Dermatology

Question 1

Tx for eczema?

Answer 1

• Topical emollients
• Topical steroids, potency as required (only for 7 days)
  -Tacrolimius/pimecromilus if not controlled with topical steroid
  -Azathioprine, ciclosporin for very severe disease
  (Sedating histamines eg. hydroxyzine at night)

Question 2

Tx of psoriasis?

Answer 2

Topical steroid + vitamin D analogue
Emollients
Phototherapy
Non-biologic and biologic drugs

Question 3

Mx of multiple myeloma?

Answer 3

o Induction  thalidomide/bortezomib + dexamethasone
o Bone disease  bisphosphonates + analgesia

Question 4

Most important electrolyte abnormality in refeeding syndrome?

Answer 4

Phosphate

Question 5

What is Fibromuscular Dysplasia (FMD) and discuss ix and mx?

Answer 5

• Fibromuscular dysplasia (FMD) = an idiopathic non-atherosclerotic, non-inflammatory disorder of arteries encompassing two subtypes, focal and non-focal FMD. Lesions predominantly affect the renal and cervical arteries (10 per 100,000)
• Signs & symptoms:
  o Renal artery FMD: resistant HTN (74%), abdominal bruits, unilateral small kidneys
  o Cervical artery FMD: chronic migraines (70%), pulsatile tinnitus
• Investigations:
  o Gold-standard = CTA  catheter angiography (+ MRA head if confirmed)
  o Bloods (lipids, autoantibodies, ESR)
  N.B. FMD is a cause of renal artery stenosis
• Management:
  o Stop smoking Cx: cervical & coronary artery dissection, renal infarction
  o Anti-platelets clopidogrel
  o Anti-HTN 1st: ACEi or ARB
  o Surgery surgical stenting (renal, cervical, iliac arteries)

Question 6

Antibodies in pernicious anaemia?

Answer 6

Anti-intrinsic factor antibodies

Question 7

Marker of bowel cancer?

Answer 7

CEA

Question 8

What is AFP a marker of?

Answer 8

Liver cancer
Non-seminoma

Question 9

What is lLDH a marker of?

Answer 9

seminoma (testicular cancer)

Question 10

Marker of breast cancer?

Answer 10

CA 15-3