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Medicine 🩺 > Dermatology 🧴 > Flashcards

Dermatology 🧴 Flashcards

1
Q

Predominant cell type of epidermis?

A

Keratinocytes

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2
Q

Synthetic Function of keratinocytes:

A

1) Synthesis of structural proteins
2) Synthesis of Vit D under the influence of UVB
3) Synthesis of lipid

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3
Q

Conversion of T4 to T3 in skin is done by-

A

Keratinocytes

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4
Q

Disorders caused by mutation in keratin genes-

A

Blistering dusorders
Ichthyosis

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5
Q

Site of lipid production in the skin-

A

Epidermis

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6
Q

Disorders caused by mutation in filaggrin gene-

A

Ichthyosis Vulgaris
Atopic eczema

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7
Q

Types of cells found in the epidermis-

A

1) keratinocytes
2)Melanocytes
3)Langerhans cells
4)Merkel cells

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8
Q

Prime function of Langerhans cells-

A

Antigen presentation to lymphocytes

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9
Q

Melanocyte origin-

A

Neural crest

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10
Q

Melanin is synthesized from-

A

Amino acid Tyrosine

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11
Q

Cells responsible for signal transduction of fine touch-

A

Merkel cell

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12
Q

Connectors between two cells of the epidermis-

A

Desmosome

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13
Q

Connector between epidermal basal cell and basement membrane-

A

Hemi desmosome

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14
Q

Components of basement membrane of the skin are-

A

From outer to inner-
Lamina lucida
Anchoring filament
Lamina Densa
Anchoring fibrils

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15
Q

Connector between basement membrane to the dermis-

A

Anchoring fibrils

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16
Q

Predominant cells of the dermis-

A

Fibroblasts

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17
Q

Acellular part of dermis consists of-

A

CARE
Collagen I and II
Elastin
Reticulin
Amorphous ground substance (GAG,hyaluronic acid, Dermatan sulphate)

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18
Q

Cells of the dermis-

A

D=Dendritic cells
E=Endothelial cells
R=
M=Mast cells,Mononuclear phagocytes
I= kind of looks like L ( lymphocytes-T)
S=Scar tissue ( fibroblast)
+ Neurons (obvi pain sensation)

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19
Q

Thermoregulation is maintained by-

A

Eccrine sweat glands

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20
Q

Body odour and pheromones-

A

Apocrine sweat glands

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21
Q

Acts as shock absorber-

A

Dermis
Subcutaneous fat

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22
Q

In diascopy,Apple Jelly nodules are found in-

A

Lupus vulgaris ( cutaneous TB)

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23
Q

Patch testing is the investigation of choice for-

A

Type 4 hypersensitivity/ Delayed

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24
Q

Prick tests are used to investigate-

A

Type 1 hypersensitivity

25
Q

Conversion of hormones that occur in the skin-

A

Vit D
Thyroxine

26
Q

Maintenance of fluid balance-

A

Stratum corneum

27
Q

ABCDE Features of Malignant Melanoma-

A

Asymmetry
Border irregular
Color irregular
Diameter > 0.5 cm
Elevation irregular
(+ loss of skin markings)

28
Q

Major features of malignant melanoma-

A

SSC
Change in-
Size
Shape
Color
( diameter >0.5 minor change)

29
Q

Causes of common scaly rashes-

A

Atopic eczema
Psoriasis
Pityriasis Rosea
Pityriasis versicolor
Drug eruption
Lichen planus
Tinea corporis
Secondary syphillis

30
Q

Pathophysiology of Acne Vulgaris-

A

1) Increased sebum production
2) Colonisation of pilosebaceous ducts by propionibacterium acnes which causes inflammation
3) Hypercornification( follicular epidermal hyperproliferation) and occlusion of pilosebaceous ducts

31
Q

Regarding epidemiology of acne-

A

-Starts during puberty
-Affect over 90% adolescents
- can persist beyond adolescence. Beyond 25 years, more common in female than male
- propionibacterium is anaerobic

32
Q

Treatment of acne vulgaris-

A

Mild to moderate:
1) Topical Benzoyl Peroxide
Or, Topical Retinoic acid
2) if inflammation present 1 +
Mild infl-
Topical Erythromycin
Or, Topical Clindamycin
Moderate infl-
Oral tetracycline/ oxytetracycline/lemecycline
3) COCP in female ( Cyproterone acetate in pcos)

Moderate to severe: Oral Isotretinoin

33
Q

A 24 years old 16 wks pregnant female is being treated for acne with benzoyl peroxide with limited efficacy. Which drug can be added next ?

A

Erythromycin
( others are C/I)

34
Q

A man on acne medication presents with darkening of skin. No H/O prolonged sun exposure. Drug responsible?

A

Minocycline

35
Q

Side effects of isotretinoin?

A

-dryness of eyes and mouth
- increased triglycerides level
- teratogenecity
-mood disturbance: depression, suicide
-light photosensitivity

36
Q

A 21 years old female is on isotretinoin for acne . She wants to start a family. How long does she have to wait before conceiving

A

At least 2 months from cessation of isotretinoin therapy

37
Q

Risk factors for SCC:

A
  • Chronic UVR exposure
    -immunosuppressed organ transplant recipient
    -high numbers of PUVA therapy
    -Ionizing radiation: Radiotherapy,thermal radiation
    -Chemical carcinogens: Arsenic, coal tar
    -Oncogenic HPV
    -Chronic inflammation
    -Chronic skin ulcer : Discoid lupus erythematosus or vulgaris
    -Dystrophic Epidermolysis Bullosa
38
Q

Malignant Cause of acanthosis nigricans

A

Gastric adenocarcinoma

39
Q

Most common immunobullous disease?

A

Bullous pemphigoid

40
Q

Pathophysiology of BP?

A

Antibody against hemidesmosomal BP antigens (BPAg-1 & 2)

41
Q

A 65 years old lady presents with Itchy blisters in her hands and legs. Examination of the trunk reveals tense blisters. Mouth and vulva examination unremarkable. Dx?

A

BP
( no mucosal involvement- BP
mucosal involvement- PV)

42
Q

How will you confirm diagnosis of BP?

A

Skin biopsy

43
Q

Investigation findings of BP?

A

Skin biopsy- subepidermal blistering with eosinophil rich inflammatory infiltrate

Direct immunofluorescence- IgG and C3 in BM

Indirect immunofluorescence-anti epidermal antibidy (IgG)

44
Q

Treatment of BP?

A

Very potent topical glucocorticoids (Clobetasol propionate 0.05%)

45
Q

Pathophysiology of PV

A

IgG autoantibodies directed against desmogleins-1&3

46
Q

Antibody formed only against desmoglein-1

A

Pemphigus foliaceus

47
Q

45 years old patient with flaccid blisters in chest, tummy and face. Mouth is also involved. Dx?

A

PV

48
Q

Diagnosis of pv by-

A

Skin biopsy

49
Q

Investigation findings of pv

A

Skin biopsy- intra epidermal blistering and acantholysis
Direct immunofluorescence- IgG + C3
(“chicken wire” appearence)

50
Q

Treatment of pv?

A

High dose systemic glucocorticoids such as prednisone

51
Q

A patient with chronic diarrhea develops itchy blisters on elbows, lower back and buttocks. On examination, the lesions are excoriated. Mouth examination unremarkable. Dx?

A

Dermatitis Herpetiformis

52
Q

Dermatitis Herpetiformis has a strong association with which disease?

A

Coeliac disease

53
Q

Investigation of DH?

A

Diagnostic- Skin biopsy :
1)subepidermal vesiculation in the dermal papillae
2) neutrophil & eosinophil rich substrate
Direct immunofluoroscence:
Granular IgA in papillary dermis
Assessment of anti endomysial and tissue transglutaminase antibody

54
Q

Treatment of DH?

A

Gluten free diet
Dapsone

55
Q

Which antibody is found in skin biopsy of DH?

A

IgA

56
Q

A 42 years old man presents to Dermatology OPD with a skin rash with intense itching. On examination there are vesicles and papules on his elbows,knee and buttock. Dx?

A

Dermatitis Herpetiformis

57
Q

A 42 years old male presents to dermatology OPD with maculopapular rashes on his wrists, forearms and lower back. and intense itching. On examination he is icteric.mouth and genitals are also involved.
1) Dx?
2) what will you prescribe for his intense itching?

A

1) lichen planus
2) potent local glucocorticoids

58
Q

Treatment of lichen planus?

A

-Potent local glucocorticoids
-short course of systemic glucocorticoids in extensive disease

Medicine 🩺 (19 decks)

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