DERMATOLOGY

Question 1

white patches on tongue, asymptomatic, smoker, T2DM
ix: ?

Answer 1

oral leukoplakia
cannot be rubbed off
biopsy
risk of malignancy

Question 2

exacerbating factors for psoriasis

Answer 2

trauma
alcohol
drugs : beta blockers, lithium, NSAIDs, ACEi, infliximab, antimalarials
withdrawal of systemic steroids

Question 3

tender, erythematous lesions on shin especially
diagnosis ?
pathology ?
causes ?

Answer 3

erythema nodosum
inflammation of subcutaneous fat
infections, sarcoidosis, SLE, Behcets, malignancy, lymphoma,
drugs : penicillins, sulphonamides, COCP
pregnancy

Question 4

intense itchy rash with vesicles on palms of hand, dry skin with peeling and occurs in humid weather like summer,
cause?
treatment ?

Answer 4

pompholyx eczema or dyshydrotic eczema
emollients or high potent steroids

Question 5

palpmoplantar pustulosis - similar to pompholyx eczema - but differs at

Answer 5

lesions on other parts of body, have psoriasis and not associated with humid weather

Question 6

dry, peeling, scaling erythematous skin affecting typically one hand

Answer 6

tine magnum

Question 7

vesicuopustular waxy, yellow brown lesions on palms and soles, associated with reactive arthritis

Answer 7

keratoderma blennorhagicum

Question 8

hypo or. hyper pigmented macule and patches on chest and back, become more noticeable on tanning.
lesions are usually flat
woods light- yellow green fluorescence

caused by ?
first line management ?

Answer 8

pityriasis versicolor
malassezia furfur

ketokonazole shampoo

Question 9

red or silver ring shaped rashes with clear centre, itchy and - usually a isolated lesion

Answer 9

tine corporis

Question 10

photosensitivity and blisters in sun exposed areas, liver and skin disease

Answer 10

porphyria cutaenea tarda

Question 11

circular red rash that spreads outwards from tick bite
systemic symptoms

Answer 11

Lyme disease
borrelia burgdorferi

Question 12

auto immune, well demarcated, erythematous plaques with silvery scales, auto immune related
extensor surfaces

Answer 12

psoriasis

Question 13

orange peel lesions on shins

Answer 13

pretibial myxoedema
assoc. with graves disease

Question 14

small red papule to deep red necrotic ulcers with vioalaceous borders, assc with IBD, connective tissue disease, myeloproliferative
pus- skin - deep ulcers

Answer 14

pyoderma gangrenous

Question 15

shiny plaques on skin, red brown with yellow brown and atrophic centre, erythematous - can have surrounding telangiectasia

plaques- lipid involvement ( yellow brown)- some association with diabetes-

Answer 15

necrobiosis lipoidica diabeticorum

Question 16

fitz Patrick skin types
1
2
3
4
5
6

Answer 16

1. never tans, always burns( red hair, freckles and blue eyes)
   2.usually tans , always burns
   3.always tans, sometimes burns ( dark hair, brown eyes)
2. always tans, rarely burns
   5.sunburns and tanning after extreme UV exposure ( brown skin- Indian)
3. black skin - never tans , never burns

Question 17

papular lesions , hyper pigmented and depressed centrally
present on dorsal surface of extremities

Answer 17

granuloma annulare

Question 18

planus, papular, purple, puristic, polygonal lacy rash
wickhams striae over surface

Answer 18

lichen planus
inflammatory condition of skin and mucus membranes

Question 19

itchy white porcelain spots on the vulva of elderly women
usually are atrophic patches
can be seen in men and in children also

Answer 19

lichen sclerosis

Question 20

self limiting rash , viral in origin, single pink or red oval herald patch and followed by similar lesions on the skin cleavage lines - Christmas tree pattern
itchy only at night time

Answer 20

pitryaisis rosea

Question 21

coin shaped plaques that maybe vesicular or crusted
very itchy

Answer 21

Discoid eczema

Question 22

preceding streptococcal infection , small round oval pink scaly papule - drop/tear shaped

Answer 22

guttate psoriasi
- resolves spontaneously
- can try UVB phototherapy

Question 23

eczema, itchy red rash in pregnancy

Answer 23

atopic eruption in pregnancy

Question 24

third trimester, pruritic rash, appear in abdominal striae
mx ?

Answer 24

Polymorphic eruption of pregnancy

emollient or low/mild potent steroids

Question 25

2-3rd trimester, pruritic blistering rash, peri umbilical later spreading to other parts mx?

Answer 25

pemphigoid gestationitis oral steroids

Question 26

eczematous lesions on sebum rich areas- eyebrows, nasolabial folds, peri auricular and periorbital associated with HIV , Parkinson's mx?

Answer 26

seborrheic dermatitis - caused by malasezzia ketoconazole shampoo topical steroid

Question 27

itchy, vesicular skin lesions on extensor surfaces associated with coeliac, IBD skin biopsy - igA deposits

Answer 27

dermatitis herpetiformis - gluten free diet - dapsone

Question 28

rapidly progressive from small lesions to raised red brown lesion, often spherical in shape, smooth surface may bleed or ulcerate linked to trauma, pregnancy

Answer 28

pyogenic granuloma

Question 29

infectious disease, contamination from infected animals- parapoxvirus single or few lesions on hands and fingers with surrounding erythema and regional lymphadenopathy

Answer 29

ORF

Question 30

contagious, crusted golden lesions typically around the mouth diagnosis ? caused by ? first line ? second line ? if extensive

Answer 30

impetigo stepto/staph hydrogen peroxide -- if doesn't help then topical fusidic acid flucloxacillin, if pen allergic then erythromycin

Question 31

blisters, pruritic- no mucosal involvement

Answer 31

bullous pemphigoid mx- biopsy, oral steroids

Question 32

blisters with mucosal involvement

Answer 32

pemphigus vulgaris

Question 33

blisters or bullae in response to trauma to fragile skin usually manifests early in childhood

Answer 33

epidermolysis bullae

Question 34

sweets syndrome associated with aka :

Answer 34

acute myeloid leukaemia acute febrile neutrophilic dermatosis

Question 35

skin disorders associated with diabetes

Answer 35

necrobiosis lipidoica vitiligo lipoatrophy candidiasis granuloma annulare

Question 36

children, multiple raised pearly white/flesh coloured lesions with central umbilication/dimple

Answer 36

molluscum contagious self limiting, referral if associated to HIV, lesions near eye or genital area

Question 37

acne rosacea--- redness, telangiectasia rx: acne vulgaris - pustules, comedones rx:

Answer 37

-- alpha agonist brimonidine to reduce flushing, topical ivermectin , metronidazole/azelaic acid laser for telangiectasia -- topical steroid/antibiotics

Question 39

venous ulcer ix: mx:

Answer 39

ABPI compression stockings, oral pentoxyifylline - vasodilator

Question 40

hirsutism - androgen dependent hair growth causes

Answer 40

PCOS, cushings syndrome adrenal hyperplasia androgen therapy obesity adrenal tumour androgen secreting tumours phenytoin, steroids rx- oral COCP - co-cyprindiol, or eythnylestradiol, and drosperinone topical eflornithine

Question 41

hypertrichosis causes

Answer 41

minoxidil, ciclosporin, diazoxide congenital porphyria cutanea tarda anorexia nervosa

Question 42

contact dermatitis - late type 4 hypersensivity

Answer 42

skin patch test -

Question 43

target lesions on hands, feet and spreading to torso- mild pruritic, self limiting triggered by infections ( mycoplasma or HSV), drugs ( penicillins, allopurinol, NSAIDS, OCP,), SLE, sarcoidosis, malignancy

Answer 43

erythema multiforme

Question 44

on pressing down go white and fill from centre ? edges ?

Answer 44

spider nave heridetery hemorrhagic telangiectasia

Question 45

first line treatment for capillary hemagioma

Answer 45

propranolol

Question 46

isotretinoin should not be combined with tetracyclines due to risk of ?

Answer 46

intracranial hypertension

Question 47

sun exposed areas, nodule with a central depression, some telangiectasia,

Answer 47

BCC

Question 48

sun exposed areas, ass with actinic keratosis, can appear as an ulcer but no rolled edges

Answer 48

SCC

Question 49

acne vulgars treatment of choice in pregancy

Answer 49

erythromycin

Question 50

acne vulgaris treaments to avoid in pregnancy

Answer 50

doxy/lymecycline steroids

Question 51

painful lesion on the helix of ear

Answer 51

chondrodermatitis nodularis helices rx: cyrotheraphy, steroid, collagen injection, surgery

Question 52

scabies 1) type of hypersensivity 2) itching persists how many weeks post treatment 3) treatment

Answer 52

1. type 4 delayed 2. 6 weeks , retreat if new burrows 3. permetrin 5%v- leave on skin for 8-12hrs or malathion 0.5% leave on skin for 24hr repeat in 7 days severe infection with crusting skin - IVERMECTIN

Question 53

auspitz sign

Answer 53

erythematous plaques covered in silver white scale when scraped expose the underlying red membrane that bleeds- seen in psoriatic plaques

Question 54

struck on appearance on skin, varying colours, keratin plugs can be seen in older people

Answer 54

seborrheic keratoses rx- curettage, shave biopsy, cryosurgery

Question 55

bowens disease

Answer 55

squamous cell carcinoma insitu

Question 56

familial history, atypical multiple mole-melanoma, variable size color and irregular borders

Answer 56

dysplastic naevus syndrome

Question 57

recurrent MTP joint pain, peptic ulcer disease and ruddy complexion cause for pruritic ?

Answer 57

polycythemia

Question 58

depigmented skin patches, associated with auto immune conditions ( alopecia aerate, hashimotos, pernicious anemia, SLE, T1DM, Addisons) dx: tx:

Answer 58

vitiligo topical steroids/ tacrolimus

Question 59

well demarcated, erythematous circular patch with raised edges and central hypopigmentation with itch

Answer 59

tinea corporis caused by trichophyton

Question 60

skin lesion associated with rheumatic fever, annular erythematous macules or papule that spread outwards with central clearance

Answer 60

erythema marginatum

Question 61

nose bleeds, IDA, erythematous lesions on skin, mucus membranes

Answer 61

heridetary hermorrhagic telangectasia aka osler weber rendeu syndrome

Question 62

first line in treatment of acne rosea

Answer 62

topical ivermectin other alternatives- topical azelaic acid and metronidazole

Question 63

lower limb lesions, pink/brown well defines, dimple sign - on pressing asymptomatic

Answer 63

dermatofibroma