Formative week 1

Question 1

A 58 year old man presents in July with blisters on the dorsal aspect of his hands which have been appearing over the last few months, crust over and heal leaving scarring. He works as a joiner and is aware that his skin has also been more fragile than usual. You notice that he has a lot of hair growing on his cheeks. He is generally well and on no medication
What is the most likely diagnosis?

Answer 1

Porphyria Cutanea tardia

Question 2

What are functions of the skin?

Answer 2

Barrier function
Thermo regulation
Immune defence
Metabolism and detoxification
Communication
sensory

Question 3

What layer is odland bodies associated with?

Answer 3

Granular layer

Question 4

What layer is associated with corneocytes?

Answer 4

Keratin Layer

Question 5

What layer is associated with highly metabolically active small cuboidal cells?

Answer 5

Basal layer

Question 6

What layer is most associated with polyhedral cells with lots of desmosomes?

Answer 6

Prickle cell layer

Question 7

Naisl are biochemically similar to hair. True or false

Answer 7

TRUE

Question 8

Which nails grow fester- toe or finger

Answer 8

toe

Question 9

Which of the following is a component of the strain of MRSA (Methicillin Resistant Staphylococcus Aureus) which causes severe skin infection such as necrotising fasciitis?

Answer 9

Panton Valentine Leukocidin

Question 10

What virulence factors?- enables binding of the organism to host tissue

Answer 10

Adhesin

Question 11

What virulence factors?-enables the organism to invade a host tissue

Answer 11

Invasin

Question 12

What virulence factors?- enables the organism to avoid host defence mechanism

Answer 12

Impedin

Question 13

What virulence factors?- causes damage to the host directly

Answer 13

Aggressin

Question 14

What virulence factor? Induces damage to the host directly

Answer 14

Modulin

Question 15

A 3 year old boy presents on a sunny day in June. His mother reports he keeps crying and rubs at his skin when playing outside and this has been going on for a few weeks. His skin is sometimes a bit red, but there is never a rash and his skin is clear on examination now. He is skin type 1 with a few freckles evident, generally well, on no medication and there is no family history of skin problems.
What is the most likely diagnosis?

Answer 15

Erythropoietic protoporphyia

Question 16

The developmental growth pattern of skin follows which of the following

Answer 16

Blaschko’s lines

Question 17

Skin problems make up what percentage of all general practice consultations

Answer 17

15-23%

Question 18

What is the mediator of type 1 hypersensitivity reactions

Answer 18

IgE

Question 19

What is the mediator of type 11 and 111 hypersensitivity reactions

Answer 19

IgM and IgG

Question 20

What is the mediator of type 1V hypersensitivity reactions

Answer 20

Th1 cells

Question 21

Immediate hypersensitivity

Answer 21

Type 1

Question 22

Direct cell killing

Answer 22

Type 2

Question 23

Immune complex mediated

Answer 23

Type 3

Question 24

Delayed type hypersensitivity

Answer 24

Type 4

Question 25

Anagen

Answer 25

Growing phase

Question 26

Catagen

Answer 26

Involuting phase

Question 27

Telogen

Answer 27

Resting phase

Question 28

Where are langerhans cells formed?

Answer 28

Bone marrow

Question 29

What is vitamin D metabolism carried out by

Answer 29

Keratinocytes

Question 30

Where is energy stored

Answer 30

Subcutaneous fat

Question 31

Where is collagen found and what does it provide?

Answer 31

Found in dermis and provides tensile strength

Question 32

Where do cells proliferate from

Answer 32

Basal layer

Question 33

What are sebaceous glands attached to

Answer 33

Hair follicles in the skin

Question 34

WHAT IS THE COMMONEST SWEAT GLAND ON THE FACE

Answer 34

Eccrine

Question 35

Which glands are involved in scent

Answer 35

Apocrine glands

Question 36

What is the function of lymphatics

Answer 36

Immune surveillance

Question 37

What is the function of meissner's corpuscles

Answer 37

vibration sensation

Question 38

What is the function of eccrine glands

Answer 38

Moisten palms/soles for grip

Question 39

What is the function of pacinian corpuscles

Answer 39

Pressure sensation

Question 40

What is the function of apocrine glands

Answer 40

scent glands

Question 41

What is the function of sebaceous glands

Answer 41

Maintain skin barrier

Question 42

Are topical steroids lipophilic or lipophobic

Answer 42

They are lipophilic

Question 43

Why is is important that topical steroids are lipophilic

Answer 43

This allows passive diffusion across the plasma membrane where they combine with cell receptors and bind to steroid responsive elements in the DNA

Question 44

What is absorption affected by

Answer 44

Skin thickness, skin state, occlusion, the vehicle used and drug concentration

Question 45

What enzyme is deficient in acute intermittent porphyria

Answer 45

PBG deaminase

Question 46

What enzyme is deficient in erythropoietic protoporphyria

Answer 46

Ferrochelatase (which leads to a build up of protoporphyrin IX)

Question 47

When does erythropoietic protoporphyria present and what does it present with

Answer 47

Presents in early childhood with discomfort, itch or tingling in sun exposed skin but often there are no clinical signs.

Question 48

Where are keratinocytes confined to?

Answer 48

Epidermis

Question 49

Where are heme-desmosomes found?

Answer 49

within the demo-epidemral junction

Question 50

Define prevalence

Answer 50

The proportion of a population affected by a disease at any given time

Question 51

How many days does it take for a cell to migrate from the basal layer to the keratin layer

Answer 51

28

Question 52

What is the function of the keratin layer

Answer 52

waterproof barrier

Question 53

WHat is the function of the sebaceous glands

Answer 53

skin lubricant

Question 54

What is the function of blood vessels

Answer 54

temperature regulation

Question 55

What is the function of fibroblasts

Answer 55

Collagen synthesis

Question 56

What is the function of melanocytes

Answer 56

DNA protection from UV radiation

Question 57

Which layer of the epidermis is the most metabolically active

Answer 57

Basal layer