Brainscape's Knowledge GenomeTM

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


See full index

MBChB 4 > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are the functions of skin?

A

Protection:

  • Mechanical, heat, cold, light

Metabolic:

  • Conversion of T4
  • Synthesis of Vitamin D
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What questions should be explored in history of presenting complaint for a skin condition?

A
  • How long has it beeng going on for
  • How has it progressed?
  • Has it regressed and replased?
  • Associated with exposure to anything
  • How has it affected work etc
  • How have you been trying to treat it?
  • Have you been put on any next drugs?
  • FHx of skin conditions/ Family have skin problems (lice/scabies)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the distribution of a scabies infection?

A

Ankles, Knees, Belt, flexor surface wrist, cubital fossa ( flexor surface), Axilla

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

Typically where do you not see scabies above?

A

Neck and above

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

What are the features of a macule?

A
  • Flat lesions
  • < 1cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What are the features of a patch?

A
  • Flat lesions >1cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the features of a papule?

A
  • Raised lesions
  • < 0.5mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the features of a nodule?

A
  • Raised lesions > 0.5 mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the features of plaques?

A
  • Raised edge
  • Flatter surface
  • > 1 cm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the features of a pustule?

A
  • Raised lesions filled with pus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the features of a vesicle?

A
  • Raised lesions filled with fluid < 0.5mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What are the features of a bulla?

A
  • Raised lesions filled with fluid > 0.5mm
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are the features of purpura?

A

Raised red rash that will not blanch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the features of a wheal?

A

A compressible dermal swelling

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

What feature suggestes a chronic ulcer?

A

Undermining

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

What are fungal infections associated with?

A

A fine scaly edge / patch

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

Describe the nail anatomy

A

Nail matrix

Root of nail

Proximal nail fold

Eponychium (visble part of nail that is under cuticle)

Curticle

Lanula ( halfmoon base of nail)

Peronichium

Nail plate ( Body of nail)

Hyponychium

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

What is the hair cycle?

A
  • Anagen: Growing phase
  • Catogen: Cease growing phase
  • Telogen: Resting phase
  • Exoge: Hair falls out, pushed by another new hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What questions should you ask related to hair loss?

A

Pattern of loss:

  • Generalised
  • Scarring
  • Localised

Hair denstity changes

Inflammation?

Pustules? –> Follicular plugging

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

What is telogen effluvium?

A
  • Gernalised synchronised catogen
  • Sudden abrupt hairless resulting from recent body stress
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What may cause telogen effluvium?

A

Triggered by:

  • Severe illness
  • bouts of fever
  • haemorrhage,
  • childbirth
  • severe dieting
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

How does telogen effluvium differ from aplopecia arreta?

A
  • Alopecia areata is more patchy hairloss
  • Onset is abrupt, but waxes and wanes in alopecia
  • Presence of “exclamation mark hairs” in alopecia arreta
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What conditions may cause generalised hair loss?

A

Telogen Effluvium

Alopecia areata

Malnutriton

Androgenic alopecia

Endocrine: thyroid disease

Drugs

Deficiecny: Iron, zinc, vitamin D

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

Is telogen effluvium perminent?

A

Transient loss of hair

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

What is androgenic alopecia?

A
  • Non-scarring hair loss in male pattern/female pattern balding
  • Familial
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

How does androgenic alopecia differ in men and women?

A

Men: Hair loss begins at temples and then crown

Women: Diffuse hair loss over crown. Bald areas replaced by vellos hair

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

What is traction alopecia?

A

Hair pulled out by beatification treatment, including repeated straigthening,

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

What is this?

A

Tinea capitus: Patch of scaling with broken hairs

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

What investigations should be undertaken for hair loss?

A
  • Hair pull test
  • Hair pluckings
  • Skin scraping
  • Scalp biopsy (+ immunofluorescence for CDLE)
  • Blood tests
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What electrolyte is important for hair?

A

Iron

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

Causes of scarring hair loss?

A
  • Burns/Trauma
  • Cutaneous discoid lupus erythematosus
  • Frontal fibrosing alopecia
  • Lichen planus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is this diagnosis?

A

Alopecia areata

  • Yellow/black dots
  • Broken hairs
  • Tapering hairs
  • Exclamation point hair
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is the treatment for alopecia areata?

A
  • None
  • Topical steroids/systemic steroid
  • PUVA
  • Dithranol
  • Diphenocyoprone ( causes dermatitis reaciton on scalp)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is trichotillomania?

A

Obscession in pulling out hairs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the investigations for tinea capitus?

A

Skin scramping

Hair plucking

Woods lamp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Trx for tinea capitus?

A

Oral antifungal:

Giseofluvin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What nail features may be assoicated with telogen effluvium?

A

Beaus lines

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What are the treatment for cuteanous discoird lupus erythematosis?

A

Topical Steroid

Hydroxychloroquine

Photoprotection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Treatment for andriogenic alopecia?

A
  • Minoxidil (anti-hypertensive, helps with hair regain)
  • Anti-androgens
  • Wig service
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What do Beau’s like form?

A

Acute arrest of the nail from bodily stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What conditions are associated with hirsutism?

A

Adrenal hyperplasia (adrenal tumour)

PCOS

Ovarian malignancy

Hyperprolatinaemia

Drugs: Danazol, glucocorticoids

Associatied with: Seborrhea, acne and androgenetic alopecia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What investigations should be carried out for hirsutism?

A

Testoesterone

Dehydroepiandrostone (DHEA)

Sex Hormone Binding Globulin (Free androgen index)

LH

FSH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is the most adundant circulating steroid?

A

Dehydroepiandrosterone (DHEA)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Why should you measure sex hormone binding globulin in hirsutism?

A

Measure the amount of bound and unbound steroid. Increased unbound steroid/androgen is associated with hirsuitism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is hypertrichosis?

A

Excessive hair growth in a non-andogengenic distribution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What may cause hypertrichosis?

A

Malnutrition

Anoexia

Porphyria C.T

Drugs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What drugs are associated with hypertrichosis?

A

Minodixil

Phenytoin

Cyclosporin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Is hyerptrichosis localised or generalised?

A

Both

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is this condition ?

A

Acute paronychia

50
Q

What are the organisms associated with acute paronchyia?

A

Staph aureus

Strep Pyogenes

51
Q

What is the cause of chronic paronychia?

A

Mostly candida

52
Q

This is an accral malignant melanoma. What sign is it displaying?

A

Hutchinson Sign: Spreading pigmentation

53
Q

What is a myxoid cyst?

A
  • Smooth domed swelling that contains clear jelly-like material.
  • Found on proximal nail folds
54
Q

What is genital lichen sclerosis?

A
  • Non-induated shiny macules on genital (penis / vulva)
  • Intractable itch
  • Men:
    • May cause urethral meatus stenosis
    • Fusion of foreskin to gland
  • Females:
    • Increased risk of vulval carcinoma
55
Q

What are the nail features of lichen planus?

A
  • Longitudinal ridging
  • Pterygium
56
Q

What is lichen planopilaris?

A

Scarring hair loss resulting from lichen planus on scalp

57
Q

What type of drug reaction is this?

A

Exanthematous drug erruption

(Most common type of drug erruption)

58
Q

What drugs are associated with drug erruptions?

A

Penicillins

Carbamazepine

Allopurinol

NSAID

59
Q

When can a exanthematous drug eruption occur?

A

Anywhere up to 2-3 weeks post administration

60
Q

What drug reaction typically occurs up to 36 hours after comsuming?

A

Drug induced urticaria

61
Q

What is this?

A

Erythema Nodosum

Large painful dusky plaques on shins

62
Q

What are the causes of erythema nodosum

A

SUBLOTS

Sulphonamides

Ulcerative Collitis

Bechet’s

Leprosy

Oral contraceptive pill

Tuberculosis

Sarcoidosis

63
Q

What is steven johson syndrome?

A

Mucosal errosions and epidermal detahcmenrt on < 10% of skin

  • Associated with fever
64
Q

What may steven johnson syndrome turn into?

A

Toxic epidermal necrolysis (TEN) when >30% of skin affected

Patients may become septic

65
Q

What drugs may cause steven-johnson syndrome?

A
  • Allopurinol
  • Anti-convulsants
  • NSAIDs
66
Q

What is SJS/TEN?

A

Overlap of steven johnson syndrome and toxic epidermal necrolysis (between 10-30% of skin affected)

67
Q

What is the diagnosis?

A

Erythema Multiforme

  • Discoid target lesions
  • Requires 3 distinct colours to be termed multiforme/tagret lesions
68
Q

What are the causes of erythema multiforme?

A

MIPPSS

  • Mycoplasma
  • Idiopathic (50%)
  • Penicillin
  • Phenytoin
  • Herpes Simplex
  • Sulphonamides
69
Q

What small vessel vasculitis can be associated with drug erruptions?

A

Leukoclastic vasculitis

70
Q

What drugs may cause leukoclastic vasculitis?

A

PANTS

Penicillin

Allopurinol

Aniodarone

NSAIDs

Thiazide

Sulphonamides

71
Q

What complication is associated with leukocytoclastic vasculitis?

A

Kidney failure

(It’s an IgA vascultis)

72
Q

What are the drug causes of Erythroderma?

A

Barbiturates

Beta blockers

Gold

Quinine

Sulphonamides

Hydroxychloroquine

73
Q

What diseases can cause erythroderma?

A

Psoriasis

T cell lymphoma

74
Q

What is this?

A

Erythroderma (>90% of body affected)

75
Q

What is this?

A

Lichenoid erruption

76
Q

What drugs are associated with lichenoid eruptions?

A

B blockers

Catopril (Ace inhibitor)

Thiazides

Frusemide

77
Q

What drugs promote photosensitivity?

A

Quinine

Thiazide

Doxycycline

78
Q

What drugs are associated with drug induced lupus erythematosis?

A

Beta blockers

Thiazides

Phenytoin

Hydralazine (smooth muscle dilator)

Porcainamide (anti-arrhythmatic)

79
Q

What drugs are associated with drug induced pemphius?

A

Catopril

Penicillin

Penicillamine

Gold

80
Q

What drugs are associated with drug induced pemphigoid?

A

Frusemide

Penicillamine

Penicillin

Sulphasalazine

81
Q
A
82
Q

What essential questions should you ask in history of presenting complaint for queried skin cancer?

A

How long has it been there?

Associated symptoms?

How has it progressed over time?

Have you had skin cancer before?

Immunosuppressed

83
Q

What skin cancers are mostly related to prolonged sun damage?

A

BCC

SCC

84
Q

What skin cancer is related to intermittent burst of sun damage?

A

Melanoma

Associated sites are places exposed on “sunny days” (e.g. women legs, mens torso)

85
Q

What is this?

A

Keratoacanthoma ( mimics SCC)

86
Q

What are the features of a keratoacanthoma?

A
  • Shouldered volcano
  • Central necrotic region
  • Rapid growth, then regress
87
Q

What is the Clark Level?

A

Clark 1: Confined to epidermis

Clark 2: Confied to papillary dermis

Clark 3: Full fitness to end of papillary dermis

Clark 4: Reticular dermis invasion

Clark 5: Invasion of deep subcutaenous tissue

88
Q

What are the subtypes of BCC?

A

Nodular BCC

Superficial BCC

Infiltrative (Sclerotic)

89
Q

What are the features of basal cell carcinomas?

A
  • Rodent ulcers ( crust, falls off, recrusts)
  • Rolled edges
  • Pearly edge
  • Telectangasia
90
Q

How does infiltrative BCC differ in morphology?

A
  • Poorly defined margins
91
Q

What are the subtypes of SCC?

A
  • Actinic Keratosis
  • Bowenoid disease
92
Q

Describe the features of Squamous cell carcinoma?

A
  • Scaly lesions
  • Ulcerating lesions
  • Indurated edge
93
Q

What genetic mutation do most SCC’s carry?

A

p53 tumours suppressor mutation

94
Q

What autosomal dominant genetic condition is associated wtih multiple self-healing SCC?

A

Ferguson-Smith: Chromosome 9q mutation

95
Q

Where are SCC most commonly found?

A

Lower lip and mouth ( oral cancer attributable to smoking)

96
Q

Describe surgical management for skin lesions?

A
  1. Basic excision (low risk lesions)
  2. Mohs surgery (> 6mm)
  • Recurrent lesions
  • Higher risk lesions
97
Q

What is partial thickness squamous carcinoma termed?

A

Acitinic Keratosis

98
Q

How can skin lesions be managed non-surgically?

A
  • Cryotherapy
  • Topical chemotherapuetics:
    • Imiquidmod
    • Efudex (5-flurouracil)
  • Photodynamic therapy
99
Q

What is full thickness squamous carcinoma termed?

A

Bowens disease

100
Q

Describe this lesions? What is it?

A
  • State site + size
  • Plaque with reniform projections
  • Sharply demarcated border
  • Mild crusting/ keratosis

Bowens disease

101
Q

What are the benefits of Mohs micrographic surgery (MMS)?

A
  • Surgical lesions removal + real time histology
  • Opportunity to clear margins before closing
  • Goldstandard for : SCC + High risk BCC
102
Q

When is Mohs surgery indiciated?

A
  • Contiguous tumour ( No multifocal elsions/ satelite lesions)
  • Poorly defined borders
  • Recurrent tumours
  • Critical tumour site
  • Large tumours >6mm
  • Aggressive histology
103
Q

What are the mask areas of the face?

A

Periauricular

Periorbital

Temple

Nasal

Perioral

104
Q

How would you describe Mohs surgery to a patient?

A
  • Examines 100% of tumour margins
  • Tumour is cut one layer at a time from the underside
  • If bottom layer is free of dysplastic cells, then margins are clear / If not, required to extend margins
105
Q

What are the features of an aggressive SCC?

A
  • Large > 2 cm
  • Recurrent lesions
  • Poorly differenitated
  • Perinasal / perivascular invasion ( on microscopy)
  • Rapid growth
  • Formed on previously irradiated skin
  • Immunosuppressed patient
  • Deep invasion > 4mm ( Clark 4 )
106
Q

What percentage of SCC metastasise?

A

5%

107
Q

What type of hypersenitivity reaciton is contact dermatitis?

A

Type IV

108
Q

What monitoring should be consider for oral anti-fungals?

A

LFT

May cause hepatitis

109
Q

What is a misdiagnosed tinea infeciton termed?

A

Tinea Incognito

Excessively grows due to previous treatment of steroid and immunosuppression of skin

110
Q

Names of mild, moderate, potent and very potent steroids?

A

Mild: Hydrocortisone

Moderate: Eumovate

Potent: Betnovate

Very potent: Dermovate

111
Q

What is Fucidic acid used as?

A

An anti-microbial

112
Q

When should canestin HC be considered as treatment?

A

Seborrhaic dermatitis

(Anti-fungal + steroid works as it is a fungal infected area)

113
Q

What is melasma?

A

Mask of pregnancy

(find further information)

114
Q

What is Pleva?

A

(Get notes)

115
Q

What must be monitored with dapsone treatment?

A

FBC - Dapsone may cause haemoloysis leading to anaemia

116
Q

What is palmoplantar pustulosis and what is dyshydrosiform pemphigoid?

A

(get notes)

117
Q

What are the bacterial causes of blisters?

A

Bullous impetigo ( Staph aureus)

Staph scalded skin syndrome

Necrotising fascitis (Strep pyogenes)

118
Q

What are the viral causes of blistering?

A

Herpes simplex - Eczema herpeticum
Varicella zoster - chicken pox
Coxsackie - hand, foot and mouth disease

Parapox - Orf

119
Q

What condition(s) cause intradermal blisters?

A

Pemphigus

120
Q

What condition(s) cause supradermal blisters?

A
  • Bullous pemphigois
  • Dermatitis herpetiformis
  • Linear IgA disease
  • Epidermolysis bullosa acquisita
121
Q
A

MBChB 4 (9 decks)

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