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MRCP 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

Guttate psoriasis

A

H/o preceding streptococcal infection
Droplet shaped
Self limiting
Recovery hastened by:
Phototherapy/topical steroids/emollients

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2
Q

Phototoxic skin reactions

A

Confluent erythema
Seen with Ciprofloxacin (all Quinolones)

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3
Q

Ustekinumab

A

Used in psoriasis
Anti IL 12 and IL 23 monoclonal antibody

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4
Q

HPV infection on fingers

A

Kissing warts, adjacent fingers involved

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5
Q

Traumatic nail change vs subungal melanoma

A

Hutchinson sign in melanoma: hyperpigmentation (blue/black) of nail bed

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6
Q

Onychomycosis

A

Yellow/brown
Brittle crumbling nails

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7
Q

Side effects of isotretinoin

A

Anaemia
Thrombocytopenia/thrombocytosis
Rise in ESR

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8
Q

Keloid scars treatment

A

intralesional triamcinalone

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9
Q

Co-prescription of tetracyclines and isotretinoin must be avoided

A

Increased risk of benign intra-cranial HTN
and pregnancy test is a must before istretinoin

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10
Q

Chediak-Higashi syndrome

A

Recurrent bacterial infections
Thrombocytopenia
Neurological symptoms
Inclusion bodies and lysosomal granules in leucocytes
Albinism

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11
Q

Oculo-cutaneous albinism

A

type 1: complete absence of melanin
type 3: reddish hair, blue/grey eyes

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12
Q

Thyroid acropachy

A

Seen in Graves
Soft tissue swelling and clubbing in hands

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13
Q

De quervain’s thyroiditis

A

Sub acute hyperthyroidism biochemically
Malaise and neck pain
Post viral illness

Treated with NSAIDs and Pred/propranolol
Not Carbimazole

Decreased uptake on radio-nucleotide scan

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14
Q

Drug of choice in late pregnancy for hyperthyroid?

A

Carbimazole
Risk of maternal hepatotoxicity with PTU

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15
Q

Drug of choice in breast feeding for hyperthyroid?

A

PTU

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16
Q

Drug of choice in early pregnancy (first trimester) for thyrotoxicosis?

A

PTU

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17
Q

Mc Cune Albright syndrome

A

Precocious puberty
Hyperthyroidism
Cafe au lait spots U/L
H/o fractures due to polyostotic fibrous dysplasia
Increased risk of osteosarcoma and breast cancer

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18
Q

Thyrotoxicosis factica

A

Low thyroglobulin levels
Abuse of thyroxine tablets
No goitre

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19
Q

Post partum thyroiditis?

A

Anti TPO positive
Upto 6 months post partum

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20
Q

Tinea capitis treatment?

A

Griseofulvin for 4-6 weeks (Microsporum)
Terbinafine (Trichophyton)
Itraconazole
Fluconazole

Topical ketoconazole not as effective

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21
Q

Tinea incognito

A

When appearance of tinea has been altered by the use of steroid creams

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22
Q

Cryptococcal meningitis

A

Initial cough, lung symptoms (pneumonitis)
Neurotropic encapsulated yeasts: Meningitis
Skin lesions like molluscum contagiousum
Rx: Amphotericin B, Flucytosine

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23
Q

Striae in pregnancy due to which hormone?

A

Cortisol

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24
Q

Erythema multiforme seen in?

A

Mycoplasma
HSV (M/C)
Penicillins
Sulphonamides

(target shaped lesions with burning sensation but non-pruritic)

Type 4 hypersensitivity reaction

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25
Q

EM major?

A

Seven Johnson’s syndrome
Mucosal involvement+

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26
Q

Pemphigoid gestationis?

A

Bullous pemphigoid of pregnancy
Rx: Topical steroids

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27
Q

Bullous pemphigoid association?

A

Psoriasis
Dementia
CVA
Parkinson’s

Rx: Oral steroids

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28
Q

Which cell infiltration in pyoderma gangrenosum?

A

Neutrophils

29
Q

Treatment escalation in pyoderma gangrenosum

A

Topical steroids/topical Tacrolimus*
Oral steroids
Infliximab/Adalimumab (TNF alpha inhibitors)
Topical/oral calcineurin inhibitors (Tacrolimus)

30
Q

Lupus vulgaris

A

Cutaneous TB
Developing countries

31
Q

Granuloma annulare

A

Skin biopsy and histology: Necrobiotic collagen surrounded by palisading histiocytes + lymphocytic infiltrate

a/w HIV, lymphoma

32
Q

High risk HPV subtypes

33
Q

Minocycline side effect

A

Hyperpigmentation

34
Q

Drug induced pseudo lymphoma syndrome

A

anti epileptics
antibiotics
anti arrhythmics
anti histamines
anti depressants

35
Q

Lofgren syndrome

A

Fever
B/L lymphadenopathy
Erythema nodosum: neutrophilic panniculitis (a/w HLA B27)

Rx: NSAIDs, steroids, immunosuppressants
compression socks

(Acute sarcoidosis)

36
Q

Erythema induratum

A

Posterior calves
Indurated nodules and plaques
TB

37
Q

Erythema marginatum

A

Acute rheumatic fever
Group A beta haemolytic streptococci

38
Q

Caplan’s syndrome

A

RA
Pneumoconiosis

39
Q

Hereditary hemorrhagic telengectasia

A

Osler-Weber-Rendu
Autosomal dominant
Telengectasia of skin and buccal mucosa

Epistaxis
GI bleed due to AVM
AVM in GI, lung, liver, brain
Microcytic anaemia

40
Q

Prophylactic Aciclovir

A

400mg BD for 1 year
>6 episodes of HSV in 1 year

41
Q

Standard treatment for genital herpes

A

Aciclovir 200mg five times/day OR
400mg TDS

42
Q

Herpetic whitlow

A

Digital herpes simplex

43
Q

Treatment of hair loss due to androgen excess

A

Topical Minoxidil
Finasteride (anti-androgen)

44
Q

Pseudoxanthoma elasticum

A

Angioid streaks in retina
Gi haemorrhage
Skin changes in axilla and neck

45
Q

Porphyria cutanea tarda

A

Fragility and skin blistering on sun exposed areas
Milia at site of healing blisters
Deficiency of uroporphyrinogen decarboxylase
RF: alcohol, sunshine, estrogen

46
Q

Morphea ie: localised scleroderma

A

Indurated/thickened plaques in females
eg: after piercing/trauma/infection hypo/hyperpigmented plaque

Rx: steroids/phototherapy/methotrexate

47
Q

Dermatitis herpetiformis Rx:

A

Gluten free diet
Dapsone

Resistant cases: Oral sulphapyridine

NOT steroids

48
Q

Psoriasis treatment escalation

A

Topical steroids/Calipotriol ie. Vit D
Narrow band UVB (if no past h/o skin cancer)
Methotrexate, ciclosporin, phototherapy
Adalimumab/Infliximab/Etanarcept
(after excluding TB; TNF alpha antagonist)
Ustekinumab (Anti IL 12/23)

Acitretin in severe pustular etc psoriasis not arthritis
?dimethyl fumarate

49
Q

How long to avoid pregnancy if taking Acitretin?

A

3 years after
4 weeks before

50
Q

Pustular psoriasis

A

Urgent hospital admission
Sin biopsy: sun corneal pustules and neutrophilic infiltration
Rx: topical emollients/topical steroids

51
Q

DH histology features?

A

IgA deposits in dermo-epidermal junction

52
Q

Psoriasis drug triggers?

A

Lithium
Anti-malarials
NSAIDs
Beta blockers
Lisinopril

53
Q

Gutatte psoriasis Rx:

A

Narrow band UVB

54
Q

Lupus pernio

A

Nose turning red over months
Cutaneous Sarcoid

55
Q

Lichen planopilaris

A

receding hair line (peri folliculitis) plus lichen sclerosis

56
Q

What is lichen planus associated with?

A

Koebner’s phenomenon
Liver diseases

57
Q

LP like reaction caused by which drugs?

A

Thiazides
Beta blockers
Phenothiazines
Anti malarials
Methyl dopa

58
Q

Koebner’s phenomenon is seen in?

A

Psoriasis
Lichen planus
Vitiligo

59
Q

Capillaritis

A

Due to prolonged exercise
Progressive pigmented purport
Schamberg disease
Pin-point macules and Cayenne pepper spots

60
Q

HSP histology

A

Perivascular IgA deposits

61
Q

Erythema nodosum Rx:

A

Colchicine

62
Q

Erythema gyratum repens

A

Paraneoplastic
Erythematous woody grainy appearance

63
Q

Drug used prior to pituitary surgery in Cushing’s with multiple medical co-morbidities

A

Ketoconazole

64
Q

What is yellow nail syndrome associated with?

A

Bronchiectasis

Rx: Spontaneous or Vitamin E

65
Q

Pityriasis rosea

A

First herald patch
Then crops of salmon pink lesions along cutaneous lines
Christmas tree distribution
HHV 6,7

66
Q

Bazar syndrome

A

Acrokeratitis paraneoplastica
Squamous cell ca of upper digestive tract

67
Q

Drugs causing photosensitive rash

A

P Phenothiazines
Q Quinine
R Retinoids
S Sulphonamides
T Tetracyclines

68
Q

Treatment of hidradenitis suppurativa?

A

Oral Tetracyclines (Doxy or Lyme)

MRCP 2 (7 decks)

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