Dermatology & Plastics Flashcards

1
Q

Describe acne

A

Caused by glands under the skin producing too much oil. This can block the pores and cause acne. Unrelated to diet or being unclean - in fact over-washing exacerbates acne.

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2
Q

Mx of acne

A

Conservative: wash BD with mild soap, no picking/ scratching

Medical: benzoyl peroxide, retinoid creams, topical abc, oral abx (lymecycline, oxytetracycline)
COCP
3-6 months treatment

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3
Q

Advice for order of applying creams

A

Emollients - then wait few mins before applying steroids

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4
Q

How can eczema differ in Asian/ Black communities?

A

Extensor surfaces/ discoid

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5
Q

Mx infected eczema

A

Fusidic acid cream (short doses - avoid resistance)

Consider oral fluclox

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6
Q

Eczema emergency

A

Herpeticum - aciclovir and same-day referral

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7
Q

Psorasis consideration when taking hx

A

Cardiovascular/ DM risks

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8
Q

First-line psoriasis medical mx

A

Topical vit D analogue OD +/- potent steroid for 4-8 weeks

Advise that stopping suddenly can cause relapse

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9
Q

Names for flat lesions

A

Macule - patch - telangiectasia

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10
Q

Names for raised lesions

A

Plaque - papule - nodule

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11
Q

Names for fluid-filled lesions

A

Vesicle - bulla - pustule - wheal

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12
Q

Triggers for eczema

A

Endogenous: genetic, stress, female hormones

Exogenous: topical irritants, contact allergens, extremes of temp/ humidity, S.aureus, diet, inhaled allergens

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13
Q

What % psoriasis have joint disease?

A

14%

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14
Q

Describe rash of psoriasis

A

Well-demarcated circular and oval bright red elevated plaques, distributed….

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15
Q

Questionnaire for patients with dermatological disease

A

Dermatology Life Quality Index

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16
Q

In whom is guttate psoriasis more common

A

Young adults 1 month after a strep sore throat

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17
Q

What is the name of most common rash that is caused by drugs (or infection)?

A

Toxic erythema

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18
Q

What are the dangerous drug eruptions? Why are they life-threatening?

A

Toxic epidermal necrolysis
Stevens-Johnson Syndrome

Fragile bullae form revealing red, raw underlying dermis
If mouth involved, hard to ingest anything - treat as burns

19
Q

Which drug can pigment skin grey?

A

Amiodarone (can take 1 year to go)

20
Q

What are Campbell de Morgan spots?

A

Cherry angiomas

21
Q

What are dermatofibroma?

A

Raised papules or nodules that dimple on pushing.
Caused by minor trauma.
Multiple in immunocompromised or SLE

22
Q

What does solar keratosis look like?

A

Stuck on red/ white
aka acitinic keratosis (can metasisise to SCC)
can be treated with topical treatments

23
Q

What does seberrhoec keratosis look like?

A

Stuck on black

24
Q

What is the pre-malignant form of SCC

A

Bowen’s disease (CIS)

25
Q

What does SCC look like?

A

Non-healing ulcer on sun-exposed skin

26
Q

Mx SCC

A

excise under LA with clear margins

advanced disease can spread to lymph nodes - FNA if enlarged

27
Q

Most common skin cancer

A

BCC (80% NMSC) - pearly edges, rarely metastasise

28
Q

What is melanoma in situ?

A

When all cells are in epidermis

29
Q

ABCDE of melanoma

A
asymmetry
border irregularity
colour irregularity
diameter (7 mm)
evolving
30
Q

What determines survival in melanoma?

A

Breslow thickness

31
Q

Ix for melanoma

A

Excise with 2mm border
SNLB
Bloods
CXR + liver US/ or CT chest, abdo, pelvis

32
Q

What virus is responsible for Kaposi’s sarcoma?

A

HPV8

33
Q

Which tissue is Kaposi’s a proliferation of?

A

Connective tissue

34
Q

Location of pemphigus vs pemphigoid

A

Pemphigus mosly mucous membranes (but can be elsewhere)

Pemphigoid on trunk + limb

35
Q

Lupus pernio vs lupus vulgaris

A

Pernio: nose - sarcoid
Vulgaris: brownish tubercles - TB

36
Q

Why is SCC common post-renal transplant?

A

immunosuppression

37
Q

Name of leg ulcer that can transform to SCC

A

Marjolin

38
Q

Graft vs flap

A

Graft is skin only

39
Q

Signs of smoke inhalatation

A

singed nasal hairs, carbon particles in the sputum, hoarseness and elevated carbon monoxide levels in the blood

If there is concern about significant airway injury, anaesthetic input should be sought early, as an endotracheal tube may be required. Swelling of the airway worsens over the first 24-48hrs after acute injury, making intubation much more difficult.

40
Q

which type of tissue most affected by electtrical burns

A

muscle
(damage less apparent on surface)

may be compartment syndrome

41
Q

Features of second degree burns (partial thickness)

A

Blisters, severe pain, hypersensitivity and weeping skin

Dermis involved

42
Q

What is Parkland formula?

A

First 24 hrs = 2-4mL kg of crystalloid (Ringer’s Lactate) × patient weight (kg) × % BSA (area of burn)

Half of this amount should be given in the first 8 hours and the rest over the next 16 hours, but urine output should also guide fluid prescribing.

Monitor urine output and test for myoglobinuria, which can cause acute renal failure.

43
Q

Dressings for burns

A

Paraffin gauze dressings are a good option in superficial burns and silver nitrate dressings are preferred for deeper ones

44
Q

Parkland Formula

A

4% x TBSA x kg
50% in first 8 hrs
following 50% in next 16h