skin

Question 1

patient presents with fungal infection of the scalp where hair is falling out

Answer 1

refer to gp

Question 2

patient presents with new acne. she is 40. what do you suggest

Answer 2

refer acne if it has appeared first time in someone other than teenager

Question 3

2 possible causes of dandruff

Answer 3

dry skin
overgrowth of fungus

Question 4

mild dandruff can be treated easily by shampoos containing selenium, salicyclic acid, coal tar, zinc. These two dont smell nice and can also cause irritation in some people though

Answer 4

selenium
coal tar

Question 5

male pattern baldness and certain types of hair loss in women can be treated OTC with minodixidil. Which strengths are available how how long does it need to be used to see effect?

Answer 5

2% solution
5% solution and foam

needs at least 2 months continuous use before any effect is seen
any new hair that grows could shed 3-4 months after stopping

Question 6

most common cause of itchy scalp

Answer 6

esp in children
head lice
white egg cases = nits

Question 7

Freederm gel preparations contain nicotinamide.
What is it

Answer 7

anti inflammatory
reduces selling and redness of acne

Question 8

cause of warts

Answer 8

HPV

Question 9

what do verruccas look like

Answer 9

warts on soles of feet
have tiny black dots on them

Question 10

name the 2 steroids available OTC

Answer 10

HC
clobetasone

Question 11

what is HC 1% OTC available for

Answer 11

allergic contact dermatitis
irritant dermatitis
insect bite reactions
mild to moderate eczema

Question 12

what is clobetasone butyrate available for OTC

Answer 12

reduce inflammation, itching and dryness of skin during eczema and dermatitis flare ups

Question 13

Restrictions to HC sale - age

Answer 13

Nobody under 10
Nobody pregnant or BF
Not on broken or infected skin
Not on face or around anal/genital areas
Thin application only as it can thin the skin
Not suitable for large areas of skin
Max 7 days

Question 14

Age restriction for clobetasone OTC

Answer 14

nobody under 12
do not use on face, around groins, genitals or between toes

Question 15

what is a fingertip measure

Answer 15

tip of adult index finger to first crease
this is enough cream to cover an area that is twice that of an adult palm

Question 16

what is scabies caused by

Answer 16

mite infestation
they get under epidermis of skin and cause itchy rash to appear up to 8 weeks after pt infected

Question 17

what is this

Answer 17

scabies

Question 18

scabies is passed on how?

Answer 18

long periods of skin to skin contact with an infected person as well as sexual intercourse and sharing of clothes, towels and bedding

Question 19

if one person has scabies, does everyone need to be treated

Answer 19

yes all close contacts and household members at the same time whether they have the rash or not to avoid re-infecting the treated people

Question 20

what areas to treat in scabies

Answer 20

everywhere below neck needs to be treated in scabies including anal/genital areas, wrists, armpits, breats, soles of feet, in between toes and fingers
particular attention to between fingers and toes and under fingernails

Question 21

what areas to treat for scabies in children under 2 and the elderly

Answer 21

everywhere including scalp, face and ears
avoid eyes and mouth

Question 22

which insecticides are recommended to kill mites in scabies

Answer 22

malathion
permethrin

Question 23

true or false - apply insecticides e.g. malathion, permethrin to skin for scabies after a hot bath

Answer 23

false. needs to be applied to cool, dry skin.

Question 24

scabies - how long to leave malathion on the body

Answer 24

24h

Question 25

scabies - how long to leave permehtrin on the body

Answer 25

8-12 hours

Question 26

does scabies treatment need to be repeated

Answer 26

yes after 7 days to ensure any recently hatched mites are eliminated

Question 27

treatment of scabies in pregnant women and children under 2

Answer 27

refer to GP

Question 28

on the day of scabies treatment application, what else should they be advised to do

Answer 28

Wash their clothes, towels and bedding at over 50°C. Items that can not be washed, can be placed in a plastic bag for 72 hours. This will kill any remaining mites and prevent re-infection.

Question 29

patient has used permethrin (8-12 hour application) twice now (repeated after 7 days to ensure any eggs that hatched also killed). But, they say they are still itching and would like some more treatment.

Can you supply?

Answer 29

no
itching and rash associated with scabies infestation can persist for up to a month after treatment for the associated itching to settle down and longer for genital lesions to resolve

Question 30

meningitis symptoms are similar to flu. what are some common symptoms that require urgent referral

Answer 30

Headache, neck or back stiffness, dislike of bright light, nausea and vomiting and irritability or drowsiness. There is usually a skin rash (which may appear purple in colour) that does not disappear when a glass is pressed on it.