Dermo Summary Q's

Question 1

Name 3 different topical steroids of increasing potency (+dose)

Answer 1

Dermovate (Clobetasol propionate 0.05%)
Betnovate (betamethasone 0.02%)
Hydrocortisone 1%

Question 2

a patient with history of eczema, present to GP surgery with vesicular rash over face, what is spot diagnosis?

Answer 2

eczema herpeticum

Question 3

triggers of atopic eczema (4)

Answer 3

temperature, humidity, stress, ??

Question 4

what systemic conditions can present as Erythema Nod and Pyoderma Gang?

Answer 4

EN - IBD, Sarcoid, Strep, Prego

PG - RA, UC, PSC, haemo CA

Question 5

name 5 dermo coniditons assoc with systemic disorder?

Answer 5

PG, EN, dermatitis herpetiformis, aconthiasis nigracans, thyroid acropachy, jaundice, cushings/addisons, acne (pcos)

Question 6

DDx for skin cancer (4)

Answer 6

solar keratosis, BCC, SCC, lentigo maligna

Question 7

Pt suspected skin CA, what Investigations, staging and treatment will be done?

Answer 7

I - biopsy stained with melaninA and FNA lymph node
Stage - TNM (breslows, clarkes, sentinal node, ?mets)
T - MOH’s, cryotherapy, chemo if mets

Question 8

RF for cellulitis

Answer 8

wound, prev surg, obvious puncture site (bites, needle) venous disease, preg??

Question 9

what abx’s used for necro fas (3)

Answer 9

clindamycin, vanc, ben pen

Question 10

name 3 precautions/side effects of oral retinoid?

Answer 10

isotretinoin - cant be preg (teratogen) / ??depression / dry lips, dry skin, LFT abnorm

Question 11

pathway of treating ACNE

Answer 11

OCP, topical retinoids +/- topical ABx’s

–> systemic abx’s –> refer and systemic retinoids

Question 12

pathway of treating PSORIASIS

Answer 12

topical emollients, steroids, vit D3, coal tar

• -> phototherapy
• -> methotrexate (only really if nail changes/severe)

Question 13

pathway of treating ECZEMA

Answer 13

topical emollients, steroids +/- anti-hist

–> flares = potent steroids

Question 14

what drugs can predispose to psoriasis?

Answer 14

B Blockers, anti malarials, lithium

Question 15

what dermo condition commonly follows a strep throat infection?

Answer 15

guttate psoriasis

Question 16

patient with severe psoriasis is started on methotrexate, what precautions and advice must be given? (3)

Answer 16

start folate
warn of risk to lungs (do cxray +/- PFT’s)
can cause kidney damage (do U+E’s)
warn of risk of infection (take baseline RBC/WBC count)

Question 17

how would you manage a patient with ??pyoderma Gang or erythema nod?

Answer 17

PG - topical/oral steroids

EN - bedrest and NSAIDS

Question 18

how could a patient potentially prevent developing skin ca?

Answer 18

Slip - into long sleeved clothes/ into the shade
Slop - on some suncream
Slap - on a hat

Question 19

if a patient attends a+e with cellulitis, and systemicly unwell, what medication would you give and what route?

Answer 19

IV Vanc and Ciproflox

oral fluclox if stable

Question 20

signs of severe burns o/e

Answer 20

soot in mouth, burnt/swollen tongue/oropharynx, hoarseness, singed nose hair, burns not blanching