Dermatology

Question 1

what genes are associated with psoriasis?

Answer 1

HLA-B13, HLA-B17, HLA Cw6

Question 2

what immune cells are involved in the pathophysiology of psoriasis?

Answer 2

T cell activity stimulates keratinocyte proliferation, T helper cells prpducing IL-17 designated Th17

Question 3

what are the environmental conditions that make psoriasis worse?

Answer 3

skin trauma, stress, triggered (e.g. streptococcal infection) or improved (e.g. sunlight) by environmental factors

Question 4

what is the treatment of hirsutism?

Answer 4

weightless
cosmetic techniques
oral contraceptive pill - co-cyprindiol (dianette) or ethinylestradiol and drospirenone (Yasmin)
facial hirsutism - topical eflornithine - contraindicated in pregnancy and breast feeding

Question 5

causes of hypertrichosis?

Answer 5

drugs: minoxidil, ciclosporin, diazoxide
congenital hypertrichosis lanuginosa, congenital hypertrichosis terminalis
porphyria cutanea tarda
anorexia nervosa

Question 6

what is the commonest cause of hirsutism?

Answer 6

PCOS

Question 7

how do you assess hirsutism?

Answer 7

Ferriman-Gallwey scoring system

Question 8

which skin conditions appears in the last trimester of pregnancy?

Answer 8

polymorphic eruption of pregnancy

Question 9

which skin condition is associated with the 2nd and 3rd trimester of pregnancy?

Answer 9

pemphigoid gestationis

Question 10

which skin condition is associated with the 2nd and 3rd trimester of pregnancy?

Answer 10

pemphigoid gestationis

Question 11

which skin type never tans, always burns (often red hair, freckles and blue eyes)?

Answer 11

Fitzpatrick skin type I

Question 12

which skin type usually tans, always burns?

Answer 12

Fitzpatrick skin type II

Question 13

which skin type always tans, sometimes burns (usually dark hair and brown eyes)?

Answer 13

Fitzpatrick skin type III

Question 14

which skin type always tans and rarely burns (olive skin)?

Answer 14

Fitzpatrick skin type IV

Question 15

which skin type sun burns and tanning after extreme UV exposure (brown skin, e.g. Indian)?

Answer 15

Fitzpatrick skin type V

Question 16

Black skin (e.g. afro-carribbean) never tans, never burns?

Answer 16

Fitzpatrick skin type VI

Question 17

common side effect for isotretinoin?

Answer 17

dry skin, eyes, lips/mouth

Question 18

what should females be on while using isotretinoin?

Answer 18

females should ideally be using two forms of contraception (e.g. Combined oral contraceptive pill and condoms)

Question 19

features of lichen plants?

Answer 19

purple, pruritic, papular, polygonal rash on flexor surfaces. WIckham’s striae over surface
oral involvement common

Question 20

lichen sclerous features

Answer 20

itchy white spots typically seen on the vulva of elderly women

Question 21

what are the four main diagnostic criteria of Osler-WEber, Rendu syndrome?

Answer 21

epistaxis: spontaneous, recurrent nosebleeds
telangiectases: multiple at characteristic sites (lips, oral cavity, fingers, nose)
visceral lesions: for examples GI telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM

family history: a first degree relative with HHT

Question 22

what are features of the rash that presents with meningococcal septicaemia

Answer 22

meningism, non-blanching rash

Question 23

what are the features of the rash associated with scarlet fever?

Answer 23

strawberry tongue, facial sparing

Question 24

what are the features of the rash associated with chicken pox?

Answer 24

itchy, starting on head before spreading, macular>vvesicular>papular

Question 25

what are the features of the rash associated with measles?

Answer 25

starting on face, spreading to body, koplik spots

Question 26

what is a strawberry nave?

Answer 26

infantile haemangiomas are soft raised vascular swellings on the skin surface - usually bright red in colour

Question 27

what is a salmon patch?

Answer 27

flat, dull red areas found on the face or neck

Question 28

what is a port wine stain?

Answer 28

vascular birthmark that tend to be unilateral deeper or purple in color do not resolve spontaneously and in fact darken and become raised over time

Question 29

what skin condition is associated with Parkinson's disease?

Answer 29

seborrheic dermatitis

Question 30

what conditions should be considered if oral lesions can be wipes off?

Answer 30

candiasis and lichen plans

Question 31

what conditions should be considered if oral lesions cannot be wiped off?

Answer 31

leukoplakia

Question 32

what conditions are associated with vitiligo?

Answer 32

``` type 1 diabetes mellitus Addison's disease autoimmune thyroid disorders pernicious anaemia alopecia areata ```

Question 33

what part of the skin does pemphigus affect?

Answer 33

antibodies target the desmosomes that connect the cells they burst easily

Question 34

what conditions cause pyoderma gangrenosum?

Answer 34

``` idiopathic in 50% inflammatory bowel disease: ulcerative colitis, Crohn's rheumatoid arthritis, SLE myeloproliferative disorders lymphoma, myeloid leukaemias monoclonal gammopathy (IgA) primary biliary cirrhosis ```

Question 35

what complication is most associated with psoralen plus PUVA therapy?

Answer 35

squamous cell cancer

Question 36

which type of melanoma invades aggressively and metastasizes early?

Answer 36

nodular melanoma

Question 37

what is the most common type of malignant melanoma?

Answer 37

superficial spreading

Question 38

what commonly precedes pityriasis Rose?

Answer 38

viral infection - recent respiratory tract infections

Question 39

what is a common locations for keloid scars?

Answer 39

sternum

Question 40

what is the most typical feature of a superficial spreading melanoma?

Answer 40

changing mole

Question 41

what factors exacerbate plaque psoriasis?

Answer 41

trauma alcohol drugs: beta blockers, lithium, antimalarials (chloroquine and hydroxychloroquine), NSAIDs and ACE inhibitors, infliximab withdrawal of systemic steroids

Question 42

what is the most common type of BCC?

Answer 42

nodular BBC

Question 43

what score is used to assess pressure ulcers?

Answer 43

Waterloo score - takes into factor BMI, nutritional status, skin type, mobility and continence