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Finals revision > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Define and name 3 features of hyperlipidemia

A

Xanthelsama

Xanthoma - Yellow flat plaques of lipid-containing macrophages on the body

Corneal arcus - Lipid deposition around the corneal margin

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2
Q

What is Basal cell carcinoma and what are the types

A

Slow-growing invasive malignant tumor of epidermal keratinocytes - common at head and neck

Nodular

Rarely metastases

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3
Q

Name 5 RF for BCC

A

UV exposure
sunbeds
Hx of sunburn
Skin injury - burns and scarring
Increased age
FHx
Immunosuppression

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4
Q

How do you describe a BCC

A

Round
Rolled edges
Raised
Telangiectasia
Central depression
Non-tender
Spontaneous bleeding
Shiny - pearly

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5
Q

How do you describe a skin lesion

A

SCAM

S
- Size
- Shape
- Site

Colour

Associations

M
- Margins
- morphology

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6
Q

How is a BCC managed

A

Cryotherapy
Surgical excision and histology
Radiotherapy

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7
Q

What is a SCC

A

First growing invasive tumor of epidermal keratinocytes

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8
Q

RF for SCC

A

Bowens disease
Actinic keratosis
Immunosuppresion
Skin scarring / burns
Radiation
UV exposure
Elderly
Fair skin
Smoking

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9
Q

What is Bowens disease

A

Precancerous SCC in-situ

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10
Q

What are the features of SCC and how is it managed

A

Rapidly expanding nodule
Ulceration
Areas of bleeding

High risk of mets
- sentinel biopsy
- CT scan

Management
- surgery
- Radiotherapy

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11
Q

What is malignant melanoma

A

Invasive malignant tumour of epidermal melanocytes

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12
Q

What are the types of melanoma

A

Superficial spreading

Nodular - easily bleeds
most aggressive

Lentigo - older / sun exposure

Acral lentiginous - Black

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13
Q

What is impetigo and name 2 common organisms

A

Superficial skin infection

Staph aureus
Strep pyogenes

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14
Q

How does impetigo present

A

pruritus
golden crusted lesions

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15
Q

Management of impetigo

A

Limited + Non bullous - Hydrogen peroxide / fusidic acid

bullous / extensive - flucloxacillin

48hr after starting Abx / until all lesions crusted over

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16
Q

What is urticaria and what causes it

A

Small itchy lumps associated with erythematous rash - can be localised or widespread
swelling of epidermis and dermis
Due to mast cell activation and histamine release

allergens - food / animals
contact with chemicals
medications
insect bites

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17
Q

Management of urticaria

A

Nonsedating - Loratidine / Cetirizine

severe flare - oral steroids

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18
Q

What is angio-oedema

A

Swelling of SC and submucosal tissue
Painful
No pruritus

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19
Q

Name 3 drugs that can cause SJS

A

Penicillin
Lamotrigine
Carbamazepine
Pheytoin
Allopurinol

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20
Q

What is shingles

A

Acute dermatomal painful blistering rash

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21
Q

Name 3 RF for a pressure sore

A

Incontinence
reduced mobility
Malnourished

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22
Q

What is cellulitis and name 2 causative organisms

A

bacterial infection affecting dermis and SC tissue

Strep pyogenes
Staph aureus

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23
Q

Clinical features of cellulitis

A

erythema
swelling
fever
blisters / bullae
malaise
nausea
pain
breach of skin barrier

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24
Q

What is erisypalis

A

Acute superficial cellulitis involving upper dermis
Strep pyogenes

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25
clinicla features of erisypilis
boarders sharply defined red painful swollen
26
RF for cellulitis and erysipelas
DM Immunosuppression Venous insufficiency Obesity Ulcers Pressure sore Trauma Lymphoedema
27
Management of scabies
Topical Permethrin
28
Management of head lice
4% dimeticone lotion
29
Outline a venous ulcers
caused by venous insufficiency Ulcer is gaiter region - medial mallelous Large Shallow Granulated base Irregular - sloping borders pain less than arterial pain relieved by elevation chronic venous changes Varicose eczema Lipodermatosclerosis Haemosiderin deposition Thrombophlebitis
30
Outline an arterial ulcer
affect toes / dorsum of foot - pressure points smaller than venous deep well defined boarders punched out apperance less likely to bleed painful pain worse on elevation Assosciated with PAD - Absent pulses - pallor - Intermitent claudication
31
what is a leg ulcer
wound or break in the skin that doe snot heal or heals slowly due to underlying pathology
32
Investigations for leg ulcers
ABPI Arterial <0.9 Bloods - assess for infection and co-morbidities FBC CRP HbA1c Charcoal swabs
33
Management of venous ulcers
compression bandaging
34
Management of arteril ulcers
reduce modifiable RF treat HTN Prescribe statin Prescribe antilpatlet
35
Causes of leukonychia
Hypoalbuminemia Fungal nail infections Lymphoma
36
causes of clubbing
CHD CF IBD IPF Lung cancer Bronchiectasis IE Cirrhosis
37
causes of onycholysis
trauma psoriasis fungal
38
What is Acne
Chronic inflammation of pilosebaceous unit
39
Describe the pathophysiology of acne
Increased sebum production, trapping of keratin and blockage of the pilosebaceous unit Leads to swelling and inflammation in the unit blocked unit = comedomes
40
Clinicla features of acne
Non inflammatory lesions - comedomes inflammatory lesions - papules - pustules
41
Outline the management of acne
Education and patient information 1st line: Topical retinoid +/- Benzoyl peroxide +/- Topical antibiotic + Antibiotic - Lymecycline Isotretinoin
42
What is the definition of atopic dermatitis / eczema
Chronic inflammatory skin disorder due to defects in normal continuity of skin barrier leading to inflammation
43
What is dermatitis hepatiformis
AI blistering rash itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)
44
What is erythema nodosum and give 4 causes
Inflammation of SC fat - tender nodular lesions over shins NO - idiopathic D - Drugs (Penicllins) OCP Sarcoidosis / TB UC / Crohns Micro - Strep pyogenes
45
Outline the pathophysiology of eczema
Defects in skin barrier due to damaged filaggrin provide entry point for irritants, microbes and allergens that create an immune response --> Inflammation
46
Describe the atopic triad
Allergic rhinitis Asthma Eczema
47
Describe the clinical features of eczema
dry skin flares: erythrematous poorly demarcated itchy patches Lichenification scaly excoration marks infants - face / trunk / extensor adults - flexures
48
Outline the management of eczema
Avoid irritants / scratching / bathing in hot water / using soaps that remove natural oils M - Emollients QDS (E45 / Diprobase cream) Flares - thicker emollients (Hydromol ointment ) - Steroid creams Specialist - topical tacrolimus - phototherapy - immunosuppresants - oral steroids / MXT
49
Name 2 organism that cause eczema herpeticum
HSV - 1 VZV
50
Clinical features of eczema herpeticum
Widespread painful vesicualr rash with systemic sx - fever - lethargy - irritability
51
Investigation and management for eczema herpeticum
Virla swabs Aciclovir
52
Name 4 RF for cellulitis
Obesity Lymphoedema Led ulcer Wound Immunocompromised
53
What is contact dermatitis
Inflammatory skin disorder triggered following exposure to irritant or allergen
54
Describe the 2 forms of contact dermatitis
Irritant - non allergic - pain and burning sensation - dry erythematous rash Allergic - Type 4 hypersensitivity reaction can extend beyond site of contact
55
What is seborrhoeic dermaitis
chronic dermatitis due to inflammatory reaction related to proliferation of normal skin inhabitant - fungus called malasseiza furfur affects sebum richa reas: scalp periorbital auricular nasolabial folds
56
What is psoriasis
chronic autoimmune iflammation due to hyperproliferation of keratinocytes and inflammatory cell infiltration characterised by well-demarcated erythematous scaly plaques
57
outline the classification of psoariasis
plaque - symmetrical plaques on extensor surfaces / back / scalp flexural guttate - small tear dropped shaped plaques on trunk following streptococcal infection pustualr - palmes and soles
58
clinical features of plaque psoriasis
itchy well-demarcated red elevated lesions silver scale appearance symmetrical distribution
59
RF for psoariasis trigger
skin trauma strep infection drugs - b blocker / lithium / NSAIDs withdrawl of steroids alcohol smoking cold weather stress
60
Outline the management of psoriasis
Education - avoid triggers Emollients Flare - Steroids OD + Topical Vit D analogue OD (reduces keratinocyte proliferation) - Vit D analogue BD - Potent corticosteroid BD Phototherapy systemic treatment - MXT - Ciclosporin Biologics - Infliximab
61
Give 3 A/E of MXT
Pneumonitis Hepatotoxicity Myelosuppresion
62
give 3 common cuases of ithching with a rash
Utricaria atopic eczema psoriasis scabies
63
give 3 common causes of itching with no rash
renal failure jaundice lymphoma polycythaemia rubra vera
64
What is the difference between bacteriostatic and bacteriocidal
Bactericidal antibiotics kill the bacteria and bacteriostatic antibiotics suppress the growth of bacteria
65
What is the kobner phenomena
Skin lesions develop at site of injury
66
Name 4 types of psoriasis
Flexural Guttate Plaque Pustular
67
Name 2 skin conditions associated with the kobner phenomenon
Psoriasis Lichen planus Vitiligo
68
4 factors to address in management of a pressure sore
Nutrition Analgesia Antibiotics Regular dressing Pressure relieving mattress Tissue viability referral Patient positioning Need for debriedment
69
Outline a pressure score grading
1 - non blanching erythema 2 - partial thickness loss 3 - full thickness loss 4 - extensive destruction with muscle / bone involvement
70
4 features of lichen sclerosis
Ithcy dyspareunia pain on urination
71
3 differentials for lichen sclerosis
SCC VIN Lichen planus vitiligo
72
Management of lichen sclerosis
topical steroids avoid soaps / irritants emollients - relive dryness

Finals revision (17 decks)

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