Investigation

Question 1

what is necrobiosis lipoidica a sign of

Answer 1

diabetes

Question 2

why would LFTs/kidney enzymes be good in skin investigation

Answer 2

liver/kidney disease may cause pruritus

Question 3

in what patient would a blood glucose be beneficial

Answer 3

necrobiosis lipoidica

Question 4

what would a CXR diagnose in a patient with pruritus

Answer 4

lymphoma

hilar lymphadenopathy

Question 5

how do you take bacterial swab

Answer 5

take from affected area

Question 6

how do you take viral swab

Answer 6

take sample including vesicular fluid

Question 7

how do you take fungal sample

Answer 7

scrape for mycology

nail clippings if infected nail

Question 8

what type of biopsies can you do to skin

Answer 8

shave
currettage
punching
elliptical incision/excision

Question 9

what is elliptical excision

Answer 9

take it all out

Question 10

what is elliptical incision

Answer 10

take some of it out

Question 11

indications of immunofluorescence

Answer 11

detection and localisation of antibodies and complement

Question 12

what tests can you do for type 1 hypersensitivity

Answer 12

IgE test or prick test

Question 13

what is a prick test

Answer 13

injection of suspected substance to look for wheal and flare

Question 14

what do you need to be careful of in prick testing

Answer 14

anaphylaxis

Question 15

what is a patch test and what is it used for

Answer 15

allergens applied to back for 48 hours under occlusion and check after 72-96 hours

Question 16

indications for cryotherapy?

Answer 16

viral warts
seborrhoeic keratosis
small actinic keratosis
skin tags

Question 17

mechanism of action of cryotherapy?

Answer 17

intracellular ice formation
osmotic changes
vascular changes
immune stimulation

Question 18

describe how to use spray method of cryotherapy

Answer 18

identify target area and choose nozzle

spray 1cm away and when frozen start freeze time and keep frozen for duration

Question 19

describe how to use cotton bud method of cryotherapy

Answer 19

transfer small amount liquid nitrogen to container and dip bud into pot and apply to lesion

Question 20

true/false - viral warts die in liquid nitrogen

Answer 20

false - they survive and can be spread

Question 21

acute complications of cryotherapy

Answer 21

blistering
burning sensation
bleeding
oedema

Question 22

delayed complications of cryotherapy

Answer 22

nerve damage 
hypo/hyperpigmentation 
infection
ulceration 
poor healing

Question 23

describe how to take ABPI

Answer 23

relax patient
locate brachial pulse and place doppler over, inflate cuff until silent doppler then release until return of arterial noise
locate dorsalis pedis and posterior tibial and and apply cuff above malleoli
put gel over dorsum of foot and post medial malleolus and take BP reading in same way as arm

Question 24

describe how to calculate ABPI

Answer 24

highest ankle pressure in right/left ankle // highest brachial pressure in both arms