Dermatology Formative Flashcards

1
Q

Gel

A

Thickened aqueous solution

-semi-solid, containing high

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2
Q

Lotion

A

Liquid formulation

Suspension of medication in water/alcohol/other liquid

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3
Q

Pastes

A

Semi-solids, stiff, greasy, difficult to apply, often used in cooling, drying, soothing bandages
-contain finely powdered material

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4
Q

Ointment

A

Semi-sold grease/oil, no preservative, less cosmetically attractive, greasy

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5
Q

Cream

A

Semisolid emulsion of oil in water, contains preservative, cosmetically acceptable, non greasy

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6
Q

Examination for herpes simplex

A

Blister fluid: electron microscopy, viral culture and PCR

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7
Q

Usual cause of cellulitis?

A

beta haemolytic streptococcus

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8
Q

Diagnosis of cellulitis?

A

Serologically (so do a blood test and look for antibodies)

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9
Q

Treatment for cellulitis?

A

Phenoxymethylpenicillin (or erythromycin) and flucloxacillin

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10
Q

Investigation for scabies?

A

Skin scrapings for microscopy

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11
Q

Investigation for ring worm?

A

Skin scraping for microscopy and culture, and woods light

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12
Q

Investigation for impetigo?

A

Swab of lesion sent in bacterial container for microscopy and culture

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13
Q

Atrophy

A

Thinning of the skin

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14
Q

Crusted

A

Dried serum or exudate on the skin

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15
Q

Scaly

A

Visible flaking and shredding of surface skin

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16
Q

Erosion

A

Partial epidermal loss

denuded area of skin

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17
Q

Weal

A

Itchy raised “nettle rash” like swelling due to dermal oedema

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18
Q

Large, flat-topped elevated, palpable lesion

A

Plaque

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19
Q

Organism causing boils?

A

Usually staph aureus

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20
Q

Treatment for boils?

A

Erythromycin (occasionally incision and drainage)

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21
Q

Organsim causing pitted keratolysis?

A

Corynebacterium

-frequently involves the soles of the forefoot and appears as numerous punched out circular lesions

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22
Q

Chronic lesions of lupus vulgaris are at high risk of developing what?

A

High risk of developing squamous cell carcinoma

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23
Q

How are warts spread?

A

Warts are spread by direct contact, they are also associated with trauma

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24
Q

Common cutaneous infection of childhood caused by pox virus. Lesions are multiple small (1-3mm) translucent papules which often look like fluid filled vesicles but are infact solid. Individual lesions may have a central depression called a punctum. They exhibit the Kobner phenomenon. They occur at any body site including the genitalia

A

Molluscum contagiosum

-rarely require treatment as they spontaneously resolve

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25
Q

Disease of sheep and goats

  • caused by pox virus
  • 1-2 cm reddish papules with a surrounding erythema which usually becomes pustular
A

Orf

  • lesions resolve spontaneously after 4-6 weeks
  • Occasionally, orf is complicated by erythema multiforme
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26
Q

What can complicate orf?

A

Erythema multiforme can complicate orf

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27
Q

Asymmetrical scaly patches which show central clearing and an advancing scaly, raised edge

A

Tinea corporis

  • central clearing is not a universal feature and it is recommended that all asymmetrical scaly lesions should be scraped for fungus
  • Ring worm of the face often arises after the use of topical steroids
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28
Q

When does ringworm of the face often arise?

A

Ringworm of the face often arises after the use of topical steroids

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29
Q

The skin in the toe clefts looks white, macerated and fissured

A

Tinea pedis (athletes foot)

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30
Q

How is scalp ringworm spread?

A

Scalp ringworm is spread by close contact and may also be spread indirectly by hairdressers

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31
Q

Clotrimazole, miconazole, terbinafine

A

Anti-fungals (e.g. for ringworm)

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32
Q

Intensely itchy rash caused by the mite sarcoptes scabiei
It presents clinically with itchy red papules (or occasionally vesicles and pustules) which can occur anywhere in the skin but rarely on the face
-especially web spaces between fingers and toes
-palms and soles
-around wrists and axillae
-male genitalia
-around nipples and umbilicus

A

Scabies

33
Q

Treatment for scabies

A

Permethrin 5% (tobical sabicide)

-applied and washed off after ten hours

34
Q

Enhance rehydration of epidermis

-For all dry/scaly conditions esp. eczema

A

Emollients

35
Q

How much emollient do you need to prescribe weekly?

A

Prescribe 250-500g weekly

36
Q

Vasoconstrictive
Anti-inflammatory
Anti-proliferative

A

Topical cortico-steroids

37
Q

Hydrocortisone 1%

A

Mild

38
Q

Clobetasone Butyrate 0.5%

A

Moderate

39
Q

Modrasone

A

Moderate

40
Q

Elocon

A

Potent

41
Q

Betamethasone valerate 0.1%

A

Potent

42
Q

Clobetasol proprionate 0.05%

A

Very potent

43
Q

Use of topical steroids

A

Eczema (dermatitis)
Psoriasis
Other non-infective inflammatory dermatoses e.g. lichen planus
Keloid scars (usually intralesional)

44
Q

Quantity of topical steroid needed for whole body application?

A

20-30g

45
Q

Quantity of steroid in 1 fingertip unit?

And how much does this cover?

A

1/2g

Covers 2 hand areas

46
Q

Topical steroid side effects?

A

Thinning of skin, purpura, stretch marks
Perioral dermatitis
Fixed telangectasia
Steroid rosacea

47
Q

May worsen or mask infections
Systemic absorption
Tachyphylaxis : decrease in response to anti-inflammatory effects
Rebound flare of disease (esp. psoriasis)

A

Topical steroid

48
Q

Povidone iodine
Chlorhexidine
Triclosan
Hydrogen peroxide

A

Antiseptics

have bacteriostatic/ bactericidal effects

49
Q

Anti-septic you could use in acute exudative eczema or pompholyx?

A

Potassium permanganate rinse/soak/bath

50
Q

Topical antibiotics for acne?

A

Clindamycin, erythromycin, tetracycline

51
Q

Topical antibiotics for rosacea?

A

Metronidazole

52
Q

Topical antibiotics for impetigo?

A

Mupirocin, fusidic acid

53
Q

Type of anti-viral required for eczema herpeticum?

A

Oral anti-viral needed for eczema herpeticum

54
Q

Type of medication needed for candidi and pityrasis vesicolour?

A

Anti-yeast

55
Q

Medication needed for dermatophytes (ringworm)

A

Anti-fungal

56
Q

Menthol
Capsaicin
Camphor/phenol
Crotamiton

A

Anti-pruritics
-Menthol is added to calamine and other lotions/creams to impart cooling senstation
Capsaicin is from red chilli peppers –> depletes substance P at nerve endings and reduces neurotransmission, effect gradually builds
Camphor/phenol –> for pruritis ani

57
Q

When might you use camphor/phenol?

A

For pruritis ani

58
Q

This is from red chilli peppers, depletes substance P at nerve endings and reduces neurotransmission, effect gradually build

A

Capsaicin

59
Q

Give an example of a keratolytic

A

Salicylic acid

10-40%

60
Q
Used to soften keratin: 
Viral warts
Hyperkeratotic eczema & psoriasis
Corns and calluses
To remove keratin plaques in scalp
A

Keratolytics

e.g. salicylic acid 10-40%

61
Q

What is podophyllin used for?

A

Genital warts

62
Q

Treatment of warts?

A
Keratolytics  e.g.Salicylic acid
Formaldehyde
Glutaraldehyde
Silver nitrate
Cryotherapy (usually                            liquid nitrogen)
Podophyllin (genital warts)
63
Q

Topical psoriasis treatment?

A
Emollients and choice of:
 Coal tar 
 Vitamin D analogue
 Keratolytic
 Topical steroid
 Dithranol
64
Q

Pros and cons of vitamin D analogues?

A

Clean, no smell
Easy to apply
BUT can be irritant
Use limited to ?100g weekly

65
Q

Side effects of dithranol

A

Difficult to use and irritant and stains normal skin

“dithranol staining and burning”

66
Q

Treatments for scalp psoriasis

A

Greasy ointments to soften scale
Tar shampoo
Steroids in alcohol base
Vitamin D analogues

67
Q

Psoriasis in axilla

A

Topical steroids for face, flexures and groin/genitals

68
Q

Imidazoquinoline amine
Immune response modulator
Enhances innate & cell-mediated immunity
Anti-viral, anti-tumour effects

A

Imiquimod

69
Q

Tacrolimus, pimecrolimus

A

Calcineurin inhibitors

  • suppress lymphocyte activation
  • topical treatment of atopic eczema, especially face, children
70
Q

When would you use calcinuerin inhibitors?

A

Topical treatment of atopic eczema, especially face, children

  • does not cause cutaneous atrophy
  • may cause burning sensation on application(?risk of cutaneous infections ?? risk of skin cancer?)
71
Q

Side effects of topical therapies?

A

Burning or irritation
Contact allergic dermatitis
Local toxicity
Systemic toxicity

72
Q

UVA and UVB, which is responsible for direct/indirect DNA damage

A

UVA: indirect damage
UVB: direct damage

73
Q

Being female and having malignant melanoma?

A

Improve the prognosis

74
Q

Adverse prognostic factors for malignant melanoma

A

Vascular invasion
Nodular subtype
Ulceration

75
Q

Where do you get arterial ulcers?

A

Foot/mid shin

76
Q

Where do you get venous ulcers?

A

Medial or lateral malleolus

77
Q

What is the breslow thickness?

A

Depth from the granular layer of the epidermis to the deepest melanoma cell

78
Q

Cutaneous horn

A

Made of keratin

-most common lesions are seborrhoeic keratoses

79
Q

Where do dermatofibromas commonly develop?

A

Lower legs