Passmed/Pastest/Capsule

Question 1

what is pellagra

Answer 1

Vitamin D3 deficiency causing the 4 D’s:

diarrhoea
dermatitis
dementia
death

Question 2

what causes pellagra

Answer 2

alcoholism

izoniazid

Question 3

what type of burns require IV fluids

Answer 3

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

Question 4

what is a common coexisting factor for lichen planus

Answer 4

mucous membrane involvement (particularly oral mucosa)

Question 5

what are features of lichen planus infection

Answer 5

4Ps 
papular
polygonal
purple 
pruitis 

on FLEXOR surfaces, wickams striae on top

Question 6

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

Answer 6

trichophyon rubrum

Question 7

what are features of spider naevi

Answer 7

Blanching

Question 8

what causes spider naevi

Answer 8

liver failure
COCP
Pregnancy

Question 9

whats curlings ulcer

Answer 9

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

Question 10

what is hereditary haemorrhagic telangiectasia

Answer 10

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

Question 11

whats the diagnostic criteria for hereditary haemorrhagic telangiectasia

Answer 11

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

Question 12

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

Answer 12

topical diclofenac
fluorouracil cream
topical imiquimod

Question 13

what are features of Pemphigoid gestationis

Answer 13

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

Question 14

what are features of Polymorphic eruption of pregnancy

Answer 14

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

Question 15

what is pemphigus vulgaris

Answer 15

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

Question 16

what population is pemphigus vulgaris more common in

Answer 16

the Ashkenazi Jewish population

Question 17

what are features of pemphigus vulgaris

Answer 17

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

Question 18

how do you treat pemphigus vulgaris

Answer 18

steroids first line

immunosuppressants

Question 19

what causes Chondrodermatitis nodularis helicis

Answer 19

Trauma
pressure
cold

Question 20

what do bullous lesions with no mucosal involvement tend to be

Answer 20

bullous pemphigoid

Question 21

what is vitiligo commonly associated with

Answer 21

addisons disease

Question 22

what is the best treatment for telangiectasia in acne rosacea

Answer 22

laser therapy

Question 23

how do you treat lichen planus

Answer 23

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

Question 24

what is the treatment for rosacea

Answer 24

mild/moderate: topical metronidazole

severe/resistant: oral tetracycline

Question 25

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

Answer 25

Chest X-ray - exclude Tb and Sarcoidosis

Question 26

whats the treatment for lichen sclerosis

Answer 26

topical steroids and emollients

Question 27

what skin conditions are associated with hepatitis B

Answer 27

erythema multiforme urticaria polyarteritis nodosa lichen planus

Question 28

what skin conditions are associated with hepatitis C

Answer 28

``` erythema multiforme urticaria polyarteritis nodosa lichen planus cryoglobulinaemia porphyria cutanea tarda ```

Question 29

what adhesive structure is attacked in bullous pemphigoid

Answer 29

hemidesmosomes

Question 30

what is attacked in pemphigous vulgaris

Answer 30

desmoglein - antibodies are generated again desmosomes

Question 31

what is a rodent ulcer

Answer 31

a BCC

Question 32

what is a classic histological sign of pemphigus vulgaris

Answer 32

acantholytic keratinocytes

Question 33

what does necrotising fasciits feel like if palpated

Answer 33

there is a crackling sensation

Question 34

what is first line for hair lice treatment

Answer 34

dimeticone 4% gel

Question 35

what is nikolskys sign

Answer 35

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

Question 36

what is behcets disease

Answer 36

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

Question 37

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

Answer 37

1st - permethrin cream applied neck down for 8-14 hours | 2nd - malathion cream for 24 hours

Question 38

what is erythema chronicum migrans

Answer 38

rash associated with lyme disease spreading target lesion

Question 39

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

Answer 39

infantile haemoangioma - (strawberry mark)

Question 40

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

Answer 40

capillary malformation

Question 41

when do infantile haemoangiomas disappear

Answer 41

usually by 7 years old

Question 42

when do infantile haemoangiomas need treatment

Answer 42

when they interfere with vision/feeding or rapidly nlarge

Question 43

when do capillary malformations tend to enlarge

Answer 43

pregnancy, puberty, menopause

Question 44

do capillary malformations go away

Answer 44

rarely

Question 45

what is vitiligo most associated with

Answer 45

autoimmune thyroid disease

Question 46

what is dovobet

Answer 46

topical steroid + vit D3 combo cream

Question 47

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

Answer 47

adalimumab

Question 48

what is telogen effluvium

Answer 48

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

Question 49

what triggers telogen effluvium

Answer 49

childbirth trauma major life events bereavement

Question 50

whats the prognosis for telogen effluvium

Answer 50

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

Question 51

what is angagen effluvium

Answer 51

hair loss associated with specific medications

Question 52

what medications are associated with anagen effluvium

Answer 52

``` chemotherapy TCAs allopurinol beta blockers retinoids ```

Question 53

what is trichotillomania

Answer 53

psychatric condition where people pull out their own hair

Question 54

what is the most common side effect for isotretinoin

Answer 54

dry skin/lips

Question 55

what is erythema ab igne

Answer 55

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

Question 56

what does erythema ab igne look like

Answer 56

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

Question 57

what is peutz-jeghers syndrome

Answer 57

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

Question 58

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

Answer 58

cancer - particularly gastrointestinal cancer | 15x chance

Question 59

what specfic growths does peutz-jeghers syndrome cause

Answer 59

multiple intestinal hamomartomatous polyps

Question 60

what is paronychia

Answer 60

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

Question 61

how do you treat paronychia

Answer 61

``` Oral Abx (flucloxacillin) Incision and drainage under local anaesthetic ```

Question 62

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

Answer 62

no - not often anyway

Question 63

in what diseases does amoxicillin cause a rash

Answer 63

infectious mononucleosis | chronic lymphocytic leukaemia