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MRCP > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are the 5 layers of the epidermis from outermost to innermost

A

Stratum corneum, lucidum, granulosum, spinosum, germinativum

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2
Q

Which layer of the epidermis gives rise to keratinocytes and contains melanocytes

A

Stratum germinativum

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3
Q

How many naevi equate to increased risk of developing melanoma

A

> 50 naevi 2mm or more in diameter

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4
Q

What is the most important factor in determining prognosis of a patient with melanoma

A

Invasion depth of the tumour (Breslow score)

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5
Q

What is the 5 year survival in patients with >4mm depth of melanoma

A

50%

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6
Q

Where is venous ulceration most typically seen

A

Above medial malleolus

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7
Q

What is the most important test to investigate non-healing ulcers

A

ABPI

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8
Q

What is the treatment of venous ulcer

A

Compression multi-layer bandaging

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9
Q

Which cancers are associated with acanthosis nigricans

A

GI, gastric cancer

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10
Q

Which cancers are associated with dermatomyositis

A

Lung and ovarian cancer

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11
Q

Which cancers are associated with erythema gyratum repens

A

Solid organ malignancies - Lung and breast cancer

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12
Q

Which cancer is associated with erythroderma

A

Lymphoma

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13
Q

Which skin condition is associated with glucagonoma

A

Necrolytic migratory erythema

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14
Q

Which skin condition is associated with myeloproliferative disorders

A

Pyoderma gangrenosum

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15
Q

What is Sweet’s syndrome (Acute febrile neutrophilic dermatosis) associated with

A

Haematological malignancy e.g. myelodysplasia, AML

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16
Q

Which skin condition is oesophageal cancer associated with

A

Tylosis

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17
Q

Which condition is associated with migratory thrombophlebitis

A

Pancreatic cancer

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18
Q

What are the 4 common causes of shin lesions

A

Erythema nodosum, pyoderma gangrenosum, pretibial myxoedema, necrobiosis lipoidica diabeticorum

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19
Q

Which infections can present with erythema nodosum

A

Strep, TB, histoplasmosis, brucellosis, campylobacter

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20
Q

Which ulceration skin condition can PSC and PBC be associated with

A

Pyoderma gangrenosum

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21
Q

Which conditions are associated with increased risk of seborrhoeic dermatitis

A

HIV, Parkinson’s

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22
Q

Which skin condition is seen in young adults and presents with a herald patch on the trunk followed by a fir tree appearance

A

Pityriasis rosacea

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23
Q

What is first line treatment of impetigo

A

Topical fusidic acid

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24
Q

Which skin condition presents with telangiectasia after sitting in front of a fire for prolonged periods

A

Erythema ab igne

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25
Q

What is the first line management of actinic keratosis

A

Fluorouracil cream for 2-3 weeks (can give steroid after to reduce inflammation)

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26
Q

Which skin condition is associated with IgA in the dermis and anti-gliadin antibodies

A

Dermatitis Herpetiformis

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27
Q

What skin condition arises from a scar typically in young black males

A

Keloid scar

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28
Q

Which two conditions are most associated with vitiligo

A

Pernicious anaemia, T1DM

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29
Q

Which drugs cause hirsutism/hypertrichosis

A

Phenytoin, minoxidil, cyclosporin, diazoxide

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30
Q

Which conditions cause hypertrichosis

A

Congenital, PCT, anorexia nervosa

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31
Q

Which interleukin is increased in eczema

A

IL4

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32
Q

What is the treatment of eczema herpeticum

A

IV aciclovir

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33
Q

Which skin condition presents with target lesions on upper limbs

A

Erythema multiforme

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34
Q

What causes 50% of erythema multiforme

A

HSV

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35
Q

Which drugs cause erythema multiforme

A

Penicillin, sulphonamides, carbamazepine, allopurinol, NSAIDs, COCP

36
Q

Which condition is characterised by a positive Nikolsky’s sign

A

Toxic Epidermal Necrolysis

37
Q

What is the treatment of toxic epidermal necrolysis

A

ITU, volume expansion, IV IG

38
Q

Which systemic condition is granuloma annulare associated with

A

Diabetes

39
Q

What is the most common skin presentation in TB

A

Lupus vulgaris (50%)

40
Q

Which deficiency causes ingesting soil/clay

A

Zinc deficiency

41
Q

What oral treatment is safe for acne in pregnancy

A

Oral erythromycin

42
Q

Which immune cells are involved in psoriasis

A

Th1 cells

43
Q

What is the first line treatment of psoriasis

A

Topical steroid + topical calcipotriol

44
Q

Which cancer does PUVA increase the risk of developing

A

Squamous cell carcinoma

45
Q

Which skin condition appears 2-4 weeks after strep infection in children and resolves spontaneously

A

Guttate psoriasis

46
Q

What investigation is used to diagnose PCT

A

Increased urinary uroporphyrinogen

47
Q

What is the treatment of PCT

A

Chloroquine, venesection

48
Q

Which skin condition causes blisters with mucosal involvement due to antibodies against desmoglein 3

A

Pemphigus vulgaris

49
Q

Which skin condition causes sub-epidermal blistering with IgG and C3 in dermoepidermal space

A

Bullies pemphigoid

50
Q

Which skin condition presents with flushing and abdominal pain and increased urinary histamine

A

Systemic mastocytosis

51
Q

Which skin disorders are photosensitive

A

Discoid lupus, PCT, SLE, pellagra, herpes labialis, xeroderma pigmentosum

52
Q

What skin presentation is associated with mcCune-Albright syndrome

A

Cafe-au-lait spots

53
Q

Which type of leprosy presents with extensive skin involvement and symmetrical nerve involvement

A

Lepromatous leprosy (multibacillary) - low degree of cell-mediated immunity

54
Q

Which type of leprosy presents with minimal skin involvement and asymmetric nerve involvement

A

Tuberculoid leprosy (paucibacillary) - high degree of cell-mediated immunity

55
Q

What is the treatment of leprosy

A

Rifampicin + dapsone + clofazimine

56
Q

Which drugs can trigger psoriasis

A

Beta blockers, lithium, antimalarials, NSAIDs, ACEis, infliximab

57
Q

What is the most common skin malignancy secondary to immunosuppression

A

Squamous cell carcinoma

58
Q

Which condition causes a photosensitive rash and blistering on dorsal aspect of hands due to hepatocyte damage

A

Porphyria cutanea tarda

59
Q

Which acne drug can cause irreversible skin pigmentation

A

Minocycline

60
Q

What is the treatment of alopecia areata

A

Topical corticosteroids or watchful waiting

61
Q

Which areas of the skin does dermatitis herpetiformis tend to affect

A

Elbows, knees, buttocks

62
Q

Which HHV is thought to play a role in pityriasis rosea

A

HHV-6, HHV-7

63
Q

What is the most aggressive form of melanoma

A

Nodular melanoma

64
Q

What is the most common form of melanoma

A

Superficial spreading melanoma

65
Q

Which type of melanoma looks like a suspicious freckle on the face or scalp after chronic sun exposure

A

Lentigo maligna

66
Q

What is the first line treatment of pityriasis vesicular

A

Topical antifungal - ketoconazole shampoo

67
Q

Which skin condition has a pruritic rash on flexor surfaces and mucosal involvement

A

Lichen planus

68
Q

What is the treatment of lichen planus

A

Potent topical steroids, benzydamine mouthwash

69
Q

Which biological therapies can be used for psoriasis management in secondary care

A

Anti-TNF drugs: Infliximab, etanercept, adalimumab

70
Q

What are the causes of livedo reticularis

A

Antiphospholipid syndrome, SLE, PAN, cryoglobulinaemia, EDS, homocystinuria, idiopathic

71
Q

What kind of hair loss does discoid lupus cause

A

Scarring alopecia

72
Q

What is the management of pyoderma gangrenosum

A

Oral steroids

73
Q

What is the most potent topical steroid

A

Dermovate - clobetasol propionate 0.05%

74
Q

Which skin condition causes abdominal pain and monocytosis on blood film

A

Systemic mastocytosis

75
Q

What is the treatment of immune related adverse effects to checkpoint inhibitors in melanoma

A

Corticosteroids

76
Q

When can a patient be fast track discharged 2 hours after symptom resolution in anaphylaxis

A

Good response to single dose of adrenaline and given epipen

77
Q

When does a patient need to be kept for 6 hours before discharge after anaphylaxis

A

2 doses of IM adrenaline needed, or biphasic reaction in the past

78
Q

When does a patient have to be kept in minimum 12 hours after symptom resolution in anaphylaxis

A

Severe reaction requiring >2 doses adrenaline, severe asthma, possibility of ongoing reaction, presents late at night

79
Q

What percentage of anaphylactic reactions are biphasic

A

20%

80
Q

Which condition presents with tear drop papules on the trunk and limbs

A

Guttate psoriasis

81
Q

What can be used to accelerate treatment in guttate psoriasis

A

UVB phototherapy

82
Q

What is the treatment of unstable, progressive vitiligo

A

Oral betamethasone pulse therapy with narrow band UVB

83
Q

Which type of dermatitis occurs in dry areas of the world with diamond-shaped plates of skin

A

Asteatotic eczema

84
Q

What is the investigation for pemphigus vulgaris

A

Direct immunofluorescence of skin

85
Q

What is first line treatment of dermatitis herpetiformis

A

Dapsone

86
Q

Which cutaneous form of sarcoidosis presents with violaceous nodules over the nose, cheeks and ears

A

Lupus pernio

MRCP (16 decks)

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