Passmed/Pastest/Capsule Flashcards

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1
Q

what is pellagra

A

Vitamin D3 deficiency causing the 4 D’s:

diarrhoea
dermatitis
dementia
death

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2
Q

what causes pellagra

A

alcoholism

izoniazid

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3
Q

what type of burns require IV fluids

A

2nd/3rd degree burns covering >15% of the body surface (>10% in children)

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4
Q

what is a common coexisting factor for lichen planus

A

mucous membrane involvement (particularly oral mucosa)

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5
Q

what are features of lichen planus infection

A
4Ps 
papular
polygonal
purple 
pruitis 

on FLEXOR surfaces, wickams striae on top

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6
Q

whats an example of a dermatophyte (90% of toenail infections)

A

trichophyon rubrum

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7
Q

what are features of spider naevi

A

Blanching

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8
Q

what causes spider naevi

A

liver failure
COCP
Pregnancy

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9
Q

whats curlings ulcer

A

stress ulcer in the duodenum of a child in response to a severe burn

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10
Q

what is hereditary haemorrhagic telangiectasia

A

autosomal dominant condition characterised by (as the name suggests) multiple telangiectasia over the skin and mucous membranes - 20% occurs without family history however

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11
Q

whats the diagnostic criteria for hereditary haemorrhagic telangiectasia

A

3/4 (definite) or 2/4 (probable)

telangiectasia - multiple at characteristic sites (lips, oral cavity, fingers nose)

recurrent epistaxis

visceral lesions - for example gastrointestinal telangiectasia (with or without bleeding), pulmonary arteriovenous malformations (AVM), hepatic AVM, cerebral AVM, spinal AVM

family history of HHT

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12
Q

what topical treatments may be used in the treatment of mild actinic keratotis

A

topical diclofenac
fluorouracil cream
topical imiquimod

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13
Q

what are features of Pemphigoid gestationis

A

pruritic blistering lesions
often develop in peri-umbilical region, later spreading to the trunk, back, buttocks and arms
usually presents 2nd or 3rd trimester and is rarely seen in the first pregnancy
oral corticosteroids are usually required

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14
Q

what are features of Polymorphic eruption of pregnancy

A

pruritic condition associated with last trimester
lesions often first appear in abdominal striae
management depends on severity: emollients, mild potency topical steroids and oral steroids may be used

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15
Q

what is pemphigus vulgaris

A

Autoimmune disease caused by antibodies directed against desmoglein 3, a cadherin-type epithelial cell adhesion molecule

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16
Q

what population is pemphigus vulgaris more common in

A

the Ashkenazi Jewish population

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17
Q

what are features of pemphigus vulgaris

A

mucosal ulceration is common and often the presenting symptom. Oral involvement is seen in 50-70% of patients
skin blistering - flaccid, easily ruptured vesicles and bullae. Lesions are typically painful but not itchy. These may develop months after the initial mucosal symptoms. Nikolsky’s describes the spread of bullae following application of horizontal, tangential pressure to the skin
acantholysis on biopsy

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18
Q

how do you treat pemphigus vulgaris

A

steroids first line

immunosuppressants

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19
Q

what causes Chondrodermatitis nodularis helicis

A

Trauma
pressure
cold

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20
Q

what do bullous lesions with no mucosal involvement tend to be

A

bullous pemphigoid

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21
Q

what is vitiligo commonly associated with

A

addisons disease

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22
Q

what is the best treatment for telangiectasia in acne rosacea

A

laser therapy

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23
Q

how do you treat lichen planus

A

topical steroids are the mainstay of treatment
benzydamine mouthwash or spray is recommended for oral lichen planus
extensive lichen planus may require oral steroids or immunosuppression

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24
Q

what is the treatment for rosacea

A

mild/moderate: topical metronidazole

severe/resistant: oral tetracycline

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25
Q

if erythema nodosum is suspected, what is an important next line investigation

A

Chest X-ray - exclude Tb and Sarcoidosis

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26
Q

whats the treatment for lichen sclerosis

A

topical steroids and emollients

27
Q

what skin conditions are associated with hepatitis B

A

erythema multiforme
urticaria
polyarteritis nodosa
lichen planus

28
Q

what skin conditions are associated with hepatitis C

A
erythema multiforme
urticaria
polyarteritis nodosa
lichen planus 
cryoglobulinaemia 
porphyria cutanea tarda
29
Q

what adhesive structure is attacked in bullous pemphigoid

A

hemidesmosomes

30
Q

what is attacked in pemphigous vulgaris

A

desmoglein - antibodies are generated again desmosomes

31
Q

what is a rodent ulcer

A

a BCC

32
Q

what is a classic histological sign of pemphigus vulgaris

A

acantholytic keratinocytes

33
Q

what does necrotising fasciits feel like if palpated

A

there is a crackling sensation

34
Q

what is first line for hair lice treatment

A

dimeticone 4% gel

35
Q

what is nikolskys sign

A

dislodgement of intact superficial epidermis by a shearing force, indicating a plane of cleavage in the skin at the dermal-epidermal junction

36
Q

what is behcets disease

A

type of vasculitis causing mouth sores, eye inflammation, skin rashes and lesions, and genital sores.

37
Q

what is first and second line treatment for scabies + how long are they applied for

A

1st - permethrin cream applied neck down for 8-14 hours

2nd - malathion cream for 24 hours

38
Q

what is erythema chronicum migrans

A

rash associated with lyme disease

spreading target lesion

39
Q

what is the most common cause for a raised red patch on an infant - occuring usually weeks after the birth

A

infantile haemoangioma - (strawberry mark)

40
Q

what is the most common cause for a flat red/purple patch on an infant

A

capillary malformation

41
Q

when do infantile haemoangiomas disappear

A

usually by 7 years old

42
Q

when do infantile haemoangiomas need treatment

A

when they interfere with vision/feeding or rapidly nlarge

43
Q

when do capillary malformations tend to enlarge

A

pregnancy, puberty, menopause

44
Q

do capillary malformations go away

A

rarely

45
Q

what is vitiligo most associated with

A

autoimmune thyroid disease

46
Q

what is dovobet

A

topical steroid + vit D3 combo cream

47
Q

what biological therapy is indicated for psoriasis if the patient has a history of tuberculosis

A

adalimumab

48
Q

what is telogen effluvium

A

condition causing hair loss due to disruption in the hair cycle where hair shifts from the growing phase (anagen) to the shedding phase (telogen)

49
Q

what triggers telogen effluvium

A

childbirth
trauma
major life events
bereavement

50
Q

whats the prognosis for telogen effluvium

A

normally self resolves as telogen phase is about 100 days and the new hair is in the normal anagen phase - but it may take months for hair to grow back to normal

51
Q

what is angagen effluvium

A

hair loss associated with specific medications

52
Q

what medications are associated with anagen effluvium

A
chemotherapy
TCAs
allopurinol
beta blockers
retinoids
53
Q

what is trichotillomania

A

psychatric condition where people pull out their own hair

54
Q

what is the most common side effect for isotretinoin

A

dry skin/lips

55
Q

what is erythema ab igne

A

rash caused by infrared radiation - usually people who sit by fires or have hot water bottles

56
Q

what does erythema ab igne look like

A

reticulated erythema, hyperpigmentation, scaling and telangiectasias in the affected area.`

57
Q

what is peutz-jeghers syndrome

A

autosomal dominant condition causing blue/black discoloration on the lips, clubbing, abdominal pain, meleana, vomiting

58
Q

what does peutz-jeghers syndrome increase the chance of and by how much

A

cancer - particularly gastrointestinal cancer

15x chance

59
Q

what specfic growths does peutz-jeghers syndrome cause

A

multiple intestinal hamomartomatous polyps

60
Q

what is paronychia

A

Paronychia is an infection around the nail usually caused by Staphylococcus or Streptococcus

61
Q

how do you treat paronychia

A
Oral Abx (flucloxacillin) 
Incision and drainage under local anaesthetic
62
Q

do people with penicillin allergy get a rash if they’re exposed to amoxicillin

A

no - not often anyway

63
Q

in what diseases does amoxicillin cause a rash

A

infectious mononucleosis

chronic lymphocytic leukaemia