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Dermatology and Infection Flashcards

1
Q

what is erythema multiforme

A

Target lesions, little bullseyes, start back of hands and feet spread to torso
Red
Can be itchy, not always
No treatment, SELF-IMITING

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2
Q

Viral and bacterial causes of eyrythema multiforme

A

Herpes and Strep/mycoplasm

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3
Q

Drugs that causes erythema multiforme

A

Penicillin
NSAIDS
Sulphonamides
Carbamazepine

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4
Q

Can erythema multiforme be idiopathic?

A

Yes

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5
Q

What is erythema nodosum

A

Tender, red lesions that cover the shins and heal without a scar
Lasts usually 6 weeks
Can be caused by pregnancy, penicillin, sulphonamides and strep

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6
Q

What is pityriasis rosea?

A

Usually self limiting affects the face, nose and cheek area
Herald patch seen on the trunk of the body usually

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7
Q

What can pityriasis rosea develop into?

A

Fir tree longitudinal rash

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8
Q

Main forms of psoriasis?

A

Chronic plaque on the extensor surfaces (knees and elbows)
Guttate psoriasis (followed by a strep infection 2-4 weeks prior usually)

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9
Q

Guttate psoriasis meaning and what it is?

A

Gutta = tear drop shapes on the trunk
Pink scaly lesions
Usually self-limiting post strep infection

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10
Q

What management is used for Guttate psoriasis

A

Mostly self-limiting 2-3 months
Topical psoriasis tx
UVB phototherapy
Tonsillectomy to prevent recurrent strep

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11
Q

Management for chronic plaque psoriasis

A

Topical corticosteroid and vitamins D
Double vitamin D
Coal tar and topical steroid
Dithranol

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12
Q

Triggers of psoriasis

A

Trauma
Smoking
Alcohol
Stress
Drugs - NSAIDS, beta blockers, ace inhibitors and lithium

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13
Q

What bacteria causes erythema nodosum?

A

TB or strep

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14
Q

What bacteria is caused by animal bites

A

Pasteurella multiocida

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15
Q

animal bite management?

A
  1. Clean wound
  2. Co-amoxiclav OR doxycycline + metronidazole if allergic to penicillin
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16
Q

What treatment is used for human bites?

A

Co-amoxiclav

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17
Q

What is bed bugs?

A

Bugs that feed on blood at night
Cause a pruritius skin rash
Linens and bedding need a hot wash and pest control

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18
Q

What is bed bugs?

A

Bugs that feed on blood at night
Cause a pruritius skin rash
Linens and bedding need a hot wash and pest control

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19
Q

What cream can be used for most bug bites but especially bed bug bites?

A

Hydrocortisone cream

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20
Q

What is Lyme disease?

A

Bacteria borrelia burgorferi causing a bullseye rash in 1-4 weeks
This develops to headache fever arthralgia
Then later causes cardiac and neurological problems

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21
Q

What bacteria is carried by bed bugs

A

Cimex hemipetru

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22
Q

management of Lyme disease

A

Elisa test
If negative but symtpomatic repeat in 2-4 weeks
Immunoblast test
+ve and acute = doxycycline
+ve and delayed = ceftriaxone

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23
Q

What is an actinic keratosis

A

Pre-malignant skin lesion that is often skin coloured (pink/brown colour)
Crusty small and scaly
Found on sun exposed skin
Multiple lesions can be seen

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24
Q

What management is used for actinic keratosis

A

Fluoruracil cream and hydrocortisone cream for inflammation post cream tx

Topical diclofenac if mild
Topical imiquimoid can be used
Cryotherapy or cutterage to. Remove

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25
What is impetigo
Crusty, yellow/green coloured lesion usually caused by staph A (but can be caused by strep infections) Found in flexures/facial folds and limbs School exclusion until crusted or post 48 hours of antibitoics
26
Treatment of impetigo
Hydrogen peroxide 1% cream Toptical antibiotic cream (fusidic acid cream) Mucopuricin if allergic to prior Oral flucloxacillin if extensive disease
27
What types of blood ulcers are there?
Venous and arterial
28
How are venous ulcers formed?
Venous hypertension second to chronic venous insufficiency = blood stasis
29
Symptoms of blood stasis and potential venous ulcer development?
1. Oedema 2. Brown pigmentation 3. Lipodermatosclerosis 4. Eczema
30
Can impetigo impact eczema
Yes
31
Location and description of venous ulcers
Above ankle Painless Large demarkated region, irregular borders Superficial
32
Treatment of venous ulcer?
Compression banding If fail to heal >12 weeks - skin graft
33
ABPI ranges? what’s normal?
0.9-1.2
34
What number ABPI indicates arterial disease?
<0.9 >1.3
35
Location and description of arterial ulcer
Toes, heels any pressure points Deep hole punch appearance Very painful Gangrene, cold no puls and LOW ABPI
36
What’s a neuropathic ulcer
Common on plantar surfaces in diabetics Due to pressure and callous formation
37
What is pyoderma gangrenosum
Can occur at stoma sites - seen in IBD patients
38
What is a pressure ulcer
Ulcers that develop on bony prominences such as sacrum or heel Usually due to immobility - malnourishment - incontinence - immobility - PAIN
39
What score is used to screen for pressure ulcers
Waterlow score
40
Managanebt of pressure sores
moist wound healing environment - hydrocolloid dressing and hydrogels Wound swab done and ABX given Tissue viability nurse Surgical debridement if necessary
41
What is a lipoma
Benign tumour of adipoctes Smooth mobile and painless
42
Danger of lipoma?
Transition to liposarcoma - size >5cm - pain - increasing size - deep anatomical location
43
What is a keloid scar
Tumour arising from an area of trauma beyond the incision
44
Pre-disposing factors of keloids
Black Younger
45
Common sites of keloid scar?
Sternum Shoulder Neck Face Limbs Trunk
46
Management of keloid scar
1. Early = intralesional steroid 2. Excision if bad
47
heat causing burn treatment?
Remove heat source Irrigate with cool water NOT ICE COLD Cover burn in cling film
48
Electrical cause of burns
Switch off power Remove from source
49
Chemical cause of burns
Brush off powder/liquid Irrigate with cool water
50
What score is used to quantify burns
Wallace rule of 9
51
What are the Wallace’s rule of 9
Head and neck Each arm Anterior chest Anterior abdomen Posterior chest Posterior abdomen Each anterior leg
52
What is a superficial burn>
Red Painful Dry No blisters
53
What is a partial thickness superficial burn??
Pale pink Painful Blistered Slow cap refill
54
What is a partial thickness deep burn?
White patches of non-blanching redness Reduced sensation Painful to deep pressure
55
Full thickness burn - what is it??
White/brown/black in colour No pain No blisters
56
When are fluids needed for burns?
If 10/15% in children or adults
57
What is acanthosis nigricans
Symmetrical brown plaque on neck, axilla or groin (flexure regions)
58
What are causes of acanthosis nigricans
T2DM GI CANCER OBESITY PCOS CUSHINGS DRUGS
59
What is lichen Planus
Itchy rash on palms, soles, genitalia and flexor surfaces White lines on surface Oral involvement in 50% of patients
60
Management of lichen Planus
Potent topical steroids Benzydamine mouthwash Oral steroids or immunosuppression
61
What causes breakouts of lichen Planus?
Gold Quinine Thiazidess
62
What is Rosacea
Blushing papules and pustules Telangectasia Can cause blepharitis
63
Management of rosacea
Simple - high factor sun cream, camouflage cream Erythema flushing - topical brimonidine gel Mild-moderate papules - topical ivermectin Moderate - severe - topical vermectin + doxycycline oral
64
Complications of rosacea?
Rhinopyma
65
Rhinopyma treatment?
Laser treatment
66
What fungus usually causes fungal nail infections?
Trichophyton rubrum Candida can as well
67
Treatment of fungal nail infection?
Nail clipping to check for dermatophytes Topical amorolofine nail lacquer Oral terbinafine extensive Oral itraconazole
68
What is scabies
Burrowing mites in between skin webs Itching due to eggs layer 30 days post-infection
69
Management of scabies?
Permethrin Malathion Itching lasts 4-6 weeks post infection eradication.
70
What is tinea?
Fungal infection Three types of Capitis Corporis Pedis
71
What is tinea capitis?
Can cause scarring alopecia Raised pustular boggy spongy mass
72
Tx of topical capitis
Topical ketoconazole shampoo
73
Tx of tinea corporis
Oral fluconazole
74
Tx of tinea pedis
Terbinafine
75
What is cellulitis
Bacterial infection of the dermis and deeper subcutaneous tissues Usually caused by strep
76
Descriptions of cellulitis
Unilateral Well defined erythema Blisters and/ore Bullard Swelling Fever Maialsie Nausea
77
What classification system is used for management of patients with cellulitis
Eron classification
78
Managament of Eron class I?
Oral antibiotics Oral flucloxacillin Oral clarithromyacin
79
Eron class 2?
Community abx
80
Eron class 3/4
Severe, rapidly deteriorating cellulitis Admit for ABX
81
What scars can you get with acne
Ice pick scars Hypertrophic scars
82
Mild acne treatment??
Topical adapalene + topical benzoyl peroxide
83
Severe acne treatment?
Topical adapalene with topical benzoyl peroxide Topical tretinoin with topical clindamyacin WORST CASE Azelaic acid with oral lymecycline or oral doxycycline
84
What is eczema
Found on extensor surfaces and creases in older people Itchy red and flaky
85
Management of eczema
Simple emollients Topical steroids Wet wrapping
86
What is the spirochete that causes Lyme Disease?
Borrelia burgdorferi and it is spread by ticks
87
What are the early symptoms of Lyme disease?
Tick bites 1-4 weeks later (up to 30 days) Develops bulls eye rash which develop sat tick bite site and gradually gets bigger Reaches 5cm Systemic features include: - headache - lethargy - joint pain - fever
88
What happens after bulls eye rash development in Lyme disease (post 30+ days)
Severe symtpoms Cardio and neuro CARDIO - heart block - peri/myocarditis NEURO - facial nerve palsy - meningitis - radicular pain
89
What investigations are done to confirm Lyme disease?
Clinical diagnosis if bulls eye rash is present ELISA antibodies to borrelia burgdorferi is the first line test
90
If ELISA test for borrelia burgdorferi is positive then what?
Send for immunoblot test If negative repeat in 4-6 weeks time and then send for immunoblot
91
Management for confirmed Lyme disease>
Doxycycline if early disease, amoxicillin is an alternate if pregnant woman Ceftriaxone if disseminated disease
92
What is the incubation period of measles?
10-14 days before rash Infective on day 4+ of rash
93
What prodomal features are seen in measles?
Conjunctivitis Irritability Fever Koplik spots (white Buccal mucosa spots)
94
How does the rash spread in measles?
Behind ears then the whole of the body it is a glass test non-blanching rash
95
Investigations and management for measles?
IgM antibodies detectable Supportive admission if immunosuppressed or pregnant Notifiable disease = should inform public health
96
If a non-vaccinated child comes in contact with measles when should MMR be offered?
Within 72 hours of contact

UKMLA (14 decks)

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