and opiates may elicit the release of histamine from mast cells > urticaria
39
Management of urticaria
Tx the cause and aggravating factors (Stop aspirin, opiates, overheating, stress, alcohol, caffeine) Non-sedating H1 anti-histamines (cetirizine or loratadine) In pregnant, give sedating anti-histamine like chlorphenamine
40
Psoriasis main features
Itchy, scaly, well demarcated, circular, reddish, elevated lesions (plaques) Overlying white or silvery scales It can be on elbows, knees, scalp etc. NOT contagious On the extensor surfaces and scalp Strong genetic basis Vigorous scrapping> pinpoint bleeding> Auspitz' sign New lesions appear at sites of injury of the skin> Kobner's reaction Family Hx is often given as a hint ± nail changes (pitting, onycholysis)
41
Psoriasis Rx
Topical steroids Vitamin D analogues Tar preparations
42
Eczema main features
Chronic, relapsing Inflammatory skin condition Itchy red rash Affects skin creases (flexures like wrist, elbow folds, behind knees) Triggered by environmental irritants and allergens. Also URTIs (upper respiratory tract infection) can cause a flare up eczema Family history of atopic diseases like asthma and hay fever
43
Eczema treatment
1st line> emollients Topical steroids
44
Seborrheic dermatitis main features
Scaling rash Affects sebaceous glands Found on face, scalp and chest Inflammatory reaction to yeast Presents as inflamed greasy areas with fine scaling Can present as dandruff when on scalp.
45
Seborrheic dermatitis management
Regular antifungal Intermittent topical steroids
46
Px with hx of immunosuppression and smoking, with thick white marks ± inflamed mouth/tongue that can be rubbed out.
Oral thrush (candidiasis) Plaques might enlarge and become painful, causing discomfort while eating and swallowing. It might also present with inflamed painful sore mouth angles.
47
Management of oral thrush
Stop smoking Good inhaler techniques, spacer device, rinse mouth with water after use. Oral fluconazole 50mg OD for 7 days or fluconazole oral suspension
48
Px with hx of smoking, with white oral lesion with raised edges, bright white patches, sharply well-defined edges and cannot be rubbed out.
Leukoplakia Rx stop smoking and biopsy! (they are premalignant)
49
Oral lichen planus...
Lace (ornamented) like appearance lesions. Remember the 4Ps+F Purple, pruritic, polygonal, papular rash on flexor surfaces
50
Eczema in infants and children affect which part of the body? (infants, young children and older children)
Infants> face and trunk then extremities Younger children> on extensor surfaces Older children> typical distribution with flexor surfaces affected and the creases of the face and neck. Eczema occurs in around 15-20% of children and is becoming more common It typically presents before the age of 6 months but clears around 50% of children by 5 years of age and in 75% of children by 10 years of age.
51
Management of Eczema in infants and children
1st line> emollients (at least BID= twice daily) + washing, bathing (moisturising) 2nd line> topical steroids (for eczema itself)
52
Hydrocortisone acetate is a mild, moderate, potent or very potent strength steroid?
Mild Comes topical 0.5%, 1% or 2.5% To be used in mild eczema or a new case that is not responding to emollients.
53
Example of a moderate strength steroid for eczema
``` Betamethasone valerate (0.025%) or Clobetasone butyrate (0.05%) ``` for a moderate eczema with wide area of dryness, crackling and redness
54
Example of a potent strength steroid for eczema
Betamethasone valerate (0.1%) or Mometasone 0.1% (For severe eczema that causes bleeding, intense itching that prevents sleeping, and not responding to emollients and hydrocortisone) Hydrocortisone butyrate
55
Very potent strength steroid for eczema
Clobetasol propionate
56
What should be done if emollients and steroids are to be given together?
Apply emollient 1st, then wait 30 minutes, then apply the topical steroid. Also, avoid irritants and stress Tx bacterial infection if present (flucloxacillin is 1st line) If eczema awakens the patient at night then consider a sedative antihistamine (chlorphenamine)
57
Clotrimazole is a..... | used for....
Antifungal agent Used for athlete's foot, fungal groin infections, fungal nappy rash
58
What should be administered in a patient referring an insect bite with itching skin and no signs and symptoms of anaphylaxis? What if he develops a severe reaction?
Oral anti-histamine If a severe reaction develops (affects breathing) then give IM adrenaline
59
One of the 3 main types of skin cancer Lesions known as Rodent Ulcers Characterized by slow-growth and local invasion Metastases are extremely rare.
Basal cell carcinoma BCC is the most common type of cancer in the western world.
60
Features of Basal Cell Carcinoma
Many types of BCC are present. The most common type is nodular BCC (Sun-exposed sites, especially the head and neck Initially pearly, flesh-coloured papule with telangiectasia May later ulcerate leaving a central "crater")
61
Patient with white umbilicated ulcer with central depression....
Basal Cell Carcinoma | Rodent ulcers
62
Management of BCC
``` Surgical removal Curettage Cryotherapy Topical cream: imiquimod and fluorouracil Radiotherapy ```
63
White or pink papules with an umbilicated (depressed) central punctum. If squeezed they produce cheesy white material.
Molluscum contagiosum (pox virus) Can be found anywhere on the skin They resolve spontaneously in 6-24 months Usually in children and immunocompromised patients. (consider AIDS if extensive pink umbilicated papules)
64
Golden crusted skin lesions commonly found around the mouth (honey coloured crust) in children.
Impetigo Superficial bacterial skin infection usually caused by Staph aureus or Strepto pyogenes. Can be primary or a complication of an existing skin condition like eczema, scabies or insect bites. Incubation period of 4 to 10 days. Lesions tend to occur on the face, flexures and limbs not covered by clothing. Very contagious!
65
Rx of impetigo
Limited, localised, non-bullous disease 1st line hydrogen peroxide cream 1% Fusidic acid 2% or mupirocin (2nd line) If extensive non-bullous or bullous impetigo Oral flucloxacillin or Oral erythromycin if penicillin allergic.
66
What should be done with a child with impetigo?
They should be excluded from school until the lesions are crusted and healed. Or 48 hrs after commencing the antibiotic treatment.
67
What if the rash is painful and associated with fever, especially in a child with Hx of eczema?
Consider eczema herpeticum and give aciclovir.
68
When to suspect Cold Sore of Herpes Simplex Virus and not Impetigo
Hx of recurrent episodes Pain (tingling, itching, burning) before the onset of vesicles (prodromal pain) Vesicles initially filled with clear fluids More common in adults.
69
Patient that complains of flushing after alcohol or sunlight exposure. Telangiectasia can be seen in his nose, cheeks and forehead.
Acne Rosacea- a chronic skin disease of unknown aetiology Telagiectasia is common Later develops into persistent erythema with papules and pustules Rhinophyma is a nose disfigurement Ocular involvement: blepharitis
70
Rx of Acne Rosacea
Topical metronidazole may be used for mild symptoms (limited number of papules and pustules, NOT PLAQUES) More severe disease is treated with systematic antibiotics like Oxytetracycline or tetracycline
71
What is Tinea Capitis?
A fungal infection involving hair follicles and causing hair loss (alopecia) very rapidly
72
Rx of Tinea Capitis
Because of the risk of scarring, Rx is with a systemic oral antifungal such as oral terbinafine, itraconazole, or fluconazole. In children griseofulvin is used.
73
Dermatitis Herpetiformis is linked to which disease? Px with bloating, loose stools, abdominal pain, iron deficiency anemia and folate deficiency with severly itchy rash distributed over scalp, sacrum, elbows and knees.
Celiac disease. Tissue transglutaminase IgA and endomysial Abs are (+)ve
74
Indications of IM adrenaline in anaphylaxis
``` Hoarseness of voice Wheezes Shortness of Breath (SOB) Stridor Shock Facial, tongue or cheek swelling ```

PLAB Dra. Sommerhalder (7 decks)

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