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MBChB Finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

When are IV fluids recommended for burns in adults?

A

In adults, IV fluids should be given in second or third degree burns that cover 15% body surface area or more

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2
Q

Describe the clinical features of guttate psoriasis

A

Tear drop papules on the trunk and limbs

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3
Q

What is the purpose of antivirals for shingles?

A

May reduce the incidence of post herpetic neuralgia, particularly in older people

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4
Q

Name 4 conditions associated with pyoderma gangrenosum

A
  • IBD
  • RA
  • Myeloproliferative disorders
  • AML
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5
Q

What is the most likely cause of balanitis in an uncircumcised man, who has developed a tight white ring around the tip of the foreskin and phimosis?

A

Lichen sclerosis

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6
Q

Describe the clinical presentation of seborrhoeic dermatitis

A

An itchy rash affecting the face and scalp distribution
Usually erythematous, yellow and scaly

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7
Q

What is the first line treatment for a patient with rosacea who has mild papules and/or pustules?

A

Topical ivermectin

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8
Q

Name one systemic complication patients with psoriatic arthritis are at increased risk of

A

Cardiovascular disease

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9
Q

A 28-year-old man undergoes an ileocaecal resection and end ileostomy for Crohn’s disease. One year later he presents with a deep painful ulcer at his stoma site. What is the most likely diagnosis?

A

Pyoderma gangrenosum

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10
Q

A 6-year-old girl is brought to the GP with a 4-week history of flaky and itchy skin on the scalp with associated hair loss. What is the most likely diagnosis?

A

Tinea capitis

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11
Q

What drug can be given to treat refractory pain in shingles if simple analgesia and neuropathic analgesia do not help?

A

Corticosteroids e.g. prednisolone

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12
Q

How long should the break be between courses of topical corticosteroids in patients with psoriasis?

A

4 weeks

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13
Q

Can erythema nodosum be caused by pregnancy?

A

Yes

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14
Q

Describe the clinical features of atopic eruption of pregnancy

A

Typically presents as an eczematous, itchy red rash

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15
Q

Describe the clinical presentation of polymorphic eruption of pregnancy

A

Pruritic condition associated with last trimester
Lesions often first appear in abdominal striae

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16
Q

Describe the clinical presentation of pemphigoid gestationis

A
  • Pruritic blistering lesions
  • Often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms
  • Usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy
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17
Q

What is the most likely diagnosis?

A

Seborrhoeic keratoses

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18
Q

Describe the appearance of a superficial epidermal burn

A

Red and painful, dry, no blisters

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19
Q

Describe the appearance of a partial thickness (superficial dermal) burn

A
  • Pale pink, painful, blistered
  • Slow capillary refill
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20
Q

Describe the appearance of a partial thickness (deep dermal) burn

A
  • Typically white but may have patches of non-blanching erythema
  • Reduced sensation, painful to deep pressure
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21
Q

Describe the appearance of a full thickness burn

A

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

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22
Q

What is the first line treatment for acute urticaria?

A

Non-sedating antihistamines e.g. loratadine, cetirizine

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23
Q

What treatments for acne are contraindicated in pregnancy?

A

Topical and oral retinoid treatment

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24
Q

What is the first line treatment for athlete’s foot?

A

Topical miconazole

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25
Q

What is the long-term treatment for psoriasis?

A

Calcipotriol

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26
Q

What is the most likely diagnosis (history of viral URTI)?

A

Pityriasis rosea

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27
Q

What is the first line treatment for mild-moderate acne vulgaris?

A

Topical combination therapy:
* Topical adapalene + topical benzoyl peroxide

  • Topical tretinoin + topical clindamycin
  • Topical benzoyl peroxide + topical clindamycin
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28
Q

What is the first line treatment for hyperhidrosis?

A

Topical aluminium chloride preparations

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29
Q

How do you differentiate between a keloid and hypertrophic scar?

A

If the growth extends past the margins of what would be expected = keloid

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30
Q

Name one chronic condition associated with seborrhoeic dermatitis

A

HIV

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31
Q

Name the drugs commonly associated with TEN

A
  • Phenytoin
  • Sulphonamides
  • Allopurinol
  • Penicillins
  • Carbamazepine
  • NSAIDs
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32
Q

Describe the clinical features of nodular melanoma

A
  • Red or black lump or lump which bleeds or oozes
  • Typically affects sun exposed skin, middle-aged people
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33
Q

What is the first line treatment for patients with rosacea with predominant flushing but limited telangiectasia?

A

Brimonidine gel

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34
Q

A 36-year-old lady presents with localised, well demarcated patches of hair loss and small, broken ‘exclamation mark’ hairs. Which blood test is it important to do in this case?

A

TFTs - in patients with alopecia areata, it is important to screen for other autoimmune conditions, such as thyroid disease, diabetes and pernicious anaemia

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35
Q

A 52-year-old man asks you to look at the side of his tongue. The white patches have been present for the past few months and are asymptomatic. He is a smoker who is known to have type 2 diabetes mellitus.

What is the most likely diagnosis?

A

Oral leukoplakia

36
Q

Dermatitis in acral, peri-orificial and perianal distribution should make you consider what vitamin deficiency?

A

Zinc

37
Q

What are the treatment options for moderate-severe acne?

A
  • Topical adapalene with topical benzoyl peroxide
  • Topical tretinoin with topical clindamycin
  • Topical adapalene with topical benzoyl peroxide + either oral lymecycline or oral doxycycline
  • Topical azelaic acid + either oral lymecycline or oral doxycycline
38
Q

Name the drugs which are known to exacerbate plaque psoriasis

A
  • Lithium
  • Beta-blockers
  • NSAIDs
  • ACEi
  • TNF-alpha inhibitors
  • Anti-malarials
39
Q

What is pompholyx eczema?

A

Pompholyx eczema is a subtype of eczema characterised by an intensely pruritic rash on the palms and soles

40
Q

What is the likely diagnosis?

A

Pyoderma gangrenosum

41
Q

Name one side effect of ketoconazole

A

Gynecomastia

42
Q

What is the treatment of choice for facial hirsutism?

A

Topical eflornithine

43
Q

What is the most likely dianosis?

A

Basal cell carcinoma

44
Q

What is the most likely causative organism of erysipelas?

A

Streptococcus pyogenes

45
Q

What is the most likely diagnosis?

A

Pyoderma gangrenosum

46
Q

What is the first line management for pyoderma gangrenosum?

A

Oral steroids e.g. prednisolone

47
Q

How can you differentiate between spider naevi (e.g. seen in liver failure) and telangiectasia (e.g. seen in HHT)?

A

Spider naevi can be differentiated from telangiectasia by pressing on them and watching them fill. Spider naevi fill from the centre, telangiectasia from the edge

48
Q

What is the most likely diagnosis:

A 53-year-old man presents with a nodule on his chin. He is concerned because it has grown extremely rapidly over the course of the preceding week. On examination he has a swollen, red, dome shaped lesion with a central defect that contains a keratinous type material.

A

Keratoacanthoma

49
Q

What is the most likely diagnosis:

A 68-year-old farmer presents with a skin lesion on his forehead. It has been present for the past 6 months and has grown slightly in size during that time. On examination he has an ulcerated lesion with pearly white raised edges that measures 2cm in diameter.

A

Basal cell carcinoma

50
Q

What is the most likely diagnosis:

A 34-year-old gardener presents with a lesion affecting the dorsum of his right hand. It has been present for the past 10 days and occurred after he had been pruning rose bushes. On examination he has a raised ulcerated lesion which bleeds easily on contact.

A

Pyogenic granuloma

51
Q

What is the first line treatment for dermatophyte nail infections?

A

Oral terbinafine

52
Q

Name 3 complications of erythroderma

A
  • Dehydration
  • Infection
  • High-output cardiac failure
53
Q

A 14-year-old rugby player presents complaining of a lesion he has noticed for 2 weeks on his back. On examination of his back, there is a round red ring lesion of approximately 1.5cm in diameter with a central area of clearing. The edge of the rash is elevated and scaly on palpation. Which of the following organisms is the likely cause of this lesion?

A

Fungus (ringworm)

54
Q

What is the most likely causative organism of a fungal nail infection?

A

Trichophyton rubrum

55
Q

During a 6-week baby check, you notice a flat, 30x20mm, pink-coloured, vascular skin lesion over the nape of the baby’s neck, which blanches on pressure. On further questioning, this area has been present since birth and has not changed significantly. They are developing normally.

What is the most likely underlying diagnosis?

A

Salmon patch

56
Q

What is the first line treatment for perioral dermatitis?

A

Topical or oral antibiotics e.g. doxcycline

57
Q

When is oral antifungal treatment (e.g. terbinafine) indicated for a patient with athlete’s foot?

A

If initial topical treatment for athlete’s foot fails

58
Q

You are working in general practice and see a 24-year-old male with a likely diagnosis of pityriasis rosea. What most commonly precedes this condition?

A

Viral infection

59
Q

What do the antibodies in pemphigus target?

A

The desmosomes that connect the cells

60
Q

Where on the body are keloid scars most common?

A

Sternum

61
Q

A non-healing painless ulcer associated with a chronic scar is indicative of what skin malignancy?

A

Squamous cell carcinoma

62
Q

What are Curling’s ulcers?

A

Acute gastric ulcers that develop in response to severe physiological stress, such as burns

Haematemesis is a common presentation

63
Q

A 32-year-old man is involved in a house fire and sustains extensive partial thickness burns to his torso and thigh. Two weeks post operatively he develops oedema of both lower legs.

What is the most likely cause of this?

A

Hypoalbuminaemia

64
Q

How long are patients with shingles infectious for?

A

People with shingles should be advised that they are infectious until the vesicles have crusted over, usually 5-7 days following onset

65
Q

A 35-year-old female presents with tender, erythematous nodules over her forearms. Blood tests reveal a raised calcium. What is the most likely diagnosis?

A

Erythema nodosum - likely underlying diagnosis of sarcoidosis

66
Q

Name a useful treatment for keloid scars

A

Intra-lesional steroids

67
Q

Name two complications of toxic epidermal necrolysis

A

Volume loss and electrolyte derangement are potential complications

68
Q

Name a drug which may be associated with spider naevi

A

COCP

69
Q

A 78 year-old woman presents with a poorly healing area of skin on her ankle. She has a history of deep vein thrombosis 20 years ago following a hip replacement. She currently takes Adcal D3, and no other medications. On examination there is a shallow ulcer anterior to the medial malleolus. She is otherwise very well.

What investigation would be most useful in determining further management?

A

ABPI

The most appropriate management of venous ulcers is with compression dressings, however it is important to make sure the patient’s arterial supply is good enough to allow some compression

70
Q

Describe the clinical features of alopecia areata

A

Alopecia areata is a presumed autoimmune condition causing localised, well demarcated patches of hair loss. At the edge of the hair loss, there may be small, broken ‘exclamation mark’ hairs.

71
Q

What is the treatment of choice for Bowen’s disease?

A

Topical 5-fluorouracil

72
Q

Are steroids given alongside aciclovir in the management of shinges?

A

No

73
Q

Describe the clinical features of dermatitis herpetiformis

A

Dermatitis herpetiformis is an intensely pruritic, chronic autoimmune skin condition characterised by the presence of papules and vesicles, typically affecting the extensor surfaces such as elbows, knees, and buttocks

Also associated features of coeliac disease

74
Q

What is Wallace’s rule of 9?

A

Wallace’s Rule of Nine: each of the following is 9% of the body when calculating surface area % if a burn:

head + neck, each arm, each anterior part of leg, each posterior part of leg, anterior chest, posterior chest, anterior abdomen, posterior abdomen

75
Q

What is the first line treatment for lichen planus?

A

Potent topical steroids

76
Q

A 33-year-old patient comes to see you as she has noticed an itchy rash on both elbows. It has been worsening for the past week. On examination, you see a multiple polygonal, flat-topped papular lesions that each measure 5mm diameter on the flexural surface of her elbows, bilaterally. She has no other rash on the rest of her body.

What is the most likely diagnosis?

A

Lichen planus

77
Q

What is the treatment for verrucas?

A

Topical salicylic acid

78
Q

Name 3 treatment options for actinic keratosis

A

Diclofenac, 5-fluorouracil and imiquimod

79
Q

What is the first line treatment for headlice?

A

Malathion

80
Q

What is pityriasis versicolor?

A

Pityriasis versicolor is a superficial cutaneous fungal infection caused by Malassezia furfur which usually presents on the trunk or back and is scaly is appearance

81
Q

What is the most common malignacy in renal transplant patients?

A

Skin cancer (particularly squamous cell) is the most common malignancy secondary to immunosuppression

82
Q

What is the first line treatment for non-bullous impetigo?

A

Hydrogen peroxide cream

83
Q

Which rash of pregnancy spares the periumbilicus?

A

Polymorphic eruption in pregnancy

84
Q

What is the first line treatment for a patient with rosacea who has severe papules and/or pustules?

A

A ombination of topical ivermectin + oral doxycycline

85
Q

Describe the clinical features of molluscum contagoisum

A

Presents as multiple small, raised, flesh-coloured or pearly white papules with a central dimple (umbilication). It usually affects children and spreads through direct skin-to-skin contact or via fomites

MBChB Finals (18 decks)

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