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Finals > Dermatology > Flashcards

Dermatology Flashcards

1
Q

What are the functions of the skin?

A 
protect against environmental antigens
temperature regulation
sense
vitamin D synthesis
prevent fluid loss
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2
Q

What are the 3 layers of the skin?

A

Epidermis, dermis, SC tissue

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3
Q

What are emollients used for? give 2 examples

A

to rehydrate the skin and re-establish lipid layer.

Double base and Diprobase

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4
Q

Name the topical corticosteroid ladder?

A

Hydrocortisone –> eumovate –> Betnovate –> dermovate

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5
Q

3 examples where a topical corticosteroid might be used?

A

anti-inflammatory, anti-proliferative, autoimmune conditions, allergic conditions

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6
Q

When might oral retanoids be used?

A

acne, psoriasis

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7
Q

Side effects of oral retanoids?

A

dry skin/lips, disordered LFTs, increased cholsterol, myalgia, tetarogenic

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8
Q

How does tacrolimus act?

A

immunosuppressant. Calcineurin inhibitor.

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9
Q

What conditions is atopic eczema associated with?

A

atopic dermatitis, rhinitis, allergic asthma

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10
Q

What is atopic eczema? What is the distribution?

A

chronic relapsing inflammatory condition characterized by itchy erythematous scaly patches.
Adults - flexor surface
Infants - face and extensors

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11
Q

What is the pathophys of eczema?

A
  1. defective skin barrier function - increases exposure and sensitisation to antigens.
  2. Immune dysfunction - increased Th2 mediated response which increases IgE response
  3. Exacerbating factors - infection/soap/dust mites
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12
Q

What is the diagnostic criteria for eczema?

A

UK working party diagnostic criteria

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13
Q

What are some signs of eczema?

A

location of the lesions, pruritis, dry skin, erythematous patches, vesicles, weeping

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14
Q

signs of chronic eczema?

A

lichenification, hypopigmentation

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15
Q

Ix for eczema?

A

clinical history, serum IgE, allergy testing

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16
Q

Mx pathway for eczema?

A
  1. BASIC - hydrate skin, emollients, avoid triggers, antihistamines
  2. topical steroids
  3. increasing doses of topical steroids
  4. systemic therapy (ciclosporin)/UV therapy
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17
Q

What is psoriasis?

A

inflammatory and hyperproliferative disorder of the keratinocytes and inflammatory cell infiltrate

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18
Q

Signs of psoriasis?

A

erythematous well circumscribed scaly plaques at extensor surfaces and scalp and belly button
nail pitting, beau lines, oncholysis, arthritis

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19
Q

Management pathway for psoriasis?

A
  1. GENERAL - educate, avoid drugs/alcohol/stress which precipitate
  2. MILD - topical corticosteroids + vitamin D analogue (calcipitriol)
  3. phototherapy, methotrexate, retinoid
  4. Ciclosporin
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20
Q

What causes acne?

A

inflammation of the pilosebaceous follicles

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21
Q

How do hormones contribute to acne?

A

increased androgens increase the sebum produced. This leads to formation of comedomes and an inflammatory reaction.

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22
Q

Conditions associated with acne?

A

PCOS, cushing, puberty

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23
Q

Complications of unresolved acne?

A

hyperpigmentation, scarring, deformity, psychological and confidence issues

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24
Q

management pathway of acne?

A
  1. topical benzyl peroxide/retinoid
  2. topical antibiotic added
  3. Systemic tetracycline
  4. Oral isoretinoin

Oral contaceptive might be used in girls

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25
Q

Which cells are affected in SCC?

A

cancer of the keratinocytes

26
Q

RF for all skin cancer?

A

sun exposure, chronic inflammation, immunosuppressed, previous cancer

27
Q

What does SCC look like?

A

crusty and scaly lesion, ill-defined nodule which can ulcerate and bleed.

28
Q

What is BCC?

A

slow growing tumour of the epidermal keratiocytes arising from hair follicle.

29
Q

How do you go about describing a skin lesion?

A 
A - asymmetry
B - border
C - colour
D - diameter
E - evolution
30
Q

What is malignant melenoma?

A

invasive malignant tumour of the epidermal melanocytes, with high potential to metastasize

31
Q

What is the score used to quantify the depth of invasion on histology for skin cancer?

A

Breslow thickness score.

32
Q

What does impetigo look like? What causes it?

A

good crusting and weeping, caused by S.Aureus

33
Q

Mx of impetigo?

A

topical fusidic acid, oral fluclox

34
Q

What is cellulitis? Causes?

A

spreading bacterial infection of the deep SC tissue causing overlying skin inflammation. Erythematous, oedema, warm and tender.
CAUSE: S.Aureus

35
Q

DD for cellulitis?

A

bakers cyst, abscess, DVT, gout, necrotizing fasciitis

36
Q

Mx for cellulitis?

A

flucloxacillin

37
Q

What is scalded skin syndrome caused by?

A

toxin realised by coag +ve staph, causes blistering and fever

38
Q

Mx of scalded skin syndrome?

A

analgesia, fluclox, fluids (VERY PRONE TO DEHYDRATE)

39
Q

what is scabies?

A

infection with mites (transmitted skin to skin)

40
Q

Features of scabies?

A

pruritis, erythematous papules, linear burrows in interdigital spaces

41
Q

Ix for scabies?

A

skin scrapings - can visualised the mites and eggs with a microscope

42
Q

Mx for scabies

A

Topical Permethrin + antihistamine (treat whole family)

43
Q

Causes of a venous ulcer?

A

chronic venous insufficiency, incompetent valves, varicus veins, oedema

44
Q

Signs of venous insufficiency

A

ankle swelling, increased pigment, heavy legs, itching, varicose veins, lipodermatosclerosis

45
Q

what do venous ulcers look like?

A

large and shallow with sloping edges. They are not painful and have an irregular border.

46
Q

Ix of any leg ulcer?

A

ABPI, pulses, measure the area, swab for microbiology and biopsy

47
Q

Mx of a venous ulcer?

A

gradual compression and leg elevation, keep clean.

48
Q

Causes of an arterial ulcer?

A

atherosclerosis, tissue hypoxia

49
Q

Signs of arterial insufficiency?

A

absent pulses, pale, peripherally cold, parathesia, paralysis

50
Q

Symptoms of a arterial ulcer?

A

painful, irregular edge, grey base, no bleeding on debridement, punched out

51
Q

What must you not do to a arterial ulcer?

A

COMPRESS

52
Q

Appearance of a neuropathic ulcer?

A

punched out, surrounded by inflammation, bleeding with debridement painless, sloughy and necrotic base

53
Q

How does urticaria present? why?

A

itchy wheals - increased permeability of capillaries due to histamine released by skin mast cels.

54
Q

Mx or urticaria?

A

antihistamines

55
Q

What is angio-oedema?

A

swelling of tongue/eyelids/lips - can cause asphyxia, cardiac arrest and death.

56
Q

What is anaphylaxis?

A

life threatening bronchospasm, facial and laryngeal oedema and hypotension

57
Q

Mx of anaphylaxis?

A

IM adrenaline, airway protection, IV chlorphenamine, IV corticosteroids

58
Q

What drugs causes SJS?

A

anticonvulsants, Abx, NSAIDS

59
Q

What does SJS look like? What sign is positive?

A

detatchment of epidermis from dermis, mucotaneous necrosis and systemic toxicity. Nivolsky sign positive.

60
Q

What bacteria causes nectrotizing fasciitis?

A

group A haemolytic strep

61
Q

Presentation of NF?

A

severe pain, erythematous blistering and nectrotic pain, systemically unwell.

62
Q

Mx of NF?

A

fluids, Tazocin, surgical debridement

Finals (21 decks)

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