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AMC MCQ - You Can Do It!!!!!❤️❤️ > Dermatology by Dr Cintia > Flashcards

Dermatology by Dr Cintia Flashcards

1
Q

Precancerous skin lesions

A
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2
Q

Melanoma INVESTIGATION BEST

A

Surveillance:
- First 2 years: e/3m
- Next 2 years: e/6m
- After: e/1y
- 1st Deg Rel: Skin check
e/1y

For the patient with a history of melanoma:

  • First 2 years: Examination every 3 months (e/3m)
  • Next 2 years: Examination every 6 months (e/6m)
  • After 4 years: Examination every year (e/1y)

For first-degree relatives (due to increased risk):

  • Skin check: Examination every year (e/1y)

These surveillance intervals help in early detection of recurrence or new melanomas, optimizing patient outcomes through timely intervention.

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3
Q

Melanoma TREATMENT

A

Excision margin:
- In situ: 0.5cm
- <1mm: 1cm
- 1-4mm: 1-2cm
>4mm: 2cm
If eye: Refer to plastic surgery

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4
Q

NODULAR MELANOMA

A
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5
Q

ACRAL LENTIGINOUS MELANOMA

A
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6
Q

LENTIGO MELANOMA

A
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7
Q

DESMOPLASTIC MELANOMA

A
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8
Q

Squamous Cell
Carcinoma TREATMENT

A

Surgery with 3-5mm margin

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9
Q

BOWEN DISEASE BEST INVESTIGATION

A

Shave or Punch Biopsy

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10
Q

BOWEN DISEASE TREATMENT

A

Fluorouracil, Imiquimod

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11
Q

KERATOACANTHOMA

A
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12
Q

Basal Cell Carcinoma BEST INVESTIGATION

A

Biopsy

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13
Q

Basal Cell Carcinoma TREATMENT

A

Mohs Surgery with 3-4mm excision

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14
Q

Gas gangrene (Clostridial myonecrosis)

A

Gas gangrene, also known as Clostridial myonecrosis, is a severe and potentially life-threatening bacterial infection that affects muscle tissue. It is most commonly caused by bacteria from the Clostridium family, particularly Clostridium perfringens.

  1. Cause:
    • Clostridium Bacteria: These bacteria are anaerobic, meaning they thrive in environments with little or no oxygen. They are often found in soil, dust, and the intestines of humans and animals.
    • Infection Trigger: Gas gangrene typically occurs after a traumatic injury or surgery, where the bacteria can enter a wound. Once inside the body, they multiply rapidly and produce toxins that destroy tissue.
  2. Symptoms:
    • Severe Pain: The pain at the site of infection is often out of proportion to the injury.
    • Swelling and Discoloration: The affected area becomes swollen, pale, and may turn a purplish or black color as the tissue dies.
    • Gas Production: The bacteria produce gas as they multiply, which can cause a crackling sensation under the skin when touched (crepitus).
    • Foul-Smelling Discharge: The wound may ooze a thin, foul-smelling fluid.
    • Rapid Progression: The infection spreads quickly, leading to shock, organ failure, and, if untreated, death.
  3. Diagnosis:
    • Clinical Examination: The appearance of the wound, the presence of gas in tissues (seen on imaging like X-rays), and the rapid progression of symptoms are key indicators.
    • Laboratory Tests: Blood tests, cultures, and analysis of the wound tissue can confirm the presence of Clostridium bacteria.
  4. Treatment:
    • Emergency Surgery (Debridement): Immediate removal of dead tissue (debridement) is critical to stop the spread of the infection.
    • Antibiotics: High-dose intravenous antibiotics, typically penicillin and clindamycin, are administered to fight the bacteria.
    • Hyperbaric Oxygen Therapy: This treatment involves breathing pure oxygen in a pressurized room. It increases oxygen in the blood, which helps kill the anaerobic bacteria.
    • Amputation: In severe cases, if the infection has spread extensively, amputation of the affected limb may be necessary to save the patient’s life.
  5. Prognosis:
    • High Mortality Rate: Gas gangrene has a high mortality rate, especially if not treated promptly. Quick medical intervention is essential for survival.

Gas gangrene (Clostridial myonecrosis) is a rapidly progressing and deadly infection caused by Clostridium bacteria, often following a wound or injury. It is characterized by severe pain, swelling, gas production in tissues, and rapid tissue death. Immediate surgical removal of dead tissue, aggressive antibiotic therapy, and sometimes hyperbaric oxygen therapy are crucial for treatment. Without prompt intervention, the infection can lead to death.

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15
Q

Shingles

A
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16
Q

Molluscus contagiosum TREATMENT

A

No tx needed.
Resolvesin 3-6m
No school exclusion necessary
Avoid sharing towels/baths

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17
Q

Impetigo TREATMENT

A
  1. Topical mupirocin 2% OR
  2. cefalexin if widespread or large areas.
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18
Q

Staphylococcal scalded skin syndrome

A
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19
Q

Dermatophyte infections

A
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20
Q

Tinea CLINICAL FEATURES

A

Ringworm

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21
Q

Tinea TREATMENT

A
  1. Oral Griseofulvin/Terbinafine
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22
Q

Scabies CLINICAL FEATURES

A

Common in nursing homes

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23
Q

Scabies TREATMENT

A

1.Permethrin.

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24
Q

Lice

A
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25
Q

Cutaneous larva migran

A
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26
Q

PAPULAR URTICARIA

A
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27
Q

CERCARIAL DERMATITIS Erythrasma

A
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28
Q

Dermatitis CLINICAL FEATURES

A

Itchy, rash

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29
Q

Dermatitis TREATMENT

A
  1. Topical steroids & Moisturiser
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30
Q

Dermatitis Herpetiformes CLINICAL FEATURES

A

Assoc w/ Celiac Dx in elbows, knees, lumbosacral area

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31
Q

Dermatitis Herpetiformes BEST INVESTIGATION

A

Skin biopsy

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32
Q

Dermatitis Herpetiformes TREATMENT

A
  1. Dapsone.
  2. Gluten free diet
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33
Q

Atopic Dermatitis CLINICAL FEATURES

A

Kids in face, cubital, popliteal

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34
Q

Atopic Dermatitis TREATMENT

A
  1. Topical Steroids & Moisturiser
  2. Severe: Immunosuppressants - Infected: Swab then mupirocin/Dicloxacillin
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35
Q

Contact Dermatitis

A
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36
Q

Seborrheic Dermatitis CLINICAL FEATURES

A

Dandruff

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37
Q

Seborrheic Dermatitis

A
  1. Dandruff Shampoo
  2. Ketoconazole
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38
Q

Stasis Dermatitis

A
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39
Q

Discoid Dermatitis

A
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40
Q

ASTEATOTIC DERMATITIS

A
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41
Q

GENITAL DERMATITIS

A
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42
Q

Wound treatment

43
Q

Wound Healing

44
Q

SUNBURN

45
Q

Solar keratose

46
Q

SEBORRHOEIC KERATOSES

47
Q

LENTIGINES

48
Q

MELANOCYTIC NAEVI DYSPLASTIC

49
Q

NAEVI TREATMENT

A

Surgery with 2mm margin

50
Q

Acneiform Eruptions

51
Q

Acne vulgaris

52
Q

Rosacea

53
Q

Lichen planus

54
Q

Pityriasis rosea

55
Q

Psoriasis CLINICAL FEATURES

A

Cause: Autoimmune, lithium, ACE inhs

56
Q

Psoriasis TREATMENT

A
  1. Tar
  2. Steroids
  3. Calcipotriol

The RACGP guidelines for treating psoriasis typically include the following steps:

  1. Topical Treatments:
    • Corticosteroids: Applied directly to the skin to reduce inflammation and slow down the rapid skin cell turnover.
    • Vitamin D analogues: Such as calcipotriol, which help to slow down skin cell growth.
    • Coal tar and dithranol: Help reduce scaling, inflammation, and slow skin cell growth.
    • Moisturizers: Keep the skin hydrated and reduce itching and scaling.
  2. Phototherapy:
    • UVB Therapy: Exposure to ultraviolet B light can help slow the growth of affected skin cells.
    • PUVA Therapy: Combining a drug called psoralen with UVA light to improve skin symptoms.
  3. Systemic Treatments (for moderate to severe cases):
    • Methotrexate: Reduces skin cell production and suppresses the immune system.
    • Ciclosporin: An immunosuppressant that reduces the immune response.
    • Acitretin: An oral retinoid that helps normalize skin cell growth.
    • Biologics: Target specific parts of the immune system. Examples include TNF inhibitors (etanercept, infliximab) and IL-17 inhibitors (secukinumab).
  4. Lifestyle and Supportive Measures:
    • Weight management: Maintaining a healthy weight can improve treatment outcomes.
    • Smoking cessation: Smoking can worsen psoriasis.
    • Stress management: Stress can trigger or worsen psoriasis.
    • Patient education and support: Understanding the condition and having access to support groups can be beneficial.
  5. Regular Monitoring and Follow-Up:
    • Regular check-ups to monitor the effectiveness of the treatment and make adjustments as needed.
    • Screening for associated conditions such as psoriatic arthritis, cardiovascular disease, and mental health issues.

Always consider patient-specific factors when selecting and adjusting treatments.

57
Q

FLUSHING-BLUSHING

58
Q

Autoimmune blistering diseases

59
Q

Porphyrias

60
Q

Ichthyosis

61
Q

Vitiligo

62
Q

Neurocutaneous syndromes

63
Q

Pityriasis alba

64
Q

ALERGIC REACTIONS MULTI-SYSTEMIC CLINICAL FEATURES

A

ACUTE ANAPHTLAXIS - ANAPHYLACTIC REACTION

65
Q

ALERGIC REACTIONS LOCALISED CLINICAL FEATURES

A

ANGIOEDEMA - URTICARIA

66
Q

exanthematic

A

DRAFT: morbilliform; most common

67
Q

urticarial phototoxic eruption lichenoid

68
Q

cutaneous vasculitis fixed drug eruption

69
Q

Stevens-Johnson syndrome toxic

70
Q

epidermal necrolysis (TEN)

71
Q

drug rash with eosinophilia and systemic symptoms (DRESS) acute

72
Q

generalised exanthematous pustulosis (AGEP)

73
Q

Androgenetic Alopecia TREATMENT

A
  1. Topical steroids for 12w
  2. Intradermal Steroid (Triamcinolone)
  3. Minoxidil
74
Q

Hirsutism CLINICAL FEATURES

A

Cause: Valproate, phenytoin, minoxidil, steroids, danazol

75
Q

Hirsutism TREATMENT

A
  1. Shave
  2. Laser
  3. Spironolactone
76
Q

NAILS DISORDERS

77
Q

ONYCHOMYCOSIS

78
Q

INGROWN TOENAILS

79
Q

PARONYCHIA

80
Q

ONYCHOLYSIS

81
Q

Brittle nails

82
Q

Koilonychia

83
Q

Aphthous stomatitis

84
Q

Photodermatoses

85
Q

Erythema nodosum

86
Q

Erythema multiforme

87
Q

Erysipelas CLINICAL FEATURES

A

Upper dermis and lymphatics, non-purulent

88
Q

Cellulitis CLINICAL FEATURES

A

Deeper dermis, SC fat, purulent/non purulent

89
Q

Cellulitis TREATMENT

A

IV Flucloxacillin

90
Q

Hemangiomas TREATMENT

A

-If in eyes, nose, ears, trachea->Laser Qx or refer
-Other parts: Observe/Reassure (self-resolve by 7yo.
-Propranolol can be used

91
Q

Acne CLINICAL FEATURES

A
  • Non-inflamm: Comedones
  • Inflamm: Pustules/Papules
  • Severe: Scarring
92
Q

Acne TREATMENT

A

-Mild: Benzoyl peroxide + Topical retinoin
-Mod: Non inflamm (Benzoyl peroxide + Retinoin. Inflamm (Benzoyl peroxide+Doxicycline, if pregnant Erythromycin)
-Severe: Isoretinoin (Oral). In females add OCPs

93
Q

Allergies CLINICAL FEATURES

A

Just local symptoms

94
Q

Allergies TREATMENT

A
  1. Strop triggers
  2. Emollients
  3. Oral promethazine
  4. Steroids
95
Q

Anaphylaxis CLINICAL FEATURES

A

Respiratory problems

96
Q

Anaphylaxis TREATMENT

A
  1. Adrenaline IM: (All 1:1000)
    - <6m: 0.10 mg
    - 6m-6y: 0.15mg
    - 6-12y: 0.3mg
    - >12y: 0.5mg
97
Q

Vitamin D deficiency CLINICAL FEATURES

A

Children: Rickets (Bowlegs, rachitic rosary, soft skull).
Adults: HypoCa (Tetany, prox myopathy, frontal bossing)

98
Q

DERMATOLOGY CLINICAL FEATURES

A

Night blindness, scaly skin, bitot spots (foamy appearance on conjunctiva), corneal degeneration

99
Q

Vitamin B3 deficiency CLINICAL FEATURES

A

3 Ds (Dermatitis, Diarrhoea, Dementia).

100
Q

Vitamin B3 deficiency TREATMENT

A

Resolves in 3-6m
No school exclusion necessary
Avoid sharing towels/baths

101
Q

Alopecia - SCARRING

102
Q

Alopecia - TELOGEN EFFLUVIUM ANAGEN EFFLUVIUM

103
Q

Alopecia - TRICHOTILLOMANIA HIRSUTIES-

AMC MCQ - You Can Do It!!!!!❤️❤️ (50 decks)

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