Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Revision > Respiratory > Flashcards

Respiratory Flashcards

1
Q

Most common organism in bronchiectasis

A

H influenza - most common
Pseudomonas aeruginosa
Klebsiella
Strept pneumoniae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Main features of bronchiectasis

A

Chronic persistent cough
Copious excessive sputum
Recurrent respiratory tract infections

Clubbing - not specific, not always present

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Tramlines , cysts/ring opacities on CXR

A

Bronchiectasis

*CXR can often be normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

How do you confirm dx

A

HRCT

= shows bronchial dilatation and wall thickening w/ ground glass opacities

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Management of bronchiectasis

A

Bronchiectasis = permanent dilation of airways 2ry to infection/inflammation

-chest physio
-postural drainage
- ABx treatment in exacerbation / long term in severe cases
-bronchodilators - selected cases
Immunisation
Surgery - selected cases = e.g localised disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Features of life threatening asthma (11)

A 
Altered mental status w/ drowsiness
Silent chest 
Poor resp effort
Exhaustion
Cyanosis
Arrhythmia 
Hypotension
PEF <33% predicted or best
Spo2 < 92%
PaO2 <8
Paco2 = normal = 4.6-6 kpa
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Suspect mesothelioma or bronchial carcinoma when ….
(Malignant tumour of mesothelial cells)

How do you confirm dx?

A

Worker - builder , shipyard worker etc
Asbestos exposure
SOB + chest pain + weight loss
Clubbing, recurrent pleural effusion

Pleural BIOPSY (not cytology)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Asbestos exposure in ..

A

Firefighters
Construction workers
Power plant workers
Shipyard etc

Veterans

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Who should deaths from mesothelioma be reported to and why?

A

It is an industrial disease - leads to unnatural death
Report/ consult coroner
Compensation often available

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

60 y/o builder, Smoker , Comes with SOB + chest pain
CT - irregular pleural thickening
CXR - mediastinal lymphadenopathy + rt sided pleural effusion
Dx, cause ?

A

Mesothelioma
Cause - asbestos
80% of mesotheliomas are due to it
If he dies - refer to coroner

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

When should you suspect atelectasis?

A 
Dyspnoea 
Tachycardia 
\+/-Fever
Hypoxemia 
Within 72 hrs post op
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Management of atelectasis

A

Chest physio

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Common cause of tension pneumothorax

A

Mechanical ventilation

- suspect if pt suddenly deteriorates and develops low O2 sat + hypotension

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Management of pneumothorax

A

High O2 initially
Needle decompression - large bore 2nd ICS mid clavicular line
Chest drain

If pt stable - CXR

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Features of cardiac tamponade

A

Becks triad = hypotension , muffled heart sounds, high JVP (distended neck veins)
CXR - large globular heart - pericardial effusion or tamponade

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Dx + Tx of cardiac tamponade

A

Echo

Urgent pericardiocentesis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Primary spontaneous pneumothorax
Consider in …
Initial dx?

A

Tall thin males - dyspnoea + chest pain
No apparent reason, NO hx of lung disease
Dx = erect CXR if pt not severely distressed
Other wise proceed to needle decompression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Secondary spontaneous pneumothorax

Initial management

A

Occurs spontaneously
In presence of underlying lung disease - asthma, COPD

If pneumothorax = 2cm air rim (<= 50%) — aspirate/insert cannula

If >2 cm - insert chest drain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Haemothorax vs pneumothorax

A

No distended neck veins in haemothorax

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Treatment of community acquired pneumonia

Mild

A

Amoxicillin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Treatment of community acquired pneumonia

Moderate

A

Amoxicillin + clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Treatment of community acquired pneumonia

Severe

A

Co-amoxiclav +clarithromycin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Treatment of pneumocystitis jirovecii

P.Carinii

A

Co trimoxazole
(Trimethoprim + sulfamethoxazole)
AKA Bacterim

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

In case of
-severe allergy to penicillin
-pt is on statins
What antibiotics should be given in community acquired pneumonia

A

AVOID Cephalosporin - cefuroxime in severe allergy - 10% cross reactivity clarithromycin

AVOID clarithromycin - if on statins - risk of rhabdomyolysis

GIVE doxycycline

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Features of sarcoidosis (5)

A

Bilateral hilar lymphadenopathy - most common CXR finding
Erythema nodosum - tender red nodules over shin
Polyarthralgia
Hypercalcemia
Fever

Consider DX if 2 or more features seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What syndromes are associated with sarcoidosis

A

Lofgren’s syndrome
= acute form of sarcoidosis
- BHL, EN, fever, polyarthralgia
- excellent prognosis

Heerfordt’s
-uveoparotid fever
Parotid enlargement fever and uveitis 2ry to sarcoidosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is sarcoidosis

A

Multisystem disorder
Unknown aetiology
Characterised by non caseting Granulomatosis
Common young adults and people of African descent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Causes of oral thrush

Features

A

Inhaled corticosteroids
Immunosuppression
Smoking

Think white marks - can be rubbed out ***

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Treatment of oral thrush

A

Oral fluconazole 50mg OD 7 days

Good inhaler techniques, spacer device, rinse mouth after use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Long term asthma management 4 steps

A
  1. SABA - salbutamol
    I if not controlled i.e >3 doses/week
  2. SABA + inhaled corticosteroids(ICS) (beclometasone)
  3. SABA + ICS + LTRA (leukotriene receptor antagonist)
  4. SABA + ICS + LABA +/-LTRA
    LABA = salmeterol
  5. SABA + ICS + LABA +/-LTRA + increased dose of ICS
    If fails
    SABA + LTRA + triall of new drug/further increase in dose
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Difference b/w NICE and BTS guidelines for asthma management

A

Step 3

BTS - LABA (salmeterol)
NICE - LTRA (montelukast)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Side effects of beclometasone

A

Oral/ pharyngeal candidiasis
Sore throat
Dry mouth/throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Excercise induced asthma management

A

SABA

  1. SABA +ICS
  2. SABA+ICS+ LTRA (preferred) or LABA or sodium cromoglicate
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Drugs that aggravate asthma

A

Beta blockers
Aspirin
NSAIDs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Signs on examination - asthma

A

Expiration wheeze
Reduces PEFR (peak expiratory flow rate)
FEV1/FVC < 70% and improves with bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Asthma vs COPD

A

FEV1/FEV <70% (<0.7) = asthma , improves with bronchodilator

COPD - remains < 0.7

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Obstructive vs restrictive lung disease

A

Obstructive - FEV1/FVC < 70% or 0.7
Asthma, COPD, emphysema, bronchial it is

Restrictive > 70%
Interstitial lung disease, chest wall deformities, pulmonary fibrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Dx of asthma

A

Clinical
Or via spirometry
If however spitometry is Norma but patient has adopt or FHx of asthma or is clinically asthmatic
= peak flow diary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Use of peak flow diary

A

Helps determine appropriate time for use of bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is FEV1 and FVC

A

FEV1 - forced expiratory volume = volume exhaled @ end of forced expiration 1s
FVC - forced vital capacity - volume exhaled after maximal exhalation following full inspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Spirometry results asthma

A

FEV1- significantly reduced
FVC - normal
Ratio <0.7 and reversible with bronchodilators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Side effect of beta blockers

A

Bronchoconstriction

Atenolol, “lol”s

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Side effect of beta agonist

A

Tachycardia

Salbutamol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Pneumonia that does not improve with ABx + night sweats or weight loss or new pleural effusion
Suspect??
What do you do?

A

Empyema,
pleural aspiration - sent for C&S

Chest drain = for treatment of confirmed empyema or compromising effusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Causes of empyema

A

Complication of pneumonia - common
Penetrating chest trauma
Oesophageal rupture
Complication of lung surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

SIADH is seen in

A

Small cell lung ca

SIADH = low serum Na, low serum osmolality, HIGH urine osmolality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

-

A

SIADH

Cushing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

SCC of the lung cause what metabolic imbalance

A

Hypercalcemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

SIADH vs diabetes inspidus

A 
SIADH = low serum Na, low serum osmolality, high urine osmolality 
DI = hypERnatremia, high serum osmolality, low urine osmolality

*low urine osmolality in DI increases after vasopressin given

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Histopathology of SCC

A

Large polygonal cells w/ keratin pearls & bridges

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is COPD

Most common cause

A

Chronic bronchitis + emphysema

Smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Features of COPD (6)

A 
Smoking history 
Progressive dyspnoea
FEV1/FVC <0.7 irreversible 
Hyper inflated chest on CXR, 
Productive cough
Wheeze
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What can develop in severe COPD

A

Right sided heart failure

- peripheral oedema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Spirometry of COPD

A

FEV1/FVC <0.7
FEV1 <80% predicted
Increased RV - due to air trapping

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

CXR of COPD

A

Hyperinflation
flat hemidiaphragm
>7 posterior ribs seen

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is chronic bronchitis

Most common cause

A

Form of COPD
= productive cough > 3 months
+ progressive dyspnoea, wheeze, low grade fever

Tobacco smoking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

Management of COPD

A

Stop smoking !
1st line - SABA or SAMA (muscarinic antagonist)
2nd line - add LABA +LAMA

If asthmatic features present
LABA +ICS

If still breathless
LAMA + LABA + ICS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Long term O2 therapy in COPD - when? (5)

LTOT = supplementary O2 for at least 15hrs/day

A 
Severe airflow obstruction pneumonia FEV1 <30% predicted 
(Consider assessment if 30-49%)
 Sats < 02 on RA
Polycythemia
Cyanosis 
Peripheral oedema , raised JVP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

When should oral theophylline be used in COPD

A

NICE : after trials of SA/LA bronchodilators or to people that can’t use inhaled therapy

60
Q

If COPD patient is already on LTOT but is still breathless

What should be done?

A

Start on prednisolone or nebuliser normal saline to loosen secretions

61
Q

Management of COPD exacerbation

A

20-28% O2 via Venturi mask
Maintains sats b/w 88-92%
Nebs - salbutamol w/ ipratropium
IV hydrocortisone 100mg or 30 mg pred stat
-(continue as 30mg OD for 7-14 day)
If no response - IV aminophylline
Give antibiotic if purulent sputum, fever, high CRP
If after all this there’s dyspnea to evidence of acidosis = NIV
Failed NIV —- intubate

62
Q

Management of acute asthma exacerbation paediatric

A

O2
Salbutamol nebs
Ipratropium nebs
Corticosteroids - oral pred / iv hydrocortisone

If still excacerbated -
IV salbutamol IV aminophylline IV MgSo4

63
Q

Management of acute asthma exacerbation - adults

A

O2 > salbutamol nebs 5mg or terbutaline nebs +O2
Corticosteroids - 100 mg IV hydrocortisone or 40-50 mg pred oral

Severe/not improving/ life threatening
- back2back salbutamol nebs every 15 mins + ipratropium 0.5 mg to the nebs
Single dose MgSo4 1.2-2g over 20mins

If improving salbutamol nebs q4hr + pred 40-50 mg PO OD 5 days

64
Q

Asthma exacerbation

Adults vs children treatment

A

O2 > salbutamol nebs

3 step A- corticosteroids C- ipratropium

65
Q

Uses of MgSo4

A

Eclampsia
Torsasdes des pointes
Refractory asthma excacerbation - after no response to salbutamol, hydrocortisone,ipratropium bromide

66
Q

SCC vs lung adenocarcinoma

A

SCC - smokers

Adeno - non smokers

67
Q

Differentiating pneumonia

  1. Herpes labialis
  2. Erythema multiforme (target lesions)
  3. Atypical - young adult, dry cough, bilateral consolidation
  4. HIV w/ CD4 <200 + desat on excercise
  5. After flu
A
  1. StreptococcaL/pneumococcal
  2. mycoplasma
  3. mycoplasma
  4. Pneumocystis jirovecii ( carinii)
  5. Staph aureus
68
Q

Pneumonia after exposure to water
Staying in hotel
Low Na low lymphocyte

Tx?

A

Legionella

Macrolides - clarithromycin, azithromycin
Or tetracycline

69
Q

CURB 65 to determine outpatient or admission treatment

A 
C - confusion AMT score <=8/10
U- Uremia (urea > 7 mmol/l)
R- RR >=30/ min
B- SBP <=90 or DBP <= 60 
65 - age >=65

Home treatment - score 0-1 low risk, <3% mortality risk
Hospital care - score 2 or more, 3-15% mortality risk
ICU - score 3 or more - high mortality risk >15%

70
Q

Prophylaxis antibiotics in HIV
CD4 < 200
CD4 < 50

A

< 200 - cotrimoxazole (against jirovecii)

<50 - azithromycin (mycobacterium avium)

71
Q

Initial investigation in suspicion of lung ca

How do you confirm dx?

A

CXR
Dx - bronchospy

Biopsy to obtain histological/cytological specimens

72
Q

Post op prophylaxis for DVT / pulmonary embolism

A

Enoxaparin (LMWH) - ideal

73
Q

Treatment of VTE/PE/DVT

A

If not pregnant
DOACS - apixaban , rivaroxaban 1st line

If pregnant - LMWH

Warfarin and DOACS contraindicated in pregnancy

74
Q

RF for pulmonary embolism (6)

A 
COCP
Surgery
Obesity
Pregnancy 
Malignancy 
Previous VTE
75
Q

Investigation of choice for pulmonary embolism

A

CTPA

76
Q

Main causes of travellers diarrhoea

A

Campylobacter jejuni- gram neg
Salmonella “”

Self limiting, treat in elderly/immunocompromised
Sam - cipro
Camp - erythromycin/clarithromycin ; 2- cipro

77
Q

Most common organism causing pneumonia

Treatment

A

Strept pneumoniae
Gram +
Associated w/ herpes labialis

Mild - amoxicillin
Mod - amoxicillin + clarithromycin
Sev - co amoxiclav + clarithromycin

Allergic — doxycycline

78
Q

Most common organism causing UTI

Treatment

A

E. coli

Acute pyelonephritis- culture then start antibiotics
Upper UTI - cipro / co amoxiclav
Lower - trimethoprim or nitrofurantoin

79
Q

Horners syndrome

A

Ptosis, mitosis, anhidrosis

Due to compression of sympathetic chain
Pan coast tumour

80
Q

Pan coast tumour

A

Tumour of apex of lung
Spreads to nearby tissue- ribs, vertebrae
Unilateral compression of sympathetic chain - horners syndrome

Most pancoast = non small cell lung ca

81
Q

Acid base imbalance seen in pulmonary embolism

A

Repiratory alkalosis

82
Q

Acid base imbalance seen in asthma & COPD

A

Resp acidosis

83
Q

Panic attack vs pulmonary embolism - acid base

A

Both resp alkalosis

PaO2 normal in panic attack , low in PE

84
Q

Drugs that cause metabolic acidosis

A 
MAIIAD
Metformin
Aspirin (later on)
Iron
Isoniazid 
Alcohol 
Digoxin
Paracetamol - less common
85
Q

Causes of metabolic acidosis

A

Drugs - MAIIAD
Diarrhoea
Renal insufficiency
Addison’s disease

86
Q

Drugs that cause metabolic alkalosis

A

ACEi NSAIDs diuretics (ADD)

87
Q

Causes of metabolic alkalosis

A

Drugs - ADD
Vomiting - loss of gastric acid
Hypovolemia, hypokalemia
2ry hypoparathyroidism

88
Q

Respiratory acidosis causes -

A

Drugs - benzo, organophosphate
COPD asthma
Pneumothorax haemothorax
Ascites

89
Q

Respiratory alkalosis causes

A 
Any cause of hyperventilation
Pulmonary embolism 
Panic attack 
Salicylate 
Aspirin (early)
90
Q

Features of pulmonary fibrosis

A

Progressive excertional dyspnoea
Bi-basilar fine crepes - end inspiratory
Dry cough
Clubbing

*coal mines

91
Q

Anticipatory meds

  1. Pain & breathlessness
  2. Nausea & vomiting
  3. Anxiety delirium agitation
  4. Noisy resp secretions
A
  1. SC morphine
  2. SC haloperidol
  3. SC midazolam
  4. SC hyoscine butylbromide
92
Q 
Hypersensitivity pneumonitis/ extrinsic allergic alveolitis
Causing organism
Birds
Farmer
Malt
Mushroom,
A

Bird fancier - avian protein
Farmer** - saccharopolyspora rectivirgula / micropolyspora faeni
Malt worker - aspergillosis clavatus
Mushroom worker - thermophilic acctinomycetes

93
Q

EAA/ hypersensitivity pneumo
Presentation
Investigation

A

SOB, dry cough fever - 4-8 hrs after exposure (acute)
Chronic

I - CXR upper/mid zone fibrosis = diffuse micronodular interstitial shadowing
Bronchoalveolar lavage - lymphocytes is
No eosinophilia in blood

94
Q 
Paraneoplastic syndrome : lung ca
Small cell (3)
A

SIADH
ACTH - atypical, hyperglycaemia hypoK, HTN , alkalosis, muscle weakness
Lambert-Eaton = presents like myasthenia but reflexes absent, elicited after excercise
Increas in strength + power after repeated tests

95
Q

Paraneoplastic syndrome : lung ca

SCC (5)

A 
Hypercalcemia
PTH-rp secretion 
Clubbing 
Hypertrophic pulmonary osteoarthropathy
Hyperthyroidism- due to ectopic TSH
96
Q

Resp alkalosis

Pulmonary embolism vs panic attack

A

Panic attack - PaO2 normal , pco2 low

PE - both low

97
Q

Aspirin toxicity

Acid base disturbance

A

Early - resp alkalosis

Late - metabolic acidosis

98
Q

Side effects SABA

A

Tachycardia
Palpitations
Tremors
Shaky hands

99
Q

Where is mixed acidosis seen?

Management

A

Cardiac arrest
Low pH, high PaCO2 , low HCO3
- accumulation of CO2 , kidneys not over fused due to low cardiac output

Increase ventilation to washout CO2

100
Q

First step of stable asthma management

A

SABA + low dose corticosteroids

101
Q

How to clean spacers for inhalers

A

Monthly
Soak in detergent/warm water 15 mins
Air dry (not in sun)

Replace spacer every 12 months

102
Q

Bronchopleural fistula is complication of

A

Lung cancer surgery - most common pulmonary resection, pneumonectomy > lobectomy
More common in rt sided lung surgery
Can also develop after chemo, radio, or infection

103
Q

Dx of broncho-pleural fistula

Treatment

A

CT chest
Xray may show it

Tx - repair the fistula = endoscopy, bronchoscopy, open chest surgery

104
Q

Managing PE in pregnancy

A

LMWH - throughout pregnancy and at least 3 months after treatment has been given

105
Q

Types of respiratory failure

A

Type 1 - hypoxia w/o hypercapnia
= pneumonia , low o2 in air
-low po2 / pco2 low/normal

Type 2 
Hypoxia + hypercapnia 
Reduced breathing effort 
Asthma 
COPD

Low po2 + high pco2

106
Q

Methotrexate pneumonitis
Features
Imaging
Management

A

Dry cough SOB fever
Starts w/in 1st year of methrotrexate initiation
CXR - hazy opacity , prominent reticulation

HRCT chest

Mgmt - methotrexate needs to be stopped

107
Q

Common organisms causing cellulitis

Common site

A

Strept pyogenes
Staph aureus

Cellulitis- inflammation of skin and subcutaneous tissue
Shins

108
Q

Management of cellulitis

A

1 . Flucloxacillin
2. Clindamycin or clarithromycin (if penicillin allergic)

Oral clindamycin if fails to respond to flucloxacillin e.g. MRSA

Severe cellulitis - IV benzyl penicillin + flucloxacillin
MRSA - Vancomycin

109
Q

What is lichen planus

A

4P + F - pruritic, purple , papular, polygonal rash on flexor surfaces
LP - white lacy pattern on buccal mucosa

110
Q

Management of lichen planus

A

Topical steroids - mainstay
Benzydamine mouthwash or spray - recommended

Extensive lichen planus - oral steroids / immunosuppression

111
Q

Suspicion of malignant melanoma

A

Asymmetry - 2 halves look different in shape
B - irregular border / edges
C- diffeernt shades of black, brown , pink
Diameter- >6 mm
Evolves/enlarges - grows upwards /downwards/ outwards as flat lesion

112
Q

Benign mole - doesn’t bleed
Patient wants it removed
What do you do ?

A

Refer to private dermatologist

No cosmetic services - NHS

113
Q

Breslow thickness - single most prognostic variable in malignant melanoma

A

< 1 mm - 95-100% 5 year survival
1-2 mm 80-95%
2.1 - 4 mm - 60 -75%
> 4 mm - 37 -50%

114
Q

Cardiac & renal manifestations of SLE

A

Pericarditis
Proteinuria
Glomerulonephritis - diffuse proliferative

115
Q

Anti-histone is seen is

A

Drug induced lupus

Due to isoniazid or hydralazine or procainamide ( TB , HF)

116
Q

Initial screening test for SLE / most sensitive

A

ANA

117
Q

Confirmatory test for SLE

A

Anti dsDNA

Highly specific

118
Q

Drug induced lupus vs SLE

A

DIL:
Renal and nervous system involvement rare in drug induced
Usually resolves after stopping
It is ANA positive+ dsDNA NEGATIVE + anti histone antibodies

119
Q

Most common drugs that cause drug induced lupus

A

Procainamide - antiarrythmic
Hydralazine - vasodilator

Less common - isoniazid (anti-TB),minocycline, phenytoin

120
Q

Acute vs chronic urticaria

A

Acute - <6 weeks

Chronic - >6 weeks

121
Q

Drugs that can cause urticaria

A

Aspirin
Opiates

They release histamine from mast cells

122
Q

Management of urticaria

A

Treat aggravating cause
- stop aspirin, opiates, overheating, stress, alcohol, caffeine
Antihistamine (non sedating) = cetirizine, loratidine

If pregnant - sedating antihistamine - chlorphreniramine

123
Q

Key features psoriasis

A 
Itchy elevated plaques w/ overlying white silver scales
Elbows knees scalp
Not contagious 
Extensor surfaces!
Strong genetic basis/ family history  
Auspitz sign 
Kobners reaction
124
Q

Auspitz sign

A

Seen in psoriasis

Pin point bleeding after scraping

125
Q

Kobner’s reaction

A

New lesions at sites of skin injury

126
Q

Treatment of psoriasis

A

Topical corticosteroids
Vitamin D analogues
Tar preparations

127
Q

Key features of eczema

A

Itchy red rash
Skin creases - flexures - wrist , elbow folds, behind knees
Environmental triggers / URTI
FHX of atopic disease

Typically appears before age 6 mo , clears by 5 yrs in 50%, 75% by age 10

128
Q

Treatment eczema

Mild

A

Emollients - 1st line
Topical steroids
= mild - hydrocortisone acetate .5/1/2.5% (mild case , new eczema no response to emollients)

129
Q

Sebhorreic dermatitis - key features

A

Scaling rash
Affects sebaceous glands
Face scalp chest - inflamed greasy areas + scaling / dandruff on scalp
Inflammatory reaction to yeast

130
Q

Treatment sebhorreic dermatitis

A

Regular anti fungal

Intermittent topical steroid

131
Q

Oral thrush vs leukoplakia

A

OT can be rubbed out ( thick white marks +/- inflamed mouth and tongue

Leukoplakia - sharp well defined edges , cannot be rubbed out

132
Q

Treatment oral thrush

A

Oral fluconaxole 50 mg OD 7 days
Or
Fluconazole oral suspension

133
Q

Leukoplakia treatment

A

Stop smoking

Take biopsy as they are premalignant

134
Q

Eczema
- infants
- younger children
Older children

A

Infants - face + trunk > extremities
YC - extensor surfaces
OC - flexor surfaces , creases face+ neck

135
Q

Treatment eczema

Moderate

A

Betamethasone valerate .025%
Clobetasone butyrate .05%

= wide area of drynesss , crackling , redness

136
Q

Eczema - severe

Treatment

A

Potent strength
Beclomethasone valerate .1%
Mometasone .1%
Hydrocortisone butyrate

Eczema that causes bleeding/ prevents sleep due to itching / no response to emollients and hydrocortisone

Very potent = clobetasol propionate

137
Q

How should emollients be used with steroids

A

Apply emollient first - wait 30 mins

Apply topical steroid

138
Q

Antifungal for
Athletes foot
Fungal groin infection
Fungal nappy rash

A

Clotrimazole

139
Q

Itching w/o sign and symptoms of anaphylaxis give ___

If reaction is severe __

A

Oral anti histamine

Severe - IM adrenaline

140
Q

Basal cell carcinoma / rodent ulcers
Features
Most common type

A

Slow growth ,Local invasion
Mets extremely rare,Most common type of ca in western world

Sun exposed sites - head neck majority
Nodular BCC
Initially Peary /flesh coloured w/ telangestasia > ulceration leaving central crater

141
Q

Pearly white umbilicated ulcer w/ central depression

A

BCC

142
Q

BCC management

A

Surgical removal/ cryotherapy
Topicals - imiquimod, fluorouracil
Radiotherapy

143
Q

Molluscum contagiosum
Features
Treatment

A 
Pox virus
White/pink Pap ulcers w/ umbilicated/depressed central puncture 
Anywhere on skin
Cheesy/white material when squeezed
Children + immunocompromised  commonly

Tx - resolve spontaneously w/in 6-24 months

144
Q

Organism that causes impetigo

A

Staph aureus / strept pyogenes

Impetigo = superficial bacterial skin infection

145
Q

Impetigo

A

1ry / 2ry complication of existing condition ; eczema, scabies, insect bite
Children commonly ; in warm weather
Face + flexures , limbs not covered
Contagious - spreads by direct discharge / indirect spread

146
Q

Impetigo features
Appearance
Incubation

A

Incubation - 4-10 days
Golden crusted skin lesion - honey coloured crust
Very contagious

Revision (31 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions