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Finals Flash Cards 🩺 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What quantity of leave-on emollients do NICE guidelines recommend under 12s use per week?

A

250-500g

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2
Q

What quantity of leave-on emollients should adults use per week?

A

500-1000g

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3
Q

What should be considered with emollient use?

A

Burns and flammable products

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4
Q

What does ABCDE stand for in lesion identification?

A

Asymmetry, Border, Colour, Diameter, Evolution

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5
Q

What is the treatment for SEVERE acne vulgaris?

A

Oral isotretinoin

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6
Q

What is the treatment of choice for a fungal nail infection?

A

Oral Terbinafine

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7
Q

What is the most common causative organism for a fungal nail infection?

A

Dermatophytes (account for around 90% of cases) mainly Trichophyton rubrum

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8
Q

How do you investigate a fungal nail infection?

A

Nail clipping+/- scrapings of the affected nail

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9
Q

What factors may exacerbate psoriasis?

A

Trauma
Alcohol
Drug: Beta blockers, lithium, antimalarials (chloroquine and hydroxycholorquine), NSAIDs, and ACE inhibitors, infliximab
Withdrawal of systemic steroids

Streptococcal infection may trigger guttate psoriasis

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10
Q

What is the treatment of choice for rosacea with predominant erythema/flushing?

A

topical bromonidine

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11
Q

What is the treatment of choice for seborrhoeic dermatitis (face and body)?

A

Topical Ketoconazole

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12
Q

A young child with a history of atopic eczema develops a sudden eruption of painful, oedematous vesicles and pustules. They have are systemically unwell and have a fever is a stereotypical history of:

A

Eczema Herpeticum

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13
Q

A man with poorly controlled coeliac disease develops itchy vesicles on his elbows and buttocks is a stereotypical history of?

A

Dermatitis herpetiformis

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14
Q

A man presents with an itchy, purple, papular rash on the palms and flexor surfaces of the arms. The lesions are polygonal and covered in a ‘white lace’, which is a stereotypical history of:

A

Lichen planus

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15
Q

How would you describe erythema nodosum?

A

Symmetrical, erythematous, tender nodules which heal without scarring

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16
Q

How would you describe pretibial myxoedema?

A

Symmetrical, erythematous lesions seen in Graves’ disease.
Shiny orange peel skin

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17
Q

Appearance of Superficial epidermal (first degree) burns?

A

Red and painful, dry, no blisters

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18
Q

Appearance of partial thickness (superficial dermal/second degree) burns?

A

Pale pink, painful, blistered, slow capillary refill

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19
Q

Appearance of partial thickness (deep dermal/second degree burns)?

A

Typically white but may have patches of non-blanching erythema.
Reduced sensation, painful to deep pressure

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20
Q

Appearance of full thickness (third degree) burns?

A

White ‘waxy’/brown ‘leathery’/black in colour, no blisters, no pain

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21
Q

What are Escharotomies indicated?

A

In circumferential full thickness burns to the torso or limbs

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22
Q

What are some causes of Stevens-Johnson syndrome?

A

Penicillin
Sulphonamides
Lamotrigine, carbamazepine, phenytoin
Allopurinol
NSAIDs
Oral contraceptive pill

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23
Q

What are the features of Stevens-Johnson syndrome rash?

A

Typically maculopapular with target lesions being characteristic
Mucosal involvement
Systemic symptoms: fever, arthralgia

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24
Q

What is the appearance of pityriasis rosea?

A

Herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with a fine scale confined to the outer aspects of the lesions.

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25
Q

What is Mycosis fungoides?

A

A rare form of T-cell lymphoma that affects the skin

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26
Q

What is Bullous Pemphigoid?

A

An autoimmune condition causing sub-epidermal blistering of the skin

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27
Q

What are the features of Bullous Pemphigoid?

A
  • Itchy, tense blisters typically around the flexures
  • The blisters usually heal without scarring
  • There is typically no mucosal involvement (i.e. the mouth is spared)
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28
Q

What is the management of bullous pemphigoid?

A
  • Refer to dermatology for biopsy and confirmation of diagnosis
  • Oral corticosteroids are the mainstay of treatment
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29
Q

How is atopic dermatitis usually diagnosed?

A

Patch test

30
Q

What are the characteristic skin signs of Dermatomyositis?

A

The characteristic skin signs are:

  • Heliotrope rash: a purple rash on the eyelids
  • Gottron’s papules: red papules on the dorsal aspect of the finger joints.
  • Shawl rash: erythema across the upper back and shoulders
  • Nailfold erythema
31
Q

What are some causes of Acanthosis nigricans?

A
  • T2DM
  • Gastrointestinal cancer
  • Obesity
  • PCOS
  • Acromegaly
  • Cushing’s disease
  • Hypothyroidism
  • Familial
  • Prader-Willi syndrome
32
Q

What is the usual distribution of atopic eczema?

A
  • Symmetrical Flexural
33
Q

Describe the classical findings of eczema on examination?

A
  • Excoriations
  • Erythematous
  • Scaly
  • Lichenification
  • Crust
  • Weeping if infected
34
Q

What serum immunoglobulin is usually raised in people who suffer with severe eczema?

A

IgE

35
Q

What is the classical appearance of plaque psoriasis?

A
  • Red
  • Scaly
  • Well demarcated
36
Q

Name the forms of psoriasis?

A
  • Plaque psoriasis
  • Guttate psoriasis
  • Erythrodermic psoriasis
  • Pustular psoriasis
  • Flexural psoriasis
37
Q

What is Koebner phenomenon?

A

Where skin lesions appear at the sight of injury

38
Q

What is Pemphigus Vulgaris

A

Pemphigus vulgaris can be a life-threatening condition that occurs most commonly in Ashkenazi Jews.

It is usually mediated by an autoimmune process, whereby antibodies are antibodies generated against the desmosomal
protein which causes keratinocytes to separate from one another, causing widespread bulla formation.

39
Q

What is the medical term for a large blister?

A

Bulla

40
Q

What is the diagnostic test for Pemphigus vulgaris?

A

Biopsy

41
Q

What is the first-line treatment for Seborrhoeic dermatitis?

A

Topical Ketoconazole

42
Q

How long should you have as a break in between courses of steroid creams?

A

4 weeks

43
Q

Where do you most commonly find venous ulceration?

A

Medial malleolus

44
Q

What are potential complications of toxic epidermal necrolysis?

A

Volume loss and electrolyte derangement

45
Q

What are the features of Toxic Epidermal necrolysis?

A
  • Systemically unwell e.g. pyrexia, tachycardic
  • Positive Nikolsky’s sign: the epidermic separates with mild lateral pressure
46
Q

What drugs induce Toxic Epidermal Necrolysis?

A
  • Phenytoin
  • Sulphonamides
  • Allopurinol
  • Penicillins
  • Carbamazepine
  • NSAIDs
47
Q

In what skin conditions does Koebner phenomenon occur?

A
  • Psoriasis
  • Vitiligo
  • Warts
  • Lichen Planus
  • Lichen sclerosus
  • Molluscum contagiosum
48
Q

How long should you expect the rash from pityriasis rosea?

A

6-12 weeks

49
Q

What are the features of Dermatitis Herpetiformis?

A

Itchy, vesicular skin lesions on the extensor surfaces (e.g. elbows, knees, buttocks)

50
Q

What is the diagnostic process of dermatitis herpetiformis?

A

Skin biopsy: direct immunofluorescence shows deposition of IgA in a granular pattern in the upper dermis

51
Q

What is the first-line management of Scabies?

A

Permethrin 5% is first line

52
Q

WHat is the first line management of Actinic Keratoses?

A

Topical Fluorouracil creams

Typically 2-3 week course

53
Q

What is the treatment for eczema herpeticum

A

IV Aciclovir

54
Q

What constitutes a major burn?

A

Any burn with >15% TBSA (>10% in children) of partial or full thickness burns.

55
Q

What is the modified Parkland formula?

A

describes the volume of crystalloid fluid (ideally Hartmanns solution) to be administered in the first 24 hours post-burn:
Initial 24hrs (Adults): 4mL (Hartmann’s) x Weight (kg) x %TBSA burn
Initial 24hrs (Children): 3mL (Hartmann’s) x Weight (kg) x %TBSA burn
50% of the calculated volume is given within the first 8 hours post-burn, and the remaining 50% is given in the remaining 16 hours.

56
Q

What is Wallace’s rule of nines?

A

Estimates an adult’s affected BSA using multiples of 9 representing different areas of the body.
Head and neck represent 9%.
Each lower extremity is 18%.
Each upper extremity is 9%.
Anterior and posterior torso are 18% each.
For scattered or irregular burns, the palmar surface of the person’s hand represents approximately 1%.
Different calculations are used for children and infants.

57
Q

Why do systemic complications occur in burns?

A

They will arise secondary to the large inflammatory response produced by the body as a result of the burn injury. Called Systemic inflammatory response syndrome

58
Q

What is Curling’s ulcer?

A

It is a gastric ulcer that can occur following severe burns.

59
Q

What are the four main histological subtypes of melanoma?

A

Superficial spreading (60%)
Nodular (30%)
Lentigo maligna melanoma (7%)
Acral lentiginous (2%)

60
Q

What are the risk factors for developing melanoma?

A
  • UV exposure
  • Age
  • Previous melanoma
  • Skin tone (typically fitzpatrick type 1 and 2)
  • Family history
  • Predisposing conditions
61
Q

How do you examine a skin lesion?

A

Asymmetry
Border irregularity
Colour uneven
Diameter >6mm
Evolving lesion

62
Q

What are the key histological features that should be identified in a biopsy for melanoma?

A
  • Breslow thickness (distance between the stratum granulosum and the deepest point of the melanoma)
  • Degree of ulceration
  • Histological subtype
  • Immunohistocytochemistry (to identify any genetic markers, such as BRAF status, present)
  • Mitotic rate (number of mitotic figures per square millimeter)
63
Q

What is the pathophysiology of psoriasis?

A

It is a chronic, inflammatory skin condition due to hyperproliferation of keratinocytes and overstimulation of immune cells

64
Q

What nail signs would you get in psoriasis?

A

Nail pitting
Onycholysis
Yellow-brown discolouration
Subungual hyperkeratosis

65
Q

What are the risk factors for Basal cell carcinoma?

A

UV exposure
Radiation exposure
Long term arsenic exposure
Lighter skin
Fx of Gorlin syndrome, xeroderma pigmentosum

66
Q

What are the functions of the skin?

A
  • Barrier to infection
  • Thermoregulation
  • Protection against trauma
  • Protection against UV
  • Vitamin D synthesis
  • Regulate H2O loss
67
Q

What is the bacteria that contributes to the development of acne?

A

Propionibacterium acnes

68
Q

What is the treatment for Pemphigus vulgaris?

A

Systemic corticosteroids

69
Q

What test is used to identify triggers for Type 4 hypersensitivity reactions (contact dermatitis)?

A

Patch testing

70
Q

What is the best predictor of a recurrence?

A

Breslow thickness

Finals Flash Cards 🩺 (32 decks)

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