derm

Question 1

treatment for Tuberous sclerosis

Answer 1

Topical rapamycin

Question 2

Ash leaf macules

Answer 2

Tuberous sclerosis

Question 3

what skin layer is affected in psoriasis

Answer 3

keratinocytes in the stratum basale

Question 4

5 epidermis layers?

Answer 4

-Stratum corneum
- Stratum lucidum
- Stratum granulosum
- Stratum spinosum
- Stratum basale
Come Lets Get Sun Burned!

Question 5

linear deposits of IgG and/or C3

Answer 5

bullous pemphigoid

Question 6

what layer does bullous pemphigoid affect

Answer 6

dermal epidermal junction

Question 7

what results from the destruction of hemidesmosomes?

Answer 7

bullous pemphigoid

Question 8

what results from the destruction of desmosomes?

Answer 8

pemphigus vulgaris

Question 9

most common type of melanoma

Answer 9

superficial spreading melanoma

Question 10

worst prognosis melanoma

Answer 10

nodular melanoma

Question 11

what type of hypersensitivity reaction is bullous pemphigoid

Answer 11

type 2

Question 12

how are basal cells attached to the basemnet membrane

Answer 12

by hemidesmosomes

Question 13

what does ACANTHOSIS mean?

Answer 13

Increased thickness
of epithelium

Question 14

what does PAPILLOMATOSIS mean?

Answer 14

Irregular epithelial thickening

Question 15

“teardrop” psoriasis seen in young adults
- Occurs two weeks after strep throat infection

Answer 15

Guttate psoriasis

Question 16

Auspitz’s sign

Answer 16

Removal of surface scale reveals pinpoint bleeding [dilated capillaries]

Question 17

treatment for bullous pemphigoid

Answer 17

High potency topical steroids Systemic disease- Oral steroids e.g. prednisolone +/- tetracycline antibiotics e.g. doxycycline +/- antihistamine

Question 18

exclamation mark’ hairs

Answer 18

Alopecia areata

Question 19

self-induced hair loss

Answer 19

trichotillomania

Question 20

oral anti fungal?

Answer 20

oral terbinafine

Question 21

Lymphocytic-rich infiltrate in the upper dermis with epidermal spongiosis

Answer 21

Eczema (atopic dermatitis)

Question 22

Epidermal thickening with retention of nuclei in the keratin layer and absence of granular layer

Answer 22

Psoriasis vulgaris

Question 23

Acantholysis and intra-epidermal blistering with chicken wire pattern of IgG on immunofluorescence

Answer 23

Pemphigus vulgaris

Question 24

Subepidermal blistering with granular deposits of IgA in the dermal papillae on immunofluorescence

Answer 24

Dermatitis herpetiformis

Question 25

Subepidermal blistering with linear IgG along the dermo-epidermal junction on immunofluorescence

Answer 25

Bullous pemphigoid

Question 26

what causes alopecia that scars

Answer 26

discoid lupus erythematosus, lichen planopilaris

Question 27

Male: vertex thinning, receding hairline Female: diffuse central thinning, frontal hairline preserved

Answer 27

Androgenetic Alopecia

Question 28

Diffuse hair shedding Trigger: stress, illness, surgery, drugs, postpartum Positive hair pull test Non-scarring, delayed onset

Answer 28

Telogen Effluvium

Question 29

Rapid, diffuse hair loss Trigger: chemotherapy, radiotherapy Damage to hair matrix cells Non-scarring, reversible

Answer 29

Anagen Effluvium

Question 30

Patchy hair loss with absent follicular openings Cause: inflammatory/autoimmune (lichen planopilaris, discoid lupus) Permanent hair loss Scarring

Answer 30

Cicatricial (Scarring) Alopecia

Question 31

Herald patch followed 1-2 weeks later by multiple erythematous, slightly raised oval lesions with a fine scale confined to the outer aspects of the lesions.

Answer 31

Pityriasis rosea

Question 32

fir-tree' appearance

Answer 32

Pityriasis rosea

Question 33

'Tear drop', scaly papules on the trunk and limbs

Answer 33

Guttate psoriasis

Question 34

low ankle-brachial pressure index (ABPI) indicates what type of ulcer? or abnormally high

Answer 34

Arterial

Question 35

itchy sore above ankle, shallow with irregular borders, brown pigment- what type of ulcer

Answer 35

venous

Question 36

ulcer on plantar surface of feet most likely to be ?

Answer 36

Neuropathic ulcers

Question 36

normal ankle-brachial pressure index (ABPI) ulcer

Answer 36

venous or neuropathic

Question 37

Koebner phenomenon

Answer 37

describes the appearance of new skin lesions of a pre-existing dermatosis on areas of cutaneous injury in otherwise healthy skin.

Question 38

planus: purple, pruritic, papular, polygonal

Answer 38

Lichen planus

Question 39

Lichen planus treatment

Answer 39

potent topical steroids are the mainstay of treatment eg clobetasol

Question 40

waxy, “stuck-on” brown or black papules or plaque

Answer 40

Seborrhoeic keratosis

Question 41

solitary, well-demarcated, erythematous, scaly patch with a “velvety” surface

Answer 41

Bowen’s disease

Question 42

Athlete's foot organism?

Answer 42

Trichophyton

Question 43

Athlete's foot treatment

Answer 43

topical imidazole, undecenoate, or terbinafine first-line first try topical if that doesnt work do oral

Question 44

Limited, localised ipetigo managment

Answer 44

Hydrogen peroxide 1% cream for 'people who are not systemically unwell or at a high risk of complications' or topical fusidic acid topical mupirocin should be used if fusidic acid resistance is suspected

Question 45

MRSA impetigo treatment

Answer 45

Topical mupirocin

Question 46

extensive impetigo treatment

Answer 46

oral flucloxacillin oral erythromycin if penicillin-allergic

Question 47

pityriasis versicolor (also called tinea versicolor) treatment?

Answer 47

Ketoconazole shampoo

Question 48

Seborrhoeic dermatitis organism?

Answer 48

Malassezia furfur

Question 49

conditions associated with Seborrhoeic dermatitis

Answer 49

HIV Parkinson's disease

Question 50

Seborrhoeic dermatitis treatment

Answer 50

scalp- ketoconazole 2% shampoo over the counter preparations containing zinc pyrithione ('Head & Shoulders') and tar ('Neutrogena T/Gel') may be used if ketoconazole is not appropriate or acceptable to the person selenium sulphide and topical corticosteroid may also be useful Face and body- topical antifungals: e.g. ketoconazole topical steroids

Question 51

rapidly progressing painful rash in a child with eczema

Answer 51

Eczema herpeticum

Question 52

what virus causes Eczema herpeticum

Answer 52

herpes simplex virus 1 or 2.

Question 53

monomorphic punched-out erosions (circular, depressed, ulcerated lesions)

Answer 53

Eczema herpeticum

Question 54

treatment of choice for scabies

Answer 54

Permethrin 5% malathion 0.5% is second-line

Question 55

Crusted (Norwegian) scabies treatment

Answer 55

Ivermectin

Question 56

how long is shingle infectious for?

Answer 56

until the vesicles have crusted over, usually 5-7 days following onset

Question 57

what is first line treatment in psoriasis

Answer 57

a potent corticosteroid applied once daily plus vitamin D analogue applied once daily should be applied separately, one in the morning and the other in the evening) for up to 4 weeks as initial treatment

Question 58

second-line trewatment in psoriasis

Answer 58

if no improvement after 8 weeks then offer: a vitamin D analogue twice daily

Question 59

in psoriasis third-line treatment: if no improvement after 8-12 weeks then offer either:

Answer 59

a potent corticosteroid applied twice daily for up to 4 weeks, or a coal tar preparation applied once or twice daily

Question 60

examples of vitamin D analogues ?

Answer 60

calcipotriol (Dovonex), calcitriol and tacalcitol

Question 61

how do Vitamin D analogues work?

Answer 61

they work by ↓ cell division and differentiation → ↓ epidermal proliferation

Question 62

what condition is localised skin infection caused by Streptococcus pyogenes. a more superficial, limited version of cellulitis.

Answer 62

Erysipelas

Question 63

how to treat Erysipelas

Answer 63

flucloxacillin

Question 64

what are some non sedating antihistamines

Answer 64

Fexofenadine Loratadine Cetirizine chlorphenamine