Dermatology

Question 0

Palpable purpura dx

Answer 0

Vasculitis

Question 1

Classification of bruising

Answer 1

Petechiae - 10mm

Question 2

Bruising associated conditions

Answer 2

1. HTN
2. Haemarthrosis - bleeding into joints as in haemophilia
3. Ehler’s Danlos syndrome
4. Telangiectases

Question 3

Bruising investigations

Answer 3

1. FBC - lymphocytosis (CMV, leukaemia), reticulocytes (haemolytic anaemia)
2. Platelet count - leukaemia, SLE, ITP
3. APTT
4. INR
5. VwF

Question 4

Scleroderma - presentation

Answer 4

Idiopathic collagen disease involving muscle atrophy/fibrosis and affecting the oesophagus (loss of peristalsis)

1. Gradual onset
2. Anorexia
3. Dyspnea
4. Dysphagia
5. Arthralgia

Question 5

Scleroderma - examination

Answer 5

1. Hardened skin (deforms and contracts)
2. Raynaud’s phenomenon
3. Muscle weakness

Question 6

Scleroderma - investigations

Answer 6

1. ANA - 95%

2. Anticentromere antibody

Question 7

Scleroderma - Ddx

Answer 7

1. Amyloidosis
2. Eosinophilia-myalgia syndrome
3. Nephrogenic fibrosing dermopathy
4. Scleromyxoedema
5. Toxic oil syndrome

Question 8

Scleroderma - complications

Answer 8

1. Oesophageal dysmotility with GORD and barrett’s
2. Pulmonary fibrosis (ILD)
3. Pulmonary hypertension
4. Renal crisis
5. Digital infarction

Question 9

CREST - limited scleroderma

Answer 9

1. Calcinosis (calcium deposits in tissue)
2. Raynaud’s phenomenon
3. Oesophageal dysmotility
4. Sclerodactyly
5. Telangiectasia (spider veins)