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Dermatology MSRa Flashcards

1
Q

skin conditions associated with Reiter’s syndrome?/ reactive arthritis? waxy yellow rash

A

Keratoderma blennorrhagica

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2
Q

Rash target lesions on back of hands/ feet before spreading to torso after starting allopurinol?

other causes? - Pretend Another New Chant Can Stick
most common cx?

severe form?

A

erythema multiforme

cx: penicillin, carbemazepine, allopurinol, cocp, nssaids, sle, sarcoid, cancer, bacteria,

commonL herpes simplex

severe: mucosal involvement. erthema multiforme major

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3
Q

lichen sclerosis/ vs planus

A

planus - purple, pruritic, papular, polygonal rash on flexors. painful on vulva, not itchy wickham’s striae with red borders, can cause discharge and bleeding, koebner phenomenon (trauma sites), scarring alopecia
cx: gold, quinine, thiazide
tx: topical clobetasone butyrate/ topical cs/ benzydamine mouth wash

sclerosis - plaques, itchy. risj: cancer

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4
Q

red rash, nasolabial folds eczema and scalp, af parkinsons and HIV?

A

sebh derm

risks: ottitis externa and blepharitis

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5
Q

post phenytoin, mouth ulcers to blisters , fever, unwell?

other cx?

A

toxic epidermal necrolysis

cx: allopurinol, penicillns, nsaids, carbemazepine, penicillins

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6
Q

hypopigmented, scaley patches after a sun tan?

tx?

A

petyriasis vesicolor (fungal infection malassezia

topical antifungal
pregnancy/ breastfeeding: selenium sluphid

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7
Q

red crusted lesions around mouth, small testes, alopecia, anorexic?

A

zinc deficiency

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8
Q

first line hyerhidrosis tx?

A

topical aluminium chloride, iontophoresis - hands and feet, botulinum toxic (axillary

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9
Q

cx of acathiosis nigricans?

A

pcos, GI cancer, obese, acromegaly, cushings, hypothyroid, praderwilli, cocop, nicotinic acid

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10
Q

recent cold sore, rash?

A

erythema multiforme

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11
Q

sunbed, legs of women with different shades of brown?

chronic older people with slow growing features?

red/black lump that bleeds/ oozes?

A

superficial spreading melanoma (most common)

lentigo maligna - slow growing on face, neck arms

nodular - second most commonmiddle ages expsoed

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12
Q

type of melanoma: develops slowly, chronic sun exposre on face, neck arms?

A

lentigo maligna

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13
Q

sun exposed older person with waxy scaly appearance upper body?

A

seborrhaic keratosis

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14
Q

shiny area of raised skin with blood vessels running over it, central ulceration?

A

rodent ulcer

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15
Q

itchy, bruises, red palms, distended abdomen?

A

liver disease cx itch

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16
Q

ruddy complexion, paiful MTCP swelling, peptic ulcer disease, pruritus?

A

polyctythaemia

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17
Q

itchy skin, lethargy, oedema, weight gain, HTN?

A

CKD

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18
Q

scabies tx?

what type of hypersensitivity?

A

permethrin 5% ( leave for 8- 12 hrs)
2nd malathion (24 hrs)
repeat tx 7 days after
itchiness can stay for 4-6 weeks post eradication.
(type 4 hypersensitivity - itch caused by not mites themselves)

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19
Q

young boy, cyst on lateral aspect of eyebrow?

A

dermoid cyst

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20
Q

enlarging brown lesions on torso - localised proliferation of basal layer of episdemis

A

seborrhaeic keratossi

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21
Q

mobile subcutaneous lump fluctuates in size, prone to infections

A

sebaceous cyst

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22
Q

sudden patchy hair loss, positive pull test, perifollicular inflammation on biopsy?

aF?

A

alopecia areataa
associated with autoimmune coditions

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23
Q

post hair dye causing dermatitis, pigmentation, scarring alopecia?

what tpe of hypesensitive reaction?

A

allergic contact dermatits
TX: c/s, PDE4

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24
Q

non healing lesion reddish/ blue on hand/ feet with surface ulceration, blood blister like

A

pyogenic granuloma

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25
androgenic alopecia men drug? lisenced?
finasteride
26
normal ABPI? tx venous ulcers?
tx compression banges. normal abpi is 0/9-1.2
27
admitted with burns then has severe epigastric pain, haematemesis, melaena and haemodynamic instability? infection of burns? formula to assess extent of burns? how to calculate fluid deficit? describe depth of burns? when to admit to secondary care?
Curling's ulcer (peptic stress ulcer) staph A extent: wallace rule of 9s parkland formula - fluid resus over first 24 hrs= total body surface area x wegith x 4. half fluid in first 3 hrs give fluid to adults with 15%+, child 10%+ 1- sup epidermal (no blisters 2- superficial dermal blisered, slow CRT red 2- deep dermal - white+red, reduced sensation, pain on deep pressure. (cleanse, non adherent dressing, r/v 24 hrs 3rd - full thickenss, white/waxy/leathery/brown, no pain admit: superficial dermal 3%+ TBSA aduts/ 2%child, electrical, inhalation
28
small red spots on hands, FH first degree relative, recurrent nose bleeds/ rectal bleed? aslos AF?
hereditary hemofrraghic telangectasia + AV malformations red spots on lips and tongue, rectal bleeding AF: hepaic, GI, av malformations, cerebral, spinal,
29
Acne mx? mild to mod? mod? pregnant? when to refer to derm? SE of this drug?
a 12-week course topical adapalene (CI pregnancy) with topical benzoyl peroxide topical tretinoin with topical clindamycin topical benzoyl peroxide with topical clindamycin mod -add one antibiotics topical adapalene with topical benzoyl peroxide + oral lymecycline/ doxycycline a topical azelaic acid + oral lymecycline /doxycycline consider for p/o isotretinoin - if carring, tried 2 abx. SE: dry skin rasied triglycerises, hair thinning, nose bleeds, ICP raised pregnancy - erythromycin
30
light brown well defines nodule on shin from trauma/ insect. mild itch? overlying skin dimples
dermatofibroma
31
post sore throat, tear drop shapes papules on trunk. when do they resolve by? How is pityriasis rosea presenting differently?
guttate psoriasis (post streptococcal). normally resolve by 3 months herald patch followed by fir tree change along line of langer. post viral infection. .self limiting resolve by 6 weeks/ christmas tree
32
skin conditions in pregnancy?
polumorphic eruption of pregnancy pemphigoid gestinitis
33
child eczema on face worse overnight with painful blisters? punched out erosions over cheeks and dorsal wrist cx?
eczema herpeticum - needs antivirals iv cx: hsv1/2
34
Bullous pemphigoid vs pemphigus vulgaris? what is nikolsky's
bullous - no mucosal involvement. immunoflourences shows igg and C3 at dermo epidermal junction. need referral secondary care mucosal - pemphigus. nikolsky - spread of bullae after putting pressure on skin. painful, not itchy, flaccid vesicles. positiv ein TEN
35
psoriasis cx BLANQ nail features?
BB, lithium ace/arb_alcohol, NSAIDS, Quinines nails: pitting, onycholysis, subingal hyperkeratosis, loss of nail
36
deep red birthmark presnet at birth irrgeular colour small ref patch appears in first month of life increase in size until 9 months, regress spontaneously? removal? complications?
portwine stain - does not resolve on its own resolve on their own by 10 yrs, grow from 1 month to 9 months - strawberry naevus/ haemangioma - tx by BB/CS bleeds, ulcer, obstructing visual defenct, low platelets
37
thickened, discoloured nails, onychomycosis tx?
oral terbinafine (trychophrton rubrum)/ candida
38
NODOSUM cx? SORE SHINS IX?
Streptococci/ TB OCP Rickettsia Eponymous (Bechets) Sulfonamides Hansen’s disease (leprosy) IBD NHL Sarcoidosis other: penicillin, pregnany
39
telangiectasia vs spider naevi?
telangiectasia - fill from the tails side naevi frill from the centre of the web. commone with pregnancy OCP, liver disease
40
alopecia areata? tx? scarring alopecia examples?
areata - exclamation mark hairs, well demarked, regrow in 50%. try topical CS/ minox/phototherapy/ dithranol (autoimmune) scarring - trauma, lichen planus, discoid lupus, tinea capitic (kerion)
41
psoriasis mx? on hands? scalp? face/flexural/ genital? steroid break? Se of coal tar? does vit D reduce redness?
potent C/s OD + vit D analogue separately 4 weeks 2) no improvement after 8 weeks, do vit D BD 8-12 weeks, do C/s BD for 4 weeks/ coal tar once or twice a day scalp: topical cs 4 weeks OD face/ gential - mild to mod C/S OD or BD for 2 weeks max/ month secondary care: uvb 3 times a week coal tar: stains, smells vit d only reduces scale and plaque - avoid in pregnancy
42
impetigo tx? extensive disease? exclusion from school?
hydrogen peroxide 1%/ then topical fusidic acid or topical mupiricon (if fusidic is resistant) oral fluclox/ erythromycin until the lesions are crusted and healed or 48 hours after commencing antibiotic treatment
43
Cx of hirsutism?
PCOs, adrenal therpay, obese, adrenal tumour/ congnital adrenal hyperplasia, phenytoin, C/S
44
leukoplakia is?
premalignant condition which presents as white, hard spots on the mucous membranes of the mouth. It is more common in smokers. dx of exlcusion
45
acute urticaria - tx?
non sedating antihistamines (loratadine/ cetirizine) 6 weeks troublesome sleep - chlorphenimine (sedating
46
scaly, pink plaques, hyperkeratotic small lesions on farmer's forehead. x?
actinic keratosis premalignant tx: topical fluorouracil 3 weeks followed by hydrocortisone topical diclofenac - for mild topical imiquimod
47
diabetic woman bilateral erythematous lesions on her shins surrounded by telangiectasia. yellow/ blue normally no sx other skin conditions associated with DM
necrobiosis lipoidica DML neuropathic ulcer, vitiligo granuloma annulare - slight hyperpigmented papular lesions, depressed centrally
48
34-year-old man with a history of polyarthralgia, back pain and diarrhoea is found to have a 3 cm red lesion on his shin which is starting to ulcerate other cx?
pyoderma gangrenosum . BG (UC). starts on lower limb, pethargy (soften at site of minor injury) PBC, IBD, SLE, IGA, haem cancers, granulopatosis with polyangitis
49
red crusted lesions around mouth? deficiency? other s association?
zince other: short, short, hepatosplenomegaly,
50
51
pruritus cx with ruddy complexion/ gout? cx with oedema, HTN, lethargy, derranged U+ES? with hepatosplenomegaly and w/L? other cx?
Polycythaemia - gout, ruddy, peptic ulcer disease CKS lymphoma - b sx other: irone deficiency anaemia, liver disease (ascites, jaundice, enceph, gynacomastia, spider naeci etc)
52
diabetes with waxy yellow lesions? symmetrical shiny orange peel skin, red on shins, feels very hot and restless?
necrobiosis lipoidica diabeticorum pretibial myxoedema (af graves)
53
ix for non healing venous ulcer?
ABPI - assess for poor arterial flow which could be affecting healing (normal 0.9-1.2) tx: compresison bandages, venous normally on medial malleous
54
can you combine tetracycline and isotretinoin? other Se of isotretinoin
no risk of intracranial HTN dry skin, eyes and lips/mouth - nose bleeds low mood raised triglycerides hair thinning intracranial hypertension: photosensitivity
55
umbillicated small circle lesions in child? eye involvement?
molloscum contagiosum.refer urgently to opthal if eye involement
56
UVA ligh therapy can cause?
scc
57
small itchy blisters on palms and soles after sweating?
pompholyx - cold compress, emollients, top cs
58
conditions associated with vitiligo?
type 1 diabetes mellitus Addison's disease autoimmune thyroid disorders pernicious anaemia alopecia areata koebner's phenomenon
59
keloid scars most likely to form?
sternum, shoulder, neck, face, trunk tx: intran-lesional steroids - triamcinolone
60
redness around cheeks and nose worse after drinking alcohol? tx?
flushed, telangectasia, rhinophyma, blepharitis, worse in sunlight. tx: mild: brimonidine is a topical alpha-adrenergic agonist mild to mod pustule topical ivermectin +- doxycycline
61
tender, erythematous plaques and nodules, often accompanied by fever and neutrophilia with B/G fever, high neutrophils, malignancy haematological?
sweet's syndrome/ febrile neutrophilic dermatosis
62
80 YO man with painful nodule on ear
Chondrodermatitis nodularis helicis
63
TEN cx: difference between SJS and TEN?
TEN TBSA 30%+ and mucous membranes. positve nkikolsky's, unwell. phenytTENoin, peicillin, carbemazeTENPINE, allopurinTENlol, sulphonamides SJS rash with TBSA <10% and antiepileptics, OCP, allopurinol
64
purplish, lace-patterned discolouration of the skin? associated conditions?
livedo reticularis AF: SLE, APLS, EDS, homocystinuria, polyarteritis nodosa, ideopathy (most common)
65
66
BCC features? tx? if in high risk areas?
peary collloured, central crater, rolled edges, central crater normally routin referral if in high risk areas - surgical excision. urgent (nose/ eyes) topical imiquimod, fluoruracil
67
volcano like growth with smooth dome, past growing. likely dx? will it resolve?
keratocanthoma likely to resolve in 3 months but need urent derm opinion to exclude scc and excise
68
itchy, violaceous papules on the flexor aspects of her wrists
lichen planus - likely to have membranous involvement purple, pruritic, papular, polygonal rash on flexors
69
rich white women, stress mouth ulcers, jus stopped smoking and is now chewing gum
recurrenty apthous somatitis. pain lasts 48 hrs tx: conservative, then topical C/S/ betamethasone tablets/ beclamethason spray consider b12 sus cancer: f 3 weeks+ swelling/ rf
70

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