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Med school finals > Paeds malignancy, haem, derm > Flashcards

Paeds malignancy, haem, derm Flashcards

1
Q

What type of tumour are the majority of CNS tumours in children?

A

Astrocytoma (pilocystic astrocytoma = most common)

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2
Q

Where are astrocytomas found?

A

Cerebellum

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3
Q

Where are medulloblastomas found?

A

Cerebellum

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4
Q

Where are ependymomas found?

A

Posterior fossa

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5
Q

What is the WHO grade for pilocystic astrocytoma?

A

Grade I

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6
Q

What syndrome is associated with pilocystic astrocytoma?

A

Neurofibromatosis 1

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7
Q

How will pilocystic astrocytoma appear on MRI?

A

Cerebellar, well-circumscribed, cystic and enhancing

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8
Q

What mutation is most common in pilocystic astrocytoma?

A

BRAF

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9
Q

Recall the signs and symptoms of pilocystic astrocytoma

A 
Headaches (worst in morning) 
Gait problems, co-ordination problems
Visual changes
Vomiting on waking
Failure to thrive
Behaviour/ personality change
Later sign = papilloedema due to raised ICP
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10
Q

What is the typical picture of benign intracranial HTN (not malignant cause)?

A

Normal MRI, normal exam, papilloedema, 14y/o, high BMI

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11
Q

Which investigation is most appropriate in investigating an astrocytoma?

A

MRI

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12
Q

What is the specialised member of the MDT in childhood cancer cases?

A

CLIC Sargent (cancer and leukaemia in children social worker)

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13
Q

What is the first-line management for astrocytoma?

A

Surgery

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14
Q

Which CNS tumours can be treated with radiotherapy?

A

Gliomas and metastases

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15
Q

Which CNS tumours can be treated with chemotherapy?

A

High grade gliomas

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16
Q

What % of ALL is B lineage vs T lineage?

A

85% B, 15% T

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17
Q

What % of leukaemia is ALL vs AML in children?

A

80% ALL, 20% AML

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18
Q

Recall the signs and symptoms of ALL

A 
BM failure (anaemia, thrombocytopaenia, neutropaenia)
Local infiltration --> lymphadenopathy, hepatosplenomegaly, bone pain, testes/CNS
Leukaemia cutis = petechial rash on face + trunk
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19
Q

What is raised in tumour lysis syndrome?

A

Potassium, LDH, phosphate, uric acid

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20
Q

What will be seen on CXR in ALL?

A

Enlarged thymus

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21
Q

What results of BM biopsy would be diagnostic of ALL?

A

> 20% blasts in BM/ peripheral blood

Immunological and cytological characteristics

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22
Q

What should be the immediate management of a high WCC in ALL?

A

TLS needs to be reduced: allopurinol and hyperhydration

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23
Q

How many years of chemotherapy are necessary in ALL?

A

2-3 years

Boys are treated for longer because testes are a site of accumulation of lymphoblasts

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24
Q

What therapies can be given alongside chemotherapy in ALL?

A

CNS-directed therapy (if LP is negative initially)
Molecular treatment
Transplantation

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25
What types of molecular treatment are available for ALL?
Imatinib (TK inhibitor) for Ph +ve cases | Rituximab (monoclonal antibodies against CD20 for B cell depletion)
26
What age group are NHL/HL most common in?
``` NHL = childhood HL = adolescence ```
27
Which of NHL/HL is more likely to be localised to one nodal site?
Hodgkin's lymphoma
28
Compare the spread of HL vs NHL
HL = spreads contiguously to adjacent lymph nodes | NHL involves multiple sites and spreads sporadically
29
Recall the signs and symptoms of HL
Painless cervical lymphadenopathy B symptoms are uncommon, even in advanced disease Painful on drinking alcohol (in 10%)
30
Recall the investigations and results that are standard for HL
LN biopsy: Reed Sternberg cells PDG-PET/ CT staging: Ann Arbor Bloods: FBC, ESR, LFTs, LDH, Alb (prognostic markers) Immunophenotyping (CD30, CD15 - diagnostic markers)
31
How should HL be managed?
Combination chemotherapy (ABVD) and radiotherapy
32
Recall the chemotherapy regime used in paediatric HL
``` ABVD Adriamycin Bleomycin Vincristine Dacarbazine ```
33
Recall the signs and symptoms of NHL
Painless lymphadenopathy +/- compression syndrome | B symptoms - fever, weight loss, night sweats
34
Recall the useful investigations and their results in NHL
LN/BM biopsy for cytology, histology and immunophenotyping PDG-PET/ CT staging - Ann Arbor Bloods - FBC, ESR, LFTs, LDH, Alb (prognostic)
35
Recall the management approach dependent on the type of NHL
1. Urgent chemo 2. Monitor only 3. Abx eradication - H pylori gastric MALToma
36
What chemotherapy regime is used in NHL?
``` R-CHOP Rituximab Cyclophosphamide H - adriamycin?? O - vincristine??? Prednisolone ```
37
What is Burkitt's lymphoma a type of?
B cell NHL
38
What are the different variants of burkitt's lymphoma - and what are their different causes?
Endemic (EBV) Sporadic (EBV) Immunodeficiency (HIV)
39
Why is endemic Burkitt's so common in Africa?
Chronic malaria reduced EBV resistance
40
What part of the body does Burkitt's lymphoma affect?
JAW/ facial bones
41
What type of cell does burkitt's lymphoma arise from?
Germinal centre cells
42
What is the histopathological appearance of burkitt's lymphoma?
Starry sky
43
What translocation is most common in burkitt's lymphoma?
t(8;14)
44
What is the prognosis for burkitt's lymphoma?
Really bad as fastest growing human tumour known
45
Where does osteosarcoma tend to occur?
Long bones - 60-75% in the knee
46
Recall the signs and symptoms of osteosarcoma
Relatively painless Mass/ swelling Restricted movement
47
Where does osteosarcoma tend to metastasise to?
Lung
48
What will be shows on XR in osteosarcoma?
Soft tissue calcification - sunburst appearance | Elevated periosteum = Codman's triangle
49
What investigations should be done following XR in suspected osteosarcoma?
Biopsy | CT/MRI/PET
50
How should osteosarcoma be managed?
Specialised sarcoma team Surgery + chemo Post-treatment OT/PT/ orthotics etc
51
What is the surgical management of osteosarcoma?
Limb-sparing surgery +/- amputation
52
What is the prognosis for osteosarcoma?
Poor - 60% 5 year survival
53
What is the difference between osteosarcoma and Ewing's sarcoma?
Osteosarcoma forms bone | Ewing's sarcoma forms mesenchymal tissue
54
How does Ewing's sarcoma appear under the microscope?
Small round blue cell tumour
55
What is the median age of Ewing's sarcoma development?
15y
56
Where does Ewing's sarcoma develop?
Long bones - arms, chest etc
57
What translocation is associated with Ewing's sarcoma?
t(11:22)
58
What are the signs and symptoms of Ewing's sarcoma?
Mass/ swelling and bone pain (no pain in osteosarcoma) | Malaise, fever, paralysis (may precipitate osteomyelitis)
59
What investigations are appropriate to investigate Ewing's sarcoma?
XR Biopsy CT/PET/MRI
60
What would be seen on XR in Ewing's sarcoma?
Bone destruction with overlying onion-skin layers of periosteal bone formation
61
What is the main management of Ewing sarcoma?
Surgery + VIDE chemotherapy + radiotherapy
62
What management should be given post-treatment for osteosarcoma?
OT, PT, dietician, orthotics/ prosthetics
63
Which cells have undergone malignant transformation in retinoblastoma?
Retinal cells
64
What is the main difference in presentation between hereditary and spontaneous retinoblastoma?
Hereditary is nearly always bilateral whereas spontaneous is unilateral
65
Recall the pattern of inheritance of retinoblastoma
Autosomal dominant mutation on chromosome 13
66
Recall the 2 key signs and symptoms of retinoblastoma
Negative red reflex | Squint
67
Recall the 2 key investigations in retinoblastoma
MRI and EUA (examination under anaesthetic)
68
How should retinoblastoma be treated?
Enucleation ( eye removal) | Chemotherapy (BL) + laser treatment to retina
69
What is the average age of diagnosis of retinoblastoma?
18 months
70
What type of tissue and where does neuroblastoma arise?
Neural crest tissue in adrenal medulla and SNS
71
What is a benign tumour of the same tissue as neuroblastoma originates from called?
Ganglioneuroma
72
Which gene is associated with a poor prognosis for neuroblastoma?
N-MYC
73
Where is the mass most likely to be found in neuroblastoma?
Abdomen
74
Recall the symptoms of neuroblastoma
Systemic: WL, pallor, hepatosplenomegaly, bone pain, limp
75
What additional symptoms of neuroblastoma are likely in people under 2 years?
Symptoms of metastases (poorer prognosis in under 1s)
76
What urinary abnormality may be seen in neuroblastoma?
Urinary catecholamine metabolites eg VMA/HVA
77
How should neuroblastoma be managed?
In very young infants spontaneous regression can occur If localised primaries with no metastases --> surgery alone If metastatic: chemotherapy + radio (with autologous stem cell rescue) + surgery
78
In general, which haematological disorders are autosomal dominant vs recessive?
``` Dominant = generally structural disorders Recessive = generally metabolic disorders ```
79
Which genetic abnormality predisposes women to haemophilia?
Turner's syndrome
80
When is haemophilia most likely to present, and with what symptoms?
At around 1y, as this is when walking (and therefore falling) begins Haemarthrosis Suspicions of NAI (if no FH)
81
How does haemophilia present if it presents at neonatal age?
Intracranial haemorrhage Bleeding circumcision Prolonged bleeding from venepuncture
82
Which measures of clotting time are normal vs prolonged in haemophilia?
PT normal, APTT prolonged(PT is extrinsic, APTT is intrinsic)
83
In girls, what is the top alternative differential for the same signs and symptoms as haemophilia?
vWD
84
How should mild haemophilia be managed?
Desmopressin - this stimulates f8 and vWF release
85
How should severe haemophilia be managed?
Prophylactic factor replacement via Hickman line
86
How should minor bleeds be managed in haemophilia?
IV infusion of f8/9 concentrate - raise to 30% normal
87
How should major bleeds be managed in haemophilia?
IV infusion of f8/9 concentrate - raise to 100%, then maintain at 30% for 2w
88
What is the other name for idiopathic thrombocytopaenic purpura?
Immune TP
89
In what age group is ITP seen?
2-6y
90
What is the most common cause of ITP?
Viral infection - ITP presents about 1-2w later
91
Recall the aetiology of ITP
Immune destruction of platelets by IgG autoantibodies
92
How should ITP be investigated?
Diagnosis of exclusion - do an FBC and blood smear
93
How should ITP be managed?
In 80% of children it is acute, benign and self-limiting: will resolve spontaneously within 6-8w Only treat if evidence of major bleeding or persistent minor bleeding
94
How should major bleeding in ITP be managed?
IV Ig + corticosteroids + anti-RhD
95
How should life-threatening haemorrhage be treated in ITP?
Platelet transfusion
96
When is ITP considered chronic?
after 6 months persistence
97
How should chronic ITP be managed?
Mycophenalate mofetil Rituximab Eltrombopag (thrombopoeitin agonist) 2nd line = splenectomy
98
Recall the symptoms of IDA In children
May be asymptomatic | Feeding slowly, tiring quickly, "pica" (eating soil, dirt, etc)
99
What iron supplement dose is appropriate for children?
Ferrous sulphate 200mg TDS
100
Upon which chromosome is the beta globin gene found?
Chromosome 11
101
When does HbA synthesis become predominant?
6m
102
What is the defect in sickle cell anaemia?
Defective beta globin chain | Glutamine to valine on codon 6 on C11
103
What is the inheritance pattern of SCA?
Autosomal recessive
104
Recall the genotype that encodes for sickle cell trait?
BB^s
105
Recall the genotype that encodes for sickle cell anaemia?
B^s B^s
106
Recall the genotype that encodes for HbC disease
B^c B^s
107
What is beta thalassaemia?
Redcuced beta globin synthesis
108
What is the inheritance pattern of beta thalassaemia?
Autosomal recessive
109
What are the 3 phenotypes of alpha thalassaemia and genotypes?
4 alpha globin deletions = alpha thalassaemia major/ Hb Barts 3 alpha globin deletions = HbH disease 1/2 alpha thalassaemia deletions = alpha thalassaemia trait
110
What is the prognosis of each of the phenotypes of alpha thalassaemia?
Hb Barts = fatal in utero via hydrops fetalis HbH disease = mild/ mod anaemia Trait = asymptomatic with mild/ no anaemia
111
What is the gold standard diagnostic method for both SCD/ thalassaemia?
Electrophoresis
112
What is the most common early sign of SCD?
Hand and foot syndrome (swollen hands and feet and dactylitis)
113
What 2 infections are people with SCD particularly at risk of getting?
Pneumococcus and parvovirus
114
What symptom of SCD only presents in children (not adults)?
Splenomegaly
115
What screening test should be done in suspected SCD?
Solubility test
116
What is the gold standard diagnostic method for SCD?
Haemoglobin electrophoresis
117
What would a blood smear show in SCD?
Sickle cells, Howell-Jolly bodies, nucleated RBCs
118
What prophylactic medications should be given to people with SCD?
OD oral penicillin | OD oral folic acid
119
Why is folic acid given in SCD?
Hyperplastic erythropoiesis, growth spurts, increased turnover
120
How should acute crises be treated in sickle cell disease?
``` Analgesia Hydration Abx O2 Exchange transfusion ```
121
How should the chronic problems of SCD be treated?
Hydroxycarbamide | HSCT in severe cases
122
Recall the 3 key signs and symptoms of beta thalassaemia major
Extramedullary haematopoiesis Anaemia Iron overload
123
Recall 3 signs of extramedulllary haematopoiesis
Bone expansion Hepatosplenomegaly Frontal bossing
124
Recall the signs of beta thalassaemia trait
Microcytosis - otherwise asymptomatic
125
What would a blood smear show in thalassaemia?
``` Microcytic red cells Tear drop cellls Microspherocytes Target cells Shistocytes Nucleated RBCs ```
126
How should beta thalassaemia major be managed?
Blood transfusion +/-Iron chelation (desferrioxamine/ deferiprone)
127
Recall 4 signs and symptoms of HDN in the newborn?
Yellow amniotic fluid Pallor Jaundice 24-36 hours after birth Hydrops fetalis (hepatosplenocardiomegaly)
128
How can HDN be investigated?
Coombe's test pos Haemolysis --> raised uBR and reticulocytes Amniocentesis/ USS (shows organomegaly)
129
How can HDN be prevented?
Prophylaxis within 72 hours of a sensitising event Kleiheur test can determine need for more If before 20w: 250IU If after 20w: 500IU Routine antenatal anti-D prophylaxis is done if necessary, following antibody screen at 28 weeks Prophylaxis = 2 doses of anti-D
130
How can HDN be treated?
Phototherapy (uBR) IV Ig (if bilirubin is rising fast)If severe or in utero --> transfusion into umbilical vein
131
Which 6 inborn errors of metabolism are tested for at the newborn blood test screen?
``` PKU MCADD Glutaric Aciduria T1 Isovaleric acidaemia Homocysteinuria MSUD ```
132
What is the inheritance pattern of those inborn errors of metabolism?
Autosomal recessive
133
What is the deficiency in PKU?
Phenylalanine hydroxylase
134
Recall the typical appearance of a child with PKU
Blonde hair, blue eyes, eczema, microcephaly
135
What are the symptoms of PKU (unmanaged)?
Learning difficulties and seizures
136
How is PKU managed?
Low phenylalanine diet
137
Recall the signs and symptoms of MCADD
Encephalopathy within 1w + SIDS | Hypoglycaemia and hypoketonuria
138
What investigation is done to diagnose MCADD?
Urinalysis: shows absent ketones and medium-chain dicarboxylic aciduria
139
What is G6PD's role?
Rate limiting enzyme in the pentose phosphate shunt
140
What is the inheritance pattern of G6PDD?
X - linked
141
What are the main signs and symptoms of G6PDD?
Neonatal jaundice | Acute intravascular haemolysis (--> fever, malaise, abdo pain and dark urine)
142
What type of disease is Gaucher's disease?
Lysosomal storage disease
143
What is Gaucher's disease a deficiency of?
Beta-glucosidase
144
Which group of people are particularly at risk of getting Gaucher's?
Ashkenazi Jews
145
What are the 2 forms of Gaucher's disease, and their symptoms?
Acute infantile form: hepatosplenomegaly, neurological degeneration with seizures Chronic childhood form: hepatosplenomegaly and BM suppression (with anaemia)
146
Which form of Gaucher's disease is most common?
The chronic childhood form
147
What would be seen on BM aspirate in Gaucher's disease?
Gaucher cells
148
How is Gaucher's disease managed?
Splenectomy, bisphosphonates (because of BM suppresion), enzyme replacement, treat anaemia
149
What is the most common form of galactosaemia?
Gal-1-PUT deficiency
150
Recall the signs and symptoms of galactosaemia
High cBR Hepatomegaly Hypoglycaemia Sepsis (gal-1-phos inhibits the immune response)
151
How does galactosaemia present if not picked up in infancy?
BL cataracts
152
How is galactosaemia managed?
Avoidance of galactose
153
How many types of glycogen storage disease are there?
5
154
What symptoms are specific to McArdle's GSD?
Muscle cramps/ weakness after first few mins of exercise, followed by a second 'wind' of energy
155
Recall the symptoms of GSD with the reason behind each one
Hypoglycaemia (G6P cannot leave cells) Lactic acidosis (G6P builds up as lactate) Neutropaenia (G6P suppresses the immune system)
156
How should glycogen storage disease be managed?
Manage intake of CHO carefully to avoid storage
157
Describe the levels of acne
Comedones are either open (blackheads) or closed (white heads) Papules/ pustules Nodulocystic/ scarring
158
From what age can acne be managed medically?
12
159
What skin cleaning advice can you give to adolescents with acne?
Don't over clean - twice per day with gentle soap is okay
160
Why should picking/ squeezing of comedones be avoided?
Risk of scarring
161
How long does It take topical medication to start working in acne?
Up to 8w
162
How can mild to moderate acne be managed?
Topical retinoid +/- benzoyl peroxide OR Topical antibiotic + benzoyl peroxide Azelaic acid 20%
163
How can moderate acne be treated?
Max 3 months of oral antibiotic Add BPO/ retinoid to Abx OR COCP + BPO/ retinoid
164
When should a referral to a dermatologist be made in acne vulgaris?
``` Nodulocystic acne/ scarring Severe form (eg acne conglobata/ acne fulminans) Severe psychological distress Diagnostic uncertainty Failure to respond to medications ```
165
Where is eczema commonly found?
Flexures
166
What 2 differentials should always be considered in suspected eczema?
``` Contact dermatitis (so do patch testing) Food allergies (blood or skin prick testing) ```
167
What treatment can be used in all severities of eczema?
Emollients
168
What other treatments are available in mild eczema?
Mild-potency topical corticosteroids
169
What other treatments are available in moderate eczema?
Moderate-potency topical corticosteroids , topical calcineurin inhibitors and bandages
170
What other treatments are available in severe eczema?
Potent topical steroids, phototherapy, topical calcineurin inhibitors and bandages
171
How should infected eczema be managed?
Flucloxacillin
172
How should eczema herpeticum be managed?
Oral aciclovir
173
Recall the steroid ladder
``` Help Every Busy Dermatologist Hydrocortisone Eumovate Betnovate Dermovate ```
174
When should an immediate referral be made in eczema?
Eczema herpeticum
175
What does eczema herpeticum look very similar to?
Impetigo
176
What is the fancy medical name for port-wine stain?
Naevus flammeus
177
Where are port wine stains found?
In trigeminal nerve distribution
178
What is the cause of port wine stain?
Could be all kinds of syndromes with long names | Most often = Sturge Weber syndrome
179
Recall 3 alternative names for naevis simplex
Salmon patches/ stalk bites/ angel's kiss
180
Describe the appearance of naevus simplex
Pink/ red patch at birth that goes redder when the infant cries
181
When does infantile haemangioma develop?
A few days/ weeks after birth
182
How long do infantile haemangiomas last?
6-10 months, then they shrink
183
Where are most infantile haemangiomas found?
Head and neck
184
Describe the appearance of the different types of infantile haemangioma
``` Superficial = bright red area of warm skin Deep = blue lump Mixed = bright red areas on a blue lump ```
185
Recall 3 causes of infantile haemangioma
1. Kasabach-Merritt: kaposiform haemangioendothelioma -->thrombocytopaenia --> haemangioma with thrombocytopaenia 2. PHACES syndrome 3. LUMBAR syndrome
186
What is PHACES syndrome?
Posterior fossa malformations, haemangioma, arterial abnormalities, cardiac abnormalities, eye abnormalities and sternal abnormalities
187
What is LUMBAR syndrome?
``` Lower body/ lumbosacral haemangioma Urogenital anomalies Myelopathy Bony deformities Anorectal/ arterial anomalies Renal anomalies ```
188
When should an MRI be used in investigation of an infantile haemangioma?
If deep/ multiple/ near the eye
189
How should infantile haemangiomas be managed?
Conservatively - medical photography + review in 3 months
190
If an infantile haemangioma is in a sensitive area, what can be prescribed?
Topical timolol
191
What is the prevalence of congenital haemangioma?
Very rare
192
What are the 3 types of congenital haemangioma?
Rapidly involuting congenital haemangiomas (RICH) Non-involuting congenital haemangiomas (NICH) Partially-involuting congenital haemangiomas (PICH)
193
How can rapidly-involuting congenital haemangioma and non-involuting congenital haemangioma be clinicially differentiated?
RICH is at maximum size at birth and involutes by 12-18 months NICH continues to grow as baby does and do not shrink
194
Other than the haemangioma itself, what sign might be present in congenital haemangioma?
Transient thrombocytopaenia
195
If a congenital haemangioma needs to be removed, how should it be done?
Embolisation
196
What is erythema toxicum?
Benign skin condition present in 50% of newborns
197
What is the prevalence of erythema toxicum?
50% of newborns
198
What needs to be excluded in suspected erythema toxicum?
Congenital infection
199
How does erythema toxicum appear?
Maculo-papular-pustular lesions
200
Where does erythema toxicum begin and spread to?
Begins on face and spreads to limbs
201
How does Milia appear?
White pimples on nose and cheeks
202
What is the cause of milia?
Retention of keratin and sebaceous material of the pilosebaceous follicle
203
How should milia be treated?
It's self-limiting
204
What is the pathogen in molluscum contagiosum?
Pox virus
205
What age group does molluscum contagiosum affect?
2-5 yo
206
How does molluscum contagiosum appear?
>1 small pink skin-coloured/ pearly papules, ulcerated/ umbilicated
207
What are the signs and symptoms of molluscum contagiosum?
Painless usually, may occasionally be itchy
208
How long does molluscum contagiosum usually last, and when is it considered chronic?
6-9 months | >2 years
209
How is chronic molluscum contagiosum managed?
Cryotherapy
210
How does mongolian blue spot appear?
Blue/ black maculopapular discolourisation at base of spine and on buttocks
211
In which infants is mongolian blue spot most likely?
Afro-caribbean or asian infant
212
How is mongolian blue spot managed?
It's self-limiting
213
What is the most common pathogen in impetigo?
Spathylococcus aureus
214
How does impetigo appear?
Golden-yellow, crusted appearance
215
Recall the 3 grades of impetigo
Localised and non-bullous Widespread, non-bullous Bullous, systemically unwell
216
How do you treat each different grade of impetigo?
Localised non-bullous: topical hydrogen peroxide Widespread non-bullous: oral flucloxacillin OR topical fusidic acid Bullous, systemically unwell: oral flucloxacillin
217
For how long should children with impetigo be excluded from school?
Until lesions crusted over/ 48 hours after Abx started
218
What is nappy rash most commonly a form of?
Contact dermatitis
219
Recall the signs and symptoms of each different type of nappy rash
Irritant: well-demarcated variety of erythema, oedema, dryness and scaling Candida albicans: erythematous papules and plaques with small satellite spots or superficial pustules Seborrhoeic: cradle cap and BL salmon pink patches, desquamating flakes
220
How can mild erythema be managed in nappy rash?
Use of a barrier preparation
221
How can moderate erythema be managed in nappy rash?
Hydrocortisone 1% cream
222
How can candidal infection be managed in nappy rash?
DO NOT USE BARRIER - topical imidazole cream
223
How should bacterial infection be managed in nappy rash?
Oral flucloxacillin
224
What are the signs and symptoms of seborrhoeic dermatitis
Dandruff - erythematous, yellow, crusty, adherent layer (cradle cap)
225
What pathogen is seborrhoeic dermatitis associated with?
Malassezia yeasts
226
After how long should seborrhoeic dermatitis spontaneously resolve?
8 months
227
Recall the 1st line treatment for seborrhoeic dermatitis
Regular washing with baby shampoo and gentle brusing to remove scales Can soak crusts overnight in vaseline/ olive oil
228
When should 2nd line treatment be considered in seborrhoeic dermatitis, and what is it?
If scalp is affected | Topical imidazole cream BD/ TDS
229
What is the 3rd line treatment for severe seborrhoeic dermatitis?
Mild topical steroids (1% hydrocortisone)
230
What is the type of pathogen involved in tinea?
Dermatophyte fungi - Trichophytum rubrum
231
What drug is used to treat scabies?
Permethrin
232
How does tinea appear?
Ringed appearance +/- kerion
233
How is tinea capitis treated?
Oral antifungal - terbinafine
234
How are non-capitis types of tinea treated (mild/ mod/ severe)?
Mild: topical terbinafine Mod: hydrocortisone 1% Sev: oral terbinafine
235
What advice should you give in cases of tinea?
Very contagious so take steps to avoid spread - wear loose-fitting cotton clothing, do not share towels, dry thoroughly after washing, avoid scratching - no need for school exclusion
236
What is the most common cause of neck lumps?
Lymphadenitis
237
Recall 5 red flags in neck lump to screen for?
``` Sepsis Poor feeding Rapid progression Stridor Change in voice ```
238
What is the most common midline congenital mass?
Thyroglossal cyst
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What is the cause of thyroglossal cyst?
Failure of thyroglossal duct to involute
240
What is the most common lateral congenital neck mass?
Brachial cleft abnormality
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What is the cause of brachial cleft abnormality?
Failure of pharyngeal clefts to involute
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How long does lymphadenitis last?
6 weeks - self limiting
243
How should thyroglossal cyst be managed?
Asymptomatic: conservatively Symptomatic: Sistrunk's procedure (surgical removal)
244
How should brachial cleft abnormality be treated?
Asymptomatic: conservatively Symptomatic: Sistrunk's procedure (surgical removal)
245
Recall the typical distribution of atopic dermatitis in infants, older children and young adults
Infants: face and trunk Older children: extensor surfaces Young adults: localises to flexures

Med school finals (27 decks)

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