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57 Cards in this Set
- Front
- Back
What are the skin manifestations of Atopic Eczema |
Distressing, itchy skin - usually within 2 years (4-6m most commons), face and neck often first affected, pruritis leads to sleep disturbance and irritability |
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In older children, what sites are most commonly affected by Atopic Eczema? |
Flexures - this can lead to secondary infection with Staph. Aureus |
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How do emollients work? |
Improve barrier function and prevent further water loss from the skin |
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How can atopic eczema be managed? |
Emollients and other topical agents can be used, topical steroid in those >40 years old |
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Is non-compliance an issue with corticosteroid? |
Yes, concerns regarding steroid-phobia and effect delay encourage non-compliance |
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Which of dermovate, betnovate, eumovate and hydrocortisone is the most potent steroid? |
His Enormously Big Dick - Hydrocortisone (mild) - Eumovate (moderate) - Betnovate (potent) - Dermovate (v. potent) |
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What should you consider when prescribing corticosteroid? |
Age (young children more susceptible to SEf), site (thin areas more susceptible) and extent (more potential for systemic absorption if widespread disease) |
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What are the side-effects of topical corticosteroid? |
Skin thinning, rebound flares (tachyphylaxis), perioral dermatitis and hirsuitism |
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A patient with atopic dermatitis presents with umbilicated papules that contain jelly-like material, what is the likely diagnosis and treatment? |
Molluscum contagiosum - no Rx is advised, can perform cryotherapy and capsule puncture |
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A patient presents with a lesion (ulcerated) on the lip, patient complains that they have had this lesion before, what is the likely diagnosis and treatment? |
Herpes Simplex Virus |
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How does Varicella normally present? |
2 week incubation, febrile patient with crops of vesicles that are infectious till they crust that can scar |
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How does Measles normally present? |
10-12 day incubation, fever (>40)/conjunctivitis / coryza/cough, patient develops Koplik's spots at 2-3 days and rash on head at 5 days |
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How does Rubella normally present? |
Mild disease, slight fever and sore throat, rash starts on head and spreads down with tender lymph nodes In neonates, congenital rubella presents with 'blueberry muffin syndrome' |
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How does Fifth disease (Erythema infectiosum) normally present and what is the causative organism? |
Fifth disease causes bilateral slapped cheek appearance, developing a lacey rash in peripheral distribution follows several days later Parvovirus B19 |
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How does Hand, Foot and Mouth normally present and what is the causative organism? |
Enterovirus infection (Coxsackie A) that outbreaks commonly in the summer, causes small flat ulcers/blisters on hands, feet and mouth (hence the name). |
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How can headlice/pediculosis capitis be eriadicated |
Permethrin or malathion, reinfestation is common however |
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How is scabies (sarcoptes scabei) spread? |
Direct physical contact |
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How can scabies (sarcoptes scabei) be treated? |
Topical permethrin (5% cream) |
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How can Acne be treated? |
Topical - Benzoyl peroxide, topical retinoid Systemic - Oral antibiotics, OCP, Isotretinoin |
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What are the different forms of Acne? |
Mild comedonal, papules and pustules and finally nodulocystic |
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How does Erythroderma present? |
Large proportion of the skin is red spreading rapidly, cytokines are in a hyperactive state and this compromises skin function |
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What conditions can precipitate Erythroderma? |
Atopic eczema, psoriasis, pityriasis rubra pilaris and mycosis fungoides |
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4S - Staphylococcal Scalded Skin Syndromme usually present in what way? |
Caused by staphylococcal exfoliate toxin, antibiotics are essential and additional skin protecting precautions should be put in place |
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What causes Urticaria? |
Mast cell degranulation |
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How can Urticaria be managed? |
High dose anti-histamine (chlorphenamine), steroid (IV hydrocortisone), manage BP drop and look for C1 esterase inhibitor deficiency |
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What form a hypersensitivity reaction is Toxic Epidermal Necrolysis? |
TEN is a type IV (cell mediated) drug reaction |
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What is Nikolsky's sign? |
Creases and tearing of the skin causing shredding under limited pulling pressure |
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What is the first line treatment of Toxic Epidermal Necrolysis? |
Stop the offending drug - now call ITU, reuss support and call plastics |
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What is the most common infective agent when a patient with cellulitis following a venous leg ulcer? |
Staphylococcus epidermis and aureus |
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How should cellulitis be treated? |
Flucloxacillin +/- Macrolide/Penicillin |
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Which patient groups are more likely to suffer from Necrotising Fasciitis?
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Diabetes patients, IV drug users and the immunocomprimised |
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How does an actinic (solar) keratosis present? |
Discrete, rough or scaly patches of skin on sun exposed areas, very common, more common in immunosuppresion |
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How does Bowen's Disease often present? |
Usually a single patch of erythematous and scaly skin, lower leg site is common in women, it slowly expands over several years and 3% develop into invasive squamous cell carcinoma |
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How can Bowen's disease and Actinic Keratosis be treated? |
Cryotherapy, chemotherapy (5-flurouracil) cream, photodynamic therapy, immunotherapy (imiquimod) and surgical removal if required |
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80% of Basal Cell Carcinoma's occur in which region? |
Face and Neck |
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What are the risk factors associated with basal cell carcinoma development? |
Cumulative sun exposure, fair skin, age, previous radiotherapy and Arsenic |
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How does a basal cell carcinoma present? |
Asymptomatic, nodular-cystic lesion, may be pigmented |
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How can a basal cell carcinoma be treated? |
Surgical excision, radiotherapy and Moh's micrographic surgery |
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How does a squamous cell carcinoma look on gross inspection? |
Ulcerating lesion, may appear scaly with enlarging nodules |
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How can a squamous cell carcinoma be treated? |
Treatment is mainly surgical, radiotherapy can be performed if the patient is frail |
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What are the risk factors for metastasis of a squamous cell carcinoma? |
Immunosupressed patients, large tumour (>2cm), poorly differentiated and occuring in an area of scarring |
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What are the 4 Malignant Melanoma subtypes? |
Superfical spreading, nodular, acral and lentigo maligna |
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What is Breslow thickness and how does it contrast to Clark's level? |
Measurement from the granular cell level in the epidermis to the deepest part of the tumour, Clark's level assess based on layer of dermis the lesion permeates through |
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How is a malignant melanoma managed? |
Surgical excision with wide margins followed by sentinel node biospy is key, adjuvant interferon and metastatic treatment depending on metastatic concern |
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What causes Eczema?
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Barrier dysfunction of the skin |
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All eczema can be itchy and red, but how can you differentiate between acute and chronic Eczema? |
Acute - Weepy and vesicular Chronic - Dry, scaly and lichenified |
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What microbial agent is responsible for Seborrhoeic eczema and how is it treated? |
Malassezia Furfur Rx - Antifungals, shampoo if on scalp |
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Which form of eczema presents in a red raised plaque-like lesion similar to that of psoriasis? |
Discoid eczema |
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What is Pompholyx? |
Itchy vesicles on the skin, typical on the palms and soles where thicker skin is found |
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What is the most common cause of low leg eczema? |
Chronic venous insufficiency |
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What is contact eczema more commonly known as? |
Dermatitis |
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Are ointments better than creams? |
Yes, ointments are paraffin based and greasy, creams are usually water based which make them better for social use |
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What are the key for findings of Acne Vulgaris? |
Increased sebum excretion, hyper-keratosis blocking the follicle, colonisation of the duct with proprionobacterium and release of inflammatory mediators |
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The description, chronic, inflammatory, facial dermatosis with erythema and pustules best describes what condition? |
Acne Rosacea |
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How is Acne Rosacea treated? |
Metronidazole cream or system tetracycline |
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When Malassezia furfur infects other regions of the body, the condition is known as... |
Pityriasis Versicolour |
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Vitiligo is defined as the... |
absence of normal pigmentation of the skin |