FINALS > Derm > Flashcards

Derm Flashcards

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1
Q

4 causes of burns

A
  • thermal
  • electrical
  • Contact
  • chemical
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2
Q

pathology and complications of burns

A
  • haemolysis
  • leakage of plasma into interstitial space
  • extravasation and hypovolaemic shock
  • protein loss
  • secondary infection
  • ARDS
  • compartment syndrome
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3
Q

general burns mx

A
  • IV morphine
  • IX = ECG, CXR, fluid balance chart
  • wound dressings
  • limit hypothermia
  • aggressive fluids and UO monitoring
  • nutrition
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4
Q

Fluid resus calculation in burns

A
  • Adults = initial 24hrs 4ml x weight x % TBSA
  • children = 3ml x weight x % TBSA
  • 50% of the fluid calculated given in first 8 hours, remaining in 16hrs
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5
Q

TBSA means

A
  • total body surface area burned
  • extent and depth
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6
Q

most accurate method to measure burns

A

lund and browder chart

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7
Q

Superficial burn

A
  • epidermis deepest later involved
  • dry, blanching, erythema
  • painful
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8
Q

superficial partial thickness burn

A
  • Upper epidermis
  • blisters, wet, blanching, erythema
  • painful
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9
Q

deep partial thickness burn

A
  • lower dermis
  • yellow or white, dry, non blanching
  • decreased sensation
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10
Q

full thickness burn

A
  • subcutaneous tissue
  • leather, white, non blanching, dry
  • painless
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11
Q

assessing rashes - distribution

A
  • Acral = hands and feet
  • Extensor = elbows, extensor surfaces
  • Flexural = axilla
  • Follicular = face, sebaceous glands
  • Dermatomal
  • Seborrhoeic = scalp
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12
Q

assessing rashes = configuration

A
  • Discrete = separated lesions
  • Confluent = merged
  • Linear
  • Discoid = same colour
  • Target
  • Annular = colour change
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13
Q

Assessing rashes - colour

A
  • erythematous = red, blanches
  • purpuric/ petechia = caused bysmall bleeds
  • hyperpigmented = darker skin
  • hypopigmented = lighter skin
  • depigmented = white
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14
Q

assessing rashes - morphology

A
  • macule = flat altered colour
  • papule = solid raised lesion
  • vesicle = clear fluid
  • pustule = pus filled
  • wheal - oedematous papule or plaque
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15
Q

A-E dermatology

A
  • Asymmetry
  • Border
  • Colour
  • Diameter
  • Evolving
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16
Q

S+S acne

A
  • Open (blackheads) and closed (whiteheads) comedones
  • pustules
  • nodules
  • face, chest, back
  • Mild = <30, mod = 30-125, severe >125
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17
Q

Mx acne

A
  • hygeine etc
  • topical benzoyl peroxide 1st line
  • topical abx if infected = clindamycin
  • oral abx
  • isotrenitoin
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18
Q

cellulitis common organisms

A
  • staph aureus
  • strep pyogenes
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19
Q

Mx cellulitis

A
  • flucloxacillin or erythromycin
  • analgesia
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20
Q

exogenous eczema

A
  • external factor or skin insult causes
  • allergic contact dermatitis
  • photosensitive
  • post traumatic
  • drugs
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21
Q

endogenous eczema

A
  • atopic
  • seborrheic
  • discoid
  • lichen simplex
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22
Q

brief patho of eczema

A
  • breakdwon of skins natural barrier
  • subsequent IgE mediated response
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23
Q

S+S eczema

A
  • flexor surfaces
  • pruritus
  • dry skin
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24
Q

mx atopic eczema

A
  • emollients
  • topical corticosteroids
  • topical calcineurin inhibitors (tacrolimus)
  • bandages
  • oral steroids
  • antiseptics
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25
SE topical steroids
- burning/stinging - thinning - striae - acne
26
HSP background
- small vessel vasculitis - caused by deposition of IgA complexes in small arteries --> complement activation - hx recent UTRI
27
S+S HSP
- purpuric lesions on skin - extensors - symmetrical - colicky abdo pain - joint swelling - glomerulonephritis
28
Ix HSP
- urinalysis = proteinuria, haematuria - Normal platelets - ESR raised
29
Mx HSP
- analgesia - steroids = pred 1mg/kg
30
Impetigo most commonly caused by
- staph aureus - highly infectious
31
S+S impetigo
- recent damage to skin - pustules that pop and crust = yellow - itchy - clinical dx
32
Mx impetigo
- 5 days hydrogen peroxide 1% - topical abx = mupirocin - keep off school until lesions dried
33
Where is lichen planus most commonly found
- flexor surfaces and mucous membranes - t cell mediated autoimmune disorder
34
S+S lichen planus
- genitals and inside vagina - palms, soles and flexor arms - acute px - purpuric papular lesions - white lace like in mouth
35
Mx lichen planus
- topical steroids like clobetasone butyrate
36
histology lichen planus
- saw tooth patterns of epidermal hyperplasia - t cell infiltration of dermis - reduced malanocytes
37
lichen sclerosis
- small well demarcated white plaques - external genitals, not inside - itchy
38
psoriasis appearance
- well demarcated white/red erythematous plaques - silver scale - extensor surfaces - nails = pitting, ridging, oncholysis
39
psoriasis mx
- emollients and moisturisers 1. potent corticostteroid OD and Vit D analogue 4w 2. Vit D analogue BD 3. Corticosteroids BD and coal tar - Short acting dithranol - retinoids - phototherapy - systemic = methotrexate, ciclosporin, biologica
40
psoriasis background
- T cell mediated abnormal immune response - T cells release cytokines = keratinocyte proliferation
41
mx rosacea
- sun protection - avoid oil based products - topical metronidazole cream/ ivermectin - oral abx = doxy - no steroids
42
mx scabies
- permethrin 5% before bed, wash off in morning, 7 days
43
RF malignant melanoma
- age - UV - skin type -FHx
44
background MM
- proliferation of atypical melanocytes with potential for dermal invasion and metastasis
45
S+S melanoma
- asymmetrical, irregular, large, evolving lesion
46
Mx melanoma
- excision with extended margins - chemotherapy if spread
47
squamous cell carcinoma clinical features
- Speedy SCC - grow weeks -months - enlarging scaly or crusty lumps - may ulcerate - tender and painful - sun exposed sites
48
precursor to scc is
actinic keratosis
49
mx SCC
- surgical excision with extended margins, Mohs - 5-fluorouracil 4 weeks - imiquimoid 6 weeks
50
features BCC
- slowly growing plaque/nodule - skin pigmented - shiny/pearly - rolled edges - telangiectasia - central ulceration - spontaneous bleeding - asymmetry
51
biopsy of BCC shows
- apoptotic cells - peripheral palisading of nuclei - clefts of tumour tissue - basophilic aggregations of basaloid keratinocytes with large nuclei and scant cytoplasm
52
Mx bcc
- surgery - mohs if ill defined - radiotherapy
53
tinea is caused by
dermatophyte fungus
54
4 types of tinea?
- capitis = scalp - pedis = feet = athletes foot - cruris = groin - corporis = any other skin site
55
S+S tinea
- itchy and inflamed - acute onset - ring like lesion with scaly edge
56
mx tinea
- topical terbinafine 1% - econazole
57
eczema herpeticum is
complication of atopic with HSV infection
58
S+S herpeticum
- Malaise, fever - itchy, painful lesions - crusted papules - gritty eyes - LN
59
Mx herpeticum
- urgent derm referral - aciclovir
60
erythroderma caused by
rapid epidermal cell turnover
61
S+S erythroderma
- red hot itchy skin - hot - desquamation - malaise
62
Meds that cause SJS/TEN
- allopurinol - anti epileptics - sulfonamides - salicylates - imidazole
63
S+S SJS/TEN
- flu like prodrome - painful rash starts on trunk - macular rash blisters and desquamates
64
differentiate SJS and TEN
- SJS = <10% body coverage - TEN = >30%
65
venous ulcers morphology
- irregular borders - yellow fibrinous base
66
venous ulcers surrounding skin
- yellow brown to brown - pinpoint petechiae - lipodermatosclerosis
67
venous uclers often found
medial malleolar region
68
arterial ulcers usually found
pressure sites, distal points
69
morphology arterial ulcers
- dry necrotic base - wel demarcated = punched out
70
surrounding skin arterial
- shiny atrophic skin
71
other findings in arterial ulcers
- weak peripheral pulses - prolonged cap refill time
72
Molluscum contagiosum
- Pink or pearly whyte papules - Central umbilication (dimpling) 5mm in diameter - Anywhere apart from hands and feet soles - Self limiting
73
Seborrhoeic dermatitis adults
- Eczematous lesions on sebum rich areas - Otitis externa and blepharitis may develop - Scalp = ketoconazole shampoo - topical = ketoconazole
74
Urticaria
- Pale pink raised skin 1. Non sedating AH = cetirizine (up to 6w) 2. Pred
75
drugs that induce TEN
- Phenytoin - Penicillins - Carbamazepine - Allopurinol - NSAIDs - Sulfonamides
76
what might exacerbate psoriasis
- trauma - alcohol - BB - Lithium - NSAIDs - ACEi - Antimalarials - Withdrawal systemic steroids
77
dermatitis herpetiformis
- coeliac disease - itchy vesicular - extensor surfaces
78
actinic keratoses mx
- sun protection - fluorouracil cream - topical diclofenac - cryotherapy - currettage
79
Mx venous ulcers
- Compression bandaging - Oral pentoxifylline
80
Mild acne mx
- 12 w course topical combo therapy = trenitoin + clindamycin or BP + clindamycin
81
Mx mod-severe acne
- 12 w of topical combo or topical + abx oral -
82
SCC features
- sun exposed sites - rapidly expanding, painless, ulcerated nodules - cauliflower appearance - may bleed
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