Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

royal college exam > Dermatology > Flashcards

Dermatology Flashcards

You may prefer our related Brainscape-certified flashcards:
Royal College: Emergency Medicine flashcards
1
Q

Erythematous rash in newborn that SPARES folds…

A

Contact dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Erythematous rash in newborn INVOLVING folds…

A

Candida

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Treatment of mild acne

A

Topical retinoid +/- anti-inflammatory (benzoyl peroxide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

TWO risk of giant congenital nevus (> 20cm predicted adult size)

A
  1. Leptomeningeal melanocytosis (CNS involvement) 2. 1-2% risk of developing melanoma (with almost 100% mortality)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

First line treatment of scabies

A

5% permethrin - leave on overnight, treat close contacts, repeat in 1 week

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

First line treatment of head lice

A

1% permethrin x 15 mins, repeat one week later

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MRSA skin abscess management, < 1 month

A
  • admit - drainage - vancomycin IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MRSA skin abscess, infant 1-3mos, no surrounding erythema/cellulitis

A

Septra (if concern for cellulitis, add keflex)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MRSA skin abscess > 3 mos

A

I&D, send for culture

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Name of the skin lesion associated with SJS & TEN

A

Erythema multiforme

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SJS

A

< 10% skin involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Toxic epidermal necrolysis

A

> 30% skin involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Sturge-Weber syndrome

A
  • nevus flammeus (port-wine stain) in V1 - glaucoma - leptomeningeal angioma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Infants with subcutaneous fat necrosis are at risk of

A

hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

If resistant lice (failure of treatment), what can you treat with?

A

Resultz

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

If a teen with acne failed topical anti-inflammatory/antibiotics + retinoids; what else can you do?

A

Doxycycline Anti-androgens (in female patients) Add topical retinoids/benzoyl peroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Treatment for tinea capitus

A

oral terbinafine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Treatment of comedonal acne

A

retinoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Treatment of inflammatory acne - mild

A

retinoids + anti-inflammatory (benzoyl peroxide + antibiotic)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Name the lesion, when they occur, natural history

A

Halo nevus

May occur during puberty or pregnancy

The central pigmented nevus may disappear and the depigmented area usually repigments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Name the lesion

A

Spitz nevus

(pink/red, smooth, dome-shaped, firm, hairless papule)

usually < 1cm

local recurrence happens after excision 5% of the time

if suspect melanoma, excise entire lesion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Syndromes associated with the development of melanoma (3)

A

Familial mole-melanoma syndrome

Dysplastic nevus syndrome

BK mole syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Definition of atypical nevus

When do they appear?

Management

A

Acquired, 5-15mm, round to oval, irregular margins/colour

Usually develop in puberty

Management: skin exam Q6-12 mos, photos, sun protection, monitoring for melanoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What meds should you think of if someone has photosensitivity?

A

NSAIDs

Diuretics

Voriconazole

Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is Nikolsky sign?

A

Applying slight pressure with the thumb, the skin will wrinkle and the epidermis will separate from the dermis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does isotrentoin (Accutane) work for acne?

A

Isotretinoin reduces size and secretion of sebaceous glands, normalizes follicular keratinization, prevents new microcomedone formation, decreases the population of P. acnes, and exerts an anti-inflammatory effect.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How long should someone avoid becoming pregnant after stopping Accutane?

A

at least 6 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

How can you prevent the teratogenic effect of Accutane?

A

Counsel patients to use 2 forms of birth control, do monthly pregnancy tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is this? Why does it occur?

A

Traction alopecia, common in black school-aged children, due to trauma from tight-braids, headbands (increased risk if chemically-relaxed hair)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Clinical features of Trichotillomania

A

Pulling, twisting, breaking of hair producing irregular areas of hair loss. Remaining hairs are various lengths and are blunt tipped (from breaking). Scalp appears normal.

Closely related to OCD.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is this probably caused by?

A

Trichotillomania

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Which cells in the skin are important for making Vit D?

A

Spinous cells in the epidermis

33
Q

How would you recognize a Langerhans cell under electron microscopy?

A

Birbeck granule

34
Q

What type of hair is on your body? (short, soft, less pigmented)

A

Vellus

35
Q

What type of hair is on your head, eyebrows, beard, etc?

A

Terminal (coarse hair)

36
Q

What happens to your hair during puberty?

A

Androgens stimulate pubic, axillary and beard hair to change from vellus to terminal

37
Q

What is vernix in the newborn?

A

Produced by stimulation of the fetal sebaceous glands by maternal androgens

AND

desquamated stratum corneum cells

38
Q

Eccrine sweat glands on the palms and soles respond to…

A

psychophysiologic stimuli (stress!)

39
Q

Eccrine sweat glands on the hairy body surfaces respond to…

A

Body temperature

(Supplied by a sympathetic nerve, sweating is mediated by acetylcholine)

40
Q

What is an erosion?

A

Focal loss of epidermis

Heals without scarring

41
Q

What is an ulcer?

A

Lesion extending INTO dermis

Heals with scarring

42
Q

What is a Wood lamp, and what can you use it for?

A

It emits UV light at 365 nm

Useful for detecting hypopigmented macules (TUBEROUS SCLEROSIS!), certain superficial fungal infections of the scalp

43
Q

Ways to test for viruses (HSV, VZV)

A

Tzanck smear

Direct fluorescent assay

PCR

44
Q

What is this rash?

A

Malar rash, associated with SLE

45
Q

This rash appears in a 2 weeks old infant. What is it? What is it associated with?

A

Neonatal lupus

Manifest during the first weeks to months of life (annular, erythematous, scaly plaques on head/neck/trunk)

May be worsened by light exposure

Due to maternal transfer to anti-Ro/La, levels of these antibodies wane by 6 mos

10% of babies with NL have both 3rd degree heart block and skin findings

Should do labs to check for cytopenias, cholestases etc

46
Q

Skin findings of Juvenile Dermatomyositis

A

Heliotrope rash - over eyelides (or racoon eyes)

Gottron papules - over knuckles

Shawl sign - telangiectasians over shoulders

Nail fold telangectasias

Palmar hyperkeratosis “mechanics hands”

47
Q
A

Gottron’s papules of Juvenile dermatomyositis

48
Q

What is this?

What condition is it associated with?

A

Pyoderma gangrenosum

Ulcerative colitis, Crohn’s disease

49
Q

What is Sweet syndrome?

A

A tender, erythematous plaque/nodule on skin associated with

fever

anemia

leukocytosis

biopsy: neutrophilic infiltrate

50
Q

Rash of a glucagonoma?

A

Necrolytic Migratory Erythema

51
Q

When do medication-related skin eruptions occur?

Classic findings?

A

7-10 days after exposure

Start on trunk, spread peripherally, usually pruritic

May have eosinophilia

52
Q

Common medications causing drug eruptions?

A

Penicillins, cephalosporins

Sulfa drugs

NSAIDS

AEDs (carbamazepine, phenytoin, phenobarb)

53
Q

When does the rash of GVHD occur?

A

1-3 weeks after transplant, at the time of engraftment

54
Q

What is DRESS (triad)

A

Drug reaction with eosinophilia and systemic symptoms

Triad: Fever, rash, hepatitis

Occurs 1-6 weeks after exposure to the medication

30% of patients have eosinophilia

55
Q

This patient is on septra. He developed neutrophilia, fever and this rash. What is this rash called?

A

Acute generalized exanthematous pustulosis (AGEP)

Often drug-related (penicillins, macrolines, sulfa drugs)

Non-follicular, sterile pustules with underlying erythema

Associated with neutrophila, fever

Tx: stop drug! May need steroids

56
Q

Side effects of topical corticosteroids

A

Atrophy

Striae

Telangectasia

Aneiform eruptions

Purpura

Hypopigmentation

Increased hair growth

57
Q

2nd line treatment for eczema (does not thin skin)

A

Elidel, protopic (tacrolimus, pimecrolimus)

58
Q

Term infant, what is this?

A

Sebaceous hyperplasia, will disappear within the first few weeks of life

59
Q

Newborn infant, what is this?

A

Milia

Superficial epidermal inclusion cysts, contain keratinized material

1-2mm

Pearly white

On face, and in mid-line palate (Epstein pearls)

60
Q

What are Epstein pearls

A

Milia on the midline of the palate

61
Q

Newborn back

A

Mongolian spots (slate-gray nevus)

Found in people with darker skin tone

Look blue-ish because the melanocytes are arrested in their migration to the epidermis (mid-dermal)

Usually fade during first years of life, do not have malignant degeneration

62
Q
A

Erythema toxicum:

firm, yellow-white, 1- to 2-mm papules or pustules with a surrounding erythematous flare

Peak incidence day 2 of life

Smear shows eosinophils

63
Q

Newborn rash

Three types of lesions

A

Transient neonatal pustular melanosis

THREE TYPES OF LESIONS:

  1. Pustules (+PMNs) w/ NO erythema
  2. Ruptured pustules (colarette)
  3. Hyperpigmented macules (may persist up to 3 months!)
64
Q

Rash that starts at 2-10 months of age, more common in black males

Discrete erythematous papules / vesicles / pustules

Very pruritic

On hands, soles

Episodic, lasting 7-14 days

Cyclic x 2 yrs

A

Infantile Acropustulosis

65
Q
A

Aplasia Cutis (developmental absence of skin)

multiple or solitary, non-inflammatory, well-demarcated ulcers

may have collar of hair

associated with syndromes/diseases: Patau (Trisomy 13), epidermolysis bullosa

66
Q

Dyskeratosis Congenita - TRIAD

A

Reticulated hyperpigementation of th eskin

Dystrophic nails

Mucous membrane leukoplakia

(also: bone marrow failure, increased squamous cell carcinoma!)

67
Q

Causes of Erythema Multiforme

A

HSV

Develops 10-14 days after onset of HSV

68
Q

What is this? What is it associated with?

A

Erythema multiforme

(Target lesions)

Associated with HSV

Lesions typically resolve in 2 weeks

Does NOT progress to SJS

69
Q

Treatment of Erythema Multiforme?

A

Supportive - topical emollients, anti-histamines, NSAIDs

Avoid steroids (no evidence, may make sxs worse)

70
Q

Causes of Stevens-Johnson Syndrome

A

Mycoplasma pneumoniae

Drugs - sulfa, NSAIDs, antibiotics, AEDs

Genetic predisposition - Han Chinese (certain HLA types) develop this after receiving carbamazepine

71
Q

SJS vs TEN

A

Rash + involvement of > 2 mucous membranes (eyes, GI, GU, resp) forming bullae, ulcers, hemorrhage

SJS < 10%

TEN > 10% + skin tenderness, no target lesions

MUST consult ophtho - scarring can lead to vision loss

Infection is the leading cause of death

72
Q

What is this?

A

Staph scalded skin syndrome

73
Q

How do you differentiate TEN from staph scalded skin?

A

SSS - Nikolsky sign is widespread, perioral crusting/erythema, sparing of intra-oral mucous membranes (can have crusted lips, conjunctivitis)

TEN - Nikolsky sign over erythematous skin, hx of drug ingestion

(also, BIOPSY!)

74
Q

Do the bullae in staph scalded skin grow any bugs?

A

nope! they are sterile - the separation of the epidermis is due to toxin production

75
Q

Treatment for staph scalded skin

A

IV cloxacillin + clindamycin (to stop production of toxins)

76
Q

Medications causing pseudoporphyria (photosensitivity reaction)

A

NSAIDs

Tetracyclines

Diuretics

Sulfa drugs

77
Q

Baby with suspected PHACE syndrome. What other tests should you do to work-up?

A

ECHO - can have cardiac abnormalities like coarct

Ophtho exam - eye anomalies (glaucoma, cataracts)

MRI brain - posterior-fossa abnormalities, dandy-walker malformation

78
Q

these lesions developed in a female newborn

the vesicles were high in eosinophils, and the systemic WBC shows eosinophilia

what condition should you think of?

A

Incontinentia pigmenti

x-linked dominant

due to mutation in IKK-gamma/NEMO gene

royal college exam (32 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions