Dermatology Flashcards
A 67 year old man sees his GP because his wife is worried about a lesion on his back. On examination, the lesion is hyperkeratotic, non-pigmented and has started to ulcerate.
What is the most likely diagnosis?
A Melanocytic naevus B Squamous cell carcinoma C Melanoma D Basal cell carcinoma E Eczema
B - Squamous cell carcinoma
- hyperkeratotic, non-pigmented, ulcerates
A 73 year old man sees his GP because he has been experiencing episodic headaches, with no discernible trigger. He is otherwise fit and healthy, which he attributes to having a physically intensive occupation – he was a gardener for all his working life. On examination, you see a pigmented lesion on his abdomen that he says is getting bigger.
What is the most likely diagnosis?
A Melanocytic naevus B Squamous cell carcinoma C Melanoma D Basal cell carcinoma E Eczema
C - Melanoma
- headache worse on coughing/lying down = SOL (brain mets)
- gardener = sun exposure
- growing pigmented lesion = melanoma
A 14 year old boy develops an itchy rash. On observation, the skin appears dry and inflamed. There are signs of lichenification. The patient also suffers from hay fever and has allergies to penicillin and eggs.
What is the most likely diagnosis?
A Eczema B Lichen planus C Psoriasis D Herpes zoster E Cellulitis
A - Eczema
- young person, itchy rash which appears dry/inflamed
- history of atopy
- lichenification present in eczema
A 14 year old boy develops an itchy rash. On observation, the rash looks like purple plaques and it is distributed on the extensor surfaces. His nails also look abnormal; some show signs of pitting whilst the nail on his right index finger appears to be coming off the nail bed. His grandfather has the same condition, which he manages using steroids.
What is the most likely diagnosis?
A Eczema B Lichen planus C Psoriasis D Herpes zoster E Cellulitis
C - Psoriasis
- itchy rash appearing purple located on extensor surfaces
- nail pitting + onycholysis
- FHx + steroid Tx
A 65 year old woman presents to A&E with a 3-day history of a red, painful rash on her left shin. Her vital signs are all normal, and she is afebrile. Blood tests are below: Hb 12.7 g/dL(11.5-16.0) Platelets 231x10^9/L(150-400) WCC 11.3x10^9/L(4.0-11.0) CRP 44 mg/L (<10) D-dimer 219 ng/mL (<400)
What is the most likely diagnosis?
A Chickenpox B Deep vein thrombosis C Cellulitis D Erythema multiforme E Erysipelas
C - Cellulitis
- red, painful rash
- no systemic involvement (erysipelas)
A 33 year old man presents to A&E with PR bleeding and abdominal cramps, particularly in the right iliac fossa. He decided to see the doctor because he has developed a tender rash on both of his shins, which consists of purple nodules.
What is the most likely cause of his dermatological condition?
A TB B Ulcerative colitis C Psoriasis D Strep pyogenes infection E Crohn’s disease
E - Crohn’s disease
- PR bleeding + abdominal cramps + RIF pain = Crohn’s
- purple nodular tender rash on shins = erythema nodosum (ass. with IBD)
A 65 year old woman presents to A&E with a 3-day history of a red, painful rash on her left shin. Her vital signs are all normal, and she is afebrile. Blood tests are below: Hb 12.7 g/dL(11.5-16.0) Platelets 231x10^9/L(150-400) WCC 11.3x10^9/L(4.0-11.0) CRP 44 mg/L (<10) D-dimer 219 ng/mL (<400)
What is the most appropriate management?
A Topical anti-fungals B IV antibiotics C Commence sepsis 6 protocol D Oral antibiotics E Low-molecular weight heparin
D - Oral antibiotics (flucloxacillin)
- evidence of cellulitis, no systemic involvement = oral ABx (rather than IV - erysipelas)
