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My MRCP part 2 falsh cards > dermatology > Flashcards

dermatology Flashcards

1
Q

What does t cell lymphoma look like

A

mycosis fungoides, a cutaneous T cell lymphoma.

The disease presents as a pruritic eczematous rash (the pre-malignant stage) and develops telangiectasias and areas of ‘cigarette paper’ atrophy.

As malignancy develops, nodular lesions appear and proceed to become necrotic.

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2
Q

cutaneous features of dermatomyositis

A

heliotrope rash (violet/blue lesions around eyes)
guttrons
Malar erythema
Poikiloderma (i.e. variegated telangiectasia, hyperpigmentation) in a photosensitive distribution
Violaceous erythema on the extensor surfaces, and
Periungual and cuticular changes

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3
Q

causes of erythema nodosum

A

palpable nodular

TB
saroidosis
Infections (such as Streptococcus infections)
Drugs (sulphonamides, oral contraceptive pill)
Inflammatory bowel disease and
Behçet’s.
Apart from the chest x ray, the following are also important:

A throat culture
Antistreptolysin-O test (ASOT)
Mantoux test
Biochemistry

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4
Q

fishy, thin, vaginal discharge

A

BV
post coital smell
metrnidazole
pH >4.5

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5
Q

side effect of ethambutol

A

optic neuritius

normal fundoscopy

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6
Q

Beaus lines

A

Beau’s lines, a benign nail condition that presents as a jagged transverse groove on the nail plate corresponding to an episode of nail growth arrest, which can occur during an episode of severe medical illness. It usually affects several nails.

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7
Q

nail psoriasis

A

Nail psoriasis presents with pitting, onycholysis, subungual debris and yellowish nail discolouration.

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8
Q

fungal nails

A

Fungal nail infections present with thickening and discolouration of the nail plate with prominent subungual debris. It usually only affects one or several nails.

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9
Q

side effects of minocycline for acne

A

Minocycline treatment can lead to discolouration of nails.

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10
Q

features of PCP

A

Several days/weeks of increasing dyspnoea
Dry cough
Marked oxygen desaturation with exercise.

Signs of immunocompromise
Clear CXR
bilaeral crackles

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11
Q

side effects of isonia

A

side effects of isoniazid therapy include hepatits, peripheral neuritis (pyridoxine given prophylactically) and a systemic lupus erythematosus (SLE)-like syndrome.

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12
Q

telangiectasia, small mouth, beaking of nose

A

Systemic sclerosis, depsotion of connective tissue in skin and organs

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13
Q

cutaneous larva migrans

A

causes: antimal hookwoors, ancylostoma braziliense, firsct contact with dog or cat faexea, when sunbathing
acute infection with nematodes: strongloides stercoralis, necator americanus and ancylostoma duodenales

larvae burrow in dermo-epidermal junction

pruritus, raised sepiginoous erthematous rash that migrates at a rate of 1cm/day

Rx: topical thiabendazole or oral albendazole

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14
Q

scaly, hyperpigmented, erythematous plaques on sun-exposed areas and may lead to severe scarring.

A

discoid lupus erythematous

rx: Topical potent corticosteroids
Topical calcineurin inhibitors
Intralesional corticosteroids
Anti-malarials, and
Oral corticosteroids.
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15
Q

Behcets disease

A
  1. recurrent oreal ulceration
  2. recurrent genital ulceration
  3. Iritis
Other features:
fever
abdo oain
diarrhoea
episcleritis
polyarteritis
arterial and venous thrombosis
pericarditis
pustules at injection sites

HLAB5, HLAB12

Treatment: colchicie, steroids

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16
Q

cutaneous photosensitivity. Bullae develop on sun-exposed areas and lesions heal slowly, leaving scars.

A

PCT.
Porphyria cutanea tarda (PCT) is associated with deficiency of hepatic uroporphyrinogen (URO) decarboxylase.
Porphyrins are increased in liver, plasma, urine and stool. Porphobilinigen (PBG) is normal.

Factors contributing to PCT are alcohol (the commonest cause), excess iron and excess oestrogens.

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17
Q

presents as a dark brown to black plaque or nodule on acral sites.

A

Acral (peripheral) lentiginous melanomad

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18
Q

most commonly presents as an ulcerated nodule with pearly, rolled edges with telangiectasias.

A

Basal cell carcinoma

19
Q

umbilicated, pearly papules 2-5 mm in diameter are seen in patients with advanced HIV/AIDS (CD4 count less than 200 cells/mm3).

A

molloscum contangiosum

caused by a DNA pox virus called molluscum contagiosum virus (MCV).

They commonly occur on the face, especially near the eyelids; they also occur on genitals and trunk.

They should be treated with cryotherapy, liquid nitrogen or curettage.

20
Q

what is pemphigus vulgaris?

A

Blisters are thin-walled and rupture easily (intact blisters are rarely seen). Large surface areas of the body can be affected and the mortality without treatment is high.

deposition of immunoglobulin (IgG) directed against to keratinocyte desmosomes and to desmosome-free areas of the keratinocyte cell membrane, resulting in a ‘chicken wire’ appearance. The binding of autoantibodies results in a loss of cell-to-cell adhesion, a process termed acantholysis.

21
Q

what is pemphigoid

A

large tense intact blisters. Immunofluorescence of pemphigoid shows deposition of IgG and complement at the dermo-epidermal junction.

22
Q

describe pre-tibial myxoedema

A

painless, raised pinkish patches on dorsum of shins, ankle, foot
associated with graves

23
Q

describe malignant melanoma

A

ususaly multipigmented dark , assymetrical lesions with irregular borders which may enlarge rapidly and bleed.

24
Q

describe karposis sarcoma

A

Kaposi’s sarcoma is casued by the Human Herpes 8 virus and is only really seen in severe prolonged immunosupprssed patients.

25
Q

polymorphus light eruption

A

young females
rash appears in the same place
occurs after hours of sun-exposure and resolved after a few days without scarring
macules, papules, pathches, plaques

26
Q

acute lupus erthematosis

A

rash a few hours after sun exposure andno scarring, resolves after a few days
other symptoms - joint pains, oralo ulcers, hair loss
positive ANA

27
Q

discoid lupus erythematosis

A

chronic scaly, erthematous-to-hyperpigmented papules and plaues
residual scars and dyspigmentation
worsened by sun-exposure
scarring alopecia

28
Q

solar urticaria

A

urticaria upon sun exposure

reolves in a few hours instead of days

29
Q

xeroderma pigmentosum

A

sever sun sensitivity from young age

multiple lentigines, nevi, malignant skin tumors, BCCs, SCCs and malignant melanoma

30
Q

angiosarcoma

A 
malignant vascular tumours
elderly men
scalp and forhead
infiltrative vascular patch or plaue with super imposed nodules that may bleed with minor trauma
poor prognosis
chronic lympoedema
31
Q

pyogenic granuloma

A

benign vascular tumor

small, bright red, sessile or pedunculated papule at sites of previous trauma

31
Q

pyogenic granuloma

A

benign

32
Q

alopecia areata

A

localised patches, non-scarring hair loss

hair have ‘ecalmation mark’ appearance, tapered toward the base

33
Q

androgenic alopecia

A

after puberty, diffuse slow hair loss over the tomporal regions and vertx in males

34
Q

telogen effluvium

A

diffucse hair loss
1-2 months after stress episode, viral illnes,s surgey, child birth, emotional stress
regrows after 3-5 months

35
Q

Trichotillomania

A

seen in children compared to adults
localised hair loss but in bizarre pattern, hairs of differeing lengths
hisotry of pulling hair

36
Q

treatment for pemphigoid

A

extensive - oral steroids

localised - topical steroid

37
Q

causes of erythema nodosum

A

tender, nodules

commonest cause - strep infection

other common: URTI, sarcoidosis, IBD

less common - TB. histoplasmosis, coccidiodomycosis, psittacosis, cat scratch fever, yersinia, salmonellosis, chlamydia, drugs (COC< sulfonamides, antipyretics, montelukast, Hep B vaccine, omeprazole

38
Q

fibromas (skin and CNS)+ neuro +endo

type 1 (peripheral): cafe au lait spots, lisch nodules in iris, axiallary freckling, brain tumors

type 2 bilateral vesitbular schwannomas, brain tumors

A

neurofibromatosis
(associated with phaeochromocytomas and addisons)
type 1 ch 17
type 2 ch 22

39
Q

tumors in multiple organ systems

A
39
Q

tumors in multiple organ systems (CNS, retinal, adrenal, renal, panceratic)

A

VHL disease
haemangioblastomas, renal cell carcinoma
Ch3

40
Q

cutaneous + neuro (seizures, LD) + Systemic (renal, heart, brain, retina)

A

Tuberous sclerosis

Cafe au lait, shagreen, ash leaf spots, subungal fibromata

Neuro - LD,epilepsy

Systemic - retinal harmatomas, gliomatous changes of brian, rhabdomyomas of the heart, polycystic kidney disease

Ch 16

41
Q

triggers for psoriasis

A

Beta blockers
Lithium
Antimalarials, and
Non-steroidal anti-inflammatory drugs (NSAIDs).

My MRCP part 2 falsh cards (18 decks)

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