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ENT, skin, vaccines, anaesthesia - low > Skin > Flashcards

Skin Flashcards

1
Q

What is the difference between cream and ointment?

A 
Ointment = more greasy
Cream = less greasy
Ointment = more hydrating for chronic dry skin
Cream = dries out quicker and applied more frequently than ointment
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2
Q

When would you usually use gels?

A
  • for scalp and face

- have a high water content

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3
Q

When would you usually use lotions?

A
  • have a cooling effect, for large hairy areas

- alcoholic base so can sting broken skin

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4
Q

When should you be cautious of preparations containing salicylate?

A
  • in neonates - toxicity

- when applied to large areas - toxicity

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5
Q

Which patient group should you avoid benzyl alcohol in?

A
  • neonates - fatal toxicity syndrome
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6
Q

How do you apply emollients?

A
  • as often as required
  • in the direction of hair growth to reduce folliculitis
  • after washing/bathing to maximise hydration
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7
Q

What is the MHRA warning with emollients?

A
  • fire risk

- clothes/dressings easily ignite by naked flame

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8
Q

What is used to treat eczema?

A
  • steroids
  • reduce inflammation

CI - acne, rosacea, skin inf

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9
Q

Which eczema treatment is classified as VERY potent?

A
  • clobetasol (dermovate)
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10
Q

Which eczema treatment is classified as just potent?

A
  • betamethasone 0.1% (betnovate)
  • hydrocortisone
  • mometasone
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11
Q

Which eczema cream is moderately potent?

A
  • clobetasone (eumovate)

- betamethasone 0.025% (betnovate RD)

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12
Q

Which eczema creams are mildly potent)?

A
  • hydrocortisone < 2.5%
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13
Q

How often should you apply eczema cream?

A
  • NO MORE THAN TWICE DAILY
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14
Q

Why should you avoid prolonged use of eczema products on the face?

A
  • thinning skin and hyperpigmentation
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15
Q

In what order should you apply the emollient and the steroid?

A
  • emollient first

- wait half an hour and then apply steroid for max absorption

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16
Q

How do you treat rosacea?

A
  • 6 to 12 week course repeated intermittently
  • facial erythema = brimonidine
  • MHRA = risk of systeic CV effects and risk of exacerbation of rosacea
17
Q

How do you treat pustules and papules associated with rosacea?

A
  • Topical - metronidazole, azelaic acid, ivermectin

OR

  • Oral - oxytetracycline, tetracycline, erythromycin
18
Q

How do you treat acne?

A
  • isotretanoin
  • under specialist supervision
  • all retinoids or vit A derivatives are teratogenic
19
Q

What would you advise about pregnancy when a pt is starting isotretonoin?

A
  • contraception 1 month before and after treatment (2 methods ideally)
  • pregnancy test must be negative in first 3 days of menstrual cycle up to 3 days before treatment - repeat every month and for 5 weeks after stopping
  • start treatment on 2nd or 3rd day of menstrual cycle
  • seek urgent advice if you fall pregnant during or up to 1 month after
20
Q

What is the PPP?

A
  • pregnancy prevention programme

- exclude pregnancy - at least 2 negative tests

21
Q

How long is a prescription under the PPP valid for?

A
  • 7 days - max 30 day supply

- repeats and faxes not accepted

22
Q

Can you give emergency supply for PPP?

A
  • only on specialist request with negative pregnancy test
23
Q

What are the other side effects of isotretonoin?

A
  • hyperglycaemia, hypertriglyceridaemia, high cholesterol, pancreatotos, hepatotoxicity, visual distrubance
  • skin peeling, redness, severe dry skin
24
Q

How would you manage a side effect of pancreatitis with isotret?

A
  • high risk of it is triglycerides above 9mmol/L

- discontinue it if hypertriglyceridaemia is uncontrolled

25
Q

What would you do if your skin was peeling with isotret?

A

discontinue

26
Q

what would you do if you had visual distrubances with isotret?

A
  • expert referral and posisble withdrawal
27
Q

What should patients avoid during and 6 months after isotretonoin treatment?

A
  • wax epilation, dermabrasion, laser treatment - scarring
  • photosensitivity - avoid UV light, Use high factor SPF sunscreen and emollient inducing lip balm
  • stop immediately if psychiatric reactions occur

ENT, skin, vaccines, anaesthesia - low (4 decks)

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