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YEAR 3 & 5 CORE CONDITIONS > Dermatology 3 > Flashcards

Dermatology 3 Flashcards

1
Q

Which skin cancer has a worse prognosis?

A

Squamous cell carcinoma

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2
Q

Which skin cancer is more common?

A

Basal cell carcinoma

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3
Q

What is the main risk factor for basal cell carcinoma?

A

UV exposure with skin type 1/2

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4
Q

Describe a classic BCC

A

Pearly appearance with rolled edge and telangiectasia

Rodent ulcer

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5
Q

DNA mutation in PTCH TSG causes which skin cancer?

A

Basal cell carcinoma

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6
Q

What is a morphoeic BCC?

A

Ill-defined borders
Waxy
More aggressive

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7
Q

What surgery is performed for recurring/high risk BCCs?

A

Mohs micrographic surgery

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8
Q

How are BCCs normally treated?

A

Excision

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9
Q

What are the main precursors to SCC?

A 
Actinic keratoses (aka solar keratosis) - 10% progress to SCC
Bowen's disease
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10
Q

What does an SCC look like?

A

A non-healing ulcer

Punched out and crusted

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11
Q

How do you treat actinic keratoses?

A

Topical fluorouracil

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12
Q

What causes moles and freckles?

A

Benign overgrowth of melanocytes from basal layer of epidermis

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13
Q

When is a mole considered invasive?

A

If it penetrates the dermis

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14
Q

How do you assess a pigmented lesion?

A

ABCDE assessment

Asymmetry
Border irregularity 
Colour variation
Diameter > 6mm
Evolving

Itching + bleeding

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15
Q

Which scale measures skin types?

A

Fitzpatrick scale

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16
Q

What is a slow growing patch of brown skin (often resembles a freckle)?

A

Lentigo maligna

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17
Q

What can develop from lentigo maligna?

A

Lentino maligna melanoma = irregularly shaped brown macule that grows slowly

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18
Q

Where do malignant melanomas most commonly metastasise to?

A 
Lymph nodes
Liver
Lung
Bone 
Brain
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19
Q

What is the management of acne?

A

Single / then combo: topical steroid - topical retinoids, benzoyl peroxide, topical abx

PO abx - tetracyclines / erythrmocyin
- For max 3 months

COCP eg dianette

PO isotretanoin in specialist

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20
Q

What is a risk of dianette?

A

VTE

21
Q

Compare venous vs leg ulcers

A

Venous

  • Painless
  • Above ankle
  • Due to chronic venous insufficiency
  • Features of venous insufficiency = oedema, brown pigmentation, lipodermatosclerosis, eczema

Artieral

  • Painful
  • Toes and heel
  • May be area of gangrene
  • Cold with no palpable pulses
22
Q

What investigation may be done to investigate an arterial leg ulcer?

A

ABPI

23
Q

ABPI normal range

A

1.0-1.2 normal
0.8-0.9 mild arterial disease
0.5-0.79 moderate
<0.5 severe

NB if >1.2 indicates calcification of vessel

24
Q

What is the management of a venous ulcer?

A

Compression banding

Failure to heal after 12wks may need grafting

25
Q

Where and when do neuropathic ulcers occur?

A

Commonly on plantar surface of metatarsal head and plantar surface of hallux

DIabetic pt

26
Q

What ulcer is associated with IBA / RA?

A

Pyoderma gangrenosum

27
Q

Where does pyoderma gangrenosum arise and what does it look like?

A

Stoma sites

Erythematous nodules or pustules which ulcerate

28
Q

What is a Kaposi sarcoma?

A

Tumour of vascular and lymphatic endothelium

29
Q

How does kaposi sarcoma present?

A

Purple cutaneous nodules

30
Q

Who does kaposi sarcoma tend to affect?

A

Elderly males

Those with HIV

31
Q

What is a keloid scar?

A

Tumour like lesions that arise from the connective tissue of a scar and extend beyond the dimensions of the original wound

32
Q

Who is most affected by keloid scars?

A

Darker skin
Young
Commonly sternum, shoulder, neck, face

33
Q

What is the management of keloid scars?

A

Intra-lesional steroids eg triamcinolone

Excision occasionally needed

34
Q

What is a ganglion?

A

Cyst arising from a joint or tendon sheath

Usually back of wrist
3x more women

35
Q

How long do ganglions last for?

A

Several months then usually disappear

36
Q

What is a cherry hemangioma?

A

Campbell de Morgan spot

Benign proliferation of mature capillaries

37
Q

What is the most common cause of neck swelling?

A

Reactive lymphadenopathy

38
Q

Which lump in the neck may move up when swallowing?

A

Thyroid swelling

39
Q

What neck lump moves up with the protrusion of the tongue?

A

Thyroglossal cyst

40
Q

What may cause dysphagia, regurgitation, halitosis, aspiration and a chronic cough?

A

Pharyngeal puch

41
Q

What is a branchial cyst?

A

Mobile cystic mass that develops between sternocleidomastoid muscle and the pharynx

Due to failure of the obliteration of the second branchial clet in embryonic development

42
Q

What can cause a pulsatile neck mass which doesn’t move on swallowing?

A

Carotid aneurysm

43
Q

What is a cystic hygroma?

A

Error in development of lymph sacs causing a lump typically on left side of neck
Noted at birth

44
Q

What is an extra rib that forms above the first rib called?

A

Cervical rib

More in F

45
Q

What can people with a cervical rib develop?

A

Thoracic outlet syndrome (10%)

46
Q

What are some important questions to ask when someone presents with a groin mass?

A

Cough impulse?
Pulsatile and expansile?
Are both testes intrascrotal?
Any lesions in the legs eg malignancy or infections
Soft, small and very superficial (lipoma)?

47
Q

Which groin hernia has the greatest risk of strangulation - direct / indirect / femoral hernia?

A

Femoral

48
Q

Compare positions of direct and indirect inguinal hernia

A

Direct = medial to inferior epigastric artery

Indirect = lateral to inferior epigastric artery

YEAR 3 & 5 CORE CONDITIONS (30 decks)

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