Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Year 3 > dermatology > Flashcards

dermatology Flashcards

1
Q

define pressure sores

A

damage to skin over bony prominence as a result of pressure

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

aetiology/risk factors of pressure sores

A

risk factors:

  • immobility
  • alzheimer’s
  • diabetes

constant pressure limits blood flow to skin -> skin damage

occur as a result of pressure, friction, and shear stress

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

presenting signs and symptoms of pressure sores

A

most commonly located at sacrum and heel

staged from 1-4

very tender

can become infected

  • fever
  • erythema
  • foul smell
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

investigations for pressure sores

A

none

clinical dx

Waterloo score used to predict risk of pressure sores

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

management of pressure sores

A

document and categorise ulcer

nutritional support

pressure redistributing devices

negative pressure wound therapy

debridement

abx and antiseptics

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

documentation of pressure sores

A

document surface area with validated measurement technique

document estimated depth

categorise ulcers using validated classification tool

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

nutritional support for pressure ulcers

A
  • assessment by dietician
  • supplements if nutritional deficiency
  • education
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

pressure redistributing devices for pressure ulcers

A
  • high specification foam mattress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

negative wound pressure therapy for pressure ulcers

A
  • not routinely offered unless necessary to reduced number of dressing changes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

debridement of pressure ulcers

A

consider:
1. amount of necrotic tissue
2. category, size, and extent of ulcer
3. patient tolerance
4. comorbidities

use autolytic debridement with appropriate dressing

consider sharp debridement if autolytic will take longer and prolong healing

consider larval therapy is sharp debridement contraindicated or if associated vascular insufficiency

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

define psoriasis

A
  • chronic systemic inflammatory skin disease causing scaly red plaques
  • chronic relapsing/remiting disease

*can include psoriatic arthritis

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

clinical diagnosis of psoriasis

A
  • red, itchy, scaly patches
  • distribution- elbows, knees, trunk, scalp, face
  • colour- red/pink patches with some silvery scale
  • +/- joint or nail involvment
  • PMHx: IBD, obesity
  • systemic illness
  • FHx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

risk factors for psoriasis

A

strong:

  • genetic
  • trauma (scratching, tattoos, piercings)
  • infection (Streptococcal, HIV)

weak:

  • drugs (corticosteroid withdrawal)
  • stress
  • alcohol
  • smoking
  • hormonal changes (puberty, menopause)
  • high UV exposure
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

types of psoriasis

A
  1. chronic plaque- scaly plaque (most common)
  2. pustular - pus filled lesions (palms/soles) widespread=emergency
  3. guttate- tear drop patches after bacterial infection
  4. nail
  5. erythodermic - severe inflammed skin peeling in long sheets
  6. inverse- rash in skin folds
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

signs of plaque psoriasis on physical examination

A
  • raised inflamed plaque lesions
  • superficial silver white scaly eruption
  • friable skin underneath
    Auspitz’s sign (pinpoint bleeding points)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

signs of guttate psoriasis on physical examination

A
  • widespread, erythematous, fine, scaly papules
  • on trunk, arms, and legs
  • lesions often erupts after URTI
17
Q

pustular psoriasis

A
  • rare, sever, and urges
  • palmoplantar pustulosis affecting palms and soles
  • chronic
18
Q

erythrodermic psoriasis in physical examination

A
  • generalised erythema with fine scaling
  • associated with pain, irritation, sometimes severe itching
19
Q

investigations for psoriasis

A

clinical Dx

consider skin biopsy

20
Q

management for psoriasis

A
  • lifestyle changes (weight loss, stop smoking/alcohol, reduce stress/anxiety)
  • emolients (moisturisers)
  • topical corticosteroids with Ca2+ (short term), vitamin D analogues
  • salicylic acid (lift off scales)
  • short-contact dithranol (large plaque psoriasis)

Severe / >10% skin/ nail involvement/ resitant to steroids

  • refer to dermatology => calcineurin inhibitors, PUVA/phototherapy, biologic therapy, immunosuppressants (methotrexate,anti-TNF)

Plaque:

  • mild- topical therapies
  • moderate to severe:phototherapy, methotrexate, apremilast, biological agent, oral retinoid

Guttate:

  • phototherapy => methotrexate => oral retinoid =>ciclosporin

Pustular:

  • oral retinoid
  • re-PUVA
    • methoxsalen + uv-A + oral retinoid
    • acitretin administered before PUVA therapy to enhance efficacy
  • * inconvenient scheduling
  • * phototoxicity
  • * burning in dose not adequately controlled
21
Q

conditions associated with psoriasis

A
  • psoriatic arthritis (+ joint pain/swelling/stiffness)
  • Crohn’s
  • anxiety/depression
  • metabolic syndrome
22
Q

Define urticaria (Hives)

A

Superficial swelling of the skin causing a raised, red itchy rash

  • acute (<6 weeks)
  • chronic (>6 weeks)
  1. spontaneous - unknown cause
  2. autoimmune - IgE mediated allergy (food), high levels of IgG
  3. chronic inducible urticaria (CINDU)- urtiaria in response to physical stimulus (cold, water, pressure)
23
Q

Causes of urticaria

A

increased histamine release into skin => vasodilation of vessels + leaking => redness + swelling

  • Allergy- food, insect bite/sting
  • Cold/heat exposure
  • Infection- cold, hepatitis
  • Drugs - NSAIDs, antibiotics
24
Q

Hx taking for urticaria

A

HPC:

  • onset
  • Duration (<6 weeks = acute/chronic)
  • Rash symptoms (shape, size, distribution, itchy, painful)
  • severity (urticaria activity score)
  • recent infections (fever, cough)
  • check for GI symptoms (H.pylori?)

Acute Triggers

  • stresss levels
  • last thing you ate before rash/ usual diet (Food allergy- IgE-mediated)
  • any recent insect bites/stings
  • any new medication/drugs
  • work/home exposure to pets, chemicals, latex gloves
  • any recent foreign travel
  • CHRONIC RASH: medicine/ alcohol/caffeine/stress levels

PMHx:

  • Allergies
  • Autoimmune
  • psychiatric illnesses

FHx:

  • Allergies, urticaria

DHx:

  • started any new medication
25
Q

differentials for urticaria

A
  • urticarial vasculitis (painful, non-blanching, palpable rash with systemic features fever, arthralgia) - caused by infection Hep B/C, autoimmune, drugs
  • atopic eczema (dry/scaly skin, redness, lasts >24hrs)
  • contact dermatitis (eczema rash after repeated exposure to allergen, lasts >24hrs)
  • insect bites/stings (small papules)
  • chronic pruitus (itching)
  • erythema multiforme minor- rash has target like appearance
26
Q

Examination findings of urticaria

A
  • central swelling (red/white) with surrounding area of redness
  • itchy rash +/- burning sensation
  • fleeting rash (within 24hrs)
27
Q

Investigations for urticaria

A

Only if cause isn’t identified/ exclude differentials

Bedside:

  • stool culture (check for intestinal parasites)

Bloods:

  • FBC - high neutrophils (urticarial vasculitis), low Hb (anaemia)
  • ESR/CRP - exclude infection/ vasculitis
  • LFTs- exclude viral hepatitis (high ALT/AST)
  • TFTs - high thyroid autoantobodies linked with autoimmune urticaria
  • H-pylori test
  • antibody levels

Other:

  • skin prick tests (check for allergies - food/drug)
28
Q

Managament of urticaria

A

Usually don’t need treatment as resolves in a few days

  1. itchiness => Antihistamines
  2. oral corticosteroids (anti-inflammatory) for more severe symptoms
  3. peristant urticaria => refer to dermatologist
29
Q

Complications of urticaria

A
  • angiodema - swelling of deeper tissues (around eyes/lips/genitals/hands/feet)
  • anaphylaxis (EMERGENCY)- swelling of eyes/face, wheezing, lightheaded, nausea, collapse
  • chronic urticaria => emotional impact (stress, depression, anxiety)
30
Q

define eczema and types of eczema

A

eczema = group of inflammatory conditions that cause dry, itchy, red skin

Types of eczema

  • atopic dermatitis
  • contact dermatitis
  • Seborrhoeic dermatitis
  • follicular eczema
31
Q

causes/triggers of atopic dermatitis

A
  • genetic susceptibility
  • environmental triggers
  • impaired immune system
  • weak skin barrier
  • stress

Triggers:

  • synthetic clothing
  • cold weather
  • stress
  • animal hair
  • soaps/detergents
32
Q

Presenting symptoms of atopic dermatitis

A
  • itchy, red rash
  • common in children/infancy and episodic in nature
  • common sites in adults= hands, flexures of elbows, wrists, backs of knees
  • common sites in infants = scalp, face
33
Q

Examination findings of atopic dermatitis

A
  • itching, dry skin
  • acute flares - poorly demarcated areas of redness, scaling, crusting
  • chronic- thickened skin (long-term scratching)
34
Q

management for atopic dermatitis

A

mild

  • emolients
  • mild topical steroids (hydrocortisone)
  • dermol (soap substitute)
  • anti-histamines for itching (mainly for urticaria)

severe

  • strong oral corticosteroid (prednisilone)
35
Q

Complications of atopic dermatitis

A
  • infected eczema => treat with fluoxacillin (antibiotics)
  • eczema herpeticum (HSV infection due to steroid use + rash)
  1. stop steroids, oral acylcovir (for HSV) and fluoxacillin (for secondary bacterial infections)
36
Q

define cellulitis

A
  • acute bacterial infection of dermis and subcutaneous tissue causing unilateral leg swelling
  • Staph. aureaus + strep, pyogenes most common bacteria
37
Q

symptoms + signs of cellulitis

A
  • ACUTE onset
  • painful, red, WARM SWOLLEN limb
  • usually unilateral + affects lower legs
  • redness/swelling gets bigger in size
  • can have fever, malaise, rigors
  • can have blisters/ bullae
38
Q

Investigations for cellulitis

A
  • usually clinical diagnosis
  • If ulcer/dishcarge/open wound => skin swab
39
Q

Management for cellulitis

A
  • Class 1 (minimal symptoms) - oral antibiotics in outpatient
  • Class II (cormorbidities)- oral/IV antibiotics in outpatient
  • Class III (limb threatening/ severe confusion) - IV antiboitics in hospital
  • Class IV (SEPSIS)- urgent hospital referral + intensive treatment

Review after 2 days, advise patient to elevate, mositurise, take painkillers

Year 3 (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions