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MSRA General > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What is the stepwise management of chronic plaque psoriasis?

A
  1. Potent corticosteroid + Vit D OD for up to 4 weeks
  2. > 8 weeks and no improvement - give vit D BD
  3. 8-12 weeks no improvement then offer potent corticosteroid BD up to 4 weeks OR coal tar O/BD
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2
Q

What are some secondary care management methods for chronic plaque psoriasis?

A

Phototherapy
-UV B
-psoralen + UV A

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3
Q

What are some side effects of phototherapy?

A

Skin ageing, SCC

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4
Q

What are the systemic therapy options in the management of chronic plaque psoriasis?

A
  1. Methotrexate
  2. Ciclosporine
  3. Systemic retinoids
  4. Biological agents
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5
Q

How is scalp psoriasis managed?

A
  1. Potent topical corticosteroid OD for 4 weeks +/- adjuncts if no improvement
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6
Q

For which type of psoriasis is the following management used? Mild or moderate corticosteroid O/BD for 2 weeks

A

Facial/Flexural/Genital

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7
Q

How do vitamin D analogues work?

A

Reduce cell division and differentiation which leads to reduced epidermal proliferation

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8
Q

How are capillary haemiangiomas managed in children?

A

Propranolol

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9
Q

Which virus causes molluscum contagiousum and which family of viruses does it belong to?

A

Molluscum contagiousium virus

Poxviridae family

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10
Q

Which condition is often seen along with molluscum

A

Atopic eczema

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11
Q

How does molluscum present?

A

Pink white papules with central umbilication up to 5mm in diameter

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12
Q

Which part of the body is not affected by molluscum

A

Palms and soles

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13
Q

What is the management option for eczema and itching related to molluscum

A

Emollient or mild topical corticosteroid

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14
Q

Which patients with molluscum should be referred

A

HIV +ve (GUM)
Eyelid margin or ocular lesions (Ophthal)
Anogenital lesions (GUM)

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15
Q

Which drug class commonly causes SJS

A

Anti-epileptics

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16
Q

Which common medications can cause SJS

A

Penicillin
Sulphonamides
Anti-epileptics
Allopurinol
NSAIDs
OCP

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17
Q

Which malignancy is most common in post renal transplant patients

A

SCC

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18
Q

What should the margins be in SCC excision

A

< 20mm 4mm
>20mm 6mm

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19
Q

What are the management options for Actinic Keratoses

A
  1. Topical fluorouracil
  2. Topical diclofenac
  3. Topical imiquimod
  4. Cryo/curettage
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20
Q

What is the causative agent of serborrhoeic dermatitis?

A

Malassezia furfur

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21
Q

What are the classic features of seborrhoeic dermatitis?

A

Eczematous lesions in the scalpe, periorbital, auricular and nasolabial folds

Otitis external and blepharitis

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22
Q

What are some skin disorders associated with pregnancy

A

Atopic eruption
Polymorphic eruption
Pemphigoid gestationis

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23
Q

Which is the commonest skin disorders associated with in pregnancy

A

Atopic eruption

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24
Q

When is polymorphic eruption of pregnancy seen and how does it present

A

Third trimester
Pruritis
Abdominal striae

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25
Q

How is polymorphic eruption managed?

A

Emollients, mild topical or oral steroids

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26
Q

How do pemphigoid gestationis present?

A

Pruritic blistering lesions

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27
Q

How does pemphigoid gestationis spread?

A

Peri-umbilical outwards in the 2nd/3rd trimester

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28
Q

How is pemphigoid gestationis treated?

A

Oral corticosteroids

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29
Q

What are some side effects of topical corticosteroid treatment?

A

Skin depigmentation
Skin atrophy
Excessive hair growth

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30
Q

Which are the mild and moderate topical corticosteroids

A

Mild - hydrocortisone Moderate - betamethasone, clobetasone

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31
Q

Potent and clobetasol corticosteroids

A

Potent - fluticasone, betamethasone

Very potent - clobetasol

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32
Q

Which are the most common medications associated with the development of erythema nodosum

A

Penicillins
Sulphonamides
COCP

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33
Q

What are some causes of erythema nodosum

A

Strep
TB
Brucellosis

Sarcoidosis
IBD
Behcets
Malignancy
Pregnancy

34
Q

Which common cardiac drug is known to exacerbate plaque psoriasis

A

Beta-blockers

35
Q

Which antihypertensives are known to exacerbate psoriasis?

A

ACEi

36
Q

Which drugs can exacerbate psoriasis

A

Beta blockers
NSAIDs
ACEi
Lithium
Infliximab
Antimalarials

37
Q

When should antivirals be prescribed in Shingles?

A

Within 72 hours of onset of symptoms

38
Q

Which is the first line antiviral for herpes zoster?

A

Oral Famciclovir or Oral Valacyclovir

39
Q

Which are they. Most commonly affected dermatomes in shingles

A

T1-L2

40
Q

If the pain is not improving with neuropathic or OTC meds, in shingles, what else may be used?

A

Oral corticosteroids if in the first 2 weeks in immunocompetent adults

41
Q

How does lichen planus present?

A

Itchy, popular rash - palms, soles, genitalia and flexors

42
Q

Wickhams striae are seen in which condition?

A

Lichen planus

43
Q

What is Koebner phenomenon

A

New skin lesions in lichen planus

44
Q

How is lichen planus managed?

A

Potent topical steroids

45
Q

How is oral lichen planus managed?

A

Benzydamine mouthwash

46
Q

How are bullous pemphigoid and pemphigus vulgaris differentiated?

A

No mucosal involvement = bullous

Mucosal involvement = pemphigus vulgaris

47
Q

What is the different in blister type between pemphigoid and pemphigus

A

Pemphigoid - tense
Pemphigus - flaccid

48
Q

Dermatitis herpetiformis is associated with what?

A

Gluten sensitivity and coeliac disease

49
Q

Which group of people is pemphigus vulgaris more common in?

A

Ashkenazi Jewish

50
Q

How is pemphigus vulgaris managed?

A

Steroids + immunosuppressants

51
Q

How does livedo reticularis present?

A

Purplish, none blanching, reticulated

52
Q

Which conditions are associated with Vitiligo?

A

Autoimmune conditions such as thyroid disease, pernicious anaemia, SLE, alopecia, T1DM, Addisons

53
Q

Which mediations might be used in the management of Vitiligo?

A

Topical corticosteroids

54
Q

What are the criteria for mild, moderate and severe acne?

A

Mild: open and closed commodores with little to no inflammation

Moderate: widespread non-inflamm lesions + papule and pustules

Severe: inflammatory lesions, nodules, pitting, scarring

55
Q

For mmild to moderate acne, what is the treatment?

A

12 week course of retinoid/retinoic acid + antibiotic or benzoyl peroxide

56
Q

Which groups cannot take tetracylines?

A

Preggos
Beastfeeding
< 12y

57
Q

What is a complication of long term topical antibiotic use in acne?

A

Gram negative folliculitis

58
Q

Port Wine stain can be associated with which other condition?

A

Sturge Weber

59
Q

Tear dropped shape rash =

A

Guttate psoriasis

60
Q

Macular papular vesicular rash with crusting =

A

Chickenpox VZV

61
Q

Which condition classily precedes Guttate psoriasis?

A

Strep throat

62
Q

How does briminodine work?

A

Alpha adrenergic agonist

63
Q

Which drugs are used in the management of acne rosacea?

A
  1. Topical Ivermectin or metronidazole or azalaic acid
  2. Topical ivermectin + doxy if severe
  3. Flushing - briminodine
64
Q

Which conditions are associated with Vitiligo?

A

T1DM, Addisons, Autoimmune thyroid problems, pernicious anaemia, alopecia

65
Q

What is the difference between scarring and none scarring alopecia?

A

Scarring involves destruction of the hair follicle

66
Q

Which conditions are linked to scarring alopecia

A

Lichen planus, discoid lupus, tinea capitis

67
Q

which drugs can cause none scarring alopecia?

A

Cytotoxic drugs, colchicine, OCP, heparin, carbimazole

68
Q

What is the difference between a Curling’s ulcer and a Cushing’s ulcer

A

Curlings - after burns
Cushing’s - after severe head trauma

69
Q

Herald patch =

A

Pityriasis rosea

70
Q

Raised pearly white umbilical lesions =

A

Molluscum

71
Q

Which skin conditions are associated with diabetes?

A

Necrobiosis lipoidica
Candida
Staph
Neuropathic ulcers
Vitiligo
Lipoatrophy
Granuloma annulare

72
Q

Target lesions =

A

Erythema multiforme

73
Q

How can pityriasis be diagnosed?

A

Woods light showing yellow green fluorescence

74
Q

Which drugs cause erythema nodosum

A

Penicillins, sulphonamides, COCP

75
Q

What are the common causes of impetigo?

A

S. aureus
S. pyogenes

76
Q

How is impetigo treated?

A
  1. Hydrogen peroxide 1% if not unwell
  2. Topical fusidic acid
  3. Topical mupirocin if (2) fails or MRSA
  4. Oral fluclox in extensive disease (erythro if pen allergy)
77
Q

Which is the most common type of BCC

A

Nodular

78
Q

Which antihistamines are none sedating?

A

Loratadine
Cetirizine

79
Q

Which areas can plaque psorias commonly affecyt

A

Extensors
Scalp
Shins
Trunk

80
Q

Itchy papulovesicular rash =

A

Dermatitis herpetiformis

81
Q

Which is the best skin test for contact dermatitis?

A

Patch testing

MSRA General (7 decks)

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