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4th Year Exam > Dermatology ILOs > Flashcards

Dermatology ILOs Flashcards

1
Q

What is the main cause of TEN and what differentiated this from SJS?

A

Drug induced

SJS: <10% skin detachment from body
TEN: >30% skin detachment

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2
Q

Give 2 risks and 2 symptoms of TEN

A

R: Female + HIV
S: Fever + Dysphagia

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3
Q

What 4 skin lesions may be seen in TEN/SJS

A

Macules
Diffuse erythema
Targetoid
Blisters

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4
Q

What 3 things may a FBC show in TEN?

A

Anaemia
Leukopenia
Neutropenia

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5
Q

Give 3 management options for TEN

A

Stop causative drug
Analgesia
Sterile bandages
Fluid balance

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6
Q

Give 2 complications of TEN

A

Sepsis

Death (30%)

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7
Q

Define erythema multiforme and give 2 causes

A

Hypersensitivity triggered by infections e.g. HSV or EBV presenting with skin eruption characterised by typical target lesion

EBV + Penicillin

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8
Q

Give 2 symptoms of erythema multiforme

A

Fever

Lesions on hands/feet/neck/face/trunk

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9
Q

Despite erythema multiforme being mainly self-limiting, name 2 treatments and 2 epidemiological points

A

Antihistamine + Mouthwash for oral pain

20-40y/o + male

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10
Q

Define acute urticaria and give 2 causes

A

Itchy wheals (hives) lasting <24 hours +/- angioedema Type 1 IgE response

Virus
Food allergy

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11
Q

What treatment can be given in acute urticaria and in which individuals does this condition commonly occur?

A

Antihistamine

Atopic individuals

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12
Q

Name 3 drugs which can cause a Lichenoid rash

A

ACEI
Diuretics
NSAIDs

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13
Q

Define erythroderma and give 2 causes

A

Widespread reddening of skin due to inflammatory skin disease

Drug induced e.g. ACEI
Atopic dermatitis

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14
Q

Give 3 symptoms of erythroderma

A

Redness and oedema
Fever
Itch

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15
Q

Name 3 things which blood tests may show in erythroderma

A

Anaemia
Eosinophilia
Raised IgE

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16
Q

Give 3 management options for erythroderma

A

Fluid balance
Emollient
Topical steroid

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17
Q

Give 2 complications of erythroderma

A

Fluid loss

Secondary infection

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18
Q

Define cellulitis and give 2 causative organisms

A

Bacterial infection of lower dermis and subcutaneous tissue

Haemophilus Influenza
Strep. Viridans

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19
Q

Give 3 symptoms of cellulitis

A

Warmth
Unilateral redness
Blistering

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20
Q

Give 2 risks and 2 complications of cellulitis

A

R: diabetes + pregnancy
C: NF + sepsis

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21
Q

Give 3 management options for cellulitis

A

ABX
Analgesia
Fluid balance

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22
Q

Define necrotising fasciitis

A

Infection of subcutaneous fascia, rapidly spreading over hours with a mix of anaerobes and aerobes

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23
Q

Give 3 symptoms of NF

A

Firstly painful, then PAINLESS

Systemically unwell

Skin breakdown with bullae

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24
Q

Give 3 investigations of NF

A

FBC (raised WCC, CRP, CK)
Blood culture
Deep tissue biopsy

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25
Q

Give 2 treatment options for NF

A

ABX in ITU

Debridement

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26
Q

What is Staphylococcus scalded skin syndrome?

A

Staph. Aureus producing exfoliative exotoxin = widespread bullae and exfoliation

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27
Q

Define impetigo and outline treatment

A

Staphylococcal infection of epidermis, ‘honey coloured’ crust

Tx: remove crust, give fluclox.

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28
Q

Define eczema

A

Inflammation of the skin, barrier defect + inherited abnormality in Filaggrin (protein which binds keratin fibres) considered cause

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29
Q

What is atopic eczema and how is it managed?

A

Increased IgE associated with asthma and allergic rhinitis

Tx: emollient, bandage, antihistamine, antibiotics

30
Q

What is seborrhoeic dermatitis and give 1 treatment

A

Chronic, scaly inflammation on face, scalp, eyebrows and upper chest caused by overgrowth of Pityrosporum ovale yeast

Tx: Anti-yeast shampoo

31
Q

What is eczema herpeticum?

A

Herpes simplex virus complicating eczema presenting as eczema that has suddenly become painful as opposed to itchy

32
Q

Define psoriasis

A

Chronic relapsing scaling skin appearing at any age, anywhere on the body
caused by T-cell mediated AI disease

33
Q

Outline the pathology of psoriasis

A
  • Abnormal T-cell infiltration causes inflammatory cytokine, IL and TNF release = keratinocyte proliferation
34
Q

Give 3 clinical features of psoriasis

A
  • Redness (white in darker skin)
  • Scaling
  • centre of back/hairline
35
Q

Give 3 treatment options for psoriasis

A

Topical creams

Phototherapy light Tx(to increase via. D and decrease turnover)

Immunosuppression

36
Q

What are the 3 main types of skin cancer?

A
  1. Basal cell carcinoma
  2. Squamous cell carcinoma
  3. Malignant melanoma
37
Q

What can a basal cell carcinoma look like?

A
  • Shiny rolled edges
  • Ulcerated centre
  • Broken vessels
38
Q

Give 3 treatments of basal cell carcinoma

A

Surgical excision with 3-4mm margin

Curettage and cautery

Cryotherapy

39
Q

Define squamous cell carcinoma and give 2 treatments

A

From keratinocytes in normal skin or chronically inflamed skin e.g. surgical scar

Tx:

  • Surgical excision with 4mm margin
  • Curettage and cautery
40
Q

Define Lentigo melanoma

A

Precursor to melanoma usually on the face on sun damaged skin

41
Q

Define acral melanoma

A

Usually presents late and has a poorer prognosis and although rare is slightly more common in darker skin types

42
Q

Give 3 treatment options for melanoma

A

Surgical excision with margins depending on Breslow score

Immunotherapy e.g. ipilimumab

MEK (immune checkpoint) inhibitor e.g. trametinib

43
Q

Outline the parameters of the Breslow score for skin cancer removal

A
  • I = <1mm
  • II = 1-2mm
  • III = 2-4mm
  • IV = >4mm
44
Q

Define acne vulgaris and give 3 clinical features

A
  • Papules
  • Pustules
  • Open and closed comedones

Caused by keratin and sebum blocking sebaceous glands

45
Q

What bacteria is commonly implicated in acne?

A

Propionibacteria

46
Q

Give 3 treatments of acne

A

Reduce plugging: topical treatments e.g. retinoid

Reduce bacteria: topical/oral antibiotics

Reduce sebum production: hormones e.g. anti-androgen like OCP

47
Q

What is oral isotretinoin (Roacutane)?

A

An oral retinoid treatment for severe acne vulgaris which is a concentrated form of vitamin A

48
Q

Name 3 skin conditions associated with diabetes

A

Necrobiosis lipidica
Diabetic dermopathy
Granuloma annulare

49
Q

What thyroid pathology can cause dry skin?

A

Hypothyroidism

50
Q

Which skin condition of reddened concentric bands on the skin is associated with lung cancer?

A

Erythema Gyratum Repens

51
Q

What is acanthosis nigricans?

A

Smooth, velvet-like hyperkeratotic plaques in groin, neck and axillae

52
Q

What is erythema nodosum and name 2 conditions with which it is associated

A

Streptococcal infection

  • Sarcoidosis
  • IBD
53
Q

Define leg ulcers and give 2 causes

A

Full thickness skin loss on leg or foot due to any cause, acute or chronic (>4 weeks)

Pressure + Injury

54
Q

Give 3 symptoms of leg ulcers

A

Below knee, mostly inner ankles

Surrounded by mottled brown or black skin

Painless unless infected

55
Q

Give 3 treatment options for leg ulcers

A

Elevate and compress
Surgery
US guided sclerotherapy

56
Q

Name 2 groups of people who may get leg ulcers

A

Diabetics

Chronic venous insufficiency

57
Q

Define rosacea and give 3 symptoms

A

Chronic rash involving central face, starting often between 30-60 y/o

Frequent flushing or blushing

Red papules and pustles

Dry, flaky face

58
Q

Give 3 triggers of Rosacea

A

Alcohol
Sun
Spicy food

59
Q

Give 3 treatments for Rosacea

A

Reduce triggers
ABX e.g. doxycycline
Topical e.g. Metronidazole gel

60
Q

Define chronic urticaria

A

Daily or episodic wheals or angioedema present for 6 weeks or more e.g. dermographism

61
Q

What is the cause of chronic urticaria?

A

Chemical mediators from mast cells and basophils including histamine and cytokines

62
Q

What is bullous pemphigoid and name one treatment?

A

Blisters between epidermis and dermis, IgG binds to BM causing blistering. Tx: steroids

63
Q

What is bullous pemphigus?

A

IgG binds to desmosomes with mucosal involvement common

64
Q

What is dermatitis herpetiformis?

A

IgA antibodies due to intolerance of gliadin fraction of gluten (associated with coeliac)

65
Q

Define alopecia areata and give the cause

A

One or more round bald patches appear suddenly on the scalp caused by AI disorder when T-cells surround the hair follicle

66
Q

Give 3 treatments for alopecia

A

Topical e.g. potent or ultrapotent topical steroids

Intralesional cortisone injections

Systemic corticosteroids

67
Q

Define cutaneous vasculitis

A

Group of disorders where blood vessels become inflamed in the skin (capillaries, small vessels, medium vessels and large vessels (e.g. giant cell arteritis)

68
Q

Give 2 causes of cutaneous vasculitis

A

Bacterial infection

Indirect injury by autoantibodies

69
Q

Give 2 symptoms of cutaneous vasculitis

A

Petechiae

Purpura

70
Q

Give 2 indications for surgery in cellulitis

A

Sepsis syndrome

Signs of NF

4th Year Exam (20 decks)

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