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Grace Phase 2 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

what is the most common malignant skin tumour?

A

basal cell carcinoma

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2
Q

how would you treat a baby with eczema?

A

emollient

very careful w/ topical steroids if severe [can stunt growth]

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3
Q

what causes scabies? and what lesion is characteristic

A

mite under skin

linear track lesion

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4
Q

what is an unusual feature that characterises an urticaria rash?

A

rapidly changing/moves round body

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5
Q

treatment for urticaria?

A

oral antihistamine [non-sedating, then sedating if needed]

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6
Q

management of and treatment for urticaria with angio-oedema involving mouth/throat?

A

secure airway

IM adrenaline & IV hydrocortisone

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7
Q

topical treatment for mild acne

A 
benzoyl peroxide
azelaic acid
topical antibiotics
keratolytics
retinoids
vit B3 derivative nicotinamide
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8
Q

oral treatment for moderate-severe inflammatory acne?

A

oral antibiotics [3-4 MONTHS]

hormonal treatment [co-cyprindiol] in women

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9
Q

3rd line treatment of acne if topical agents and antibiotics fail?

A

oral retinoid [isotretinoin]

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10
Q

contraindication for oral retinoids for acne?

A

teratogenic!

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11
Q

1st line/mild management of eczema

A

avoid known irritants
emollients
TOPICAL CORTICOSTEROIDS [hydrocortisone]
topical calcineurin inhibitors

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12
Q

treatment of moderate/severe eczema when topical therapies unsuccessful?

A

sedative antihistamines
UV treatment
oral prednisolone/ azathioprine/ ciclosporin

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13
Q

treatment for bacterial superinfection in eczema

A

antibiotics

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14
Q

topical treatment for psoriasis?

A 
emollients
vitamin D3 analogues
coal tar
tazarotene [vit A antagonist/retinoid]
corticosteroids
dithranol
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15
Q

systemic treatment for psoriasis

A 
oral retinoic acid derivatives
methotrexate
ciclosporin
biological agents [TNF-a blockers]
phototherapy
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16
Q

contraindication for retinoic acid derivatives in psoriasis?

A

teratogenic

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17
Q

what recurrent infection may be common in adults with eczema?

A

staphylococcus aureus

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18
Q

side effects of corticosteroids for atopic dermatitis [eczema]

A 
skin atrophy
suppression of skin barrier homestasis
telangiectasia
striae [stretch marks]
acne
hypopigmentation
hypertrichosis
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19
Q

side effects of calcineurin inhibitors for eczema?

A

burning/stinging

theoretical cancer risk

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20
Q

downsides of UV therapy for eczema

A

cancer risk

increased photoaging of skin

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21
Q

how does azathioprine work?

A

blocks DNA synthesis & therefore cell proliferation

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22
Q

what is myelotoxicity?

A

bone marrow suppression

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23
Q

why is close follow-up required when using ciclosporin for eczema?

A

narrow therapeutic window

renal impairment

24
Q

what type of drug is ciclosporin?

A

calcineurin inhibitor

immunosuppressive

25
Q

seborrhoeic dermatitis is associated with proliferation of which commensal yeast colonization?

A

malassezia

26
Q

what is seborrhoea?

A

oily skin

27
Q

common uninflamed form of seborrhoeic dermatitis?

A

dandruff

28
Q

treatment of scalp seborrhoeic dermatitis

A

anti-fungal treatment

keratolytic

29
Q

treatment of seborrhoeic dermatitis on flexures, trunk and face

A

anti-fungal

steroid [for itch]

30
Q

how do topical vitamin D analogues work?

A

inhibit cell proliferation

stimulate keratinocyte differentiation

31
Q

reason to not use dithranol for psoriasis?

A

stains bath, skin, clothes etc

32
Q

what type of drug is methotrexate?

A

DMARD

immunosuppressive [anti-proliferative, anti-inflamm]

33
Q

methotrexate inhibits metabolism of which nutrient/vitamin?

A

folic acid

34
Q

guttate psoriasis is classically triggered by what bacterial infections?

A

streptococcal

[upper resp tract]

35
Q

retinoids are derivatives of which vitamin?

A

A

36
Q

the anti-proliferative action of retinoids reduces which feature of psoriasis?

A

hyperkeratosis

37
Q

when would you consider biologics in psoriasis?

A

unresponsive to standard therapies
intolerance/contraindication to standard therapies
severity meets NICE criteria for biologic

38
Q

how do TNF-alpha antagonists work?

A

bind to TNK-a, blocking receptor mediated events [inflamm]

39
Q

4 key factors associated w/ acne

A
  1. seborrhoea
  2. comedo formation [black/white heads]
  3. colonisation
  4. inflammation
40
Q

what is rosacea?

A

chronic inflammatory facial dermatosis

flushing, erythema, papules, pustules

41
Q

treatment of rosacea

A

topical antibiotic [metronidazole]

topical azelaic acid

42
Q

2 main clinical features of urticaria

A

wheals [hives]

angio-oedema

43
Q

examples of pigmented skin lesions

A

mole [melanocytic naevus]
seborrhoeic wart
freckle [lentigo, ephelis]
basal cell carcinoma

44
Q

risk factors for melanoma

A 
UV exposure
high density freckles
red hair
>100 moles
>5 atypical moles
family history
45
Q

early signs of melanoma

A

enlargement

colour change [usually darkening]

46
Q

ABCDE of melanoma

A 
Asymmetry
Border irregularity
Colour variability
Diameter >5mm
elevation irregularity
47
Q

4 types of melanoma

A

superficial spreading
nodular
lentigo maligna [face]
acral lentiginous [palms/soles]

48
Q

differential diagnosis of melanoma

A 
benign pigmented naevus
seborrhoeic wart
freckle
pigmented BCC
pyogenic granuloma
49
Q

Tx of melanoma

A

surgical excision
B-RAF inhibitors [vemurafenib]
immunotherapy - PD-1 inhibitors [nivolumab]

50
Q

mortality rate for melanoma

A

20%

51
Q

what is toxic epidermal necrolysis

A

life threatening drug reaction causing widespread blistering and skin peeling

52
Q

which types of drugs can cause toxic epidermal necrolysis

A

Abx
anti-epileptics
NSAIDs
(+ others)

53
Q

what other types of conditions may a vitiligo Pt have

A

autoimmune e.g. pernicious anaemia, hypothyroid

54
Q

what type of dermatological condition typically causes annular lesions?

A

fungi e.g. ringworm

55
Q

local S.E.s of topical corticosteroids

A 
skin thinning > atrophy/ stretch marks
bruising
tearing of the skin
telangiectasia
worsening of condition: acne/roseacea
allergy
56
Q

what are retinoids, what effect do they have + what diseases are they useful in treating?

A

components of vitamin A
reduce hyperkeratosis [skin thickening/epithelial overgrowth]
for acne, psoriasis, keratoderma

Grace Phase 2 (9 decks)

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