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General Medicine > Dermatology > Flashcards

Dermatology Flashcards

1
Q

How long does it take for a new fingernail and toenail to grow?

A

Fingernail = 3 months
Toenail = 6 months

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2
Q

What is a comedone and what are the types?

A

Open = black heads
Closed = White heads

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3
Q

What is excoriation?

A

Loss of epidermis following trauma

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4
Q

What is lichenification?

A

Well defined thickening of skin with accentuation of skin markings due to repeated rubbing and scratching

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5
Q

What is Auspitz sign and in what condition do you see it?

A

Peeling off of surface scale reveals regular areas of pinpoint bleeding

Psoriasis

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6
Q

What is koebner phenomenon and what conditions can you see it in?

A

Formation of lesions from pre-existing skin condition at site of trauma / irritation. E.g. Psoriasis, vitiligo

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7
Q

What is impetigo and what causes it?

A

common superficial bacterial infection - usually staphylococcus aureus and streptococcus pyogenes

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8
Q

What are the three types of impetigo and their causes?

A

Bullous - staph
Crusted / Non-bullous either staph or strep
Ulcerated - strep

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9
Q

What are some complications of impetigo?

A

Acute glomerulonephritis
RHD
SSS
Cellulitis
Toxic shock syndrome

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10
Q

What is the management of impetigo?

A
  • Use wet compressions to remove crust
  • Good hygiene
  • Cover affected areas
  • Keep home from school (until lesions crusted over or had 24hrs of treatment)
  • Separate towels and launder in hot water
  • Muciprocin 2% ointment
  • Abx for serious infections e.g. flucloxacillin
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11
Q

What is ecthyma and how is it treated?

A

Deep form of impetigo with ulcers forming beneath crusted sores. Scars and treated with oral Abx

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12
Q

What are some signs of folliculitis?

A

Tender red papule, with surface pustule centered on a hair follicle

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13
Q

What is furunculosis?

A

Deep form of folliculitis (usually staph)

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14
Q

What is the difference between steven johnson syndrome and toxic epidermal necrolysis?

A

SJS = <10% body surface area
10 - 30% = overla
TEN = >30% body surface area

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15
Q

Erysipelas vs Cellulitis. What is the difference?

A
  • Erysipelas is upper dermis and superficial lymphatics
  • Cellulitis is lower dermis and subcut tissue
  • Cellulitis is less marginated
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16
Q

What is the Mx of cellulitis?

A

Rest and elevation of area
Mark outline
Analgesia
IV Abx - flucloxacilin
Compression bandage

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17
Q

What is the cause of molluscum contagiosum who gets it?

A

Poxvirus
Two peaks: Children 3-9 years and young adults

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18
Q

How is molluscum spread?

A
  • skin to skin
  • Indirect contact e.g. shared towels
  • Auto-inoculation by scratching
  • Sexual transmission
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19
Q

How do you describe molluscum?

A

Waxy pinkish look with small central pit

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20
Q

What are some DDX for viral exanthem?

A

Measles
Rubella
Varicella
Fifth disease
Roseola
Infectious Mononucleosis
Enterovirus infections such as hand foot and mouth
Pityriasis Rosea
Herpes zoster and simplex
Molluscum contagiosum
HIV

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21
Q

What is the clinical presentation of measles?

A
  • incubates 7-14 days
  • Infective 2 days prior to sx till 5 days
  • URTI symptoms with fever and conjunctivitis
  • Kopplik spots (white spots on mucosa)
  • erythematous macular rash
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22
Q

What are some complications of measles?

A

Dehydration leading to death
Otitis media
Pneumonia
Encephalitis

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23
Q

What is congenital rubella syndrome?

A

Sensorineural deafness
CNS dysfunction
Cataracts
Cardiac defects

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24
Q

Where does the varicella virus remain dormant before reappearing as shingles / herpes zoster infection?

A

Anterior Horn cells of spinal cord

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25
Q

What type of lesions does varicella typically present as?

A

Vesicles - itchy

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26
Q

What is the distinguishing feature of fifth disease (parvovirus infection)?

A

“slapped cheek appearance” - firm red cheeks which feel burning hot

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27
Q

What pathogen causes hand, foot and mouth disease?

A

Coxsackie virus

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28
Q

What are some symptoms of roseola?

A

High Fever, URTI and red maculo-papular rash appearing as fever subsides

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29
Q

What are some complications of herpes zoster and management?

A

Post-herpetic Neuralgia
Corneal damage
Encephalitis

Anti-viral medication within 72hrs

30
Q

How do you describe meningococcal infection in terms of skin symptoms and describe the bacteria?

A

Haemorrhagic rash with petechiae and then purpura on trunk and limbs

Gram negative coccus

31
Q

HSV 1 is associated with ______?

HSV 2 is associated with ______?

A

HSV 1 = facial infections (cold sore)

HSV 2 = genital

32
Q

How can you treat oral HSV (cold sores)?

A

Topical antiviral (acyclovir)

33
Q

What is tinea called in the following locations?
1 - head
2 - body
3 - groin
4 - foot

A

1 - Tinea Capitis
2 - Tinea Corporis (ring Worm)
3 - Tinea Cruris
4 - Tinea Pedis

34
Q

What is the cause of tinea pedis?

A

Swimming pools, showers and occlusive foot wear

35
Q

What does pyoderma mean?

A

Any skins disease that is pyogenic

36
Q

What does pityriasis versicolor look like and who does it commonly affect, and how can it be treated?

A

Hypopigmented scaly patches

Affects Indigenous people and treated with ketoconazole shampoo

37
Q

What is SLE?

A

Autoimmune disease leading to inflammation of connective tissue

38
Q

Burkholderia pseudomallei is what type of bacteria?

A

Gram negative

39
Q

How do you treat head lice?

A

Wet combing (conditioner) with fine tooth comb

40
Q

How does scabies present and what is the treatment?

A

Itch worse as night
Pruritic excoriated nonspecific rash on trunk

Treat with permethrin cream

41
Q

What is the management of atopic dermatitis?

A

Life style - avoid hot baths, cold weather exacerbates
Use moisturizers (greasier is better)
Avoid perfume emollients
Topical corticosteroids

42
Q

What is the management of nappy rash?

A

Use disposable nappies
Increase frequency of changing nappy
Apply barrier cream at every change
Treat any candida infection
Let child spend as long as possible without nappy on

43
Q

Creams are ____ based: non greasy
Ointments are _____ based: greasy
Gels and lotions are _____ based

A

Water based

Oil Based

Alcohol Based

44
Q

What are the causes of koilonychia?

A

Iron deficiency Anemia
Haemachromatosis

45
Q

What are the causes of splinter haemorrhages?

A

Trauma
Infective endocarditis
Psoriasis

46
Q

What are some causes of terry nails?

A

Cirrhosis
CHF
Diabetes

47
Q

Who gets necrobiosis lipodica?

A

Diabetic patients

48
Q

How do you describe psoriasis lesions?

A

Well defined salmon-pink plaques with large adherent centrally located silver scale

Affect body symmetrically

49
Q

What are the causes of psoriasis?

A

Family Hx
Strep infections
Trauma (koebner phenomenon)
Medications such as BB, Lithium, prednisolone withdrawal
Excess alcohol consumption
Metabolic Syndrome
Stress

50
Q

What are some DDX of psoriasis?

A

Tinea
Folliculitis
Dermatitis
Skin Cancers
Pityriasis Rosea

51
Q

What is the management of psoriasis?

A

Education of chronicity
Modify lifestyle / exacerbating factors (stress, smoking, alcohol, weight loss)
Topical anti-inflammatories - Dithranol, tar, steroids, vit D
Specialist referral
Phototherapy (PUVA)
Can use systemic treatments (Methotrexate, cyclosporins, retinoids, biologic agents)

52
Q

Far sightedness is called _____ and corrected by _____ lens

A

Hyperopia
Convex

53
Q

Short sightedness is called ______ and corrected by ____ lens

A

Myopia
Concave

54
Q

What is erythroderma and why is it a skin emergency?

A

Erythema and scaling involving >90% of skin surface

Causes high-output cardiac failure, hypothermia and dehydration

55
Q

What is the DRESS clinical triad?

A

High fever
Organ involvement
Extensive skin rash

56
Q

What is the characteristic feature of erythema multiforme and what is the most common causes?

A

Target lesions

HSV2, CMV, EBV

57
Q

What is the main management of erythema multiforme?

A

antivirals

58
Q

What are the treatment options of acne?

A

Education - avoid squeezing, hot or humid environments
Retinoids
Topical antiseptic
Topical / oral Abx
Refer to specialist after 3-6 months of oral Abx not working

59
Q

What is rosacea?

A

Chronic rash predominantly affecting central face of adults

60
Q

What are some features of rosacea?

A

Pustules, papules, central facial erythema, telangiectasia

61
Q

What aggravates rosacea?

A

Alcohol
Hot showers
Topical steroids
Sun exposure
Stress

62
Q

What is the most common skin cancer?

A

BCC

63
Q

Describe BCC look and features of it?

A

Red / translucent nodule with shiny or pearly rolled edge with central depression. Blood vessels across surface

Locally invasive, low potential to metastasize

64
Q

What treatment options are available for BCC?

A

Excision
Liquid nitrogen cryotherapy
Topical Imiquimod cream
Curettage and cautery
Photodynamic therapy

65
Q

Describe the clinical features of SCC?

A

Firm papule / nodule
Sometime tender
No pearly edge/ telangiectasia
Adherent crust
Advanced lesions - rolled edge with ulceration / bleeding

66
Q

What are common sites for SCC?

A

H&N - lip, ear, scalp

67
Q

What margins do you use for wide excision of SCC?

A

Low risk = 4mm
High risk = 6-10mm

68
Q

How do you describe keratoacanthoma?

A

Well differentiated SCC - volcano shape with central keratotic plug

69
Q

How do you describe melanoma?

A

Flat, usually pigmented, asymmetric macule changing in size, shape or colour

Often on trunk / limbs

70
Q

What is hidradenitis suppurativa?

A

Chronic inflammatory skin condition affecting apocrine glands, particularly in the axillae

71
Q

What are some risk factors for hidradenitis suppurativa?

A

Family Hx
Obesity and insulin resistance
Smoking
IBD

72
Q

What is the cause of scarlet fever and what does the rash look like?

A

Strep throat / impetigo (GAS)

Appears 12-48 hours after fever
Starts below ears, neck, chest, armpits and groin
Rough sandpaper skin
By day 6 skin peels off and rash fades

General Medicine (10 decks)

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