Passmed

Question 1

What is the first line treatment for actinic keratosis?

Answer 1

Sun avoidance and
fluorouracil cream: typically a 2 to 3 week course. The skin will become red and inflamed - sometimes topical hydrocortisone is given following fluorouracil to help settle the inflammation

Question 2

Which antibiotic is most likely to cause toxic epidermal necrolysis?

Answer 2

Caused by penicillins such as Co-amoxiclav

Question 3

What is a curling’s ulcer?

Answer 3

Stress ulcers may occur in the duodenum of burns patients and are more common in children.

Question 4

What is the most signiicant complication of UVA therapy and psoralen for psorisis?

Answer 4

Squamous cell carcinoma

Question 5

What is the treatment of choice for scabies?

Answer 5

permethrin 5% is first-line
malathion 0.5% is second-line
pruritus persists for up to 4-6 weeks post eradication

Question 6

What kind of reaction is scabies and where does it typically affect?

Answer 6

It is a type IV hypersensitivity reaction to mites/eggs

typically linear burrows on the side of fingers, interdigital webs and flexor aspects of the wrist

Question 7

What guideance should be given to scabies patients?

Answer 7

avoid close physical contact with others until treatment is complete
all household and close physical contacts should be treated at the same time, even if asymptomatic
launder, iron or tumble dry clothing, bedding, towels, etc., on the first day of treatment to kill off mites.

Question 8

What is acanthosis nigricans and what is it a sign of?

Answer 8

This is symetrical brown velvety plaques that are often found on the neck or axillae
It is associated with hyperinsulinaeia states such as polycyctic overy syndrome or cancers most often gastric malignancy

Question 9

What is dermatitis herpetiformis and what is it associated with?

Answer 9

This is an autoimmune blistering skin reaction that is assocaited with coeliac
Should be treated with gluten avoidance

Question 10

What is the most common cause of hirsutism?

Answer 10

It is caused by polycystic ovary symptom most commonly

Question 11

What is the management of hirsutism?

Answer 11

advise weight loss if overweight
cosmetic techniques such as waxing/bleaching - not available on the NHS
consider using combined oral contraceptive pills such as co-cyprindiol (Dianette) or ethinylestradiol and drospirenone (Yasmin)

Question 12

What is the first investigation for erythema nodosum?

Answer 12

Chest x ray to rule out sarcoidosis and tuberculosis

Question 13

What type of melanoma can freckles go on to form?

Answer 13

Lentigo maligna melanoma