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Dermatology SB > Diseases > Flashcards

Diseases Flashcards

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Dermatology Board Prep flashcards
1
Q

what is hyperkeratosis

A

increased thickness of keratin layer

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2
Q

what is parakeratosis

A

persistence of nuclei in the keratin layer

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3
Q

what is acanthosis

A

increase thickness of epidermis

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4
Q

what is seen in warts

A

papillomatosis

irregular epithelial thickening

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5
Q

what is the pathology seen commonly in eczema

A

spongiosis - oedema between keratinocytes

inflammatory cell infiltrate

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6
Q

what is the common description of eczema

A

itchy, ill-defined, erythematous and scaly

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7
Q

what is acute presentation of eczema

A

papulovesicular
erthematous lesions
oedema
scaling/crusting

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8
Q

what is chronic phase of eczema

A

lichenification
elevated plaques
excoriation
increased scaling

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9
Q

what are common substances causing contact allergic dermatitis

A

nickel
topic therapies
chemicals

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10
Q

what is the immunopathology of contact allergic dermatitis

A 
1 - langerhans cells process antigen
2 - present to Th cells in dermis
3 - migrate to lymphatics 
4 - subsequent antigen challenge
5 - specifically sensitised T-cells proliferate and migrate to and infiltrate skin. Dermatitis
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11
Q

what investigation is done for contact allergic dermatitis

A

patch testing

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12
Q

how is irritant dermatitis different from contact allergic dermatitis

A

Non-specific physical irritation rather than a specific allergic reaction
e.g. nappy rash

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13
Q

what complications does irritant dermatitis have

A

implications for occupation i.e. problem with latex

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14
Q

what is the common description of atopic eczema

A 
Itch
Ill-defined erythema & scaling
Generalised dry skin
Flexural distribution 
Associated with other atopic diseases - asthma, allergic rhinitis, food allergy
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15
Q

what must be present in atopic eczema

A

itch

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16
Q

where are the flexor areas affected in eczema

A 
back of knees
inside of wrists
inside of elbows
front of ankle 
neck/eyes/genitals (less common)
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17
Q

what organisms commonly infects eczema

A

staph aureus

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18
Q

what is characterised by monomorphic punched-out lesions

A

eczema herpecticum

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19
Q

what virus causes eczema herpecticum

A

Herpes Simplex Virus

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20
Q

what gene has been linked to atopic eczema

A

filaggrin

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21
Q

what eczema can be caused by being immobile

A

stasis eczema

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22
Q

what is stasis eczema secondary to

A

hydrostatic pressure
oedema
red cell extravasation

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23
Q

Sx and Tx of Lichen Simplex

A

Can be due to scratching skin - seen on wrists, forearms, ankles and leg. White areas can be seen in the inner mouth.

Purple
Pruritic (itchy)
Poly-angular
Papules

tx - potent Topical steroid

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24
Q

what virus causes chickenpox and shingles

A

Varicella Zoster Virus

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25
Q

what does Varicella cause

A

Chickenpox

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26
Q

what does Zoster cause

A

Shingles

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27
Q

what are possible complications of chickenpox

A 
secondary bacterial
pneumonitis
haemorrhagic
scarring, absent or minor
encephalitis
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28
Q

when can chickenpox being aggressive

A

in immunocompromised adult

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29
Q

what is neonatal VZV

A

Secondary to chickenpox in mother in late pregnancy
Higher mortality
Prevention with Varicella Zoster Immune Globulin in susceptible women in contact

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30
Q

what is shingles

A

reactivation VZV

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31
Q

how is shingles different from chickenpox

A

dermatomal distribution

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32
Q

who gets shingles

A

elderly and immunocompromised

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33
Q

presentation of shingles

A

tingling/pain
erthyema
vesicles
crusting

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34
Q

what disease classical presents with Vesicles and pain in auditory canal and throat

A

Ramsay-Hunt Syndrome

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35
Q

what nerves is affected in Ramsay-Hunt Syndrome and what complications can arise

A

(Always affected) CNVII - causes facial palsy

(secondary ) CNVIII - causes deafness/vertigo/tinnitus

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36
Q

pre-school child with primary gingivostomatitis - what causes this?

A

HSV

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37
Q

characteristics of HSV

A

primary gingivostomatitis
extensive ulceration in and around mouth
blistering rash at vermillion border
can spread

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38
Q

where can HSV spread

A

finger or eczema
e.g. herpetic whitlow
OR
eczema herpeticum (LIFE THREATENING)

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39
Q

what does HSV type 1 cause

A

main cause of oral lesions
causes half of genital herpes
causes encephalitis

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40
Q

what does HSV type 2 cause

A

rare cause of oral lesions
causes half of genital cases
encephalitis / disseminated infection (particularly in neonates)

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41
Q

what is used to treat VZV and HSV

A

Aciclovir

42
Q

Aciclovir eliminated latent virus - true or false

A

false

it does not

43
Q

what infections trigger erythema multiform

A

HSV

Mycoplasma pneumonia

44
Q

what characterises erythema multiforme

A

target lesions with erythema

45
Q

what is common in children and are self limiting

A

molluscum contagiosum

46
Q

what is the typical appearance of molluscum contagiosum

A

Fleshy, firm, umbilicated, pearlescent nodules

47
Q

what causes warts and possible tx

A

Human papilloma virus

self limiting but topical salicylic acid can be used

48
Q

what HPV causes cervical cancer

A

HPV types 16 and 18

49
Q

what does HPV 6 and 11 cause

A

Genital warts

50
Q

what HPV causes warts/verrucas

A

HPV 1 and 4

51
Q

disease that causes blistering rash in back of mouth

A

herpangina

52
Q

what causes herpangina

A

enterovirus

e.g. coxsackie virus, echovirus

53
Q

what causes hand, foot and mouth disease

A

coxsackie virus

i.e. enteroviruses

54
Q

what is a.k.a slapped cheek disease and what causes it

A

erythema infectiosum

parvovirus B19

55
Q

what are complications of parvovirus B19

A

spontaneous abortion
aplastic crises (drop in haemoglobin, short RBC life span)
chronic anaemia

56
Q

how does Orf classical present

A

Firm, fleshy nodule on hands of farmers

57
Q

what is the primary infection of syphilis

A

chancre - painless ulcer typically in genitals

58
Q

what is the secondary phase of syphilis

A

red rash over body

particularly on soles of feet and palms of hands

59
Q

typically seen in secondary phase of syphilis

A

mucous membrane ‘snail track ulcers”

60
Q

what causes syphilis

A

treponema pallidum

61
Q

what is tertiary syphilis

A

when is affects CNS, CV

62
Q

how is syphillis treated and diagnosed

A

Dx - blood test or PCR swab of chancre

Tx - injections of penicillin

63
Q

what bacteria causes lyme disease

A

borrelia burgdorferi

64
Q

early classic presentation of lyme disease and later complications

A

early - erythema migrans

late - nerve palsies, arthritis, heart block

65
Q

tx of lyme disease

A

doxycyline or amoxicillin

66
Q

what is the most common type of psoriasis

A

psoriasis vulgaris

i.e. chronic plaque psoriasis

67
Q

what are key features of psoriasis

A

symmetrical

Sharply demarcated, scaly, erythematous plaques

68
Q

areas of trauma developing psoriasis - name?

A

Koebner phenomenon

69
Q

psoriatic nail changes

A

onycholysis
nail pitting
dystrophy
subungal hyperkeratosis

70
Q

what is Acne vulgaris

A

Chronic inflammatory disease of the pilosebaceous unit.

71
Q

what is the pathogenesis of Acne

A

Poral occlusion
Bacterial colonisation of duct
Dermal inflammation
Increased sebum production

72
Q

which areas does acne affect

A

related to sites with most sebaceous glands

Face, upper back, anterior chest

73
Q

acne grading

A

Mild- scattered papules and pustules, comedones

Moderate - numerous papules, pustules & mild atrophic scarring

Severe - as above, cysts, nodules and significant scarring

74
Q

what is rosacea

A

Prominent facial flushing exacerbated by sudden change in temperature , alcohol & spicy food

75
Q

what areas does rosacea affect

A

nose, chin, cheeks, forehead

76
Q

tx of rosacea

A

reduce aggravating factors
topical metronidazole
oral tetracycline

77
Q

what can treat telangiectasia

A

vascular laser

78
Q

Bullous pemphigoiD

A

split is Deeper

through DEJ

79
Q

pemphiguS vulgaris

A

split more Superficial

intra-epidermal

80
Q

who gets Bullous pemphigoid

A

elderly

81
Q

what is characteristics of bullous pemphigoid

A

localized to one area, or widespread on the trunk and proximal limbs
large tense bullae on normal skin or erythematous base
blisters burst to leave erosions

82
Q

Nikolsky sign is positive in bullous pemphigoid - true or false

A

false

it is negative

83
Q

where does pemphigus vulgaris affect

A

scalp, face, axillae, groin

84
Q

symptoms/signs of pemphigus vulgaris

A

Flaccid vesicles/bullae – thin roofed
Lesions rupture to leave raw areas - Increased infection risk
Nikolsky sign positive
Mucosal involvement (eyes, genitals) : very common

85
Q

Bullous pemphigoid vs pemphigus vulgaris - mortality

A

Pemphigus very high mortality if untreated

Pemphigoid up to 20% mortality I year treated

86
Q

Bullous pemphigoid and pemphigus vulgaris - Ix

A

Pemphigoid - Skin biopsy +ve immunofluorescence; linear IgG and C3 along basement membrane

Pemphigus - +ve immunofluorescence; intracellular IgG giving a crazy paving effect

87
Q

Bullous pemphigoid and pemphigus vulgaris - Tx

A

Pemphigoid - Clobetasol cream up to 40g/day

Pemphigus - Prednisolone 60-80mg. Can continue onto Rituximab.

88
Q

what Tx is used specifically in pemphigoid

A

tetracycline antibiotics, nicotinamide

89
Q

clinical presentation of type 1 hypersensitivity reaction

A

urticaria (hives/wheals)
angioedema
wheezing/asthma
Anaphylaxis

90
Q

what is tested during anaphylaxis

A

tryptase levels

91
Q

what test are used to identify allergen

A

Specific IgE (RAST)
Skin prick
Challenge test

92
Q

Mx of allergy

A

avoidance
anti-histamines
corticosteroids
adrenaline autoinjector

93
Q

amount of adrenaline in auto injector

A

300µg adults

150µg children

94
Q

onset of reaction in Type IV allergy

A

24-48 hours

95
Q

how is Type IV investigated

A

patch testing

96
Q

what are the 4 causes of itch

A

Pruitoceptive
Neuropathic
Neurogenic
Psychogenic

97
Q

what causes Pruritoceptive itch

A

something (usually associated with inflammation or dryness) in skin that triggers itch

98
Q

what causes Neuropathic itch

A

damage of any sort to central or peripheral nerves causing itch

99
Q

what causes Neurogenic itch

A

no evident damage in CNS, but itch caused by, e.g., opiate effects on CNS receptors

100
Q

primary biliary cirrhosis is associated with itch - true or false

A

true

Dermatology SB (11 decks)

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