Exam

Question 1

Management of basal cell papilloma/seborrhoeic keratosis

Answer 1

Cryotherapy

Question 2

Why are keratoacanthomas often excised?

Answer 2

Difficulty to distinguish between a SCC

Question 3

Difference between a papule and a nodule?

Answer 3

Papule is less than 0.5cm

both are solid raised lesions

Question 4

Staph infection around/within a hair follicle

Answer 4

Furnuncle

Question 5

Functions of skin:

a) Langerhans cells
b) Merkel cells

Answer 5

a) Antigen presenting cells of the skin

b) light touch mechanoreceptors

Question 6

Four layers of epidermis from deep –> superficial

Answer 6

Basal
Prickle
Granular
Stratum corneum

Question 7

Pearly lesion with a rolled edge and telangiectasia

Answer 7

Basal cell carcinoma

Question 8

BCC treatment options? (4)

Answer 8

Excision
Moh’s micrographic surgery
Cryotherapy
Imiquimod

Question 9

What pattern of sun exposure broadly predisposes to a) BCC b) SCC?

Answer 9

a) intense, intermittent e.g. severe episodes of sunburn

b) chronic sun exposure e.g. an outside occupation like a farmer

Question 10

Squamous cell carcinoma in situ is also known as…

Answer 10

Bowen’s disease

Question 11

SCC precursor lesions? (2)

Answer 11

Actinic keratoses

Bowen’s disease

Question 12

Patch of malignant melanocytes proliferating radially along the dermo-epidermal junction

Answer 12

Lentigo maligna

Question 13

Commonest melanoma type?

Answer 13

Superficial spreading

Question 14

Melanoma subtypes:

a) invasive growth from outset
b) seen on sole/palm/subungual
c) radially prolferating along the DEJ
d) diffuse blue/black patch on lower back/buttocks of a child

Answer 14

a) nodular
b) acral
d) lentigo maligna
d) Mongolian blue spot (congenital)

Question 15

ABCDE criteria for assessing melanoctyic lesions?

Answer 15

Asymmetry
Border (irregular)
Colour (heterogenous)
Diameter (>6mm)
Evolution over time

Question 16

Blistering skin disease:

IgG deposition in a “chicken-wire” pattern around cells within the epidermis

Answer 16

Pemphigus

Question 17

Blistering skin disease:

linear IgG deposition along the basement membrane

Answer 17

Pemphigoid

Question 18

Blistering skin disease:

IgA deposition in clusters around the dermal papillae

Answer 18

Dermatitis herpetiformis

Question 19

Mutations in which gene predispose to atopic eczema?

Answer 19

Filaggrin

Question 20

Management principles of eczema? (3)

Answer 20

Antimicrobial soap substitutes
Liberal use of emollients
Topical steroids

Question 21

Episodic eczema of the palms/soles, with bullae formation

Answer 21

Acute pompholyx eczema

Question 22

Management of rosacea? (3)

Answer 22

Trigger avoidance
Topical metronidazole
Antibiotics/roaccutane

Question 23

What treatment should be avoided in rosacea and why?

Answer 23

Topical steroids- cause widespread facial erythema and rebound flares

Question 24

Management of acne? (4)

Answer 24

Benozyl peroxide
Antibiotics
Isotretinoin
COCP/Dianette

Question 25

Signs of chronic venous hypertension? (5)

Answer 25

``` Stasis eczema Hyperpigmentation Lipodermatosclerosis Varicose veins Atrophie blanche ```

Question 26

Painful, palpable purpuric lesion --> punched out ulcer?

Answer 26

Vasculitic ulcer

Question 27

Mainstay of venous ulcer treatment?

Answer 27

Compression bandaging

Question 28

Violaceous plaques --> atrophy to become brown/yellow, seen in diabetics

Answer 28

Necrobiosis lipoidica

Question 29

Treatment of impetigo?

Answer 29

Fusidic acid if localized, flucloxacillin if generalized

Question 30

Causative agent of cat-scratch disease?

Answer 30

Bartonella

Question 31

Treatment of localized fungal disease?

Answer 31

Terbinafine, miconazole, clotrimazole (antifungals)

Question 32

Risk of systemic antifungal treatment?

Answer 32

Hepatotoxicity

Question 33

Treatment of viral warts? (4)

Answer 33

Salicylic acid ("wart paint") for 12 weeks Cryotherapy Podophyllotoxin Imiquimod

Question 34

Fluid-filled blister on finger due to direct inoculation of herpes virus?

Answer 34

Herpetic whitlow

Question 35

Causative agent of molloscum contagiosum?

Answer 35

Pox virus

Question 36

Multiple purplish patches caused by herpes virus 8

Answer 36

Kaposi sarcoma

Question 37

Child with fever, severe sore throat and vesicular rash over pharynx? Causative agent?

Answer 37

herpangina from coxasckie virus

Question 38

HPV subtypes: a) common warts b) genital warts

Answer 38

a) 1, 2, 4 | b) 6, 11, 16 and 18

Question 39

Sites favoured by psoriasis?

Answer 39

Extensor surfaces of knees and elbows

Question 40

Nail involvement in psoriasis? (3)

Answer 40

Pitting, oncholysis, subungual hyperkeratosis

Question 41

Management of psoriasis?

Answer 41

``` Vitamin D analogues Steroids for flares Narrowband UVB Coal tar preparations Dithranol ```

Question 42

Eruption of itchy reddish-purple papules on wrist, back and genitalia + lacy white streaks in oral mucosa

Answer 42

Lichen planus

Question 43

Short flu-like illness --> single/few oval patches --> sudden eruption all over body

Answer 43

Pityriasis rosea

Question 44

Patches of discolouration caused by Malassezia yeast

Answer 44

Pityriasis versicolor