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FINALS > DERMATOLOGY > Flashcards

DERMATOLOGY Flashcards

1
Q

What factors may exacerbate psoriasis?

A

trauma
alcohol
drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

Strep infection

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2
Q

What is the pathophysiology of psoriasis?

A

Systems
Immune mediated
Chronic relapsing

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3
Q

What is the most common type of psoriasis?

A

Chronic plaque psoriasis

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4
Q

Name two associated symptoms of psoriasis.

A 
Nail changes (50%)
Arthritis (5-8%)
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5
Q

Which type of psoriasis is a medical emergency?

A

Erythrodermic psoriasis - over 90% of body covered, systemically unwell.

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6
Q

What is oncholysis?

A

Nail psoriasis

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7
Q

Which drugs are likely to exacerbate psoriasis?

A 
Beta-blockers
Lithium
NSAIDs
ACEIs
Anti-malarials
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8
Q

What are the topical managements for psoriasis?

A
  1. Emollients
  2. Topical corticosteroids
  3. Vitamin D analogue - calcipotriol
  4. Calcineurin inhibitors - tacrolimus
  5. Cold tar preparations
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9
Q

Non topical therapy for psoriasis?

A

(all prescribed by dermatologist)

Phototherapy
Methotrexate
Ciclosporin
Biologics

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10
Q

What is the most suitable long-term treatment of psoriasis?

A

Vitamin D analogues (avoid long-term steroid use)

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11
Q

What is the first-line treatment of rosacea? What can be used if that is unsuccessful?

A

Topical metronidazole

Oral doxycycline

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12
Q

What is another name for BCCs?

A

Rodent ulcer

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13
Q

Describe the appearance of BCC.

A

pearly, flesh-coloured papule with telangiectasia –> ulceration, central crater

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14
Q

What is the most common type of skin cancer in the western world?

A

BCC

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15
Q

What is the most common type of BCC?

A

Nodular

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16
Q

What are the risk factors for BCCs?

A 
UV
Elderly
Male
Fair skin
immunosuppression
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17
Q

What is the gold standard management for BCC?

A

MOHS micrographically controlled excision

under microscope, layer by layer

18
Q

What margin should be given in excision of BCCs?

A

3-10mm margin of normal tissue

19
Q

What is the management of BCC if inoperable?

A

Radiotherapy

20
Q

What kind of referral should be made for suspected BCC?

A

Routine –> dermatology

21
Q

Describe the appearance of SCCs?

A

Scaly

crust

22
Q

What are the risk factors for SCCs?

A 
Actinic keratosis
UV light (most associated with PUVA therapy)
23
Q

What is actinic keratosis?

A

Pre-malignant lesion found in sun damaged skin

Removed by cryotherapy or shave curettage

24
Q

What is Bowen’s disease?

A

type of precancerous dermatosis that is a precursor to squamous cell carcinoma

Often occurs on sun-exposed areas e.g. head/lower limbs

25
Q

What is the management of Bowen’s disease?

A

Topical 5-fluorouracil - BD, 4 weeks
Topical steroids (to control inflammation from t-fluorouracil)
Cryotherapy
Excision

26
Q

When should Mohs micrographic surgery be used?

A

high-risk patients and in cosmetically important sites.

27
Q

What margins should be used in the excision of SCCs?

A

Lesion <20mm = 4mm margin

Lesion >20mm = 6mm margin

28
Q

Name some poor prognostic factors for melanoma

A

Poorly differentiated
>20mm
>4mm deep
Immunosuppression

29
Q

What is the pathophysiology of melanoma?

A

Uncontrolled growth of melanocytes

30
Q

What are the risk factors for melanoma?

A

Sun damage
Moles
Fair skin
age

31
Q

What approach should you use to differentiate between a mole and a melanoma?

A

ABCDE

Asymmetry
Border
Colour
Diameter 
Evolving

OR Glasgow 7 point checklist

32
Q

Name 4 types of melanoma.

A
  1. Superficial spreading - 70%
  2. Nodular
  3. Lentigo meligna
  4. Acral lentiginous - rare
33
Q

Which prognostic factor is most important?

A

The invasion depth of a tumour (Breslow depth)

34
Q

Which type of melanoma is the most aggressive?

A

Nodular

35
Q

What are the main diagnostic features of melanoma?

A

Mole:

  • Change in size
  • Change in shape
  • Change in colour
36
Q

What are the secondary diagnostic features of melanoma?

A

• Diameter >= 7mm
• Inflammation
• Oozing or bleeding
Altered sensation

37
Q

What is the management of melanoma?

A

2WW
Wide local excision
+/- Rx

38
Q

Name two scoring systems that are used in the management of melanoma.

A

Clarks

Breslow thickness - how deep invasion (most important in prognosis)

39
Q

Which neurological condition is associated with Seborrhoeic dermatitis?

A

Parkinson’s

40
Q

What is the first-line management of Seborrhoeic dermatitis?

A

topical fluconazole

41
Q

What is the treatment for rosacea?

A

mild/moderate: topical metronidazole

severe/resistant: oral tetracycline

FINALS (26 decks)

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