Deck 1 practice Flashcards by Anita Smith

Regarding Headlice T/F
Nits can survive 30 days away from the host

False
Nits can survive and hatch after 10 days away from the host (Bolognia)

Nits are the eggs of headlice

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T/F Regarding Headlice

Hatched eggs are tan brown

False - hatched eggs are clear to white

Bolognia:
Viable eggs are usually tan to brown in color, whereas hatched eggs are clear to white

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Regarding Headlice T/F

All topical treatments are done twice, a week apart.

True

Bolognia:

With all topical preparations (regardless of package instructions), two applications, 1 week apart,
are advisable in order to: (1) kill any nits that survived treatment; (2) better defend against the growing resistance to many pediculicides; and
(3) reduce the risk of reinfestation by means of fomites.

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Regarding Headlice T/F

Petroleum jelly is lethal

False

Bolognia
Unsubstantiated claims of successful treatment with alternative, non-pesticidal products, including petroleum jelly, hair pomade, olive oil, mayonnaise, vegetable oil and mineral oil, persist. Such products may slow the movements of adult lice and allow them to be more easily combed out
of the scalp, but these substances are not lethal to lice.

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Regarding Headlice T/F

Eggs are on the hair close to the scalp

True

Bologina: Oval egg capsules (nits) measure 0.8 mm in length and are usually laid close to the scalp for warmth; in general, eggs located within 1 cm of the scalp are unhatched. In warm climates, however, viable nits may
be found 15 cm or more from the scalp, especially in the area above the nape of the neck

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Re: Acanthosis palmaris (Tripe palms) T/F

Associated with malignancy in >50%

True (about 90%)

Rook
Acanthosis palmaris describes thickened skin of the palms and occasionally the soles with an enhanced dermatoglyphic change, causing a velvety or less commonly a pitted, honey combed pattern of the hand. It is associated with neoplasia in about 90% of cases and maybe the only paraneoplastic manifestation in 30–40%. It may also occur with one or both of malignant acanthosis nigricans or the sign of Leser–Trélat, or with florid cutaneous papillomatosis

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Re: Acanthosis palmaris (Tripe palms) T/F

More common in men

True

Rook: It occurs particularly in men, especially when the underlying tumour is a lung cancer

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Re: Acanthosis palmaris (Tripe palms) T/F

Most common malignancy is bronchial carcinoma

True

Rook
Most commonly, the underlying tumour is bronchial or gastric, together accounting for over 50% of the associated malignancies. Many other sites are reported includ-
ing tumours of the genito-urinary tract, as well as carcinomas in the breast and other organs.
Acanthosis palmaris occurring alone is more often associated with bronchial carcinoma compared with combined acanthosis nigricans and acanthosis palmaris, in
which gastric carcinoma is more common. If nail clubbing is also present (especially in a male patient), then bronchial carcinoma is very likely.
Interestingly, the appearance or exacerbation of tripe
palms in a known cancer patient may be a sign of recurrence of the malignancy

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Re: Acanthosis palmaris (Tripe palms) T/F

It tends to resolve spontaneously with treatment of underlying malignancy

? (not specifically outlined in Rook or Bologina:

Bolognia for AN (not tripe palms): Treatment of the underlying malignancy, or effective treatment of the endocrinopathy, including weight loss and use of insulin sensitizers, may result in improvement or disappearance of the acanthosis
nigricans. Recurrence of malignancy-associated acanthosis nigricans requires a search for recurrent cancer.

Dermnet
Approximately 3 out of 10 cases of tripe palms resolve when the underlying cancer is managed. However, tripe palms may persist despite remission of the underlying cancer.

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Re: Acanthosis palmaris (Tripe palms) T/F

It is associated with acanthosis nigricans

True

Rook.
Acanthosis palmaris occurring alone is more often associated with bronchial carcinoma compared with combined acanthosis nigricans and acanthosis palmaris, in
which gastric carcinoma is more common.

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What is the recurrence rate of anogenital warts with patient-administered treatments?

60%

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Is recurrence of anogenital warts more common with patient-administered or doctor-administered treatments?

Patient-administered

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What is the recurrence risk of ablative CO2 laser treatment for anogenital warts?

Less than 50%

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Which has more side effects: Podophyllotoxin or Imiquimod?

Podophyllotoxin

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What are the side effects of TCA compared to cryotherapy?

Less than cryotherapy

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Is the risk of lupus higher in ATSI individuals compared to non-ATSI individuals?

True

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Can lower lip lupus present in acute, subacute, or discoid forms?

True

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What is the most common diabetic complication?

Nephropathy

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Is tinea corporis symmetrical?

False

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What is the most common leprosy type in NT?

Borderline tuberculoid

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Is polidocanol generally painless when used in sclerotherapy?

Yes

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Is STS a chemical irritant sclerosant?

Yes

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What concentration of hypertonic saline is used in sclerotherapy?

10-25%

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What concentration of polidocanol is used to treat 1-3mm vessels?

0.1%

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For larger vessels, what is needed in terms of volume and concentration?

Larger volume of lower concentration

Does MCC have a similar incidence across all ethnicities?

Yes

What proportion of SLNB negative patients have positive nodal disease?

2/3

Is distant disease more likely with radiotherapy only treatment compared to excision and adjuvant radiotherapy?

Yes

When should SLNB be performed in MCC cases?

After WLE

Is the risk of local recurrence higher with radiotherapy monotherapy than local excision?

Yes

Does EPP have normal urine studies?

True

Can fragile blisters on hands distinguish PCT from other porphyrias?

False

Can histology differentiate pseudoporphyria from PCT?

False

Is EPP triggered by artificial light?

True

Does PCT show faecal isocoproporphyrin positivity?

True

Does vulval Crohn's present with linear fissures?

Yes

Can the diagnosis of vulval Crohn's be made without intestinal Crohn's?

Are caseating granulomas present in vulval Crohn's?

Yes

Does vulval Crohn's present as vulval oedema?

Yes

Is topical corticosteroid a useful treatment option for vulval Crohn's?

Yes

Can ear rim secondary intention healing cause puckering?

True

What should be done if secondary intention healing is on ear cartilage?

Punch hole through cartilage

What is the typical result of contractures in secondary intention healing?

30% decrease

Can secondary intention healing be used on inner canthus for defects smaller than 5mm?

Yes

Does secondary intention healing on the temple likely cause distortion of the hairline and eyebrow?

False

What type of scars is punch technique used for?

White atrophic scars

Does punch elevation require sutures?

False

Does punch excision require sutures?

True

Can punch elevation be used if the scar is less than 6mm?

False

What needs to be the same for punch grafting?

Diameter of the punch graft needs to be the same as the scar

Where does colchicine accumulate?

In platelets

What is the therapeutic range of colchicine?

Narrow

Is bioavailability of colchicine similar in most people?

False

What percentage of patients experience GI side effects from colchicine?

10%

Is colchicine safe in children?

True

Is granuloma faciale usually multiple plaques?

False

What is seen on histology in granuloma faciale?

Granulomas

Are there systemic associations with granuloma faciale?

Is granuloma faciale usually found on the trunk?

False

Can minocycline be used for granuloma faciale?

True

What is the maximum width of the pedicle in a pull-through flap of the ear?

Less than 25%

Is it better for the donor site to be adjacent to the defect in a pull-through flap?

Yes

Can a posterior ear defect be left to heal by secondary intention?

Yes

What type of sutures are used to secure the flap to the defect?

Subcutaneous sutures

Is a pull-through flap good for small defects?

Yes

Does phototherapy have an increased risk of skin cancers with multiple nbUVB treatments?

True

Is the risk of developing skin cancers with nbUVB lower than PUVA?

True

Which oral medication is more nauseous, 5-MOP or 8-MOP?

5-MOP

Does topical PUVA require eye protection after treatment?

Yes

When does more severe burn appear with PUVA?

Later than a milder burn

What is the incubation period for varicella?

2-7 days

When is a person with varicella infectious?

1-2 days before onset of rash

Are systemic symptoms more severe in children than adults with varicella?

True

What percentage of patients with only one course of vaccination can develop chicken pox?

50%

Is acyclovir helpful in case of exposure to varicella?

Yes

Is small plaque parapsoriasis more common in men or women?

Women

What does small plaque parapsoriasis show histologically?

T-cell clonality

What type of treatment is adequate for small plaque parapsoriasis?

Mild topical corticosteroid

Is small plaque parapsoriasis highly pruritic?

Yes

What is the size of each individual lesion in small plaque parapsoriasis?

Less than 5cm

What is the preferred anesthetic for reopening a facial haematoma?

Lignocaine without adrenaline

When can aspiration of a haematoma be done?

7-10 days once it liquifies

What device is used under negative pressure for haematoma management?

Penrose drain

What should be done if a large haematoma develops within 6 hours of operation?

Insert a Penrose drain

If a haematoma develops within 24 hours, what is adequate treatment?

Aspiration with 18G needle

What is cSCC?

Cutaneous squamous cell carcinoma

What is verrucous carcinoma?

An aggressive variant of SCC

What occurs in the mucosa related to epithelioma cuniculatum?

Verrucous carcinoma

Is verrucous carcinoma a poorly differentiated tumor?

Yes

Is Mohs surgery indicated for superficial involvement of DFSP?

True

DFSP is associated with activating mutations in which receptor?

Platelet Derived Growth Factor Receptor

Does DFSP metastasize rarely?

True

What is the most common location for DFSP?

Head and neck

Is Imatinib a treatment option for advanced DFSP?

Yes

Is there a gene translocation of chromosomes 4 and 20 in DFSP?

False

Is zinc deficiency associated with prematurity and low birth weight?

True

Does measurement of albumin help in monitoring zinc levels?

False

Do formula-fed infants present earlier than breastfed infants in zinc deficiency?

True

Is clinical improvement in zinc deficiency seen in 5-7 days?

False

Does zinc deficiency usually affect the trunk and spread to involve flexures?

False

What is the first incision made in a myocutaneous flap of the nose?

Lateral incision

What type of incision is made down to cartilage and bone in a myocutaneous flap?

Medial incision

Can horizontal incisions be made in the muscle/pedicle for more movement in a myocutaneous flap?

True

How is the leading edge sutured in a myocutaneous flap?

With hyper-eversion

Is the Hunt variant of myocutaneous flap more suitable for longer vertical island pedicle?

True

Is pathergy test positive in Sweet syndrome?

True

Is Bechet disease associated with Bw51?

True

Is Bechet disease more common in men or women?

Men

What is the commonest eye involvement in Bechet disease?

Pan-uveitis

Is Infliximab an effective treatment option for pyoderma gangrenosum?

True

What should be given if a woman of childbearing age experiences a needle stick injury?

BHCG

What should be given if Hep B positivity is unknown in a needle stick injury?

Urgent antivirals

When should vaccination be given after a needle stick injury?

1 week, 1 month, and 6 months

Is Hep C immunoglobulins more reliable than viral loads?

False

Do supplements affect haemostasis by acting on fibrin?

True

How many days should NSAIDs be stopped before surgery?

10-14 days

What should be used for bridging in haemostasis?

Heparin

Does Hori naevus commonly involve the cutaneous upper lip?

False

Is Q switched laser useful for Hori naevus?

True

Is HQ an effective adjunct in treating Hori naevus?

True

Does melasma affect the same area as Hori naevus?

True

Does Hori naevus improve over time?

False

Is undermining required for butterfly suture?

True

Do sutures in butterfly suture extend into the papillary dermis?

False

Should epidermal dimpling be visible with butterfly suture?

False

Does butterfly suture everts more than buried vertical mattress suture?

True

Should suture tails be left through the skin and cut later?

False

Is chelitis common in DRESS syndrome?

True

Is head and neck swelling a common feature of DRESS syndrome?

True

When does DRESS syndrome usually occur after drug exposure?

1-5 days

Is minocycline commonly associated with renal dysfunction in DRESS syndrome?

True

What is the commonest cutaneous presentation of DRESS syndrome?

Exfoliative erythema

Is chromic catgut suture stronger than plain gut?

True

Is Monocryl the least pliable of all absorbable sutures?

True

Does Monocryl have the longest-lasting tensile strength?

False

Does Vicryl have the most reactivity of all absorbable sutures?

False

Does PDSII have better handling than PDS?

True

Does atrophoderma of Pasini & Pierini usually affect the back?

True

Is atrophoderma of Pasini & Pierini more common in males?

False

Is atrophoderma of Pasini & Pierini usually indurated?

False

Does atrophoderma of Pasini & Pierini have a violaceous edge?

True

Does EAC progress faster than erythema gyratum repens?

True

Are EAC lesions painful?

True

Where is the scale located in EAC?

On the outer edge

Is EAC more common in childhood?

True

What is the most common cause of EAC?

Concurrent infection

What is the duration of TE in the donor site after hair transplant?

Up to 1 year

How long should one wait between hair transplants?

4 months

Is there a need to suture the donor site with follicular unit extraction?

What is the size of the donor site excision over the occipital protuberance?

30-35cm

Are people with very loose scalp better candidates for hair transplants?

Yes

Is excimer laser more effective than NBUVB for palmoplantar psoriasis?

True

Does broad band UVB and tar treatment increase the risk of skin cancers?

True

Does NMSC risk for NBUVB increase with cumulative dose?

True

Should NBUVB be avoided in patients on biologics?

True

Can NBUVB be combined with systemic retinoids?

True

Does scleromyxoedema present with linear papules?

True

Does scleromyxoedema usually have mucosal involvement?

False

Is scleromyxoedema associated with paraproteinemia IgM?

False

Does sensory neuropathy occur in older men with scleromyxoedema?

True

Is calcinosis common in scleromyxoedema?

False

Are medications more likely to cause SJS/TEN in children than viral causes?

False

Is the mortality rate of SJS/TEN higher in children than adults?

False

Is there a split in the granular layer in SJS/TEN?

True

Is Erythema Multiforme Major on the spectrum with SJS/TEN?

True

Is there a variant of SJS/TEN that has respiratory involvement without mucositis?

True

Does discovery of any epidermal naevus need investigation for systemic involvement?

True

If biopsy shows epidermolytic hyperkeratosis, can it be transmitted to offspring?

False

If biopsy shows epidermolytic findings, should the patient be investigated for epidermolysis bullosa?

True

Does involvement of underlying tissue/bone occur in epidermal naevus?

True

Is heterogeneous leukoplakia more likely to transform to SCC than homogeneous leukoplakia?

True

Is erythroplakia a high-risk factor for SCC?

True

Is oral verrucous carcinoma well-defined?

False

Is the soft palate a common site for SCC?

True

>90% of all oral malignancies are SCC?

True

Is onychomadesis associated with detachment of the cuticle/proximal nail?

True

Does onychorrhexis correlate with transverse nail bands?

True

Can biopsy of nail matrix show lichen planus?

True

Does apparent leukonychia grow out with nail growth?

True

Is true leukonychia due to disease of the distal nail matrix?

False

Do all subtypes of xeroderma pigmentosum exhibit photosensitivity?

True

Do 50% of patients with xeroderma pigmentosum have neurological impairment?

False

Has childhood leukemia been reported in xeroderma pigmentosum?

True

Does XPA have a higher incidence of skin cancers than XPC?

False

Does XPG tend to have the highest rate of ocular changes?

True

Is Bazex syndrome associated with underlying adenocarcinoma?

True

Is ichthyosis vulgaris strongly associated with Hodgkin's lymphoma?

True

Is acquired hypertrichosis lanuginosa associated with hem malignancy?

False

Is paraneoplastic pemphigus associated with lymphoproliferative disorders?

True

Is incontinentia pigmenti X-linked recessive?

True

What is the first stage of incontinentia pigmenti characterized by?

Vesicles

When does the verrucous stage of incontinentia pigmenti occur?

Around 6 months

Does incontinentia pigmenti affect females?

False

What stage of incontinentia pigmenti presents with verrucous lesions?

Fourth stage

Does electrosurgery through electrodessication lead to coagulation of blood vessels?

True

Is increased voltage required for electrosection to achieve a deeper cut?

True

Is electrofulguration given in contact with the skin?

False

Is electrocautery used for cutting tissue?

True

What is paraneoplastic pemphigus associated with?

Lymphoproliferative disorders ## Footnote Paraneoplastic pemphigus is a rare autoimmune blistering disorder associated with malignancies.

Incontinentia pigmenti is inherited in which pattern?

X-linked recessive

What occurs during the verrucous stage of incontinentia pigmenti?

It occurs around 6 months

Does incontinentia pigmenti affect females?

It does not affect females

What are the characteristics of the fourth stage of incontinentia pigmenti?

Verrucous lesions

What is the purpose of electrodessication?

Coagulation of blood vessels

What is increased voltage used for in electrosurgery?

Electrosection to achieve deeper cut

In electrofulguration, how is it applied?

Not in contact with the skin

Which method is considered less safe: electrocautery or electrodessication?

Electrocautery

What does bipolar probed electrocoagulation do?

Bypasses currents through the patient

What is hypofraction in radiation therapy defined as?

Less than 10 fractions

What causes more moist dequamation in radiation therapy?

Hypofraction

What is more common with hypofraction in radiation therapy?

Late skin necrosis (>10 yrs) with less than 3 sessions

What is the most common presentation of mastocytosis in adults?

Urticaria pigmentosa

What percentage of adults with mastocytosis experience flushing?

50%

Do adults or children demonstrate the Darier sign more likely in mastocytosis?

Children

What mutation is commonly associated with mastocytosis?

V600E mutation

What condition occurs due to increased excretion of bile acids in pregnancy?

Intrahepatic cholestasis

When does intrahepatic cholestasis in pregnancy most commonly occur?

First trimester

What are excoriations in pregnancy dermatoses preceded by?

Erythematous papules

What complications are associated with intrahepatic cholestasis in pregnancy?

Prematurity or low birth weight

What is congenital melanocytic naevus associated with?

Pseudomelanoma with laser treatment

What has not shown to be more beneficial over ablative laser alone?

Ablative laser and nd:YAG laser combined

What is methotrexate known to cause in males?

Mutagenic to sperm

What condition does cyclosporine cause in males?

Oligospermia

Can a male on acitretin impregnate females?

What does infliximab cause in terms of male fertility?

Low sperm count

Which antiseptic is effective against pseudomonas?

Chlorhexidine

Which antiseptic is more effective than povidone iodine in preventing SSI?

Chlorhexidine – alcohol

Does chlorhexidine eradicate MRSA when used preoperatively?

Yes

What common reaction does chlorhexidine cause in atopic individuals?

Allergic dermatitis

Is chlorhexidine ototoxic?

Yes

What type of tumors have a higher risk of surgical site infections?

Ulcerated tumors

Are ulcerated tumors an independent risk factor for infection?

Yes

Which is more useful: intraoperative antibiotics or postoperative antibiotics?

Intraoperative antibiotics

Do intra-incisional antibiotics at the time of surgery reduce infection compared to no intervention?

Yes

Are intramuscular antibiotics beneficial over topical antiseptic use alone?

Do lesions of EBA have an inflammatory base?

Is the inflammatory variant of EBA more common than the mechanical variant?

Does EBA typically affect the trunk?

Yes

What does indirect immunofluorescence of anti-skin antibodies show in EBA?

>50% positive

Can EBA involve mucosa?

Yes

Does psoriasis increase the risk of infection regardless of immune suppression?

Yes

Are biologics contraindicated in chronic hepatitis B?

Yes

What is associated with abnormal wound healing in psoriasis?

Psoriasis itself

Is acitretin safe in TB?

Yes

What should be given if psoriasis is induced by strep?

Antibiotics

Is ulcerated Gottron's part of dermatomyositis MDA5?

Yes

Are nail changes common in dermatomyositis MDA5?

Is arthritis frequent in dermatomyositis MDA5?

What is associated with interstitial lung disease in dermatomyositis?

Palmar keratoses

What pattern do palmar papules show on biopsy in dermatomyositis?

Lichenoid pattern

What predisposes to conjunctivitis in patients on dupilumab?

Previous conjunctivitis

What has high predictive value for conjunctivitis in dupilumab patients?

High IgE and eosinophils

Do you need to stop dupilumab to treat conjunctivitis?

Is eczema more likely to respond to dupilumab if the patient develops conjunctivitis?

Does severe eczema result in severe conjunctivitis?

Yes

Should distal nail biopsy be longitudinal?

Yes

Should proximal nail matrix biopsy be transverse?

Yes

Is proximal nail avulsion less traumatic than distal nail avulsion?

Yes

Should lateral longitudinal biopsy include lateral nail fold?

Yes

Can shave biopsy be used for abnormal longitudinal melanonychia?

Yes

If the band is greater than 15% of the nail, what is it suspicious for?

Subungual melanoma

Is it difficult to differentiate between longitudinal melanonychia and subungual melanoma clinically?

Yes

What rule has a high predictive value for subungual melanoma?

ABCDE rule

Is shave biopsy usually adequate for Breslow thickness assessment in melanoma?

Yes

What is the required margin for Breslow thickness of 1-2mm?

1cm margins histologically

What is the required margin for Breslow thickness of 2-4mm?

At least 2cm clinical margins

Is artificial intelligence sufficient to diagnose melanoma?

Yes

How often should digital monitoring be conducted for melanoma surveillance?

Every 3 months

Do both AJCC and BWH SCC staging have poor differentiation?

Yes

Do AJCC T2 and T3 have similar prognosis?

Yes

Which staging has higher predictive value for those at risk of distant metastasis?

BWH

Is bony involvement a criterion for BWH staging?

Yes

Does microcystic adnexal carcinoma grow slowly?

Yes

Is perineural invasion common in microcystic adnexal carcinoma?

Yes

What is the most common site for microcystic adnexal carcinoma?

Chin

What histological features are like syringoma in microcystic adnexal carcinoma?

Histo features

Is metastasis common in microcystic adnexal carcinoma?

What must be removed after deroofing in HS?

Granulation tissue

Should large defects on the buttocks be excised down to muscle/fascia?

Yes

What should extensive defects be repaired with?

STSG

What is frequently required for extensive perineal involvement in HS?

Temporary diverting ileostomy

What has the lowest risk of recurrence in HS?

Radical excision

Does the foramen for the mental nerve lower with age?

Should local infiltration be avoided after a nerve block?

Yes

Does the mental nerve work quickly?

Yes

Is the mental nerve easy to do technically?

Yes

Should adjacent gingiva and mucosa be anaesthetised?

Yes

Are IgG antibodies against anti-endomyseal antibodies present in dermatitis herpetiformis?

Yes

Is dapsone effective for bowel disease in dermatitis herpetiformis?

Yes

What percentage of patients with dermatitis herpetiformis have gluten enteropathy?

50%

What type of pattern of IgA is found in dermal papillae in dermatitis herpetiformis?

Fibrillar pattern

Is uveitis a common problem in mucous membrane pemphigoid?

Is BP180 a common antigen in mucous membrane pemphigoid?

Yes

Is the scalp often involved in mucous membrane pemphigoid?

Is BP180 often associated with malignancy?

Yes

Is indirect immunofluorescence sensitive in mucous membrane pemphigoid?

Yes

What causes eyebags in aging face?

Fat herniation

What results in more prominent vertical wrinkles in aging face?

Glabella ptosis

Do older people have shorter columella?

Yes

Is a facelift more effective for the mid third face than the lower third face?

Yes

What causes jowls in aging face?

Loose anterior platysmal bands

Is SMAS under the zygomatic arch continuous with that over the zygomatic arch?

What ensheathes the frontalis muscle?

Galea aponeurotica and superficial temporal fascia

What superficially covers the parotid gland at the superior aspect?

Parotid fascia

What travels under the zygomatic arch?

Temporal nerve

Does sebaceous skin have more stretch than non-sebaceous skin?

Is sebaceous skin more likely to leave track marks?

Yes

Is sebaceous skin more compliant than non-sebaceous skin?

Is sebaceous skin more likely to result in inverted scars?

Yes

Is sebaceous skin more brittle?

Yes

Deck 1 practice Flashcards

(310 cards)