quesmed

Question 1

4 drugs common cause of uticaria

Answer 1

penicillin, opiates, aspirin and NSAID

Question 2

where does chicken pocks start and spread too

Answer 2

face to chest

Question 3

when can children go back to school with chciken pocks

Answer 3

until lesions have crusted over

starts spots then make fluid filled blisters

Question 4

what drug makes fungal infections worse

Answer 4

steriods

Question 5

autoimmune condtions are linked to what skin condition that cause cutaneous dipigmentation due to loss of melanocytes

Answer 5

vitiligo

Question 6

what is the malar region

Answer 6

zygomatic bone of face lat side of eye

Question 7

hypertrichosis

Answer 7

hair growth

Question 8

Porphyria cutanea tarda (PCT) is the commonest type of porphyria - a group of diseases caused by

Answer 8

errors in haem and accumulation of toxic precursors

Question 9

symtpoms of Porphyria cutanea tarda (PCT)

Answer 9

causes blister/bullae formation which easily rupture to form erosions.
PCT can also cause hyperpigmentation and hypertrichosis (especially at the top of the cheek).

avoid sunlight and venesection or phelbotomy to reduce iron levels

Question 10

Pityriasis rosea is a common rash which often occurs after

what characteristics

Answer 10

URTI

It is characterized by a preceding herald patch - a single, large, discoid (coin-shaped), erythematous patch

then other spots form in chrisstmas tree pattern

self resolve

Question 11

why are Topical vitamin D analogue used in psoriasis

Answer 11

Topical vitamin D analogues are commonly used in the management of Psoriasis to help reduce the rate of skin turnover.

Question 12

pyoderma commonly seen in what bowel disease

Answer 12

crohns and UC IBD

Question 13

treatment of pyoderma - lower limb and develop post trauma
The ulcer has a pustular surface and a blue overhanging edge.

Answer 13

oral pred
immunotherapies second line

Question 14

management of nectrosiing facsicits

Answer 14

surgical debridement

osteomyelitis if gone to bone

Question 15

A 12 month old girl is brought to the Emergency Department with a new rash. Her parents report she has had eczema on her face before, but that this rash seems different. On examination the girl has multiple red, monomorphic blisters and erosions across her face and neck. She appears unwell with a fever and local lymphadenopathy. Given the most likely diagnosis, which of the following is the most appropriate initial management?

Answer 15

eczema herpeticum - IV aciclovir

Question 16

common cause of flare of psoriasis

Answer 16

skin trauma

Question 17

A 27-year-old woman presents to GP with a lesion on her lower leg. She does not know how long she has had it. On examination, it is a light brown nodule which dimples when squeezed.

What is the most likely diagnosis?

Answer 17

Dermatofibroma

This is the correct answer. Dermatofibromas are firm, flesh/ brown/ yellow-coloured nodules found most commonly on the lower leg. Patients may have a history of injuries, such as an insect bite. The dimple is present due to the firm tethering of the epidermis to the dermis

Question 18

underlying cause of eczema

Answer 18

genetic defect causing a loss of function of the protein filaggrin is thought to be an underlying cause of Atopic Eczema.

Question 19

bullous pemphigoid is topical steriods - pemphigus volgaris is

Answer 19

oral steriods

Question 20

A Pyogenic Granuloma is a reactive overgrowth of capillary blood vessels. It is a benign lesion, but can cause discomfort and frequent, easy bleeding. Pyogenic Granulomas are relatively common, occurring mostly in children and young adults and in females more often than males.

most common cause

Answer 20

on fingertip

microtrauma

Question 21

what red shin rash can be caused by chlamydia

Answer 21

erythema nodosum

Question 22

what skin condtion has oral involvemnt bullous p or pemphigus vulgairs

Answer 22

PV

Question 23

what is a keratocanthoma

Answer 23

A Keratoacanthoma is a benign epithelial skin cancer originating from a hair follicle. It appears as a solitary, firm, dome-shaped papule with a central keratin scale. Like an SCC, the papule is usually located on sun-exposed areas of the skin

Question 24

what is Erythroderma

Answer 24

Erythroderma, also known as “red man syndrome”, is defined as erythema (reddening) of more than 90% of the skin surface. It is a rare dermatological emergency presenting with generalised erythema and oedema, often followed by scaling of the skin. Commonly, those affected have an underlying skin condition, for example Atopic Eczema (as in this case) or Psoriasis. Other causes include drug reactions or malignancies such a Lymphoma

managed supportively with fluids, emollients and by treating the underlying disease (e.g. steroid for an exacerbation of atopic dermatitis) under the guidance of a dermatology specialist

Sezary syndrome, a form of cutaneous T-cell lymphoma which causes erythroderma, lymphadenopathy and hepatosplenomegaly. It is characterised by Sezary cells (atypical T cells) in the peripheral circulation.

Question 25

what is sezary syndrome

Answer 25

form of cutaneous T-cell lymphoma which causes erythroderma, lymphadenopathy and hepatosplenomegaly. It is characterised by Sezary cells (atypical T cells) in the peripheral circulation.

Question 26

pitting nails - bubbly ribbly

Answer 26

psoriasis

Question 27

koilonychia- nails that look scoped out like a cave

Answer 27

iron deficiency anameia

Question 28

commonest cause of erythroderma

Answer 28

exacerbation of pre existing atopic dermatitis

Question 29

5h side effects of ciclosporin
calcineurin inhibitor

Answer 29

Ciclosporin is a commonly used drug for the management of psoriasis. The side effects of ciclosporin can be remembered by the 5 H’s: hypertrophy of the gums, hypertrichosis, hypertension, hyperkalaemia and hyperglycaemia (diabetes)

Question 30

forms of melanoma

Answer 30

A superficial spreading melanoma is the commonest type and usually grows horizontally first, although later grows vertically.
A nodular melanoma grows rapidly in the vertical plane and is the most aggressive form of melanoma.
A lentigo maligna melanoma arises from a lentigo maligna, which is a form of melanoma-in-situ.
An acral lentiginous melanoma occurs on the palms/soles and under the nails.

Question 31

Heliotrope rash

Answer 31

purple rash on eyelids
seen in dermatomyositis

Question 32

what causes SJS

Answer 32

sulfonamides, beta-lactams (penicillins & cephalosporins), anti-epileptics, allopurinol and NSAIDs.

Question 33

genital warts what serotype of HPV

Answer 33

6 and 11

Question 34

most sensitive idnicator for dermatomyositis

Answer 34

CK

Question 35

gential warts if they require treatmnet

Answer 35

Topical podophyllotoxin

if not concerned about appearance just leave

Question 36

first line for plaque psoriasis

Answer 36

Potent topical corticosteroid + topical vitamin D is the first line treatment for plaque psoriasis.

Question 37

Erythema multiforme trigger by illness where as ereythyma migrans

Answer 37

lymes disease

Question 38

for acne as last line you can get given isorenetin what should you screen for that this can worsen

Answer 38

mental heath
This patient will likely be prescribed isotretinoin. Isotretinoin can potentially worsen mental health following use; it is, therefore, important to screen for pre-existing mental health conditions before prescribing it. It is also highly teratogenic; if this patient were female, they should also be commenced on effective contraception.

Question 39

which Erythema is associated with TB

Answer 39

Erythema nodosum refers to tender, erythematous nodular lesions which commonly occur on the shins. It is due to inflammation of the subcutaneous fat and has several causes, including infection, autoimmune disease, certain medications and malignancy. TB is a known infectious cause of erythema nodosum.

Question 40

Erythema marginatum seen in what

Answer 40

Erythema marginatum may be seen in acute rheumatic fever. The skin lesions are often circular and erythematous and tend to affect the trunk and the limbs.

Question 41

Erythema migrans seen in

Answer 41

Erythema migrans is commonly associated with Lyme disease. After a tick bite, it can appear as an erythematous rash which spreads. There is classically a central red area, surrounded by clear skin, which is then encircled by a wider red area. This is described as a bull’s eye rash.

Question 42

Erythema multiforme seen in

Answer 42

Erythema multiforme is characterised by target lesions that usually appear on the peripheries. In more severe cases, there can be mucosal involvement of the mouth, eyes or genitals. Haemoptysis is not an associated feature. The vast majority of cases are due to infection, of which herpes simplex virus is the most common infectious cause.

Question 43

Erythema infectiosum seen in

Answer 43

Erythema infectiosum (also called fifth disease or slapped cheek syndrome) is a childhood infection caused by parvovirus B19. It presents with a rash, cheek erythema and a mild fever.

Question 44

Leser-Trélat sign

Answer 44

multiple sub-keratoses

Question 45

what is koebner phenomenon

Answer 45

The Koebner phenomenon (KP), first described in 1876 by Heinrich Koebner, is the appearance of new skin lesions on previously unaffected skin secondary to trauma.

Question 46

acne roseca associated with what

Answer 46

as blepharitis and conjunctivitis, and rhinophyma (swelling and disfigurement of the nose).

comes on with alcohol

Question 47

pemphigus vulgaris of bullou pemphigoid what age

Answer 47

PV - middle aged
BP - older

Question 48

what part of body spared in follicultitis

Answer 48

hands

Question 49

allergic contact dermiatisi - what would be seen

Answer 49

T cell lymphtocyes as type 4 hypersensitivity
This is a classic history of allergic contact dermatitis, in which skin irritation is triggered by contact with an allergen. Nickel is a common allergen and can be found in jewellery. Allergic contact dermatitis is a delayed type IV hypersensitivity reaction which is mediated by T lymphocytes.

Question 50

Seborrhoeic Keratosis assocated with what

Answer 50

Gastric adenocarcinoma

These lesions have the typical description of seborrheic keratosis, rather than malignant melanoma. Seborrheic keratoses are common and benign skin growths which can usually be managed conservatively. However, a sudden eruption of many seborrheic keratoses is called Leser-Trélat sign. This is a paraneoplastic process which is associated with various malignancies, most commonly gastric or colorectal adenocarcinoma.

Question 51

withdrawal of steriods well known cause of what skin condition

Answer 51

psoriasis

along with trauma, certain medications such as beta-blockers and lithium, smoking/alcohol consumption and cold weather.

Question 52

drop shaped lesions

Answer 52

Guttate Psoriasis is a type of Psoriasis that is typically triggered by a Streptococcal infection. The rash has a sudden onset 2-4 weeks post infection. It most commonly occurs in children and young adults. ‘Gutta’ translates as ‘drop’ from Latin, describing the characteristic appearance of the rash. Guttate Psoriasis usually resolves in a few months but can persist as Plaque Psoriasis

Question 53

how should immunocompromised cellulitis be managed

Answer 53

IV abx in hospital

Question 54

Seborrheic dermatitis causes skin irritation that mainly affects areas of skin with lots of sebaceous glands. This is most commonly the scalp, however it can also affect the face, chest and upper back. Typical features include

It is thought to be caused in part by a reaction to yeast on the skin. Therefore, it is usually treated with topical antifungals, antifungal body wash and short-term topical corticosteroids if symptoms are particularly severe.

Answer 54

dandruff and scaly red patches with associated flaking.

Question 55

A 9-year-old boy is brought to the GP by his mother who is worried as he has developed a fever and a rash since yesterday. On examination, the rash is erythematous, widespread across the body and feels rough. His tongue is bright red and appears bumpy and he has enlarged cervical lymph nodes. He has also has a temperature of 38.5. Based on the most likely diagnosis, what is the most appropriate management?

Answer 55

Phenoxymethylpenicillin

The features in this case - a rash which is rough to touch, strawberry tongue, cervical lymphadenopathy and fever - point towards a diagnosis of scarlet fever. Scarlet fever is caused by group A streptococcus (specifically streptococcus pyogenes). It is treated first-line with a 10 day course of phenoxymethylpenicillin.