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F24 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Causes of erythema multi forms

A

Infection: 90%
- mycoplasma
-HSV

Drugs 10%
- NSAIDs
- abx: sulphonamides
- anti-epileptics

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2
Q

Description of erythema multiforme

A

Target lesions
Raised plaques
Confluent
Erythema

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3
Q

Describe herpes zoster opthalmicus

A

Vesicular
Small lesions
Dermatomal over V1
Erythematous
Unilateral

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4
Q

5 complications of herpes zoster opthalmicus

A

Eye: keratitis, uveitis, acute glucoma
Optic neuritis
Progressive outer retinal necrosis
Disseminated herpes zoster
Meninigoencephalitis
Ramsey hunt syndrome
Blindness
Heretic ulcers
Post herpetic neuralgia
Social/ employment complications
Analgesia dependent

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5
Q

Who requires admission for herpes zoster opthalmicus

A

Severe ocular involvement - globe
Pain requiring IV opiates
Systemically unwell
Immunocompromised

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6
Q

Blistering skin eruptions ddx

A

Erythema Miltiforme
Ten/SJS
Toxic shock syndrome
Staph scalded skin syndrome
Bullous Pemphigoid
Pemphigus vulgaris
Sunburn
Kawasaki
Insect bite
Impetigo
Drug reaction

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7
Q

Vesicular lesions

A

Primary varicella
HSV oral, genital, whitlow eczema
Hand foot and mouth cocksackie
Allergic and contact dermatitis

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8
Q

Maculopapular rashes

A

Viral exanthum
Erythema infectiousum
Roseola
Measles
Rubella
Infantile
Kawasaki
Scarlet fever
drug reaction dress

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9
Q

Petechial rash

A

cutaneous: trauma/ steroid use
Systemic: uraemic von wile brand disease
Infectious: meningococcal, influenza; haemophilia, streptococcus
Thrombocytopenia: itp, ttp, hITS, DIC, liver failure
Vasuclitis: hsp, Kawasaki chrug stras
Coughing, vomiting

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10
Q

Definition
Macular
Patch
Papule
Nodule
Petechiae
Pupura

A

Macular: flat discloration <10mm,
Patch: flat discolouration A>10mm
Papule raised <10mm
Nodule raised <10mm
Petechiae <3mm
Pupura >3mm

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11
Q

Diagnosis of Kawasaki

A

Crash and burn
Fever >5/7
4/5 criteria
1. Conjunctivitis, bilateral bulbar
2. Rash- polymorphous rash
3. Adenopathy, >1.5cm in cervical region
4. Strawberry tongue, mouth, mucosal involvement
5. Hand and feet hyperaemia, desquamatisation

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12
Q

Incomplete Kawasaki

A

Fever 5/7
And 2/3. Criteria

Or <6m and fever for 7 days unexplained

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13
Q

Ix Kawasaki

A

Fbc, crp, esr
Lfts, albumin alt
UA
Echo: coronary A aneurysm
Asot / anti dnase scarlet fever

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14
Q

Tx Kawasaki

A

Aspirin 5mg/kg
IVIG 2g/kg 10 days - prevent coronary artery aneurysm

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15
Q

Echo Kawasaki when

A

Diagnosis
2 weeks and 6 weeks

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16
Q

What is most common vasculitis in children

A

Henoch Schlein Pupura
IgA vaculitis
2-8 year olds

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17
Q

Henoch Schlein Pupura
IgA vaculitis
Age
Symptoms

A

Age 2-8 year olds
Symptoms
- palpable Pupura: lower limbs
- renal involvement: 25% Haematuria, proteinuria
- abdominal pain heme positive stool

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18
Q

Investigation and follow up hsp

A

Urinalysis and BP
Renal function
Weekly 1 month
Fortnightly 1 m
6 and 12m

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19
Q

Complications HSP

A

Interception and perforation
Renal failure

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20
Q

Erythema nodosum
Causes

A

Idiopathic
Infections: HSV, HIV, hepatitis, EBV,
Bacterial: streptococcal, TB, Yesenia
Drugs: sulfonamides, OCP, sulphonyureas
Inflammatory: sarcoidosis, IBD, bacterial, sle
Malignancy: lymphoma, leukaemia
Pregnancy

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21
Q

What is erythema nodosum symptoms

A

Tender nodules eryhematous, bilateral, subcutaneous nodules
Most: LL, ankles

Symmetrical pre tubial is most common
Tender nodule
Poor margins
1 week hard
2nd fluctuat
Lesions last 2 weeks
Arthralgia 90%

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22
Q

Biopsy of erythema nodusum

A

Michener granuloma

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23
Q

Treatment of erythema nodosum

A

Treat cause
Cease drugs
NSAIDs
Steroids
Follow up derm/ rheum

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24
Q

TeN// SJS different

A

SJS: <10%
SJS/ TEN 10-30%
TEN >30%

Severe cutaneous condition
Extreme necrosis and
Detachment of epidermis

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25
Q

Nikolsy sign

A

When pressure on skin leads to lateral expansion and detachment of the epidermis

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26
Q

Causes of SJS/ TEN

A

Drugs
1. ABX: penicillins, sulphonamides,
2. Anticonvulsants: carbamazapine, keepra
3. NSAIDs
Other
4. Malignancy
5. Infections: mycoplasma, hsv, hiv
6 autoimmune: sle

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27
Q

Erythema multi form
Minor and major

A

Minor - no mucous membrane involvement
Major - mucous membrane involvement less then 2

SJS/ ten - >2 mucous membrane
Staph scalded skin syndrome - nil

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28
Q

Complication of SJS/ ten

A

Fluid and electrolytes
Hypothermia
Pain
secondary bacterial infections
Sepsis
Ards
Mof

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29
Q

Erythema mulifrome causes

A

Infection: hsv, mycoplasma, ebv, adenovirus
Drugs: penicillin, NSAIDs, sulfonamides
Malignant

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30
Q

Erythema multiforme rash

A

Target lesions: darker central zone, light pink, bright red
Erythematous macular
Base raised plaque
Lesions central sparing
Varying size
Limbs- proximally

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31
Q

Scroten score

A

Mortality
Age >40 = 1
Hear rate >120= 1
Cancer/ malignancy =1
Epidermal detachment >10% =1 on day one
Urea >10 =1
Glucose >14 =1
Baird -<20mmol = 1

0-1= 13%
2 = 12%
3= 35%
4 = 60%
5 = 90%

32
Q

What type of sensitive reaction is scabies
Pathognomic rash
Treatment

A

Type 4
Linear burrows
Rash- small erythema is, Papule, hemorrhagic cysts
Tx/ permethion cream 5%

33
Q

What is symptoms of bachets disease

A
  1. Relapsing uveitis
  2. Oral ulcers
  3. Genital ulcers
    Vasculitis
34
Q

Biggest risk factor of cellulitis

A

Lymphedema

35
Q

Risk factors for cellulitis

A

Immunosupression
Diabetes
Immunodeficiency
Cancer
Venous stasis
Chronic liver disease
Peripheral arterial disease

36
Q

Causes of urticaria

A

Drugs: penicillin, sulfa, aspirin, NSAIDs, morhine
Infection: ebv, hep b cockamamie
Environment: dust, heat cold, animals
Foods: fish, eggs, fruit
Other: latex

37
Q

Abcde melanoma

A

Asymetry
Border irregularity
Colour variation
Diameter >6mm
Evolution

38
Q

What is association psoriasis
What is it

A

Hla b27
Autoimmune skin condition related cd 4 and 8 r cells

39
Q

Auspik sign

A

When plaques removed in psoriasis leads to pin point bleeding

40
Q

Treatment of psoriasis

A

Topical emollient
Steroids
Vitamin A and D ointment t
Cold tar
Immunomodulators
Uv therapy

41
Q

What is associated Gerald patch

A

Pityriasis rosea
Herald path- 5-10 days widespread rash
Trunk and limb
Christmas tree on back
HPV 6,7,8
Tx reassurance

42
Q

Treatment bullous pemphigoid

A

Doxycycline

43
Q

Different bullous pemphigoid and pemphigus vulgaris

A

Bollous pemphigoid
Age >60
Intensely puritic large tense blisters
Rupture form erosions
No mucous membranes
Nikolsy -ve

Pemphigus vulgaris
Younger 40-60
Involves mucous membranes
Flaccid blisters
Nikolsy sign +ve

44
Q

What causes erypsealis

A

Beta haemolytic streptococci pyogenes

45
Q

Erypsealis rash

A

Intense erythematous plaques well demarcated tender and raised
Upper dermis only

46
Q

Bite injuries abx
1st line

A

Augmentin 875/125 bd for 5 days

Or
Doxy 100mg bd
Bactrim 1 bd
Ciprofloxacin 450 tds
Levofloxacin 750 od
Plus one of
Metronidazole 500mg po tds
Clindamycin 450 tds

47
Q

What organisms in human bites

A

Staph
Viridian strep
Ekinella

48
Q

What organism causes moluscum contagiosum

A

Poxvirus

49
Q

What rash is umbilcated small flesh coloured dome Papule S

A

Molluscum contagiosum

50
Q

Hand foot and mouth

A

Cocksackie virus

51
Q

Rosella

A

Human herpes virus 6

52
Q

Erythema migrans

A

Lymes disease

53
Q

Erythema marginatum
Disease related to

A

Rheumatic fever
Macular with central clearing spares face

54
Q

Erythema infectiosum

A

Slapped cheek
Parovirus b19
Circumoral palor

55
Q

What is ritters diseases

A

Staph scalded skin syndrome

56
Q

What causes staph scalded skin syndrome

A

Exotoxin A/B
Break down desmosomes causing detachment within epidermal layer

57
Q

Rocky Mountain spotted fever
Organisms

A

Ricketsia ricketsia
Macular rash on wrists ankles spares face

58
Q

3 Cs measles

A

Conjunctivitis
Cough
Coryza

59
Q

Mesels rash

A

Mobilitorm coarse blotches
Starts face 1-2 days
Spreads down
Kopilk - white spots in mouth 1-4 days pre rash

60
Q

Measles MMR who gets dose

A

< 6 m immune
>6months non immune
>12 m 1 dose receive early

Immunocompromised or pregnancy or children -<6m

61
Q

When infectious in measles

A

3-4 days pre rash
Post exposure fever 10 days
Rash 14 days post

62
Q

Complications of measles

A

Acute otitis media
Pneumonia - leading cause of death
ADEM - acute disseminated encephalomyelitis
SSPE - sub acute pan encephalitis

63
Q

What causes eczema herpetiform

A

HSV
Disseminated viral skin reaction complicating atopic eczema
Normal skin barrier is compromised

64
Q

Common causes of contact dermatitis

A

Cosmetic dyes
Plants
Metals- nickel
Chemicals
Latex
Rubber
Photosensitive

65
Q

Diagnostic criteria for eczema

A

Pruotic skin conditions
Plus 3 of
- hx of skin creases, elbows, knees and cheeks
- ph asthma, hay fever
- hx dry skin
- hx visible flex oral eczema
- onset <2 years

Scorad - scoring atopic dermatitis

66
Q

What is erythroderma rash

A

> 90% inflammatory skin conditions erythema
Exfoliation
Oedema
Serous ooze
Eyelid swelling
Secondary infection
Lymphadenopathy

67
Q

Causes of erythroderma

A

Secondary to chronic skin condition
- pre existing dermatitis atopic, contact
Pre existing psoriasis
Pre existing blisters
Generalised drug reaction
Malignancy
Other physical
Infection

68
Q

Complications of erythroderma

A

Dehydration
Electrolyte loss
Hypothermia
Pain
Secondary bacterial infection
Protein loss
High output cardiac failure

69
Q

Causes of toxic shock syndrome

A

Tampons
Osteomyelitis
Wounds
Post miscarriage

70
Q

Causes of toxic shock syndrome
Organisms

A

Life threatening inflammatory reaction caused by infection with toxins
Staph or strep pyogenes

71
Q

Treatment toxic shock

A

IVF
Supportive
ABX - flucloxacillin and clindamycin
Vasopressin

Strep
- Ben pen
- clinda

72
Q

Symptoms toxic shock

A

Hypotension
Fever
Rash - diffuse eyrthematous
Desquamatisation
Headache
Reduced LOC

73
Q

Staph scalded skin syndrome caused by
Age

A

Exfoliative toxin producing staph aureus - lysis
Children <5 years
Symptoms: widespread rash, progresses to blisters, rupture to burns
Fever and irritability
Systemically well
Nikolsy +ve
Good prognosis
No mucous membrane s

74
Q

Most common skin cancer

A

BCC

75
Q

Precursor SCC

A

Actinic keratosis

F24 (22 decks)

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