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Dermatology Flashcards

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Dermatology Board Prep flashcards
1
Q

what does iatrogenic mean

A

caused by a drug (medication)

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2
Q

define prevelance

A

total number of cases (of a disease) within the population at any one time

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3
Q

define incidence

A

the number of new cases of a disease defined as the % of the population who develop the disease over a fixed period of time

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4
Q

what skin conditions are becoming more popular

A

skin cancers, venous leg ulceration, atopic dermatitis

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5
Q

what is illness behaviour

A

the ways in which given symptoms may be differentially perceived, evaluated, acted upon (or not acted upon) by different kinds of person

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6
Q

what is illness

A

the experience of discomfort and suffering

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7
Q

what can stigma relating to a skin problem lead to

A

a social handicap

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8
Q

what is acneiform

A

eruptions that resemble acne vulgaris, dont have comedones (blackheads)

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9
Q

what is a punctum

A

puncture mark

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10
Q 
list in order from outer to inner most
basement membrane 
basal layer
connective tissue
keratin layer
prickle cell layer
capillary cell wall 
granular layer
A 
keratin layer
granular layer 
prickle cell layer 
basal layer 
basement membrane 
connective tissue 
capillary cell wall
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11
Q

what does the ‘venom’ in mosquito bites do

A

oppose vasoconstriction, blood coagulation, platelet and immune responses

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12
Q

what are the three main cell types involved in IgE reactions and their roles

A

B cells (recognised antigen and produce antigen specfic IgE antibody)

T cells (cytotoxic, help B cells)

mast cells (release inflammatory mediators and vasoactive substances)

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13
Q

what vasoactive substances are released by mast cells

A

preformed

  • histamine
  • tryptase
  • heparin

synthesised on demand

  • leukotrienes
  • prostaglandins
  • cytokines (IL4 and TNF)
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14
Q

what effects do the vasoactive substances released by mast cells have on the dermis

A

increased blood flow

contraction of smooth muscle

increased vascular permeability

increase secretions (at mucosal surfaces)

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15
Q

what are the 5 defining features of anaphylaxis

A

laryngeal/ pharyngeal oedema

bronchospasm (wheeze)

tachypnoea (resp rate)

tachycardia

hypotension and potential cardiovascular collapse

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16
Q

what does indurated mean

A

beginning to harden

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17
Q

define cellulitis

A

spreading infection in the dermis that is not associated with necrosis

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18
Q

what do sebaceous glands secrete to defend against pathogens

A

hydrophobic oils, lyzsozome (destroys bac cell walls), ammonia (anti-bac), antimicrobial peptides (defensins)

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19
Q

name 7 cells of the innate immune response

A

monocytes/macrophages

neutrophils

dendritic cells

basophils

mast cells

eosinophils

NK cells

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20
Q

name 3 soluble mediators of the innate immune system

A

acute phase proteins (CRP)
cytokines
complement

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21
Q

are antbodies (immunoglobulins) and cytokines innate or adaptive proteins

A

adaptive

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22
Q

what does PVL do

A

kills leukocytes

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23
Q

what are the antiphygocytic virulence factors of s aureus (2)

A

capsule, protein A

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24
Q

what is the adhesin virulence factor of s aureus

A

fibrinogen binding protein

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25
Q

from which cells do malignant melanomas of the skin arise

A

melanocytes in the basal layer of the epidermis

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26
Q

what does breslow thickness refer to

A

the distance between the granular layer and the deepest tumour cell

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27
Q

what is the cause of the redness in atopic ezema

A

inflammatory cytokines causing leaky vessels and vasodilation

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28
Q

why is atopic eczema patchy

A

due to airborne patterns of allergens

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29
Q

what foods can make acne worse

A

highly processed foods, diary

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30
Q

why does combination pill help acne

A

blocks testosterone

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31
Q

what are features of severe acne

A

pseudocysts and nodules

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32
Q

what is the role of eccrine glands

A

moisten palms/soles for grip, temp regulation

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33
Q

what is the role of apocrine glands

A

scent glands

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34
Q

what is the role of meissners corpuscles

A

vibration sensation

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35
Q

what is the role of pacinian corpuscles

A

pressure sensation

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36
Q

when do sweat glands develop

A

6 months gestation

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37
Q

what layer of epidermis is most metabolically active

A

basal layer

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38
Q

how does porhpyria cutanea tarda usually present

A

in older age, blisters on sun exposed areas, crusting over and scarring

39
Q

what is maceration

A

the softening and breakdown of skin resulting from prolonged exposure to water

40
Q

where are highly metabolically active small cuboidal cells found

A

in the basal layer

41
Q

where are odland bodies found

A

in the granular layer

42
Q

where is the hyponychium

A

underlying the free edge of the nail plate

43
Q

what is the role of fibroblasts

A

collagen synthesis

44
Q

what is the role of sebaceous glands

A

skin lubrication (produce sebum)

45
Q

name the condition:
A 3 year old boy presents on a sunny day in June. His mother reports he keeps crying and rubs at his skin when playing outside and this has been going on for a few weeks. His skin is sometimes a bit red, but there is never a rash and his skin is clear on examination now. He is skin type 1 with a few freckles evident, generally well, on no medication and there is no family history of skin problems.
What is the most likely diagnosis?

A

erythropoietic protoporphyria

46
Q

what are nails made of

A

densely packed keratin

47
Q

do fingernails or toenails grow faster

A

fingernails

48
Q

how long does it take for a cell to migrate from the basal layer to the keratin layer

A

28 days

49
Q

where does nuclei loss start and finish

A

starts at granular layer, finishes in keratin layer

50
Q

what makes up 80% of the keratin layer

A

keratin and fillagrin

51
Q

how thick is the granular layer

A

2-3 cells thick

52
Q

what percentage of GP consultations are skin problems

A

19%

53
Q

what mediates type 2 and 3 reactions

A

IgG, IgM

54
Q

what enzyme is deficient in acute intermittent porphyria

A

porphobilinogen deaminase

55
Q

give the meaning of each phase:
anagen
catagen
telogen

A

a-growing phase
c- involuting phase
t-resting phase

56
Q

what cell carries out vitamin D metabolism

A

keratinocytes

57
Q

where is collagen found

A

dermis

58
Q

where do cells in the epidermis proliferate from

A

basal layer

59
Q

where are fibroblasts found

A

dermis

60
Q

where is ground substance found

A

in the dermis

61
Q

what is ground substance

A

substance found between cells and fibres in the dermis

62
Q

what component of MRSA causes severe skin infections e.g NF

A

panton valentine leukocidin

63
Q

are sebaceous glands attached to hair follicles

A

yes

64
Q

what is the most common sweat gland in the face

A

eccrine

65
Q

where are langerhan cells formed

A

in the bone marrow

66
Q

what is the path of langerhans cells

A

migrate through the epidermis and dermis and travel via lymphatics to present antigen in lymph nodes

67
Q

what does the virulence factor aggressin do

A

causes damage to host directly

68
Q

what does the virulence factor impedin do

A

evades hosts defence mechanisms

69
Q

what does the virulence factor modulin do

A

casues damage to host indirectly

70
Q

what does the virulence factor invasin do

A

invades hosts tissue

71
Q

how does erythropoietic protoporphyria present

A

in early childhood with discomfort, itch or tingling in sun exposed skin- often no clinical signs

72
Q

what enzyme is deficient in Erythropoietic protoporphyria

A

ferrochelatase- causes a build up of protoporphyrin IX

73
Q

what allows the passive diffusion of topical steroids across plasma membranes

A

their lipophillic properties

74
Q

what are the effects of topical steroids

A

anti-proliferatives (inhibit cell growth)
anti-inflammatory
vasoconstrictive

75
Q

what affects absorption of topical steroids

A

skin thickness, skin state, occulsion, vehicle, drug concentration

76
Q

what investigations for rignworm

A

skin scraping for microscopy, culture and woods light

77
Q

what is present in 90% of neurofibromatosis type 1 cases

A

cafe au lait macules

78
Q

out of these, which is autosomal dominant

  • red hair
  • tuberous sclerosis
  • atopic dermatitis
  • xeroderma pigmentosum
  • psoriasis
A

tuberous sclerosis

79
Q

what are signs and symptoms of roscaea

A

erythema, telangiectasia, papules, pustules and sometimes lymphoedema

80
Q

what is dithranol used for

A

psoriasis

81
Q

what type of HPV causes cervical cancer

A

16 and 18

82
Q

why are creams more likely than ointments to cause contact sensitisation

A

as creams contain preservatives

83
Q

what is commonly seen in history of patients with bullous pemphigoid

A

itch in the months preceding the onset of the blistering

84
Q

what foods do you exclude in coeliac diease

A

wheat, barley and rye

85
Q

what is the 1st and 2nd line treatment for roscaea

A

1st topical metronidazole

2nd oral tetracycline

86
Q

what is papillomatosis

A

rare dermatosis characterised by asymptomatic small, flat and keratosic papules (form of acanthosis nigricans)

87
Q

does chronic actinic dermatitis (photosensitivity) increase you risk of SCC

A

no

88
Q

does long term topical steroid use in atopic dermatitis increase your risk of SCC

A

no

89
Q

should compression bandages be used in arterial ulcers

A

no

90
Q

what is the difference between nodular and superficial BCC

A

nodular presents as a raised nodule

superficial presents as a slowly growing thin erythematous plaque

91
Q

what is the order of components of the scalp from inside to outside

A 
periosteum 
loose connective tissue
aponeurosis 
connective tissue 
skin

THINK SCALP

92
Q

what is the most common cancer in the UK

A

BCC

93
Q

what is the chance of getting MM in uk in lifetime

A

1 in 77

Dermatology (23 decks)

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