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MRCP Part 1 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Conditions that cause flaccid blisters

A

bullous pemphigoid (NO mucosal involvement)

pemphigoid vulgaris (mucosal involvement)

Pemphigoid = rigid blisters

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2
Q

Describe the skin condition associated with Grave’s disease

A

pretibial myxoedema. This condition is characterized by bilateral, symmetrical, non-pitting, scaly thickening of the skin with an orange-peel appearance

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3
Q

most common cancer in transplant patients?

A

SCC

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4
Q

how to diagnose carcinoid syndrome?

A

urinary 5-HIAA levels

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5
Q

what is pellagra?

A

niacin deficiency

3 D’s - dermatitis (rash on neck), diarrhoea and dementia.

consequence of isoniazid therapy (isoniazid inhibits the conversion of tryptophan to niacin) and it is more common in alcoholics.

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6
Q

drug triggers of plaque psoriasis

A

beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab
withdrawal of systemic steroids

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7
Q

which skin condition is associated with coeliac disease and what antibody causes it?

A

Dermatitis herpetiformis

deposition of IgA in the dermis

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8
Q

Eczema herpeticum

A

serious condition
IV Aciclovir

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9
Q

gold standard for diagnosing contact dermatitis

A

skin PATCH test

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10
Q

management of Pyoderma gangrenosum

A

oral pred

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11
Q

The most common malignancy in the lower lip

A

SCC

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12
Q

most common type of all skin cancers in the UK

A

BCC

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13
Q

the single most important prognostic factor for malignant melanoma?

A

depth of tumour (Breslow’s thickness)

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14
Q

pompholyx eczema

A

itchy blisters on your hands and feet.

triggers - humidity

also known as dyshidrotic eczema.

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15
Q

what are the 5 layers of epidermis?

A

Come Lets Get Sun Burnt/Girls

stratum Corneum - shedding

stratum Lucidum - thick skin

stratum Granulosum -

stratum Spinosum - thickest layer, site of keratin production

statum Basale/Germinativum - melanocytes and keratinocytes formed

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16
Q

what is lichen planus?

A

skin disorder
unknown cause
itchy papules on palms, soles, genitalia
white lines inside mucous membranes (wickhams’ striae)
nail thinning and ridging

management - topical clobetasone butyrate

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17
Q

management of rosacea

A

erythema and flushing: topical brimonidine gel

mild-to-moderate papules and/or pustules:
topical ivermectin is first-line
alternatives include: topical metronidazole or topical azelaic acid

moderate-to-severe papules and/or pustules:
combination of topical ivermectin + oral doxycycline

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18
Q

where are keloid scars more likely to form?

A

The sternum, along with other areas such as shoulders, upper arms and earlobes, is particularly prone to keloid formation due to high tension in these areas.

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19
Q

main organism causing Erysipelas

A

strep pyogenes

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20
Q

Management of Hyperhidrosis

A

Hyperhidrosis describes the excessive production of sweat.

Management options include
topical aluminium chloride preparations are first-line. Main side effect is skin irritation
iontophoresis: particularly useful for patients with palmar, plantar and axillary hyperhidrosis
botulinum toxin: currently licensed for axillary symptoms
surgery: e.g. Endoscopic transthoracic sympathectomy. Patients should be made aware of the risk of compensatory sweating

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21
Q

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

A

dermatitis herpetiformis
IgA autoimmune condition
associated with coeliac disease

22
Q

Primary herpes simplex infection can cause what rash

A

Erythema multiforme

23
Q

first-line treatment for pyoderma gangrenosum

A

Oral steroids

24
Q

What is the minimum steroid intake a patient should be taking before they are offered osteoporosis prophylaxis?

A

Equivalent of prednisolone 7.5 mg or more each day for 3 months

25
Q

Systemic mastocytosis

Features

Diagnosis

A

Systemic mastocytosis results from a neoplastic proliferation of mast cells

Features
urticaria pigmentosa - produces a wheal on rubbing (Darier’s sign)
flushing
abdominal pain
monocytosis on the blood film

Diagnosis
raised serum tryptase levels
urinary histamine

26
Q

bullous pemphigoid Skin biopsy findings

A

immunofluorescence shows IgG and C3 at the dermoepidermal junction

27
Q

bullous conditions and their antibodies

A

hemidesmosomal proteins BP180 and BP230 = Bullous pemphigoid antibodies

Desmoglein-3 i = Pemphigus vulgaris

28
Q

virus causing pityriasis rosea

A

Human herpesvirus 6 and 7

29
Q

varicella-zoster virus (VZV) is known as which herpes virus

A

Human herpesvirus virus 3 (HHV-3) also commonly known a

30
Q

Epstein-Barr virus (EBV) is known as which herpes virus

A

Human herpesvirus virus 4 (HHV-4) also commonly known as Epstein-Barr virus (EBV)

31
Q

which virus causes oral and/or genital herpes

A

herpes simplex virus-2 (HSV-2)

32
Q

which virus causes kaposi sarcoma

A

Human herpesvirus virus 8 (HHV-8)

33
Q

features of pityriasis rosea

A

in the majority of patients there is no prodrome, but a minority may give a history of a recent viral infection

herald patch (usually on trunk)

followed by erythematous, oval, scaly patches which follow a characteristic distribution with the longitudinal diameters of the oval lesions running parallel to the line of Langer. This may produce a ‘fir-tree’ appearance

34
Q

features of guttate psoriasis

A

‘Tear drop’, scaly papules on the trunk and limbs

post strep infection

35
Q

define Erythroderma

A

term used when more than 95% of the skin is involved in a rash of any kind.

36
Q

in Pemphigus vulgaris, antibodies are directed against ?

A

desmoglein 3, a cadherin-type epithelial cell adhesion molecule.

37
Q

investigation of choice for avascular necrosis of the hip

A

MRI

38
Q

the most common side-effect of isotretinoin

A

dry skin, eyes and lips/mouth

39
Q

what must all patients taking isotretinoin for acne be on?

A

contraception

it is teratogenic

40
Q

guttate psoriasis management

A

Most cases resolve spontaneously within 2-3 months

Topical agents as per psoriasis

UVB phototherapy - can speed up clearance

41
Q

Dermatitis in acral, peri-orificial and perianal distribution

A

→ zinc deficiency

42
Q

Which one of the following complications is most associated with psoralen + ultraviolet A light (PUVA) therapy?

A

SCC

43
Q

first-line treatment for lichen planus

A

Potent topical steroids

44
Q

US finding of the double-contour sign a hyperechoic, irregular band over the superficial margin of the joint cartilage,

A

The most useful characteristic lesion of gout

45
Q

Seborrhoeic dermatitis - first-line treatment is

A

topical ketoconazole

46
Q

Associated conditions of Seborrhoeic dermatitis

A

HIV
Parkinson’s disease

47
Q

infections causing pyoderma gangrenosum

A

none

48
Q

Erythema gyratum repens

A

Lung cancer

49
Q

Necrolytic migratory erythema

A

Glucagonoma

50
Q

mx lichen planus

A

topical steroids

MRCP Part 1 (20 decks)

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