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Medicine Phase 2a Dermatology > Peer Teaching > Flashcards

Peer Teaching Flashcards

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Dermatology Board Prep flashcards
1
Q

3 layers of skin

A

Epidermis
Dermis
Subcutaneous tissue (fat)

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2
Q

Layers of epidermis

A

Stratum corneum (layer of keratin)
Stratum granulosum
Stratum spinosum
Stratum basale (dividing cells)

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3
Q

Corpuscles found in dermis and what they detect

A 
Meissner's corpuscle (light touch)
Pacinian corpuscle (coarse touch/vibration)
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4
Q

Cells types in the epidermis

A

Keratinocytes
Langerhans cells
Melanocytes
Merkel cells

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5
Q

Function of keratinocytes

A

Produce keratin as a protective barrier

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6
Q

Function of langerhans cells

A

Present antigens and activate T cells

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7
Q

Function of melanoytes

A

Produce melanin which protects from UV radiation

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8
Q

Function of Merkel cells

A

Contain specialised nerve endings or sensation

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9
Q

Functions of skin

A 
Sensation
Temperature regulation
Vitamin D synthesis
Immunosurveillence
Protective barrier 
Fluid/electrolyte balance (sweating)
Structural (body shape)
Waterproofing
UV barrier
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10
Q

Inflammatory skin conditions

A

Eczema
Acne
Psoriasis

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11
Q

Cancers of skin

A

Squamous cell carcinoma
Basal cell carcinoma
Malignant melanoma

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12
Q

Infections of the skin

A

Cellulitis/necrotising fasciitis

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13
Q

Other skin conditions (not inflammatory, cancerous or infectious)

A

Ulcers - venous/arterial/neuropathic

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14
Q

Describe eczema

A

Papules and vesicles on an erythematous base

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15
Q

Clinical presentation of eczema

A

Papules and vesicles on an erythematous base; Itchy; Reaction pattern to stimuli
Commonly found on the face and flexure surfaces of the limbs

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16
Q

Types of eczema

A

Endogenous (atopic)

Exogenous (contact dermatitis)

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17
Q

Cause of exogenous eczema

A

Exogenous agent

e.g. Chemicals, Sweat, Abrasives

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18
Q

Describe history suggestive of eczema

A 
Skin crease involvement 
History of asthma or hay fever
Dry skin
Onset in childhood
Family history of atopy
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19
Q

Pathophysiology of exogenous eczema

A

Impaired skin barrier

  • > Exogenous allergen penetration
  • > Inflammation
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20
Q

What is filaggrin

A

A skin barrier protein which, if damaged increases the risk of eczema
Genetic predisposition if faulty gene

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21
Q

Management of eczema

A 
Avoid triggers
Keep nails short in children
Topical therapies (emollients, steroids for flare ups)
Oral therapies (anti-histamines, antibiotics like flucloxacillin, oral steroids if severe, phototherapy, immunosuppressants like ciclosporin)
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22
Q

Medical treatment of eczema

A 
Topical therapies: emollients, steroids for flare ups
Oral therapies: 
anti-histamines, 
antibiotics like flucloxacillin, 
oral steroids if severe, 
phototherapy, 
immunosuppressants like ciclosporin
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23
Q

What is acne vulgaris

A

Inflammatory disease of the pilosebaceous follicles

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24
Q

Pathophysiology of acne vulgaris

A

Increased sebum production (hormonal in adolescents)
Abnormal follicular keratinization
Pilosebaceous duct obstruction
Bacterial colonisation with Propionibacterium acne
Inflammation

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25
Q

Clinical presentation of acne vulgaris

A

Blackheads and whiteheads (open and closed comedomes), inflammatory lesions, papules, nodules, cysts.
Commonly found on face, chest and upper back.

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26
Q

Epidemiology of acne vulgaris

A

Puberty

Polycystic Ovary Syndrome (in adult women in which acne suddenly arises)

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27
Q

Management for acne:
Mild
Moderate
Severe

A

Mild – topical therapies e.g. benzylperoxide and topical antibiotics and topical retinoids
Moderate – oral therapies e.g. oral antibiotics and anti-androgens in females (COCP or cyproterone acetate)
Severe – oral retinoids

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28
Q

What is psoriasis

A

Chronic, inflammatory skin disease due to hyper-proliferation of Keratinocytes + inflammatory cell infiltration

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29
Q

Clinical presentation of psoriasis

A

Well demarcated erythematous plaques topped with silvery scales on extensor surfaces
Associated nail changes - pitting, onycholysis
Unusual in children
NOT itchy
Genetic predisposition

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30
Q

Precipitating factors of psoriasis

A

trauma, drugs (lithium, beta blockers), stress, smoking and alcohol

31
Q

Management of psoriasis:

Mild Moderate Severe

A

Mild – topical vit D analogues e.g. calcipotriol, topical corticosteroids, coal tar preparations, topical retinoids
Moderate – phototherapy
Severe – oral methotrexate, retinoids, ciclosporin, infliximab

32
Q

Describe basal cell carcinoma

A

Slow growing
Locally invasive
Tumour of the epidermal keratinocytes
Rarely metastasises but locally destructive
Common on head and neck, Pearly appearance

33
Q

Risk factors of basal cell carcinoma

A

UV exposure
Skin type 1 (burns rather than tans)
Aging

34
Q

Treatment of basal cell carcinoma and complications

A

Surgically excise
Radiotherapy if surgery is not appropriate
Complications – local tissue destruction

35
Q

Describe squamous cell carcinoma

A

Locally invasive malignant tumour of keratinocytes

36
Q

Risk factors of squamous cell carcinoma

A

UV exposure

Chronic inflammation e.g. wound scars, immunosuppression

37
Q

Presentation of squamous cell carcinoma

A

Scaly and crusty
Ill-defined edges
May ulcerate

38
Q

Management of squamous cell carcinoma

A

Surgical excision/radiotherapy if non-resectable

39
Q

What is malignant melanoma

A

Invasive tumour of melanocytes

40
Q

Risk factors of malignant melanoma

A

UV exposure, skin type 1, atypical moles, multiple moles, family history

41
Q

*Symptoms and Presentation of malignant melanoma

A 
ABCDE symptoms
A – asymmetrical shape 
B – boarder irregularity 
C – colour irregularity 
D- diameter >5cm
E – evolution/change of lesion
SYMPTOMS e.g. bleeding, itching
42
Q

Treatment of malignant melanoma

A

Surgical, radiotherapy

Chemo is metastatic

43
Q

Site of arterial skin ulcers

A

Toes, foot and ankle

44
Q

Site of venous skin ulcers

A

Medial gaiter region

45
Q

Edges of arterial vs venous skin ulcers

A

Arterial - Punched out and Well defined

Venous - Sloping and gradual

46
Q

Wound bed appearance of arterial vs venous skin ulcers

A

Arterial - Covered with slough and necrotic tissue

Venous - covered with slough

47
Q

Size of arterial vs venous skin ulcers

A

Arterial - Small

Venous - Large

48
Q

Exudate level of arterial vs venous skin ulcers

A

Arterial - low

Venous - high

49
Q

Pain level of arterial vs venous skin ulcers

A

Arterial - has pain

Venous - minimal pain

50
Q

Pulses of arterial vs venous skin ulcers

A

Arterial - decreased

Venous - is present

51
Q

Capillary refill of arterial vs venous skin ulcers

A

Arterial - > 3seconds

Venous - <3seconds

52
Q

Oedema in arterial vs venous skin ulcers

A

Arterial - none

Venous - present

53
Q

Hair in arterial vs venous skin ulcers

A

Arterial - none

Venous - none or may be some

54
Q

Skin colour of arterial vs venous skin ulcers

A

Arterial - rubor, elevation pallor

Venous - brown varicose veins

55
Q

Ulcer of arterial vs venous skin ulcers

A

Arterial - Tip toes, heel, lat ankle

Venous - Medial ankle

56
Q

Risk factors of arterial skin ulcer

A

Arterial disease (atherosclerosis)
Smoking
Cholestrol
Diabetes Mellitus

57
Q

Describe each of these for arterial skin ulcer:
Clinical presentation and symptoms
Ulcer appearance
ABPI

A

Pain, worse when legs elevated
Ulcer: small, sharply defined, necrotic base
Cold skin, absent peripheral pulses, shiny pale skin, loss of hair
ABPI < 0.8 suggests arterial insufficiency

58
Q

Investigations and management of arterial skin ulcer

A

Ix - Doppler studies

Mx - Vascular reconstruction (no compression bandaging)

59
Q

Risk factors for venous skin ulcer

A

Varicose veins

DVT

60
Q

Describe each of these for venous skin ulcer:
Clinical presentation and symptoms
Ulcer appearance
ABPI

A 
Pain (minimal)
Large, shallow, irregular, exudative
Warm skin
Normal peripheral pulses, leg oedema, haemosiderin, lipodermatoosclerosis
ABPI normal (>0.8 – 1)
61
Q

Management of venous skin ulcer

A

Compression bandaging

62
Q

Describe neuropathic skin ulcer

A

Often painless
Found at pressure sites (e.g. heel or toes)
Variable size, maybe surrounded by callus
Warm skin and normal peripheral pulses
Associated peripheral neuropathy

63
Q

Management of neuropathic skin ulcer

A

Appropriate foot wear
Control DM
Podiatary

64
Q

What is cellulitis

A

Bacterial infection of the deep subcutaneous tissue

65
Q

Causes of cellulitis

A

S. pyogenes

S. aureus

66
Q

Risk factors of cellulitis

A

immunosuppression, wounds, leg ulcers, trauma, athletes foot

67
Q

Presentation of cellulitis

A

Local inflammation

Systemically unwell

68
Q

Management of cellulitis

A

Antibiotics (flucloxacilin or benpen)

69
Q

what is necrotising fasciitis

A

Bacterial infection of deep fascia and tissue necrosis

70
Q

Causes of necrotising fasciitis

A

Group A haemolytic streptococcus

71
Q

Risk factors of necrotising fasciitis

A

Abdominal surgery

Immunosuppression

72
Q

Presentation of necrotising fasciitis

A

severe pain out of proportion, necrotic skin, systemically unwell, soft tissue gas seen on Xray

73
Q

Management of necrotising fasciitis

A

surgical debridement, IV antibiotics

Medicine Phase 2a Dermatology (8 decks)

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