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random factoids Flashcards

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Dermatology Board Prep flashcards
1
Q

bullous pemphogoid has a problem with…

A

hemidesmosomes

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2
Q

pemphigus vulgaris has a problem with …

A

desmoglein-3

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3
Q

drop like lesions

A

guttate psoriasis

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4
Q

derm feature of endocarditis

A

finger clubbing

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5
Q

asteatotic eczema patient presentation

A

elderly patietns in the winter months with dry legs

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6
Q

removal of melanoma rules

A

first removed with 2mm excisional biopsy then breslows value is added

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7
Q

onion skin appearanc

A

ewings sarcoma

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8
Q

sunburst pattern

A

osteosarcoma

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9
Q

does erythema blanche?

A

no

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10
Q

what is petechia?

A

> 2mm of flat purpura

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11
Q

is a nodule bigger than a papule?

A

yes

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12
Q

does roseace have comedones?

A

no

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13
Q

at what size does a skin lesion become concering?

A

> 6mm

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14
Q

what are the symptoms of ramsay hunt?

A

shingles in ear

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15
Q

pemphigus nikolsky sign

A

positive

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16
Q

pemphigoid nikolsky sign

A

negative

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17
Q

what is koebner phenomenon?

A

psoriasis / vitiligo on trauma areas

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18
Q

what sort of deramtitis is gloves?

A

allergic

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19
Q

what sort of dermatitis is soap

A

irritant

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20
Q

what cells are found in the granular layer and what do they contain?

A

large keratohyaline granules
which contain filagrin adn involcurin proteins
- odland bodies

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21
Q

which layer are the nuclei lost?

A

granular layer

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22
Q

which cells are found in the prickle layer?

A

langerhan cells

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23
Q

which layer is mainly composed of fibroblasts?

A

dermis

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24
Q

what do panician nerves sense?

A

pressure

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25
Q

what do meissener nerves sense?

A

vibration

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26
Q

aprocine sweat glands

A

armpits

oily + odourous fluid

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27
Q

eccrine sweat glands

A

palm and soles

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28
Q

what are the 2 dendritic cells in the dermis?

A

dermal DC - involved in Ag presenting and secreting cytokines
plasma DC - produce INFa (found in psoriasis)

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29
Q

pathway of vitamin D

what converts it?

A

stored at hydrocholecalciferol in the liver and changes to 1,25dihydroxycholecalciferol in the kindey

converted by 290nm UV light

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30
Q

T2 hypersensitivity examples

A

haemolytic disease of the newborn

blood transfusion recipients

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31
Q

T3 hypersensitivity examples

A

skin resting in arthurs reaction

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32
Q

T5 hypersensitivity examples

A

tuberculin reaction
contact allergy
delayed (1-2 days after contact)

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33
Q

deficiency in PCT

A

uroporphyrinogen decorbxylase –> increased uroporphyrinogen 3

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34
Q

symptoms of PCT

A 
blistering in sun exposed areas 
milla
hyperpigmentation 
hypertrichosis 
solari urticaria 
morphoea
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35
Q

peak for PCT

A

617mm

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36
Q

urine colour for PCT

A

red

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37
Q

deficiency for EP

A

ferrochelatase –> increase in protopyrin IX

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38
Q

symptoms of EP

A 
erythema
swelling
itching
burning
pain
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39
Q

peak for EP

A

634mm

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40
Q

treatment for EP

A

antioxidants

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41
Q

deficiency for ATP

A

porphobillinogen deaminase –> increased PBG

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42
Q

symptoms of ATP

A

abdominal pain
urinary symptoms
psychiatric symptoms
proximal muscle weakness

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43
Q

treatment for ATP

A

hermatin + haema arginate (in acute attack)

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44
Q

which drug / base combo is the best for skin?

A

lipophilic drug + hydrophilic base / vehicle

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45
Q

3 modes of action of topical corticosteroids?

A

vasoconstrictive
antiinflammatory
antiproliferative

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46
Q

20-30g of topical corticosteroids =

A

1 fingertip = 2 hand areas

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47
Q

side effects of topical corticosteroid use

A

skin thinning
purpura
stretch marks
sudden removal - risk of rebound pustular psoriasis

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48
Q

what do calcineural inhibitors do

A

suppress lymphocyte activatoin

- used in atopic eczema

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49
Q

hyperkeratosis

A

increased thickness of keratin layer

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50
Q

parakeratosis

A

persitence of nuclei in the keratin laer

51
Q

acanthosiss

A

increased thickness of epithelium

52
Q

papillomatosis

A

irregular epithelial thickening

53
Q

spongiosis

A

oedema fluid between squames appears to increase prominence of intercellular prickles

54
Q

pathophysiology behind lichenoid disorders?

A

damage to basal epidermis eg lichen planus

55
Q

pathophysiology behind pemphigus?

A

IgG antibodies made against desmoglein3

56
Q

pathophysiology behind pemphigoid?

A

IgG reacts with hemidesmosomes which anchor basal cells to basement membrane

57
Q

halotype of dermatitis herpetiform

A

HLA DQ2

58
Q

how to treat a small area of ring worm?

A

comitrazole cream

59
Q

how to treat a large area of ring worm?

A

terfinabine orally

60
Q

how to treat candida

A

clotimazole

61
Q

what is shingle for >4 weeks called

A

post hepatic neuralgia

62
Q

when shingles is latent where does it sti

A

dorsal sensory root

63
Q

where do adults get shingles

A

thoacic and lumbar nerves

64
Q

where do cihldren get shingles

A

cervical and sacral nerves

65
Q

what is ramsay hunt syndrome

A

VSV in 7th + 8th CN
vesicles + pain in auditory canal + throat
faical palsy
deafness, vertigo, irritation

66
Q

what is the mechanism of acyclovir?

A

guanoside analogue

67
Q

symptoms of erythema multiform

A

target lesions

68
Q

molluscum contagiosum

A

fleshy firm unbilicated nodiles (1-2m in diameter)
children / sexually transmitted
treatment - liquid nitrogen

69
Q

HPV types for genital warts

A

6+11

70
Q

HPV types for cervical cancer

A

16+18

71
Q

cause of herpangina

A

coxsackie / echo virus

72
Q

cause of hand foot and mouth

A

coxsackie

73
Q

cause of slapped cheek / erytheam infectiniosum

A

parovirus 19

74
Q

primary infection of syphilus

A

chancre (painless ulcer at site of entry)

75
Q

secondary infection of syphillus

A

red rash over body
prominent on soles of feet and palms
mucous membrane ‘snail track’ ucler

76
Q

cause of syphillus

A

sexually transmitted bacterium troponaema pallidum

77
Q

pruriceptive itch

A

somethign in skin triggers itch eg insect bite / lichen plnus

78
Q

neuropathic itch

A

damage to nerves causing itch

79
Q

neurogenic itch

A

no damage to CNS but itch caused by opiate effects on CNS receptors

80
Q

psychogenic

A

psychologic cause with no CNS damage eg delusion of infestation

81
Q

which secondary infection is common in atopic eczema?

A

staph aureus

crusting is characteristc

82
Q

pomphylax eczema?

A

spongiotic vesicles

83
Q

drug related eczema

A

eosinophils involved

84
Q

lichen simplex eczema

A

due to scratching

85
Q

stasis dermatitis

A

RBCs infiltration into extracellular compartment

86
Q

symptoms of tuberous sclerosis

A 
periungual fibroma
longitudinal ridging
infantile serizures (corical tuberous and/or calcification of falk cerebri)
ash leaf macule (earliest sign) 
harmatomas 
shagreen patches 
enamel pitting
87
Q

genetics of tuberous scelorsis

A

autosomal domiant

TSC1 (tuberin) + TSC2 (hamaratin) = tumour suppressor genes

88
Q

types of epidermolysis bullosa

A
  1. simples - epidermis
  2. junctional - junction
  3. dystrophic (dermis)
89
Q

features of neurofibromatosis 1

A

cafe au lait macules (>5 = abnormal)
neurofibromats
axillary freckling
optic glioma

90
Q

what does a fillagrin mutation cause

A

itchythosis vulgaris

91
Q

what is a malignant melanoma

A

found in basal layer

migrate into skin from neurla crest

92
Q

what is a melanoma in situ called?

A

letingo maligna

93
Q

what are the 2 types of malignant melanoma?

A

superficial - horizontal then vertical

nodular - vertical first (faster at progressing)

94
Q

which genes mutate in malignant melanoma?

A

CDK2NA
CDK4
BRAF mutation

95
Q

treatment for malignant melanoma

A

vemurafenib (targets RAF/RAS pathway)

transemitibin (targets MEK pathway)

96
Q

what are some features of BCC

A 
75% of all skin cancers
painless
slow growing 
pearly/ translucent
visible blood vessels 
>40
97
Q

which mutation is involved in BCC?

A

PTHC1 (drosphila gene pathced) - key component in the hedgehog pathway

98
Q

what are some features of squamous cell carcinoma?

A 
20% of all skin cancers
warty/ crusted 
sun damaged skin 
can travel in nerves (merkel) 
poor prognosis + can met
99
Q

what are SCC precursor lesions?

A 
actinic keratosis (elongated rete ridges) 
bowens disease (scaly, erythematous plaques, irregular bored)
100
Q

what are the high risk sites for SCC

A

ear
scalp
lip

101
Q

what is UVA

A
  • 320-400mm
  • indirect oxidant damage
  • penetrates further into skin than UBV
  • penetrates through glass
102
Q

in UVA, what are the pyramid dimers inbetween bases caused by?

A

oxidation of DNA bases eg deoxyguanosine

103
Q

what os UVB

A

290-320nm
causes direct DNA damage
more damaging than UVA

104
Q

what are acitninc lentinges?

A

age/liver spots
epidermis elongated riges
increased melanin and basal melanocytes

105
Q

what are the 4 types of malenocytic naevi?

A

congenital
acquired
dysplastic naevus
rare naevi

106
Q

describe congenital melanocytic naevi?

A

small <2cm

large >20 - risk of melanoma

107
Q

describe aquired melanocytic naevi?

A

common during infancy

melanocyte : keratinocyte ratio breaks down

108
Q

describe dyspalsic naevi?

A

> 6cm in dimaeter
asymmetric
sporadic or familial

109
Q

what are the 3 types of rare naevi?

A

halo - depigmented peripheral halo, overrun by lymphocytes
blue - dermal, pigement rich dendritic spindle cells
spitz - <20 years, large

110
Q

what are the 4 types of malignant melanoma?

A

superficial
acral / mucosal - heels fingers toes nails
lentino maligna
nodular

111
Q

what are seborrheic keratosis?

A

benign (version of BCC)
face and trunk
stuck on apperance (greasy)

112
Q

what is a malignant sign of seborrheic keratitis?

A

lesser treat

113
Q

what are the results of ABPI?

A 
1 = normal 
0.8-1.3 = compression
<0.8 = vascular disease
>1.5 = calcification
114
Q

decribe an arterial ulcer?

A

pressure areas eg feet toes
deep, punched out, not weepy, necrotic base
swings legs off bed

115
Q

describe a venous ulcer?

A

medial and lateral malleolus most common
knee to foot
pain

116
Q

which cells carry out vitamin D metabolism?

A

keratinocytes

117
Q

type 2 hypersensitivity

A

direct cell killling

118
Q

type 3 hypersensitivity

A

immune complex mediated

119
Q

which inheritance pattern is tuberous scelrosis

A

autosomal dominnat

120
Q

which numbers of HIV are for warts / verucas

A

1-4

121
Q

which symptom is present months before bullous pemphigoid?

A

itch

122
Q

what is the treatment for roseaca?

A

metronidazole gel

2. oral tetracycline

123
Q

what is the definition of breslows thickness

A

the depth from the granular layer of the epidermis to the deepest melanoma cells

124
Q

which surgery technique gives the best outcome?

A

an elliptical excision with the scalpal cutting at 90 degrees to the surface of the skin

PRIYA DERM (5 decks)

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