questions !

Question 1

antibodies are produced against what glycoprotein in pemphigus vulgaris?

Answer 1

desmoglein 3

Question 2

which conditions doe the koebner phenomenon occur in?

Answer 2

poriasis
vitiligo
lichen planus
halo naevus

Question 3

when would you swab a leg ulcer?

Answer 3

only those showing signs of infection

ONLY if ulcer is increasingly painful, exudate, malodour, enlarging

Question 4

an ABPI of what would indicate compression of an ulcer

Answer 4

0.8-1.3

**if less than 0.8 = vascular ! dont compress

Question 5

A 28-year-old man undergoes a ileocaecal resection and end ileostomy for Crohn’s disease. One year later he presents with a deep painful ulcer at his stoma site.

Answer 5

Pyoderma gangrenosum is associated with inflammatory bowel disease. It is commonly found on lower limbs and described as being painful, the size of an insect bite and growing. It looks like a margherita pizza (with a red base and yellow topping) Treatment involves steroids.

Question 6

normal ABPI

Answer 6

0.8-1.3

–> anything outwith indicates arterial disease

Question 7

woody tethered skin affecting lower leg (ulcer)

Answer 7

lipodermatosclerosis

Question 8

what is slough (leg ulcer)

Answer 8

skin debris + dead bacteria

–> needs to be removed for ulcer to heal

Question 9

how can slough be removed?

Answer 9

compression bandaging
hydrogels
manual debridement

Question 10

how should a leg ulcer be cleaned? what shape are you aiming got when padding and shaping a leg prior to bandaging?

Answer 10

warm tap water + soap substitute

cone

Question 11

how should venous dermatitis be managed?

Answer 11

apply regular emollients
consider patch testing
topical steroids
compression bandage/stockings

Question 12

what is most important therapy in healing venous leg ulcers?

Answer 12

compression

Question 13

4 y/o with blisters all over body, started yesterday now all over, fever, miserable, unable to be exmined cos so sore. covered in large blisters, some have burst leaving raw exposed sites. erythematous grave on knee is also noted.
most likely diagnosis?

Answer 13

staphylococcal scaled skin syndrome

-> from graze, results in larger blister, really sore

Question 14

A 25 year old man presents to the emergency department with 5 day history of evolving pruritic rash.
On further questioning he also reports pain and stiffness in the large joints of the lower limbs, associated with some mild abdominal discomfort. He denies recent travel or previous similar episodes.
On examination he is systemically well, but there is a bilateral palpable purpuric rash on the lower limbs bilaterally. There is evidence of mild knee swelling bilaterally, and the abdomen is tender to mild palpation but is not peritonitis.
What is the single most important next step?

Answer 14

urine dipstick

–> IgA nephropathy