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3a > Dermatology > Flashcards

Dermatology Flashcards

1
Q

In eczema, there is abnormal epithelial barrier function in the skin. This causes the entrance for what?

A

Irritants, microbes, allergens

Stimulates immune response

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2
Q

What the signs of eczema?

A

Dry, red, itchy patches on flexor surfaces
Excoriations
Lichenification
Hypopigmentation

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3
Q

Management of eczema is formed of maintenance and management of flares. How would you maintain eczema?

A

Emollients - creates artificial barrier to compensate for defective barrier

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4
Q

How would you treat flare ups of eczema?

A

Topical steroids
Antibiotics
Oral steroids

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5
Q

How would you treat severe eczema?

A

Zinc bandages
Topical tacrolimus
Phototherapy
Immunosuppressants e.g. methotrexate

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6
Q

The general rule is to use the weakest steroid for the shortest period required to get the skin under control. What are the side effects of steroid use?

A

Thinning of skin, making it more susceptible to flares

Telangiectasia

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7
Q

What lifestyle changes can be done for a patient with eczema?

A

Avoid hot baths
Avoid scratching
Avoid stress
Avoid triggering detergents and soaps

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8
Q

What are the environmental triggers of psorasis?

A 
Group strep A infection
Lithium 
UV light
Stress
High alcohol
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9
Q

What are the signs of psoriasis?

A

Salmon pink silvery scales on extensor surfaces
Red non scaly plaques on flexor surfaces
Raindrop: eruption of small circular plaques on trunk
Pyrexia
Nail pitting
Oncholysis

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10
Q

State the types of psoriasis.

A

Plaque
Guttate: triggered by infection
Pustular
Erythrodermic

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11
Q

How would you manage psoriasis?

A 
Topical steroids
Topical vitamin D analogues
Topical tacrolimus
Phototherapy
Dovobet 
Methotrexate
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12
Q

What are the complications of psoriasis?

A

Psoriatic arthritis
Anxiety and depression
Increased risk of CV disease

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13
Q

Cellulitis is an acute bacterial infection of the dermis. Which organisms most commonly cause cellulitis?

A

Strep.pyogenes
Staph aureus
MRSA

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14
Q

What are the risk factors for developing cellulitis?

A 
Leg oedema
Ulcers
Immunosuppression
Fungal infection
Eczema 
Obesity
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15
Q

What the signs of cellulitis?

A 
Acute onset 
Hot, red, swollen tender skin
Unilateral
Fever
Malaise
Commonly lower limb
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16
Q

What are the differential diagnoses of cellulitis?

A

DVT
Septic arthritis
Gout

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17
Q

What investigations would you do if you suspected cellulitis?

A

Bloods: raised WCC, ESR/CRP

Blood cultures

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18
Q

How would you manage cellulitis?

A

Antibiotics e.g. flucloxacilin

Analgesia

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19
Q

What are the complications of cellulitis?

A

Necrotising fascilitis
Myositis
Abscess
Septicaemia

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20
Q

Outline the pathophysiology of acne vulgaris/

A

Increased sebum –> Trapping of keratin —> Blockage of pilosebaceous unit —> Swelling and inflammation, exacerbated by propionibacterium —> Comedones and papules

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21
Q

What are the signs of acne?

A 
Papules
Pustules
Comedones
Blackheads 
Ice pick scars
Hypertrophic scars
Rolling scars
Hyperpigmentation
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22
Q

How would you manage mild acne?

A

Topical retinoid
Topical antibiotic
Benzoyl peroxide
Oral contraceptive

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23
Q

How would you manage moderate acne?

A

Oral antibiotics

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24
Q

How would you manage severe acne?

A

Oral retinoids

25
Q

What are the side effects of isotretinoin?

A 
Dry skin and lips
Photosensitivity
Suicidal ideation
Stevens-Johnson syndrome
Teratogenic effects
26
Q

Urticaria is caused by the release of histamine. Where is histamine secreted from?

A

Mast cells

27
Q

What are the causes of acute urticaria?

A

Allergies
Medications
Viral infections
Insect bits

28
Q

What are the causes of chronic urticaria?

A

Autoimmune condition e.g. SLE
Sunlight
Exercise
Stress

29
Q

How would you manage urticaria?

A

Antihistamines
Oral steroids
Montelukast
Omalizumab

30
Q

Molluscum contagiosum is a viral skin infection caused by the molluscum contagiosum virus. What type of virus is this?

A

Poxvirus

31
Q

How does molluscum contagiosum present?

A

Small flesh coloured papules with a central dimple, appears in crops

32
Q

How would you manage molluscum contagiosum?

A

No treatment normally required
Avoid sharing towels
Immunocompromised patients: topical benzoyl peroxide, cryotherapy

33
Q

Impetigo is a superficial bacterial skin infection, usually caused by which organism?

A

Staph. aureus

34
Q

What are the signs of non-bullous impetigo?

A

Lesions around nose and mouth

Golden crust exudate

35
Q

How would you manage non-bullous impetigo?

A

Topical fusidic acid
Antiseptic cream
Oral flucloxacillin

36
Q

What are the signs of bullous impetigo?

A 
Fluid filled vesicles on skin
Golden crust exudate 
Fever
Malaise
Scalded skin syndrome
37
Q

How would you manage bullous impetigo?

A

Flucloxacillin

38
Q

What are the complications of impetigo?

A

Cellulitis
Sepsis
Scarring
Scarlet fever

39
Q

Scabies are tiny mites called Sarcoptes scabiei that burrow under the skin causing infection and intense itching. What are the signs of scabies?

A

Itchy small red spots
Track marks
Rash between finger webs

40
Q

How would you manage scabies?

A

Permethrin cream
Oral ivermectin
Treat whole household
Crotamiton cream for itching

41
Q

What type of scabies is found in immunocompromised patients?

A

Crusted scabies - These patient may have over a million mites in their skin. They are extremely contagious. Rather than individual spots and burrows, they have patches of red skin that turn into scaly plaques

42
Q

Headlice presents with an itchy scalp and visible lice. How would you manage head lice?

A

Dimeticone 4% lotion

Fine combs

43
Q

Which virus causes shingles?

A

Varicella zoster (HSV3)

44
Q

Who can develop shingles?

A

Anyone who has previously been infected with chickenpox

45
Q

What are the trigger factors for reactivation of varicella?

A

Pressure on nerve roots
Radiotherapy at level of nerve root
Spinal surgery
Infection

46
Q

What are the signs of shingles?

A 
Dermatomal distribution of blisters 
Unilateral
Never crosses midline 
Localised pain 
Enlarged lymph nodes 
Nerve pain
47
Q

What are the complications of shingles?

A

Facial nerve palsy
Encephalitis
Post herpetic neuralgia

48
Q

How would you manage shingles?

A

Aciclovir

Analgesia

49
Q

How would you manage post herpetic neuralgia?

A

Topical capsaicin
Amitriptyline
Gabapentin
Botulinum toxin

50
Q

Rosacea is a chronic rash involving the central face, what are the signs of this?

A 
Erythema 
Papules
Pustules
Telangiectasia
Frequent blushing or flushing
Sensitive skin prone to burning and stinging 
Conjunctivitis 
Rhinophyma
51
Q

How would you manage rosacea?

A 
Avoid oil based creams and makeup 
Sunscreen
Doxycycline 
Metronidazole cream
Ivermectin cram
52
Q

State the types of ringworm.

A

Tinea capitis - scalp
Tinea pedis - athletes foot
Tinea corporis - body
Onychomycosis - nail

53
Q

What are the signs of ringworm?

A 
Itchy rash
Erythema
Well demarcated scales 
Hair loss
Flaky skin 
Discoloured and deformed nails
54
Q

How would you manage ringworm?

A

Creams: clotrimazole
Anti fungal shampoo
Oral antifungals e.g. fluconazole
Topical steroid

55
Q

Which sensory nerve ganglia do cold sores arise from?

A

Trigeminal nerve ganglion

56
Q

Which sensory nerve ganglia does genital herpes arise from?

A

Sacral nerve ganglia

57
Q

What are the signs of herpes simplex?

A 
Blistering lesions
Neuropathic pain
Flu like prodrome
Dysuria
Inguinal lymphadenopathy
58
Q

How would you treat herpes?

A

Aciclovir
Topical lidocaine
Analgesia

3a (13 decks)

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