ENT and Derm

Question 1

erythema nudism

Answer 1

symmetrical, erythematous, tender heal without scarring, common cause - streptococcal infections, sarcoidosis, IBD, drugs

Question 2

pretibial myxoedema

Answer 2

symmetrical, erythematous lesions seen in Grave’s

shiny, orange peel skin

Question 3

necrobiosis lipoidica diabeticorum

Answer 3

shiny, painless areas or yellow/red skin , associated with telangiectasia

Question 4

hirsutism

Answer 4

androgen dependent hair growth in women, PCOS is bushings, congenital adrenal hyperplasia, androgen therapy, obesity adrenal tumour, androgen secreting ovarian tumour

Question 5

management of hirsutis

Answer 5

waxing, bleaching, cocp

Question 6

hypertrichosis

Answer 6

hair independent of androgens

Question 7

squamous cell carcinoma

Answer 7

no melanocytes, telengestasia around outside, rf - excessive exposure to sunlight, actinic keratoses, immunosuppression, smoking, long-standing leg ulcers,

Question 8

acne rosacea

Answer 8

chronic skin disease, affects nose, cheeks and forehead, flushing, telangiectasia, with persistent erythema, papillose and pustules, rhinopehyma,

management - topical metronidazole for mild symptoms, severe disease - systemic antibiotics, daily application of high-factor suncream, laser therapy for prominent telangiectasia

Question 9

vitiligo

Answer 9

autoimmunem loss melanocytes, depigmentation of the skin
associated conditions - type 1 DM, addison’s autoimmune thyroid disorders, pernicious anaemia, alopecia
management - sun bloc, camouflage make up

Question 10

sore throat

Answer 10

indications for abx - unilateral peritonsillitis, history of rheumatic fever, increased risk from acute infection (child with diabetes, immunodeficiency)
centor criteria - tonsillar exudate, tender cervical lympadenopathy or lymphadenitis, fever, cough,

PEN V or erythromycin 7/10 day

Question 11

pyoderma gangrenosum

Answer 11

lower limbs, initially small red papule, deep, red necrotic ulcer with violaceous border, accompanied systemic symptoms - fever, myalgia
IBD, RA, SLE, lymphoma, myeloid leukaemia, monoclonal gammopathy, PBC

management - oral steroids first line, other immunosuppressive therapy, role in difficult cases

Question 12

granuloma annulare

Answer 12

papular lesions, slightly hyper pigmented, hands, feet, extensor aspects arms and legs

Question 13

reactive lymphaedemopathy

Answer 13

most common neck swelling

Question 14

lymphoma

Answer 14

rubbery, painless lymphaedopathy, night sweats, splenomegaly

Question 15

thyroid swelling

Answer 15

hypo,eu. hyperthyroid, MOVES UPWARDS WHEN SWALLOWING

Question 16

thyroglossal cyst

Answer 16

<20 years old, midline, between the isthmus of thyroid and hyoid bone, moves upwards with profusion of the tongue, painful if infected

Question 17

pharyngeal pouch

Answer 17

posteromedial herniation between thropharyngeus and cricopharynxgeus, gurgles on palpation

sx - dysphagia, regurg, aspiration, chronic cough

Question 18

cystic hygroma

Answer 18

congenital lymphatic lesion, found in neck, most evident at birth

Question 19

branchial cyst

Answer 19

oval, mobile cyst, develops between sternocleidomastoid muscle and pharynx, develop due to failure of obliteration of second branchial cleft

Question 20

cervical rib

Answer 20

more common in adult females

Question 21

carotid aneurysm

Answer 21

pulsatile lateral neck mass, doesn’t move on swallowing

Question 22

erythema multiforme

Answer 22

hypersensitivity reaction,

target lesions, seen on back of hands / feet, spread to torso, pruritus occasionally seen