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GPhC BNF > Skin COPY > Flashcards

Skin COPY Flashcards

1
Q

ISOTRETINOIN MHRA WARNINGS?

A 
NO WAXING/LASER DURING AND 6 MONTHS LATER.
AVOID UV SUNLIGHT
Report low mood/behaviour changes
PPP
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2
Q

ISOTRETINOIN CONTRACEPTION ADVICE?

A

CONTRACEPTION 1 MONTH BEFORE, DURING AND AFTER!1 HIGHLY EFFECTIVE (IUD) OR 2 COMPLEMENTARY (COC+BARRIER)PROGESTOGEN-ONLY- not rated!

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3
Q

What is this?

A

Chicken pox

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4
Q

What is this?

A

Acne

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5
Q

What is this?

A

Atopic Dermatitis

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6
Q

What is this?

A

Cold Sores

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7
Q

What is this?

A

Cradle Cap

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8
Q

What is this?

A

Dandruff

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9
Q

What is this?

A

Fungal Nail Infection

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10
Q

What is this?

A

Hand Foot and Mouth

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11
Q

What is this?

A

Impetigo

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12
Q

What is this?

A

Measles

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13
Q

What is this?

A

Meningitis- rash that does not fade when glass rolled over
stiff neck
fever

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14
Q

What is this?

A

Mumps- swollen glands

:0o

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15
Q

What is this?

A

Nappy Rash

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16
Q

What is this?

A

Psoriasis- silver scales, red patches of skin

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17
Q

What is this?

A

Rubella- red/pink/spotty rash, all over body

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18
Q

What is this?

A

Scarlet Fever- sunburn red rash, sandpaper
red lines folds of skin
flushed face
strawberry tongue

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19
Q

What is this?

A

Slapped Cheek Syndrome- red rash on both cheeks

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20
Q

What is this?

A

Tinea Capitis (fungal infection of the scalp)

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21
Q

What is this?

A 
Tinea Corporis (fungal infection of the body)
scaly, ring shaped area- trunk, legs
raised, expanding rings
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22
Q

What is this?

A

Jock itch

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23
Q

What is this?

A

Tinea Pedis (Athlete’s foot)

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24
Q

What is this?

A

Wart / Verruca

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25
Q

As well as runny nose, cough and a high fever, what is another symptom of measles?

A

Conjunctivitis

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26
Q

Do you refer measles to the GP?

A

Yes - advise the patient to phone first to reduce risk of spreading the infection

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27
Q

What is the advice for patients with measles, mumps or rubella?

A

To stay hydrated

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28
Q

How long after symptoms disappear should a child stay off school with measles, mumps or rubella?

A

Measles - 4 days

Mumps - 5 days

Rubella - 6 days

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29
Q

Which over the counter products can be given to patients with measles, mumps or rubella?

A

Paracetamol and Ibuprofen

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30
Q

As well as fever, headache and malaise, what is another symptom of mumps?

A

Swelling of one or both glands which shows at the sides of the face

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31
Q

As well as fever, headache and malaise, what is another symptom of rubella?

A

Swelling of glands which shows up at the back of the neck

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32
Q

What are the 3 OTC treatments for chicken pox?

A
  1. Calamine lotion
  2. Cooling gels
  3. Paracetamol
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33
Q

What are the two pieces of lifestyle advice given to patients with chicken pox?

A
  1. Stay hydrated

2. Cut nails short to avoid scratching

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34
Q

Flu-like symptoms, nausea, vomiting, lethargy and muscle ache are non-specific signs of meningitis. What are the specific signs? (7)

A
  1. Severe headache
  2. Stiff neck
  3. Altered mental state
  4. Non-blanching rash
  5. Photophobia
  6. Seizures
  7. Unconsciousness
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35
Q

As well as Olive Oil BP and gently brushing flakes away, which shampoo can be used in the treatment of cradle cap?

A

Ketoconazole 2% Shampoo

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36
Q

What are the referral criteria for nappy rash? (5)

A
  1. Yellow/weeping (infection)
  2. Broken skin
  3. Symptoms for over 2 weeks
  4. Concomittant genital / oral thrush
  5. Rash in other areas of the body
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37
Q

What are the treatment options for nappy rash? (5)

A
  1. Clotrimazole 1% cream
  2. Dimeticone
  3. Zinc
  4. Lanolin
  5. Castor oil/Cod liver oil (creates a water resistant barrier)
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38
Q

What are the referral criteria for eczema/atopic dermatitis?

A
  1. Yellow/Weeping (infection)
  2. Sever symptoms (cracked/bleeding)
  3. Treatment failure
  4. Not previously diagnosed / No identifiable cause
  5. Symptoms for over 2 weeks
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39
Q

What are the two types of topical treatment used in atopic dermatitis?

A
  1. Emolients

2. Corticosteroids

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40
Q

Which two corticosteroids can be used in atopic dermatitis?

A
  1. Hydrocortisone

2. Clobetasone

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41
Q

What is the minimum age can hydrocortisone cream be sold for OTC?

A

10

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42
Q

What is the minimum age that clobetasone can be sold for OTC?

A

12

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43
Q

As well as moisturising creams, when else can emolients be applied to treat atopic dermatitis?

A

In the shower/bath as a soap substitute

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44
Q

What is the maximum duration of treatment for OTC hydrocortisone and clobetasone cream?

A

7 days

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45
Q

Which drugs can cause acne as an adverse effect? (5)

A
  1. Lithium
  2. Phenytoin
  3. Progestogens
  4. Levonorgesterol
  5. Norethistrone
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46
Q

When treating acne OTC, after how long do you refer if unresponsive?

47
Q

Which OTC product is used to treat acne?

A

Benzylperoxide:2.5%, 5% or 10%

48
Q

Especially during the initial stages of treatment with benzoyl peroxide, which side effects can patients experience?

A
  1. Drying
  2. Stinging
  3. Soreness
  4. Peeling
49
Q

What arethe counselling points for OTC acne treatment with benzyol peroxide? (4)

A
  1. Regular use is required
  2. Might take a while to work
  3. Avoid greasy, oil-based cosmetics
  4. Sunglight is helpful
50
Q

Occuring 6-24hrs before, what is the prodomal symptom of cold sores?

A

Tingling and irritation

51
Q

How long do most cold sores take to heal?

52
Q

What are the referral criteria for cold sores? (5)

A
  1. Painless lesions (may be cancerous)
  2. Babies/young children
  3. Sore and lasting for over 2 weeks
  4. Affecting the eyes
  5. Immunocompromised patients
53
Q

Which antiviral can be used topically to treat cold sores?

54
Q

To treat cold sores, how many times a day should aciclovir be applied?

A

5 times a day

55
Q

When treating cold sores, when should patients start using topical aciclovir to maximise effectiveness?

A

During the prodromal phase

56
Q

As well as topical aciclovir, what can be sold OTC for the treatment of cold sores?

A

Hydrocolloid patches - promote wound healing

57
Q

What is the duration of treatment for cold sores using OTC Zovirax cream?

A

At least 4 days, up to 10 days

58
Q

How long does it usually take for warts and verrucas to disappear on their own?

A

6 months - 2 years

59
Q

What are the referral criteria for warts and verrucae? (8)

A
  1. Facial warts
  2. Change in size/shape
  3. Bleeding
  4. Itching
  5. On the genitals
  6. Immunocompromised patients
  7. No improvement after 3 months with OTC treatment
  8. Diabetes
60
Q

What are the 2 OTC treatment options for warts and verrucae?

A
  1. Salicylic acid

2. Cryotherapy

61
Q

Counselling patients with warts:what should they do before applying treatment?

A

Soak their hands/feet in warm water for 5-10mins

62
Q

Counselling patients with warts:what should they do once a week?

A

Remove dead skin with pumice stone

63
Q

When should you refer someone who presents with dandruff?

A

If you suspect it might be psoriasis

64
Q

What is the first line treatment for dandruff?

A

Ketoconazole 2% shampoo

65
Q

How often should ketoconazole 2% shampoo be applied when treating dandruff?

A

Twice a week for the first 2-4 weeks then,

Weekly/Fortnightly thereafter

66
Q

After ketoconazole 2% shampoo, what is the other OTC treatment option for treating dandruff?

A

Selenium Sulphide 2% Shampoo

67
Q

What is the least effective OTC treatment for dandruff but is still used?

68
Q

How long does it take to see improvement of dandruff after starting OTC treatment?

69
Q

When using shampoos to treat dandruff OTC, what counselling advice should you give patients?

A

Leave it on for 5 minutes before rinsing off

70
Q

Which skin condition can be trigger by stress?

71
Q

What are the referral criteria for psoriasis? (2)

A
  1. No previous diagnosis

2. Moderate - Severe (may need dermatologist)

72
Q

What is the only OTC option to treat psoriasis?

A

Emollients

73
Q

Athelete’s Foot, Jock Itch, Tinea Capitis and Tinea Corporis are all caused by which type of infection?

74
Q

What is Tinea Corporis better known as?

75
Q

What are the referral criteria for fungal infections? (5)

A
  1. Spreading of symptoms
  2. Signs ofbacterial infection
  3. Diabetics
  4. Immunocompromised
  5. Unresponsive to treatment
76
Q

What is the referral criteria for someone presenting with athlete’s foot?

A

If the toenail is also affected

77
Q

Which 3 topical antifungals can be used to treat fungal “tinea” infections?

A
  1. Clotrimazole
  2. Ketoconazole 2% (Daktarin Gold)
  3. Miconazole (Daktarin)
78
Q

How long after symptoms subside should patients continue to treat fungal “tinea” infections?

79
Q

As well as antifungal creams, what are other OTC treatment options for fungal “tinea” infections? (2)

A
  1. Combination products (Antifungal and Corticosteroid) - e.g. Daktacord
  2. Terbinafine
80
Q

Should you refer impetigo?

81
Q

Which recent POM to P OTC product is used for the treatment of fungal nail infections?

A

Amorolfine 5% nail laquer

82
Q

What is the specific indication for OTC amorolfine 5% nail lacquer use?

A

No more than 2 nails affects

Only beneath the tips or sides of nails

83
Q

Is amorolfine 5% nail lacquer used in the OTC treatment of fungal nail infections licensed for use in patients of all ages?

A

No, over 18 only

84
Q

How often should amorolfine 5% nail lacquer be applied when treating fungal nail infections OTC?

A

once a week

85
Q

What should the patient do before applyingamorolfine 5% nail lacquer for the OTC treatment of fungal nail infections?

A

File down the nail, cleanse and degrease

86
Q

How long is treatment duration foramorolfine 5% nail lacquer for the OTC treatment of fungal nail infections? TOES

A

9-12 months

87
Q

How long is treatment duration foramorolfine 5% nail lacquer for the OTC treatment of fungal nail infections? FINGERNAILS

88
Q

Should you refer a baby with slapped cheek syndrome?

89
Q

A self-limiting disease, how long does it take for slapped cheek syndrom to heal?

90
Q

Should you refer someone with shingles?

91
Q

Can you catch shingles from someone with chicken pox?

92
Q

Can you catch chicken pox from someone with chicken pox?

93
Q

Should you refer a baby with hand foot and mouth disease?

A

If no improvement after 7-10 days

94
Q

Often with swollen tonsils, after which infection does scarlet fever usually develop from?

95
Q

Should you refer someone with scarlet fever?

A

Yes, to the GP

96
Q

SKIN INFECTIONS

SCABIES VISUAL SYMPTOM?

A

Red spot with silverly interlinking lines- webbing of fingers/toes

97
Q

SCABIES TREATMENT & COUNSELLING?

A

APPLY MALATHION & PERMETHRIN TWICE, 1 week apart
APPLY TO WHOLE BODY- scalp/neck/face/ears
TREAT ALL MEMBERS OF THE FAMILY
AVOID PHYSICAL CONTACT WITH OTHER PEEPS
REAPPLY TO WASHED HANDS!

98
Q

SCABIES- BENZYL BENZOATE POINTERS?

A

Less effective
Irritant, avoid in children
Up to 3 consecutive days

99
Q

HEADLICE TREATMENT

WET COMBING?
DRUGS?
NOT RECOMMENDED?
MHRA WARNING?

A

WET COMBING? Comb for 30mins, 4 day intervals, no lice for 3 sessions (3 weeks)

DRUGS?
Dimeticone- apply for 8hrs, dry naturally- repeat after 7 days
Malathion- apply for 12hrs, dry naturally- repeat after 7 days (AVOID IN SEVERE ECZEMA/ASTHMA cos alcohol, astags)

NOT RECOMMENDED? Benzyl benzoate/permethrin

MHRA WARNING? SOME PREPS ARE FLAMMABLE, FIYAAAAAAAAAA

100
Q

ECZEMA- dry, flaky skin- small red spots

DD FROM PSORIASIS?

A

PSORIASIS- silvery scales, bingo!

101
Q

TYPES OF ECZEMA?

A

IRRITANT
ALLERGIC CONTACT
ATOPIC

102
Q

ECZEMA TREATMENT
EMOLLIENTS?
TOPICAL CORTICOSTEROIDS?
ANTIHISTAMINES?

A

EMOLLIENTS? Apply as bath/shower emollients. Avoid aqueous cream due to high risk of skin infections
TOPICAL CORTICOSTEROIDS? Mild- face & genitals
ANTIHISTAMINES? NOT in atopic dermatitis

103
Q

ECZEMA DRUG TREATMENT
MILD-MODERATE?
MODERATE-SEVERE?

A

MILD-MODERATE? Pimecrolimus

MODERATE-SEVERE? Tacrolimus

104
Q

SEVERE REFRACTORY ECZEMA TREATMENT? systemic G

A

CICLOSPORIN
AZATHIOPRINE
MYCOPHENOLATE MOFETIL
MONOCLONAL ANTIBODIES- tocilizumab?

105
Q

PSORIASIS

VISUAL SYMPTOM?

A

Skin thickening

Silvery white scaling/raised/larger patches/plaques

106
Q

PSORIASIS- systemic, immune-mediated inflammatory skin disease (joints too)-> psoriatic arthritis

107
Q

PSORIASIS TREATMENT?

A

EMOLLIENTS
TOPICAL CORTICOSTEROIDS
COAL TAR PREPS
VITAMIN D (topical/analogue)

108
Q

PSORIASIS TREATMENT- TOPICAL an L?

A

PHOTOTHERAPY- UVA/UVB through trained professional
SYSTEMIC- methotrexate/ciclosporin/acitretin (second-line)
OK then mate

109
Q 
TOPICAL CORTICOSTEROIDS
MILD?
MODERATE?
POTENT?
VER POTENT? (solo)
COUNSELLING?
A 
MILD? Hydrocortisone
MODERATE? Clobetasone
POTENT? Betamethasone
VER POTENT? Clobetasol (solo)
COUNSELLING?
prolonged use- skin thinning, OTC hydrocortisone 1%, 7 days
apply thinly- fingertip unit hand? ok
do not apply to broken skin
110
Q

ACNE- FIRST-LINE TREATMENT OPTIONS?

A 
ADAPALENE
BENZOYL PEROXIDE
CLINDAMYCIN
LYME/DOXYCYCLINE
ERYTHROMYCIN
111
Q

SEVERE ACNE- ISOTRETINOIN

MHRA WARNING & ADVICE? PEN

A

PPP (pregnancy prevention programme)- take contraceptive 1 month before+after, 30 days supply treatment
ED/decreased libido- rare
Neuropsychiatric reactions- seek medical attention, mood change
AVOID UV LIGHT/LASER SKIN TREATMENT/DERMABRASION/EPILATION

112
Q 
SCALP & HAIR CONDITIONS
DANDRUFF TREATMENT
MILD?
PERSISTENT/SEVERE?
PSORIASIS OF SCALP?
A

MILD? Shampoos containing antimicrobials- pyrithione zinc/selenium/tar extracts
PERSISTENT/SEVERE? Ketoconazole shampoo
PSORIASIS OF SCALP? Coal tar & salicylic acid

113
Q

HIRSUTISM TREATMENT? (hormonal/cos of drugs- minoxidil, corticosteroids, progestogens, phenytoin)

A

Weight loss Laser therapy Eflornithine Co-cyprindiol

114
Q

ALOPECIA TREATMENT?

A

FINASTERIDE
OR
MINOXIDIL

GPhC BNF (48 decks)

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