GP ILA itch

Question 1

how to hodgkin’s lymphomas spread

Answer 1

continguity (i.e. next one along - think Hodgkin’s if there are enlarged lymph nodes in chains). (non-hodg do not spread in chains)

Question 2

symptoms of hodgkin’s other than painless node enlargement

Answer 2

b symptoms - fever weight loss, night sweats

pruritus, fatigue, anorexia, alcohol induced pain at site of node, breathlessness

Question 3

modifying features of ann arbor

Answer 3

A or B = presence/absence of B symptoms
S: used if spread to the spleen.
E: used if disease is extranodal
X: used if the largest deposit is >10 cm large or if mediastinum is wider than ⅓ of chest on CXR

Question 4

what may be seen on cxr in hodgkin’s

Answer 4

mediastinal widening

Question 5

test for EBV (must be ruled out if suspect hodgkin’s)

Answer 5

monospot test

Question 6

how do you treat hodgkin’s

Answer 6

chemo and radio (NOT surgery)

Question 7

macule vs papule vs pustule vs vesicle

Answer 7

macule: flat, discoloured
papule: raised, solid
pustule: raised, filled with pus
vesicle: raised, filled with fluid
bulla: big blister

Question 8

why can renal disease cause itch

Answer 8

uraemia

Question 9

systemic causes of itch

Answer 9

• cholestasis
• CKD
• HIV
• malignancy
• neuro (compression, nerve root irritation, peripheral neuropathy)
• anaemia
• drugs
• menopause
• pregnancy
• obsessive states, schizophrenia

Question 10

drugs that can cause itch?

Answer 10

OPIOIDS!!!!!!!!!!!!!
allopurinol
amiodarone
statin

Question 11

what is cholestatis

Answer 11

reduction in bile flow

Question 12

intrahepatic causes of cholestasis

Answer 12

primary biliary cirrhosis
pregnancy (cholestasis of preg)
hepatitis b and c
alcoholic liver disease
acute hepatitis

Question 13

extrahepatic causes of cholestasis

Answer 13

gallstone
bile duct tumour
pancreatic tumour
pancreatitis

Question 14

what should you examine with itch and why??

Answer 14

examine abdo and lymph nodes for hepatosplenomegaly and lymphadenopathy of lymphoma

Question 15

med for treatment of itch in cholestasis

Answer 15

colestyramine

Question 16

example of mild steroid

Answer 16

hydrocortisone

Question 17

what is canesten HC

Answer 17

hydrocortosone with natifungal

Question 18

name of mild steroid with antibacterial

Answer 18

fucidin H (hydrocort with fusidic acid). works against staph.

Question 19

2 examples of moderate steroids

Answer 19

betnovate RD (betamethasone)
eumovate

Question 20

what drugs do you prescribe by brand name?

Answer 20

topical steroids
lithium
theophylline

Question 21

example of potent steroid

Answer 21

betnovate

Question 22

what does dovobet contain and what is it used for

Answer 22

betamethasone and calcipotriol (vitamin D). used for psoriasis

Question 23

name of v potent steroid

Answer 23

dermovate

Question 24

side effects of topical steroids

Answer 24

adrenal suppression
cutaneous SEs
cushing’s
glaucoma and cateracts

Question 25

what cutaenous SEs of topical steroids

Answer 25

skin atrophy
striae
easy bruising
telangiectasia
localised thicker longer hair

Question 26

how do you measure how much creame to apply

Answer 26

fingertip unit