Dr. Akinbami Flashcards
ALOPECIA:
a. Total loss of scalp hair called
b. Partial loss of scalp hair called
c. Total body hair loss called
a. ALOPECIA TOTALIS
b. ALOPECIA AREATA
c. ALOPECIA UNIVERSALIS
Scarring alopecia denotes ____ loss
Irreversible Loss
maybe signs of systemic diseases
Treatment of Alopecia (hint: 2)
Treatment difficult
Topical/intralesional steroid
Minoxidil
Which of the Herpes simplex strain is sexually transmitted and causes genital lesions
HSV-2
Prickle cell layer of the epidermis is stratum ______
Stratum spinosum
Skin distribution of Psoriasis is on the symmetrical flexural areas, T/F
FALSE
On the symmetrical extensor area
Skin distribution of Atopic dermatitis is on the asymmetric flexural area, T/F
FALSE
On the Symmetrical flexural areas
What surgical treatment is used for tattoo removal
Dermabrasion
Topical treatment has no systemic toxicity, T/F
FALSE
Reduced systemic toxicity.
Choice of vehicle for local application is as important as choice of the active ingredient, T/F
TRUE
Greases reduce moisture loss while many lotions do the reverse.
Circumscribed flat area of skin discoloration <0.5cm is a _______
Macule
Solid elevation of the skin <5mm is _____
Papule
Solid elevation of the skin exceeding 1cm in diameter is _____
Nodule
Associate the primary skin lesion with the disease condition
a. Lepromatous leprosy
b. Keloids
c. Acne
d. Neurofibromatosis
e. Onchocerciasis
f. Urticaria
g. Herpes simplex
h. Herpes zooster
a. Nodule
b. Plaque
c. Papule
d. Nodule
e. Nodule
f. Wheal
g. Vesicle
h. Vesicle
Pus containing dermal elevation <5mm is _____
Pustle
Nodule filled with compressible fluid or semisolid material is______
Cyst
Associate the secondary skin lesion with the disease condition
a. Seborrheic dermatitis
b. Impetigo
c. Infected dermatitis
d. Psoriasis
e. Onchocerciasis
f. Scabies
a. Scales
b. Crust/scabs
c. Crust/scabs
d. Scales
e. Excoriations
f. Excoriations
In keloids, inflammatory reactions and fibroblasts are much fewer than in scars, T/F
TRUE
Common in pruritic diseases that can present with excoriation are (hint: 5)
Uremia
Scabeis
Urticaria
Obstructive jaundice
onchocerciasis
Mention hypopigmented (hypomelanosis) lesions (hint: 4)
PITYRIASIS ALBA
TINEA VERSICOLOR
SEBORRHEIC DERMATITIS
LEPROSY
Mention Depigmented (Amelanosis) lesions (hint: 5)
ALBINISM
PIEBALDISM
VITILIGO
ONCHOCERCA DERMATITIS
POST BURNS
Mention hyperpigmented (hypermelanosis) lesions (hint: 7)
NAEVI
CAFÉ AU LAIT SPOTS
ECZEMA
MELASMA (CHLOASMA)
FIXED DRUG ERUPTION
LENTIGOS
MALIGNANT MELANOMA
Classic warning signs of skin malignancy are (hint: ABCDE)
A Asymmetry
B Border irregularity
C Colour (Non-uniform-brown, red, black, white)
D Diameter (>6mm)
E Evolving over time
Malignant melanoma is common in dark people, T/F
FALSE
Rare in dark people
Malignant melanoma is related to exposure to sunlight, T/F
TRUE
The 4 types of malignant melanoma recognized are
- Lentigo maligna melanoma
- Superficial spreading melanomas
- Nodular melanoma
- Acral lentiginous melanoma
The form of Malignant melanoma that occurs in black people is
Acral lentiginous melanoma
Treatment of Malignant melanoma (hint: 3)
Wide excision
Nodal dissection
Chemotherapy
Can Chemotherapy be used to treat Malignant melanoma, T/F
TRUE
Seborrheic dermatitis is synonymous to Eczema, T/F
TRUE
Treatment for Seborrheic dermatitis (hint: 3)
Treatment with selenium sulphide or ketoconazole shampoo and 1% hydrocortizone cream
What test do you carry out in a suspected contact dermatitis
Patch test
Patch test may help in identifying offending agent
Lesions of contact dermatitis can never spread, T/F
FALSE
Lesion tends to conform to sites of contact initially but may later spread
Acne affects more females than males, T/F
FALSE
Mention causes of Acne (hint: 5)
PCOS
Cushing’s syndrome
Virilising tumours
Metabolic steroids
Acne vulgaris
Peak age for Acne vulgaris is _____
18
Drug Eruption Types (hint: 6)
1.Maculo-papular/exanthematous.
2. Urticaria +- angioedema/anaphylaxis
3. Exfoliative dermatitis (sulphonamides, carbamazepines)
4. Erythema multiforme major (Steven-Johnson Syndrome)
5. Toxic Epidermal Necrolysis
6. Fixed Drug Eruption
Inflammatory acne is result of host response to the _____
Follicular propionibacterium acne
Treatment of acne
Soap and water wash
T4C 500mg BD x 8/52
Generalized eruption mostly on the trunk, arms & thighs (shirt & short distribution) preceded by Herald patch is _____
Pityriasis Rosea
Causative organism in Pityriasis versicolor
Pityrosporum orbiculare
(Org. Previously called malasezia furfur)
Treatment for Pityriasis alba is _____
Resolves spontaneously over months /years
No treatment required
Treatment of Pityriasis versicolor
Topical imidazole antifungal (Clotrimazole)
Topical selenium sulphide shampoo to affected area@ night, wash following am. Repeat x2 @ weekly interval
Pityriasis alba is associated with _____
Atopy
Management of Callosities is
Keratolytics (5-10% salicylic acid ointment or 10% urea cream)
Callosities is painful, T/F
FALSE
Corns is painful, T/F
TRUE
Treatment of Corns
Attention to foot wears
Keratolytics
Cushioning (Corn pads)
Autosomal dominant hyperkeratosis of palms/soles is______
KERATODERMA
Treatment is Keratolysis
Most common form of skin cancer
Basal cell cancer
Basal cell cancer is mainly on light exposed areas esp. face, T/F
TRUE
The Dermatophytes most commonly involved in Dermatophytosis are (hint: 3)
Microsporum
Trichophyton
Epidermophyton
The following dermatophyte infection and their related affected body parts
a. Tenia barbae
b. T. manus
c. T. cruris
d. T.Capitis
e. T corporis
f. T unguium
g. T, pedis
a. Bearded areas of face & neck
b. Hand(s)
c. Genital, pubic, groin, perineal, perianal (Jock itch)
d. Skin of the scalp, eyebrows, eyelashes
e. Skin of body
f. Toenails or Fingernails (onychomycosis)
g. Foot- soles of feet & interdigital spaces (Athlete’s foot)
Onychomycosis is also called ______
Tinea unguium
Epidermophyton spp. affects mostly the _____ part of the body
Feet
Treatment for dermatophytosis
Treatment by topical/systemic antifungal
Scabies is caused by _______
An itch mite, Sarcoptes scabei
Skin lesions seen in scabies is due to __________
Hypersensitivity reaction to the parasite
The pruritus in scabies occurs mostly at night, T/F
TRUE
Rash in scabies is described at __________
Papulopustular rashes esp.
in interdigital spaces
Flexor surface of the wrist
Elbow and axillary fold
Areolar of breast
Male genitalia, esp. phallus
Along belt line
Buttocks
Treatment for scabies
Bath & scrub lesion wt sponge to open up burrows
25% benzyl benzoate cream/lotion applied from top of patient to bottom
Alternatively, permethrine, malathion, 1% lindane, crotamiton (Eurax) or 10% sulphur ointment is used
Pediculosis is caused by ________
A lice, Pediculus humanus coporis/capitis/pubis
Pediculosis pubis is spread via ______
Direct contact (coitus)
Predisposing factors for Pediculosis (hint: 3)
Overcrowding
Dirty clothing
Poor personal hygiene
Treatment for Pediculosis
1% lindane (gamma benzene hexachloride, BHC)
Applied daily X 2/7 in form of shampoo, cream Or lotion or as combination of shampoo followed by cream or lotion
Disinfect combs, brushes and clothing
Herpes zooster affects posterior Root ganglia, T/F
TRUE
Treatment for Herpes zooster
- Acyclovir (Zovirax)
2.Post herpetic neuralgia
Opiods
TCAs
Carbamazepin
Gabapentin - Steroids may decrease incidence of post herpetic neuralgia, though it does not shorten period of acute pain
Plasmodium spp. is an obligate intracellular protozoa, T/F
TRUE
Which species of plasmodium can persist in the liver as Hypnozoites
P vivax & P ovale
some schizonts persists as HYPNOZOITE in liver and may remain dormant for weeks/months or up to 3yrs
Synchronous release of merozoites occur every 48hrs in P. falciparum, T/F
TRUE
Tertian malaria
Synchronous release of merozoites occur every 48hrs in P. vivax, T/F
TRUE
Tertian malaria
Synchronous release of merozoites occur every 48hrs in P. malariae
FALSE
Quartan malaria(72hrs)
Duration of macrogametocyte & microgametocyte in man lasts for ____days to _____months
7days to 2 months
P. malaria invades only young RBCs & reticulocytes,T/F
FALSE
Invades only aging RBCs
Duration of infection is shortest with P. falciparum, T/F
TRUE
Duration of infection is longest with P. vivax, T/F
FALSE
P. malariae
Which Plasmodium spp. is almost a commensal infection in some adults
P. malariae
Which Plasmodium spp. development is suppressed in patient of HbF, HbS
P. falciparum
Duffy antigen is required for infection with _____ Plasmodium spp.
Vivax
Breastmilk provides protection from Plasmodium spp., how?
B/c it is deficient in PABA
In stable endemic malaria, transmission is generally high, T/F
TRUE
In unstable malaria, herd immunity is low, T/F
TRUE
Define transmission index in malaria
Proportion of infants less than one year with parasitaemia
(microscopic proven parasitemia)
Spleen rate is above 75% in children aged 2-9yrs is Hyperendemicity, T/F
FALSE
Holoendemicity
In Holoendemicity, there is low adult spleen rate, T/F
TRUE
Spleen rate in Mesoendemicity is _____
11-50%
Sporozoites & gametocytes inducee pathologic changes, T/F
FALSE
_________ is associated with the affinity of parasitized RBC for vasular endothelium of capillaries of internal organs
Histidine-rich, falciparum protein knob
Dilutional hyponatremia seen in pathophysiology of malaria is due to ______& _______
Secondary Aldosterone & ADH secretion
Hypoglycemia in pathophysiology of malaria is due to ______
TNF & Impaired gluconeogenesis
Incubation period of plasmodium falciparum is b/w _____to ____days
8 - 20 days
Malaria paroxysm follows rupture of _______
Matured schizonts in RBC
The primary attack of malaria after the IP is characterized by ________
Influenza like syndrome, such as
Asthenia
Arthralgia
Myalgia
Headache, nausea
In tertian malaria, the paroxysm/cycle repeats itself every ______hours
48hrs
Nephrotic syndrome is a delayed complication of which Plasmodium spp.
P. malariae
The gold standard diagnosis for malaria is
Microscopy
Thick film is superior in terms of parasite identification, T/F
TRUE
Thick film superior in terms of parasite identification.
Thin film needed for specie identification
Leishman stain can be used for both thick and thin film, T/F
FALSE
Giemsa for thick & thin films
Leishman for thin film
1-10 parasites per 1 thick film field is how many +
3+
11-100 parasites per 100 thick film field is how many +
2+
Mention the 3 methods of microscopy based diagnosis of malaria
- Blood film exam.
- Quantitative Buffy coat (QBC)
- Benzothiocarboxypurine (BPC) method
_________ is based on detection of parasite specific Histidine-rich protein II
Parasight F antigen based test
Optimal T antigen based test detects ______ in Plasmodium parasite
Lactic dehydrogenase (pLDH)
The 4 types of serological tests to diagnose malaria are
- Indirect Fluorescent antibody Test (IFAT)
- Indirect Heamagglutination Test (IHAT)
- Immunoprecipitation technique (Double gel diffusion test)
- Enzyme linked immunosorbent assay (ELISA)
In uncomplicated malaria, Artemisinine base combination therapy is recommended. Give the 3 combinations & doses
Artemeter-lumefantrine(120 :20)
Artesunate (4mg/kg) + Amodiaquine (10mg/kg)
Artesunate (4mg/kg dly *3days) + Mefloquine 25mg base/kg
If the 3 ACT recommended in uncomplicated malaria fails, give ______
Oral Quinine
Targets for malaria chemoprophylaxis (hint: 5)
- Non-immune travelers to endemic countries
- Returning immigrants to endemic areas
- Pregnant women
- Immunocompromised
- Sickle cell anaemic patients
In malaria chemoprophylaxis in pregnancy (, when should the first dose be commenced and when should the last dose be given
First dose after 16th week’
Last dose not later than one month before EDD
Malaria chemoprophylaxis in Sickle cell disease patient
for children & adult + doses
PROGUANIL
Children 100mg daily
Adult 200 mg daily
Malaria Chemoprophylactic drugs in gen (hint: 3)
Atovaquone/Proguanil (Malarone)
Mefloquine (250mg weekly)
Doxycycline (250mg daily)
Define shock
State of overwhelming systemic reduction in tissue perfusion characterized by decreased cellular oxygen delivery and utilization as well as removal of waste by product of metabolism
N/B: Inadequate tissue perfusion
Hypotension is synonymous to shock, T/F
FALSE
Hypotension, though common in shock, is not synonymous with shock
Which shock has mortality rate of >60%
Cardiogenic shock
List the types of shock
HYPOVOLAEMIC SHOCK
CARDIOGENIC SHOCK
DISTRIBUTIVE SHOCK
OBSTRUCTIVE SHOCK
Anaphylactic shock is an example of distributive shock, T/F
TRUE
Neurogenic shock is an example of obstructive shock, T/F
FALSE
Septic shock is an example of ______ type of shock
Distributive shock
Pulmonary embolism will cause which shock?
Obstructive shock
Tissue hypoxia sets in when the ratio of oxygen delivery to oxygen consumption is ______
<2:1
Cellular hypoxia causes release of cytokines & secondary inflammatory mediators, T/F
TRUE