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Dermatology Flashcards

1
Q

Where are Langerhan Cells usually found?

A

In the Stratum Basalis

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2
Q

Where and what do the Merkels cells do?

A

Base of epidermis

Gentle - localised pressure

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3
Q

Where and what do the Meissner corpuscles do?

A

Immediately below Epidermis
- heavy on palms and lips

Light touch

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4
Q

Where and what do Ruffini’s corpuscles do?

A

In the dermis

Deep pressure and stretching

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5
Q

Where and what do Pacinian corpuscles do?

A

Deep dermis

Deep touch and proprioception

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6
Q

What is a Macule:

A

Flattened area of abnormality.

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7
Q

What is a papule:

A

Raised area of skin

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8
Q

What is a Pustule:

A

Raised, full of pus

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9
Q

What is a plaque:

A

Raised large area of skin. like a papule but much larger. can often be crusted.

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10
Q

What is a Vesicle:

A

Small blister formation

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11
Q

What is a bulla:

A

Large blister formation

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12
Q

What is erythematous:

A

Red, inflamed

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13
Q

What must be present for the diagnosis of acne vulgaris?

A

At least 3/4 of the following:

  • Papules
  • Pustules
  • Erythema
  • Comedones
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14
Q

What is the gene that is thought to be associated with atopic eczema and may be associated with other atopic pathologies such as asthma?

A

Filaggrin

- chromosome 1

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15
Q

What is it called when the herpes virus infects someone (usually infant) with eczema leading to wide spread papules which are itchy and sore?

A

Eczema Herpeticum

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16
Q

What is is called when there is direct damage to the skin via a substance, involving no immune reaction? i.e. it has a direct noxious effect?

A

Irritant contact dermatitis

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17
Q

If a female comes into the clinic with acne, which much worse during particularly times of the menstrual cycle and is overweight, what should you be thinking as a possible cause?

A

Polycystic ovarian syndrome

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18
Q

What are the main types of acne?

A

Vulgaris

Fulminans
- emergancy

Steroid

Inversus

Rosacea

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19
Q

What is needed to make a diagnosis of acne?

A 
Comedones 
papules 
pustules 
and/ or 
erythema
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20
Q

What must females be placed on if taking isotretinion A?

A

Pregnancy prevention program

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21
Q

What infection may be a risk factor for developing psoriasis and what type would someone develop?

A

Strep infection.

Gluttate
- short lived

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22
Q

What are the major types of psoriasis?

A

Plaque

Gluttate

Keobner

  • occurs in place of trauma
  • usually around scars

Inverus

Palmer pustular

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23
Q

What is the genetic susceptibility in eczema?

A

Filaggrin

- chromosome 1

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24
Q

Outline the pathophysiology of atopic eczema

A

Type I Hypersensitivity reaction

edema pushes the keratinocytes apart causing pickling.

leads to itching and cracking

Lichenification occurs

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25
What is it called when there is a co- infection of eczema and herpes?
Eczema Herpeticum
26
What are second line treatments for eczema?
Immunosuppressive UV Oral retinoids Biological agents
27
What are the main subtypes of eczema?
Atopic Contact Seborrhoeic dermatitis Venous
28
What is the pathogen in Seborrhoeic dermatitis? Also what is it commonly known as in babies?
Pityrosporum Ovale Cradle cap
29
What is the treatment of seborrhoeic dermatitis?
Ketoconazole shampoo Antimicrobial face wash steroid cream moisturisers UV
30
How does UV light increase the risk of skin cancer?
Immunosuppression: Trans UCA transformed to Cis UCA Cis UCA switches off immune cells. Direct cellular damage: - free radicals - double stranded DNA break - mutations in p53
31
What are some key symptoms of a skin cancer?
Increase in size Itchiness Ulceration/ bleeding
32
What gene is usually damaged in basal cell carcinoma?
PTCH gene | - suppressor protein as mpat of the sonic hedgehog pathway
33
What's a type of excisional surgery that can be used on cancerous cells?
Mohs Micrographic surgery
34
Name two premalignant conditions of squamous cell carcinomas:
Actinic kertatosis Bowen's disease - carcinoma in situ
35
What measurement is used to work out prognosis of melanoma?
Clinical appearance histological - Breslow's depth
36
What are the surgical excisions for melanoma?
<1mm = 1cm margin >1mm = 2cm margin
37
List the treatment options for melonoma:
Surgical excision Immunotherapy - PDLA-4 = Ipilimumab Immune check point - MEK inhibitors BRAF v600E inhibitors - Vemurafenib Imaging for metastasis assessment of lymph nodes
38
What the most common pathogens of impetigo? and what is the treatment?
S. Aureus S. Pyogenes **Fusidic acid
39
What the classification system used for cellulitis?
Enron Classification
40
Whats the drug choice for OPAT in cellulitis?
Ceftriaxone
41
What are some common pathogens that are associated with bites? What is the treatment:
S. aureus S. Strep Anaerobics Pasteurella Capnocytophaga - these two are common in cats treatment: 1st: Co-amoxiclav 2nd: doxycycline + metronidazole Surgical debridement Prophylactic treatment: - rabies - tetanus
42
When an IV drug user comes in with an infection, what else should be done out with cultures and antibiotics?
chest x-ray echocardiogram
43
What is the bacteria associated with highly virulent and contagious boil formation on the skin?
PVL staphylococcus PVL is an exotoxin produced by S. Aureus
44
What the phases of hair growth?
Anagen - nourishment Catagen - follicle detaches Telogen - follicle falls out
45
What is the immune mediated type of hair loss seen? list some types of presentation with it? and what is a poor prognostic sign? How is it treated?
Alopecia Areata: Immune development against hair follicles. associated with other immune conditions such as thyroid disease. - Localised alopecia areata - Alopecia totalis - Alopecia universalis Treated: - Clobetasol - topical steroid - topical immunotherapy - 5% minoxidil
46
What the type of hair loss that occurs due to stress?
Telogen effluvium
47
What is it called when there is a psychological problem of hair pulling?
Trichotillomania
48
List some skin conditions seen in diabetes:
Necrobiosis Lipoderca - yellow/ red patches on shins Diabetic dermopathy - brown spots on shins Sceledema - hardening and thickening of skin Granuloma Annulare - small papule rings that join together to form large rings Type III Aconthosis Nigricans
49
If there was an islet tumour of the pancreas, what skin disease may you see? and how does it present?
Necrolytic migratory erythema - blistering rash with scaly plaques usually around the mouth
50
If a person had lung cancer, what skin condition may you see? how does it present and list some other cancers it is associated with:
Erythema Gyratum Repens Circular, woodgrain pattern Breast cervical G.I
51
If a person had adenocarcinoma of G.I tract what skin condition might you see?
Type I acanthosis nigricans
52
In B6 deficiency what skin condition may you see?
Pyridoxine dermatitis | - around lips and mouth
53
In zinc deficiency, what skin condition may you see?
Acrodermatitis enteropathica
54
If a person has inflammatory condition such as, Chrons or RA, or even myeloma, what skin condition may they have?
Pyoderma Gangrenosum
55
In acute erythroderma, what is the pathology and what are the complications?
inflammatory reaction involving nearly the entire skin. usually due to drug reactions. complications include: - infection - temperature dysfunction - high output heart failure significant loss of fluids
56
What drug may cause venous ulceration?
Nicrorandil
57
What investigations should be done when someone has a venous ulcer? What are the scores?
Ankle brachial pressure Index. <0.8 ratio - occlusion >1.1 ratio - calcification
58
How does cellulitis and impetigo differ?
Impetigo is infection in the superficial levels - honey crusted with discharge where as cellulitis is deeper dermis and subcut tissue. usually presents with fever and deep red rash
59
What drug may cause Psoriasiform rash?
Beta Blockers | Lithium
60
Name a drug that commonly causes a fixed rash?
Paracetamol
61
What cancer is associated with PTCH gene defects?
Basal cell carcinoma
62
Which type of blistering condition causes the entire epidermis to lift up? and how does this contrast to another blistering condition?
Bullous Pemphigoid Pemphigus - affects the desmosomes - leading to intra epidermal skin splitting.
63
What the biggest cause of erythema multiforme?
HSV
64
What is the classification system used for cellulitis?
Enron system
65
What kind of rash does a Tick bite cause and what is the bacteria implicated in it?
Erythema Migrans Borrelia Burgdorferi
66
Name a skin manifestation that comes about due to IBD and what are the symptoms:
Erythema Nodosum Extremely painful across the shins. Also associated Step infections
67
List several histological differences you would see in palmer skin vs skin from the arm:
Palmer skin: - is thicker and contains Stratum lucidum - there is lack of sebaceous glands - Lack of hair follicles Think skin: - dermal papilla are much more pronounced
68
List some histological findings of Psoriasis:
Parakeratosis - retention of nuclei at top of the skin Increased mitotic figures in the basal layer Infiltration of lymphocytes and macrophages Increased/ prominent capillaries
69
Describe the gross features of psoriasis:
Demarcated salmon pink coloured plaque with silver loose scale surrounding - inflamed - white scales
70
Define plaque:
Elevated superficial solid skin lesion that >1cm in diameter
71
What disease is associated with Telectangasia within the nails?
SLE
72
What is the pathophysiology underlying SJS?
Formation of a [Maculopapular rash] and Bullae to the epidermis coming off the papillary junction due to apoptosis of the keratinocytes - induced by CD8 Cells T cell mediated immune reaction. * *this can only truly confirmed by biopsy of the skin where - keratinocyte apoptosis will be seen - peeling of the epidermis of the papillary junction
73
What are some common symptoms of SJS, some causes and how is it treated?
Prodrome - flu like symptoms Peeling maculopapular rash with blistering across <10% of skin. commonly affects oral/ gum area. Treated with: Admit to ICU ABC approach - removal of drugs or causes - and restrict any sulphur containing drugs - Fluids IV - loss of fluid through burns - Dressings - Pain management - Infection control - possible use of IV IgGs - Special mattress protection
74
What are some characteristic findings of Erythema Multiform
Target lesion - which has a centre of blistering - which allows it to be differentiated from other target lesions. Due to HSR most commonly associated with HSV
75
What tests would you carry out for Urticaria:
FBC ESR - checking for vasculitis Eosinophil count ANAs Thyroid tests - associated with underactive thyroid

Phase 3 (50 decks)

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