Derm

Question 1

Molluscum contagiosum ass red eye

Answer 1

Urgent eye r/v

Question 2

Squamous cell carcinoma worst prognosis

Answer 2

Immunosuppressed
(Eg kidney transplant)
More than 20mm diameter
More than 4 mm deep

Question 3

Chronic subdural hematoma

Answer 3

Crescent in shape, presents weeks to months after trauma, with confusion, reduced consciousness
Hypodense on CT.
Can occur due to bridging veins in elderly, or shaken baby syndrome in infants

Question 4

Acute SDH

Answer 4

Crescentic and hyperdense om CT

Question 5

Spider nevi

Answer 5

Central red papule with surrounding capillaries
( fill from centre after blanching, while telangiectasia fill from edges)
Associations: liver disease, pregnancy, COCP

Question 6

Dermatofibroma

Answer 6

dimpling upon pressure on peripheries, seen in young adults on limbs

Question 7

Spitz naevus

Answer 7

red/pink in colour, seen in children, rapidly grwoing ( need cytology), do not bleed

Question 8

seborrhiec keratosis

Answer 8

warty, greasy looking, stuck on appearence

Question 9

compound nevus

Answer 9

dome shaped

Question 10

Junctional nevus

Answer 10

nevus on mucus membranes, palms on soles, have varying colours in nevus

Question 11

Psoriasis triggers

Answer 11

Drugs
(Lithium, Betsa blockers, ACE X, antimalarials- chloroquine, HcQ, NSAIDS, withdrawal of systemic steroids, trauma, alcohol

Question 12

BCC

Answer 12

Most common skin CA
Presents as slow growimg pearly nodule with rolled edge, local invasion

Question 13

SCC of skin

Answer 13

Also develops on sun exposed regions
Is scaly amd crusty or ulcerated

Question 14

Malignant melanoma

Answer 14

A- asymmetry
B- border irregularity
C- colour varitaion
D- diameter more than 6

Question 15

Keratoacanthoma

Answer 15

Keratin filled crater dome shaped noduleneeds urgent der reviw

Question 16

Psoriayoc arthropathy

Answer 16

similar to RA
seronegative, symmetric poly arthritis
pencil in cup, telescoping fingers, new bone formation, nail chnages such as pitting and onycholysis
Mx steroids
MTX in severe disease ( little role in axial disease)

Question 17

Osler weber Rendu syndrome aka Herdeitary haemorrhagic telengiactasia

Answer 17

1) positive family hsitory ( first degree relative)
2) Nasal bleeding
3) AVM such cerebral, hepatic, spinal, GIT ( can present with rectal bleed)
4)telangiactasias multiple incl face, lips, oral cavity, fingers

Question 18

lobulated, erythematous and raised lesion in babies

Answer 18

strawberry nevi, regress wiit time, if causing problem such as problem with vision- propranalol can be given, may not be prsenet at birth

Question 19

isotretinoin SE

Answer 19

1) dry skin
2) hair thinning
3) intracneial htn ( avodi with tertacyclihnes)
4)low mood
5) raised triglycerides
6) nose bleeds

Question 20

seborrheic dermatitis

Answer 20

first line Txx topical ketoconazole
Ass with HIV and parkinsons

Question 21

polymorphic eruption of pregnancy vs pemphigoid gestationis

Answer 21

polymorphic eruption of pregnancy-
start on abdomen, in third trimester, no blisters, usually on striaes

pemphigoid gestationis
also beigns on abdomen, blistering lesions, periumbilical distribution beginning in second or third trimester

Question 22

Stopic eruption of pregnancy

Answer 22

eczematous itchy red rash, most common skin lesions in pregnancy

Question 23

Antihistamins categories

Answer 23

sedating- chlorpheniramine
Non- sedating-cetirizine
loratidine

Question 24

MYxoid cysts

Answer 24

found in middle aged women, benign, ass with degenerative joint diseases such as OA usually found on distal and dorsal aspect of finger

Question 25

roughened red papules in patient with dermatomyositis

Answer 25

Gottrons papules

Question 26

dermaotmyositis

Answer 26

proximal muscle weakness and tenderness raynauds resp muscle weakness, fibrosing alveolitis dysphagia, dysphonia Ix Anti Jo ( overlap with poly) Anti Mi AntiTIF1

Question 27

melanoma types

Answer 27

superficieal spreading0 most common, seen in women, on areas of intermitten intense sun exposure eg legs (a growing mole) nodular- seen in chronically sun exposed areas eg face , neck- red or black lump Lentigo less common, on chronially sun exposed regions acral lentigious in nail beds

Question 28

spider nevi vs hereditary haemorrhagic telangiectasia

Answer 28

spider nevi- fill from centre when pressed and released HHT fill from edges

Question 29

Lichen planus

Answer 29

planar, pruritic, papular, polygonal found on flexure surfaces, palms and soles koebner phenomenon- new lesion appearing at the site of trauma

Question 30

pyoderma gangrenosum

Answer 30

associated with Crohns and UC, lesions develop or worsen at the site of injury, begins as putusle or nodule that breaks down into an ulcer with violaceous border and purulent base, is painful

Question 31

bullous pemphigoid

Answer 31

tense blisters in elderly develop on normal skin at dermo epidermal junction no mucosal involvement, negative nikolsky signs, blisters dont break

Question 32

pemphigus vulgaris

Answer 32

involves, mucosa, nikolsky sign present ( applying pressure sideways on blister causes it to extend) breakable blister

Question 33

Fitzpatrick type 1 skin

Answer 33

pale,freckles, always burns and never tans in sun

Question 34

brown discolouration on skin Dx and MX

Answer 34

ptyriasis versicolor can occur on face neck or arms after a suntan may be hypopigmnetated, borwn or pink malassezia furfur Mx ketoconazole if fails oral itraconazole

Question 35

acne rosacea

Answer 35

typically affects nose cheeks and forehead redness, papules and pustulescan also occur, rhinophyma can also occur ocular involvement- blepharitis Mx: topical brimonidine for redness ( alpha adrenergic agonist Topic ivermectin and oral doxy for severe disease

Question 36

~Actinic keratosis

Answer 36

small scaly or crusty lesions, may be red , brown or same colour as skin, develop in areas of sun exposure Mx_ flourouracil, 2-3 weeks skin will become red with Tx sometimes hydrocort is given to decrease inflammation

Question 37

malignancy ass with acanthosis nigricans

Answer 37

gastric adenoca

Question 38

Scarring Alopecia

Answer 38

-Burning and radiation -tinea capitis -lichen planus -discoid lupus