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Medicine Year 5 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

how do you measure the extent of a burn

A

wallaces rule of 9’s

  • head & neck - each arm - each anterior leg - each posterior leg - anterior chest - posterior chest - anterior abo - posterior abdo
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2
Q

what is the most accurate method of measuring the extent of a burn

A

lund and browden chart

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3
Q

red and painful burn which is dry with no blisters

A

superficial epidermal (1st)

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4
Q

pale pink burn which is painful, blistered and has a slow capillary refill

A

superficial dermal (2nd)

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5
Q

white burn with patches of non-blanching erythema, reduced sensation and pain on deep pressure

A

deep dermal (2nd)

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6
Q

white waxy, brown leathery or black burn with no blisters and no pain

A

full thickness (3rd)

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7
Q

give some initial management for burns

A

first aid
ANALGESIA
early intubation if burns to face/inhalation injuries
urinary catheter
IV fluids

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8
Q

management of superficial epidermal

A

analgesia and emollients

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9
Q

management of superficial dermal

A

no emollients, non-adherent dressing to keep the blister intact

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10
Q

management of severe full thicknesss burns

A

escharotomies

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11
Q

where are deep dermal, full thickness, superficial dermal more than 3% in adults or 2% in paeds, inhalational injuries, electrical or chemical burns managed

A

secondary care

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12
Q

burns more than 10% in adult or 5% in child or complex burn

A

burns unit

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13
Q

what causes oedema weeks after a burn

A

loss of plasma proteins

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14
Q

what is the formula for IV fluid calculation in burns patients

A

PARKLAND FORMULA

% SA of the burn x weight x 4

give half in first 8 hours and half in next 16

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15
Q

skin cancer presenting as a painless bleeding ulcer on sun exposed skin with RF of sunlight, smoking, leg ulcers, genetics, bowens disease, actinic keratosis

A

squamous cell carcinoma

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16
Q

management of skin cancers

A

surgery with wide excision

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17
Q

what factors contribute towards a poor prognosis in skin cancer

A

deep/large diameter or patient immunosuppressed

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18
Q

precancerous dermatosis
slow growing red scaly patches in sun exposed areas
managed with topical flurouracil

A

bowen’s disease (-> SCC)

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19
Q

premalignant condition with small crusty, scaly and itchy lesions in the sun
managed with topical flurouracil, diclofenac or surgery

A

actinic keratosis

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20
Q

benign tumour similar to an SCC
dome crater filled with keratin

A

keratocanthoma

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21
Q

skin cancer with a pearly white edge

A

BCC

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22
Q

most common BCC raised translucent papule on face with local destruction

A

nodular BCC

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23
Q

what are the 4 other BCC types

A

superficial: trunk in 50’s
morpheaform: flat irregular plaque
cystic: clear blue-grey
basosquamous: very invasive

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24
Q

most common type of malignant melanoma presenting as a slow growing mole in a young person

A

superficial spreading malignant melonoma

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25
second most common malignant melanoma presenting as a red/black bleeding lump in sun exposed areas of middle aged which metastasises early
nodular malignant melanoma
26
least common malignant melanoma presenting as a growing mole in elderly
lentigo maligna
27
rare form of malignant melanoma in the nails, palms or soles of darker skinned individuals which exhibits hutchinsons sign
acral lentiginous
28
what are the surgical margins of malignant melanoma based on
breslow thickness
29
premalignant condition in smokers presenting with white hard spots on the mucous membranes of the mouth
leucoplakia
30
what are the two types of dermatitis
irritant: non allergic on hands from cleaning/cement allergic: T4 hypersensitivity with weeping eczema
31
management of allergic dermatitis
patch test and steroid
32
20-45 year old woman presenting with clusters n the perioral region which worsen with steroids and are treated with ABx
perioral dermatitis
33
dermatitis around the anus
zinc deficiency
34
eczematous rash on the face associated with otitis externa and blepharitis treated with ketoconazole/steroids
seborrheic dermatitis
35
SE of ketoconazole
gynaecomastia
36
autoimmune condition causing IgA deposits in coeliac disease presenting with itchy vesicular lesions on extensors treated by removing gluten or dapsone
dermatitis herpetiformis
37
antibodies against desmosomes causing mucosal ulcers and skin blisters managed with steroids and immunosuppressants
pemphigus vulgaris
38
blistering skin in the elderly treated with steroids
bullous pemphigold
39
pathophysiology of vitiligo
reduced melanocytes causes well demarcated depigmented skin precipitated by trauma
40
management of vitiligo
suncream, make up, tacrolimus, steroids, phototherapy
41
what must you test for in patients who have been diagnosed with vitiligo or alopecta acreta
other autoimmune diseases
42
which organism causes impetigo
staph aureus/pyrogens
43
presentation of impetigo
golden crusted lesions
44
treatment of impetigo
hydrogen peroxide (or fusidic acid/oral fluclox/eryth if extensive)
45
school exlcusion for impetigo
until lesions crusted or 48 hours after abx as contagious
46
pink pearly white papules with central umbilication on the trunk and flexors which self-resovle in 18m
molluscum contagiosum
47
virus which causes molluscum contagiosum
pox
48
widespread pruritis and linear burrows which are spread by skin to skin contact
scabies
49
management for scabies
2 doses of PERMETHRIN at least 1 week apart for the whole family
50
how long can the itch last after successful therapy for scabies
4-6w
51
management of verruca
salicyclic acid
52
management of headlice
malathion
53
management of hyperhidrosis
topical aluminium chloride
54
most common site for keloid scars
sternum
55
where are sebaceous cysts commonly found
scalp central punctum
56
common eczematous itchy rash in pregnancy
atopic eruption of pregnancy
57
pruritis in abdominal striae which spares the peri umbilicus in the 3rd trimester management
polymorphic eruption of pregnancy emollient / steroid
58
pruritic blistering lesions around the umbilicus in the 2nd/3rd trimester management
pemphigoid gestationis oral steroid
59
itchy white spots on the vulva of elderly women management
lichen sclerosis potent topical steroid (clobetasol)
60
Purple Pruritic Papular Polygonal rash on flexor surfaces, genitals and palms with oral involvement, Wickham's striae and koebner phenomenon management
Lichen planus potent topical steroid (clobetasol) or benzylamine mouthwash
61
inflammation of the SC fat causing tender, red and nodular lesions on shins associated with strep, TB, sarcoidosis, pregnancy, malignancy, COCP and penicillin management
erythema nodosum self resolves in 6w
62
hypersensitivity reaction triggered by herpes, SLE, malignancy, penicillin, NSAID, sulph, carbamazepine, COCP, allopurinol causing TARGET LESIONS
erythema multiforme
63
requirement of erythema multiforme major
mucosal involvement
64
severe end of the spectrum which causes erythema multiforme to stevens johnson syndrome patients are systemically unwell with positive nikolyskys
toxic epidermal necrolysis
65
management of toxic epidermal necrolysis
ICU - Fluids - Immunoglobulin - Immunosuppression
66
chronic and painful inflammatory skin condition in women under 40 years with DM, PCOS or smoking presenting with red nodules in the axilla which can rupture and cause rope like scarring
hidradenitis suppurativa
67
management of hidradenitis suppurativa
good hygiene, weight loss, stop smoking, steroid, flucloxacillin
68
complications of hidradenitis suppurative
sinus tracts, fistula, comedomes, lymphatic obstruction
69
rare condition causing skin ulceration, fever and myalgia assoaciated with IBD, RA, SLE, biliary cirrhosis, lymphoma and myeloproliferative disorders treated with steroids and immunosuppression
pyoderma gangrenosum
70
surgery with pyoderma gangrenosum
postpone
71
benign small red spot which can bleed/ulcer associated with trauma, pregnancy, crohns, UC and treated with steroids or surgery
pyogenic granuloma
72
which virus causes shingles
herpes zoster
73
how does shingles present
prodrome: fever, lethargy, headache, burning pain rash: red and macular in T1-L2
74
management of shingles
aciclovir in 72 hours to prevent post herpetic neuralgia steroids NSAID paracetamol if severe pain
75
3 risk factors for shingles
age HIV immunosuppression
76
which bacteria causes acne
propionibacterium acnes
77
classification and treatment of acne
mild-moderate-severe stepwise 1. topical retinoids/benzylperoxide 2. oral ABx (tetracyclines) or COCP 3. Isotrenitoin
78
how do you initiate isotrenitoin
under specialist treatment if scarring
79
main side effect of isotretinoin
dry skin
80
which medications do you need to avoid when managing acne in pregnancy
retinoids tetracyclines isotrenitoin
81
herpes simplex or coxsackie virus causing a rapidly progressive painful rash in children with 'monomorphic punched out erosions'
eczema herpeticum
82
treatment of eczema herpeticum
IV aciclovir
83
which type of eczema presents as small puritic blisters on the palms and soles in humidity or high temperatures
pompholyx eczema
84
management of pompholyx eczema
cool compress, emollients, steroids
85
flushing and telangiectasia of the face exacerbated by sunlight associated with papules and pustules and BLEPHARITIS
rosacea
86
management of rosacea
suncream/hats laser therapy for telangiectasia topical metronidazole/brimodine tetracyclines if severe
87
what does trauma (koebner phenomenon), alcohol, withdrawal of systemic steroids, BB, NSAID, ACEi, infliximab and anti-malarials exacerbate
psoriasis
88
3 main medications in the management of psoriasis
emollients, topical steroid, vitamin D analogue
89
how should you use steroids in psoriasis
4 week break between steroid doses if you've been on strong steroids for 8 weeks then vitamin D analogue only
90
which therapy for psoriasis can predispose SCC
PUVA light therapy
91
which medication can be used in psoriasis to reduce the number of long term flares
calcipotriol
92
tear drop scaly patches on the trunk and limbs 2-3 weeks after strep throat infection which resolves in 2-3 months (can use steroid or UVB)
guttate psoriasis
93
herald patch then multiple red raised oval lesions 1-2w later with a fir tree appearance which resolves in 6w sometimes associated with resp infection
pityriasis rosea
94
superficial fungal infection affecting the trunk causing hypopigmented lesions after sun exposure
pityriasis versicolour
95
management of pityriasis versicolour
ketoconazole shampoo
96
management of onychomycosis (fungal nail infection)
nail clipping or scraping oral terbinafine
97
RF for onychomycosis (fungal nail infection)
DM
98
itchy peeling skin on the feet management
tinea pedis topical terbinafine
99
what is tinea corporis managment
ringworm oral fluconazole
100
fungal infection of the scalp caused by trichophyton which glows green under woods lamp and treated with oral terbinafine or ketoconazole shampoo
tinea capitis
101
symmetrical brown, velvet plaques on the neck axilla and groin associated with T2DM, GI cancer, COCP, PCOS, cushings, obesity, thyroid and acromegaly
acanthosis nigricans
102
vascular birthmark which self resolves
salmon patch
103
management of a strawberry naevis
propranolol if large and bleeding
104
management of a child with new onset purpura
immediate referral for ALL or meningococcal disease
105
management of healthcare workers who are not naturally immune to varicella
vaccinate
106
management of facial hirsitism
topical eflornithine
107
management of severe urticaria
ST oral steroid and antihistamine
108
side effect of steroids in darker pigmented skin
patchy depigmentation
109
what is a curlings ulcer
stress ulcer in burns patients causing haematemesis

Medicine Year 5 (27 decks)

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