Dermatology

Question 1

What sign is Nikolsky’s sign?

Answer 1

Twisting pencil rubber on skin causes peeling/desquam
Positive: pemphigus
Negative: pemphigoid

Question 2

First-line management of pityriasis

Answer 2

Topical ketonazole

Question 3

Antibodies found in coeliac disease

Answer 3

Anti-TTG

Question 4

Antibodies involved in pemphigus vulgaris

Answer 4

Antibodies against desmoglein III

Question 5

What are 2 main signs to monitor in a patient with toxic epidermal necrolysis?

Answer 5

Fluid loss, electrolyte imbalances

Question 6

What would be seen on skin biopsy of dermatitis herpertiformis?

Answer 6

IgA deposition in dermis

Question 7

Oral therapies for rosacea

Answer 7

Tetracycline
Isotretanoin

Question 8

First line management for ulcers assoc with rheumatoid and IBS etc

Answer 8

Suggests pyoderma gangrenosum
Oral prednisolone

Question 9

Management of scabies

Answer 9

Topical permethion

Question 10

Large red mark on baby’s shoulder which is getting bigger suggests?

Answer 10

Haemangioma
- no management (spontaneously regresses in childhood)

Question 11

What cell causes wheals/hives?

Answer 11

Mast cells
- due to histamine release, hence the itch

Question 12

Itchy blisters on extensor surfaces with granular IgA at dermal papillae suggests?

Answer 12

Dermatitis herpetiformis

Question 13

How can you differentiate between erythroderma and TEN/SJS?

Answer 13

Erythroderma - widespread (90%) erythema, causes fluid loss/hyponatraemia/systemic symptoms, usually pre-existing skin condition
TEN/SJS - drug reaction/viral illness, erythematous blisters that become target signs, Nikolsky positive, involves surfaces e.g. conjunctivae, mouth, GI tract

Question 14

Most useful investigation in blisters spreading to other sites

Answer 14

Biopsy with immunofluorescence

Question 15

X-ray signs of psoriatic arthritis

Answer 15

joint space narrowing and periarticular erosions

Question 16

Presentation of secondary syphillis

Answer 16

Maculopapular rash covering the torso and limbs as well as the palms and soles
Lymphadenopathy and systemic upset

Question 17

What skin condition can Crohn’s cause?

Answer 17

Erythema nodosum

Question 18

Small brownish lesion on leg that dimples when squeezed

Answer 18

Dermatofibroma

Question 19

Differntiating between lichen planus, sclerosis and simplex chronicus?

Answer 19

Lichen planus - lacy white lines with irregular purple plaques on mouth and skin
Lichen sclerosis - inflam/destruction of genital tissue
Lichn simplex chronicus - excessive scractching causing lichenification, thick/leathery/dark skin

Question 20

Medication for gout causing SJS

Answer 20

Allopurinol

Question 21

Causative organism in eczema herpeticum

Answer 21

HSV

Question 22

Lichen planus can cause what nail changes?

Answer 22

Onychorrhexis
- longitudinal nail ridges

Question 23

Recurrent sinusitis assoc with erythema nodosum

Answer 23

GPA

Question 24

Management of genital warts

Answer 24

Topical podophyllotoxin

Question 25

Most common nail change with psoriasis

Answer 25

Pitting
- leukonychia can also occur less commonly

Question 26

First line inv for purpuric rash with suspected IgA vasculitis

Answer 26

Urine dip

Question 27

Describe pyoderma gangrenosum

Answer 27

Ulcer with pustular surface and a blue overhanging edge
- caused by Crohn’s e.g.

Question 28

Skin thickening assoc with Raynaud’s

Answer 28

Systemic sclerosis