Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3B > Dermatology Primary Care > Flashcards

Dermatology Primary Care Flashcards

1
Q

What is the pathophysiology of acne vulgaris?

A

Increased sebum production (exacerbated by androgens), occlusion of follicular ducts by hyperkeratinisation, and bacterial colonization of ducts, which breaks down triglycerides, producing free fatty acids that cause dermal inflammation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Which bacteria colonizes follicular ducts in acne vulgaris?

A

Proprionibacterium acnes

p.acnes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Name four risk factors for acne vulgaris.

A

P.acnes infection
Puberty and menstrual cycles (increased androgens)
High glycaemic load diets
Stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Which areas of the body does acne vulgaris present?

A

Areas rich in sebaceous glands: face, back, sternal area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the three cardinal features of acne vulgaris?

A 
Open or closed comedomes
Inflammatory papules (ruptured comedomes)
Pustules
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is an alternative name for comedomes?

A

Open - blackheads

Closed - whiteheads

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are three other features of acne vulgaris?

A

Premenstrual exacerbation
Seborrhoea
Deep dermal inflammation and keyloid scarring.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Name the 5 main variants of acne.

A 
Infantile
Steroid
Conglobata
Acne excoriee
Acne fulminans
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the symptoms of acne fulminans, other than severe necrotic crusted lesions?

A

Malaise, pyrexia, arthralgia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the management of acne fulminans?

A

Urgent prednisolone and analgesics

Oral isoretinoin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drugs are known to cause or exacerbate acne?

A 
Anabolic steroids
Corticosteroids
Isoniazid
Ciclosporin
Anti-epileptics
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the first line treatment of mild to moderate acne?

A

Topical retinoid or antibiotic, with benzoyl peroxide.
e.g. adapalene 0.1%/isoretinoin
e.g. clindamycin 1%
Both with benzoyl peroxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the 2nd line treatment for acne vulgaris?

A

Addition of PO antibiotic: doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Why should macrolide antibiotics such as erythromycin be avoided in the treatment of acne?

A

High levels of p.acnes resistance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

The COCP is an alternative 2nd line treatment for acne in women; how does it work?

A

Anti-androgen activity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the indications for referral to a dermatologist for treatment with PO isotretinoin (roaccutane)?

A

No response to two different abx
Scarring
Severe psychological distress
Severe variant such as fulminans or conglobata.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What are the side effects of isotretinoin?

A

Mucosal dryness
Teratogenic
Depression rarely

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the pathophysiology of atopic eczema?

A

Atopic individuals who have a mutation in the epidermal barrier protein filaggrin are predisposed to dysfunction in the skin barrier.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Which cells are overactive in atopic eczema and what antibody is produced?

A

Overactive Th2 lymphocytes

Produce IL4 and IL5 Stimulate IgE production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are some exacerbating factors for atopic eczema?

A

Stress
Detergents
Food allergens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the distribution of atopic eczema?

A

Flexures

Infants - face to body

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are five signs of atopic eczema?

A 
Erythematous scaly patches
Vesicles
Excoriations
Lichenification
Post-inflammatory hypo/hyperpigmentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Name two complications of atopic eczema.

A

Secondary infection with s.aureus

Eczema herpeticum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the treatment of eczema herpeticum?

A

PO or IV aciclovir

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is the triple combination treatment of atopic eczema?

A

Topical steroid
Emollients
Bath oil/soap substitute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are three side effects of topical steroids?

A

Skin atrophy
Telangiectasia
Adrenal suppression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the management of fissured digits in eczema?

A

Haelan tape (Fludroxycortide)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of cream is initiated in secondary care for atopic eczema?

A

Topical immunomodulators such as tacrolimus ointment or pimecrolimus cream

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What antibiotic is prescribed for secondary infection of atopic eczema?

A

PO flucloxacillin 7-10d

/Erythromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is pompholyx eczema?

A

Itchy vesicles/blisters on palm and sides of fingers.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

When should patch testing be considered?

A

Irritant/allergic dermatitis suspected

Hand eczema.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the classification of dermatophytosis (tinea infections)?

A 
Corporis (body)
Capitis (scalp)
Pedis (feet)
Cruris (groin)
Unguium (nails)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How are tinea infections diagnosed?

A

Microscopy of skin and nail specimens - hyphae and spores

Woods UV light for tinea capitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What is the treatment of tinea infection?

A

Clotrimazole/miconazole cream

Capitis and Unguium require systemic agents such as terbinafine OD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Name four risk factors for candidiasis infection?

A

Broad spectrum antibiotics
Immunocompromise
Pregnancy
Diabetes mellitus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How does oral candidiasis present?

A

Pseudomembranous - curd like white patches in the mouth

Acute erythematous - can have marked erythema and soreness

37
Q

What is the treatment of oral candidiasis?

A

Miconazole gel or nystatin suspension

38
Q

What are the symptoms of oesophageal candidiasis?

A

Dysphagia/retrosternal pain

Usually oropharyngeal candidiasis too

39
Q

What is oesophageal candidiasis associated with?

A

Treatment of haematological malignancies

40
Q

How is oesophageal candidiasis diagnosed?

A

Therapeutic trial of fluconazole

Endoscopy

41
Q

What is the treatment of oesophageal candidiasis?

A

Admission

PO fluconazole, can escalate to IV fluconazole

42
Q

Name four types of candida skin infection.

A

Napkin dermatitis
Balanitis
Intertrigo
Chronic paronychia/onychomycosis

43
Q

How are topical candida skin infections managed?

A

Topical imidazole cream e.g. clotrimazole

If itchy, add mild corticosteroid

44
Q

What is pityriasis versicolor?

A

Flaky velvety discoloured patches/macular lesions, with mild itching, appear mainly on the chest and back
Proliferation of malassezia fungi and change to a pathological mycelial form

45
Q

What are three risk factors for pityriasis versicolor?

A

Hyperhidrosis
Occlusive clothes
Immune suppression

46
Q

How is pityriasis versicolor diagnosed?

A

Clinical

Examination using Wood’s light

47
Q

What is the treatment of pityriasis versicolor?

A

Clotrimazole cream or shampoo

48
Q

What factors exacerbate pruritus ani?

A

Sweating
Heat
Incontinence
Bowel movement

49
Q

What are some secondary causes of pruritus ani?

A

Primary skin conditions
Infection e.g. candida, threadworm
Anal disease e.g. fissure

50
Q

How is pruritus ani managed?

A

Bismuth subgallate/zinc oxide
Hydrocortisone 1%
Chlorphenamine

51
Q

When do you refer patients to colorectal surgeons for exclusion of anorectal pathology in the case of pruritus ani?

A

Self care measures and symptomatic treatment do not settle symptoms after 6 weeks
Negative blood tests

52
Q

Give five causes of pruritus vulvae?

A 
Sensitive vulval skin
Primary skin conditions
Urinary or faecal incontinence
Menopause
Pregnancy
53
Q

What are four signs of herpes skin infection?

A

Herpetic whitlows
Cold sores
Vesiculation
Tingling irritating prodrome of around 4-6 hours

54
Q

What should you do if not sure that a patient has a herpes skin infection?

A

Take a swab of blister fluid for virology

55
Q

What is the treatment of herpes simplex skin infection?

A

Symptomatic treatment unless immunocompromised or atopic eczema.
Aciclovir 400mg 5x daily

56
Q

What is the treatment of human papilloma virus (warts)?

A

Cryotherapy or topical salicyclic acid

57
Q

What is the treatment of scabies?

A

5% permethrin cream

58
Q

What are four signs of scabies?

A 
Burrows
Finger web crusting
Nodules
Blisters
VERY ITCHY
59
Q

What is the treatment of lice?

A

Dimeticone 4% lotion

Malathion 0.5% lotion

60
Q

What is urticaria?

A

Skin rash occurring in reaction to an antigen

61
Q

What is urticaria pigmentosa?

A

Generalised eruption of cutaneous mastocytosis

62
Q

What are the signs and symptoms of urticaria pigmentosa?

A 
Hives and Darier's sign
Diarrhoea
Tachycardia and Vascular collapse
Nausea and vomiting
Headache
63
Q

What is the histology of urticaria vasculitis?

A

Cutaneous lesions resemble urticaria but histologically shows features of vasculitis.

64
Q

How is urticarial vasculitis diagnosed?

A

Clinical
Skin biopsy and histology
Low complement/anti-C1q antibodies

65
Q

What is the cause of seborrheic eczema?

A

Overgrowth of malassezia furfur and strong cutaneous reaction

66
Q

What are some presentations of seborrheic eczema?

A

Cradle cap
Erythematous scaling
Dandruff
Blepharitis

67
Q

What is the treatment of seborrheic eczema?

A

Daktacort preparation

Ketoconazole shampoo

68
Q

How are allergic and irritant dermatitis diagnosed?

A

Patch testing

69
Q

What are some common allergens for allergic contact dermatitis?

A 
Nickel
Chromates
Lanolin
Rubber
Plants
70
Q

What are some signs of varicose eczema?

A

Scaling/crusting in gaiter area

Signs of stasis - hyperpigmentation, oedema, atrophie blanche, venous leg ulcers

71
Q

What is the treatment of varicose eczema?

A

Ankle exercises, elevation, compression to control oedema
Emollients and moderately potent corticosteroid
Ichthammol/zinc bandages

72
Q

How does discoid/nummular eczema present?

A

Well defined, v itchy, papules/plaques that may be scaly or vesicular.
Symmetrical distribution on trunk and limbs

73
Q

What is the treatment of nummular eczema?

A

Triple therapy except the corticosteroid is potent/very potent.

74
Q

Define impetigo.

A

Superficial infection of the skin.

75
Q

What is the usual causative organism in impetigo?

A

S.aureus

Strep pyogenes

76
Q

What is the treatment of non-bullous and bullous/resistant impetigo?

A

Non-bullous - fusidic acid TD 7d

Bullous - PO flucloxacillin

77
Q

What is the name for infections of the dermis and deep dermis and subcutaneous tissue?

A

1) Erysipelas

2) Cellulitis

78
Q

How do you differ between erysipelas and cellulitis?

A

Cellulitis has poorly demarcated borders

79
Q

What are the two types of melanocytic naevi?

A

Congenital and acquired

80
Q

What is a seborrheic wart?

A

Common benign hyperkeratotic skin lesion associated with ageing

81
Q

What is seen on dermoscope in seborrheic warts?

A

Thickened epidermis
Gyri and sulci
Milia like cysts

82
Q

What is the treatment of seborrheic warts?

A

Cryotherapy when there is cosmetic dislike or repeated irritation

83
Q

Define photosensitivity and photoaggravation

A

1) conditions triggered by light

2) disorders worsened by light but not due to abnormal sensitivity

84
Q

What occurs with polymorphic light eruption?

A

Hours-days after light exposure, itchy red papules, vesicles, and plaques appear on exposed sites.
Itchy and burning

85
Q

How is polymorphic light eruption managed?

A

Prevention - sun avoidance and protection

Treatment of acute attack - potent topical steroids, short course oral steroids

86
Q

What is solar urticaria?

A

The skin swells within minutes of exposure to natural sunlight or an artificial light source emitting UV radiation

87
Q

What are the causes of acanthosis nigricans?

A

GI cancer
Diabetes or obesity
PCOS, acromegaly, Cushing’s

88
Q

How do you differentiate between a sebaceous cyst and a lipoma?

A

Both are smooth and compressible

Sebaceous cyst - central punctum, more superficial, overlying skin is not mobile
Lipoma - no punctum, deeper, overlying skin is mobile

Phase 3B (20 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions