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PRE REG > Skin > Flashcards

Skin Flashcards

1
Q

Which formulation is most suitable for chronic dry skin areas?

A

Ointments as they are greasy, more occlusive barrier over skin and most hydrating. Also insoluble in water.

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2
Q

What do gels consist of?

A

High water content

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3
Q

What functions do lotions have?

A

Cooling effect such as calamine lotion

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4
Q

What is a potential side effect of aqueous cream?

A

Use as a leave on emollient may increase the risk of skin reactions – particularly in eczema

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5
Q

What are emollients used for

A

to soothe, smooth and hydrate the skin in all dry and scaling conditions. Applies frequently even after condition improves. More useful in excema than psoriasis

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6
Q

State the MHRA warning for emollients?

A

Avoid naked flames

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7
Q

State a side effect of benzyl alcohol in neonates?

A

Fatal toxicity syndrome

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8
Q

How long should bath additives be added to water before use?

A

10-20 minutes to ensure effective hydration

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9
Q

Which bath-based emollient contains soya-bean oil?

A

Balneum and should be avoided in those patients with an allergy to soya and nut

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10
Q

State some counselling points for emollients?

A

Should be applied in direction of hair growth to avoid risk of folliculitis Avoid naked flames
Apply after bathing to maximise hydration

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11
Q

What is the tx for nappy rash?

A

first line is to ensure that nappies are changed frequently. Can apply mild corticosteroid but avoid in neonates. If rash is fungal than clotrimazole 1% can be used.

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12
Q

State the use of urea in urea-containing emollients?

A

It is a keratin softener and a hydrating agent

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13
Q

State the treatment for acute impetigo on small areas of skin?

A

Topical fusidic acid cream
Mupirocin to treat methicillin-resistant staph aureus
not for longer than 10 days to prevent development of resistance

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14
Q

State the treatment for extensive, widespread longstanding treatment for impetigo?

A

1) Flucloxacillin
2) Clarithromycin if penicillin-allergic

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15
Q

What is used topically for rosacea?

A

Metronidazole

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16
Q

What drug is used for treatment of burns?

A

Silver sulfadiazine

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17
Q

What is the tx for ringworm?

A

Topical antifungal eg clotrimazole

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18
Q

What drug is used for treatment of acute bacterial skin structure infections?

A

Tedizolid

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19
Q

What is the tx for pityriasis versicolor

A

antifungals such as clotrimazole or ketoconazole

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20
Q

What is the tx for candidasis?

A

Topical imidazole antifungal eg clotrimazole

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21
Q

State the treatment for angular cheilitis?

A

Fusidic acid / miconazole daktarin creams

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22
Q

State the treatment for cold sores (herpes labialis)?

A

Acyclovir cream – apply cream 5 x daily
Best applied at earliest stage – when prodromal changes of sensitisation are felt in lip and before vesicles occur
Peniclovir cream – apply cream 8 x daily

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23
Q

State the treatment for scabies?

A

Permethrin / malathion

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24
Q

State the symptoms of scabies?

A

Intense itching at night
Silvery lines with dot at end by mites Rash often starts between fingers Very infectious

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25
Q

State the counselling points to patients with scabies:

A

All members of household should be treated
Wash all bedding at 50 degrees
Now recommended that both malathion/permethrins should be applied twice, one week apart. Apply to the whole of the body including, scalp, neck, ears, face, fingers
Orla sedating antihistamine at night may also be given to help sleep

26
Q

State the treatment of headlice?

A

Dimeticone – it coats headlice and interferes with water balance in lice by preventing excretion of water
Course of treatment should be 2 applications of product 7 days apart to kill lice emerging from first application

27
Q

State the process of wet combing?

A

With a plastic/metal detection comb preferably for 30 minutes
At 4-day intervals for minimum of 2 weeks and carried on until no lice are found on 3 consecutive occasions

28
Q

State the use, indication of amorolfine?

A

Apply 1-2 x a week for 6 months for fingernails and for toenails 9-12 months
Also available as an OTC via but only if fungal nail infection is on maximum 2 nails only

29
Q

State the counselling point for when patients are taking terbinafine?

A

Patients need to be counselled on signs and symptoms of liver disorder occur:
Nausea, anorexia, jaundice, vomiting, fatigue, right upper abdominal pain, dark urine, pale stools
Discontinue in progressive skin rash – stevens-johnson syndrome, toxic epidermal necrolysis

30
Q

How are emollients used in excema?

A

For dry skin and itchiness. Can increase the efficacy of topical steroids and have a steroid sparing effect. Use continues even if symptoms improve

31
Q

What is the difference between eczema and psoriasis?

A

eczema characterized by poorly demarcated red, dry areas with fine scale,” while psoriasis appears as “red, well-circumscribed lesions (called plaques) with heaped-up, white scaling”

32
Q

Which drugs can provoke psoriasis?

A

Lithium, chloroquine and hydroxychloroquine, ace inhibitors, beta blockers, nsaids, ace inhibitors. May not occur until drug has been taken for weeks/months.

33
Q

Discuss the tx of psoriasis

A

Emollients
coal tar
topical steroid if on trunk or limbs
scalp - topical steroid for 4 weeks
pustular = urgent same day referral to specialist

34
Q

State the topical corticosteroid potencies?

A

Mild = hydrocortisone acetate less than 2.5%
Moderate = clobetasone (eumovate), betamethasone 0.025% (Betnovate-RD), trimovate Potent = mometasone 0.1%, betamethasone valerate 0.1%
Very potent = clobetasol (dermovate), nerisone

35
Q

What is the OTC licensing for purchasing hydrocortisone cream?

A

Only to be sold in patients over 10 years old+
To be applied sparingly, 1-2 times daily. Maximum use for 7 days only.
Should not be sold to children under 10, pregnant ladies AND should not be sold for use on face, anogenital region, broken/infected skin (including cold sores, acne, athletes’ foot)

36
Q

What advice should be given with topical steroids?

A
  • how much to apply
  • how long for
  • seek advice if condition worsens
37
Q

What is the treatment of hyperhidrosis?

A

Condition of excessive sweating. Aluminium chloride hexahydrate – potent antiperspirant

38
Q

What is pruritus’ caused by?

A

Systemic disease – jaundice, endocrine disease, iron deficiency, chronic renal disease, skin disease, side effect of opioid analgesics.

39
Q

What can be used to relieve pruritus – and provides a cooling effect?

A

Levomenthol cream

40
Q

Which cream can be used to relieve pruritus in eczema and what side effect does it have? Doxepin 5% cream

A

Can cause drowsiness and can cause sensitisation

41
Q

What is common in biliary obstruction?

A

Pruritus

42
Q

What is the treatment of drug induced cholestasis and primary biliary cirrhosis?

A

Colestyramine

43
Q

Why should acne treatment be started early?

A

To prevent scarring

44
Q

Which contraceptive can be used for acne?

A

Dianette - Co-cyprindiol (women only)

45
Q

What is used in severe acne and can only be prescribed by consultant dermatologist?

A

Isotretinoin

46
Q

What is the first line tx for acne of any severity?

A
  • fixed combination of topical adapalene with benzoyl peroxide
  • fixed topical tretinoin with clindamycin
    mild to moderate
  • benzoyl peroxide with clindamycin
    moderate to severe
  • adapalene, benzoyl peroxide and lymecycline or doxy
  • ## azelaic acid with oral lym or doxy
47
Q

What is isotretinoin used for?

A

Severe acne in adolescents and also in females in their 30s-40s
Must only be prescribed by consultant dermatologist
Given for at least 16 weeks
Females patients must be registered with pregnancy prevention programme
For a prescription of isotretinoin for female – a pregnancy test must be done and also dispensed within 7 days of the prescription date
Isotretinoin is teratogenic. Limited to 30 days tx.
Some side effects: severe dryness of skin and mucous membrane, nose bleeds, joint pains,

48
Q

State a MHRA warning for isotretinoin?

A

May cause sexual side effects, erectile dysfunction and decreased libido

49
Q

State common side effects of isotretinoin?

A

Severe dryness, joint pain, back pain, alopecia, cheilitis, dry eye, increased risk of infection

50
Q

State contraception and conception advise for patients taking isotretinoin?

A

Women advised to use effective contraception 1 month prior to starting treatment, during treatment and for one month following treatment
Women should be advised to use 1 method of contraception but ideally 2 methods of contraception advised
Oral progestogen contraceptives not considered effective

51
Q

State monitoring requirements for isotretinoin?

A

Measure hepatic function and serum lipids before treatment, one month after treatment and then every 3 months

52
Q

When should you discontinue treatment with isotretinoin?

A

Risk of pancreatitis if triglycerides above 9mmol
Visual disturbances
Severe skin peeling
Haemorrhagic diarrhoea (blood in vomit/diarrhoea)
Psychiatric disorders – depression, anxiety and suicidal thoughts occur

53
Q

What should you also advise above patients with isotretinoin?

A

Avoid wax epilation, dermabrasion, laser treatments during treatment and for 6 months after treatment
Avoid exposure to UV sunlight and use sunscreen and emollient and lip balm
§

54
Q

State the use of brimonidine tartrate?

A

Facial erythrema in rosacea

55
Q

State the two MHRA warnings for using brimonidine gel?

A

Systemic cardiovascular events, bradycardia, hypotension and dizziness reported Symptom exacerbation has been reported

56
Q

State the treatment for cradle cap in infants?

A

Coconut oil / olive oil applications followed by shampooing

57
Q

What can hirsutism be caused by?

A

Hormonal changes in females and side effect of the drugs: minoxidil, corticosteroids, anabolic steroids, androgens, danazol, progestogens
Weight loss can reduce hirsutism in obese women

58
Q

Which drug is used to treat acne associated with venous thromboembolism?

A

Co-cynpridiol

59
Q

How is androgenic alopecia (baldness) treated in men?

A

Finasteride or topical minoxidil

60
Q

What virus causes warts?

A

Human papillomavirus

PRE REG (24 decks)

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