Slides Review 1 Dr.Hulayel AlHarbi
<ul><li>43y female presented with this rash, what other investigation should be done for her ? </li></ul>
molluscum contagiosum <ul><li>Molluscum contagiosum is a viral skin disease characterised by firm, round, translucent, umb...
<ul><li>71y female present with several months of fascial discmfort  and gritty eyes , what is the diagnosis ? </li></ul>
systemic sclerosis <ul><li>strikingly line - free forehead   </li></ul><ul><li>small beaked nose </li></ul><ul><li>' pucke...
<ul><li>50 y old lady presented with high BP, what clinical sign demonestrated her? What others cutaneous manifestations a...
Loss of subcutaneous fat in Cushing syndrome <ul><li>Other cutaneous manifestations : </li></ul><ul><li>Early brusis ( com...
<ul><li>60y old male heavy smoker for 20y presented with 3 months of proximal muscle weakness, what is the Dx? What other ...
Gottron sign in Dermatomyositis <ul><li>It associated with internal malignancy in 7-50%, ass with: </li></ul><ul><li>Lung ...
<ul><li>42y old man refered  by his dentist with these lesions what is the Dx? </li></ul>
Kaposi Sarcoma <ul><li>caused by HSV-8 </li></ul><ul><li>Classical kaposi (Ashkenazi Jews &Mediterranean origin): </li></u...
<ul><li>36y male HIV patient presented with cough and haemoptysis , what is the Dx ? </li></ul>
Kaposi Sarcoma <ul><li>Pulmonary manifestations include pleural, parenchymal and airway lesions, and recurrent pleural eff...
<ul><li>28y male presented with painful red eye. He has previous tow attacks of shingles, what is the Dx ? </li></ul>
Kaposi sarcoma (eye) <ul><li>In classical KS no Rx needed. </li></ul><ul><li>In AIDS many patient will respond to HAART. <...
<ul><li>28y male presented with SOB,fever,cough. His symptoms appeared 3 days after this rash, what is the Dx? Rx ? How to...
Chickenpox & varicella pneumonia <ul><li>Treatment: </li></ul><ul><li>Acyclovir IV 7-10 days </li></ul><ul><li>Corticoster...
<ul><li>52y old Greek women presented with DVT, which HLA type associated with this syndrome ? </li></ul>
Behcet Disease <ul><li>Presentation: </li></ul><ul><li>Oral & genital ulcers, Iritis, episceleritis, fever, diarrhea, abd ...
<ul><li>35 y lady with sickel cell disease presented with abd pain, this her fundus exam what is the Dx? </li></ul><ul><li...
Angioid Streaks  <ul><li>This uncommon condition is characterised by breaks in Bruch's membrane which resemble blood vesse...
<ul><li>78 y old lady presented with this rash, what is the diagnosis ? </li></ul>
Pemphigoid <ul><li>Large blisters healed without scarring </li></ul><ul><li>It caused by IgG autoantibodies againist the b...
<ul><li>72y lady presented with dysphagia  </li></ul><ul><li>What autoantibody is highly specific for this syndrome ? </li...
CREST Syndrome <ul><li>Calcinosis, Raynaud phenomenon, Esophageal dismotility, Sclerodactyly & Telangiectasia </li></ul><u...
<ul><li>What are the diseases associated with this condition? </li></ul>
Acanthosis Nigricans <ul><li>Endocrine : Acromegally, Cushing syndrome, Insuline resistance type 2 Dm </li></ul><ul><li>Id...
<ul><li>45 y female known with DM, HTN, Hypothyrodism presented with this skin lesion which enlarging over the last 2 mont...
Necrobiosis Lipodica Diabeticorum <ul><li>Predominantly affect young women with type 1 DM and retinopathy and neuropathy. ...
<ul><li>58 y female presented with gradually enlarging rash. She has hx of RA. Her urine dipstick was negative and FBS nor...
Necrobiosis Lipodica Diabeticorum <ul><li>Predominantly affect young women with type 1 DM and retinopathy and neuropathy. ...
<ul><li>This 40 y male just came from holiday, what is the DX ? What type of  therapy is most appropriate to induce remiss...
Porphyria Cutanea Tarda <ul><li>Cutaneous photosensitivity is the predominant finding with pruritic blisters. </li></ul><u...
<ul><li>82 y old Jewish lady presented with this rash. What is the DX ? </li></ul><ul><li>What is the RX ? </li></ul>
Pemphigus Vulgaris <ul><li>Blistering disease of elderly. </li></ul><ul><li>Thin wall blisters usually ruptured easly only...
<ul><li>65 y old man treated for IHD and heart failure, what are the drugs can cause this condition ? </li></ul>
Gynaecomastia <ul><li>Drugs inhibit testosterone : </li></ul><ul><li>Ketoconazole, Metronidazole, Cimetidine, Etomide, Cis...
<ul><li>58 y old male, tall with small testes what is his karyotype ? </li></ul>
Gynaecomastia <ul><li>Klinefelteris  Syndrome </li></ul><ul><li>The karyotype 47 XXy </li></ul>
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Slides Review 01 FOR DOCTORS

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Slides Review 01 FOR DOCTORS

  1. 1. Slides Review 1 Dr.Hulayel AlHarbi
  2. 2. <ul><li>43y female presented with this rash, what other investigation should be done for her ? </li></ul>
  3. 3. molluscum contagiosum <ul><li>Molluscum contagiosum is a viral skin disease characterised by firm, round, translucent, umbilicated papules containing caseous matter and peculiar capsulated bodies </li></ul><ul><li>It is caused by a DNA virus of pox family </li></ul><ul><li>HIV serology should be done. </li></ul>
  4. 4. <ul><li>71y female present with several months of fascial discmfort and gritty eyes , what is the diagnosis ? </li></ul>
  5. 5. systemic sclerosis <ul><li>strikingly line - free forehead </li></ul><ul><li>small beaked nose </li></ul><ul><li>' puckered mouth' ( radial furrowing around the lips </li></ul><ul><li>multiple telangiectasia ( in advanced cases </li></ul><ul><li>mouth and soft palate - may shrink so that denture wearers complain of poorly fitting dentures </li></ul><ul><li>The patient may be unable to close their eyes due to skin tethering </li></ul>
  6. 6. <ul><li>50 y old lady presented with high BP, what clinical sign demonestrated her? What others cutaneous manifestations ass with this syndrome? </li></ul>
  7. 7. Loss of subcutaneous fat in Cushing syndrome <ul><li>Other cutaneous manifestations : </li></ul><ul><li>Early brusis ( commonest sign ) </li></ul><ul><li>Skin atrophy </li></ul><ul><li>Stria and purpura </li></ul><ul><li>Peels off skin when adhesive tape ( like damp tissue paper ) applied on it, Liddle,s sign. </li></ul>
  8. 8. <ul><li>60y old male heavy smoker for 20y presented with 3 months of proximal muscle weakness, what is the Dx? What other disease ass with this syndrome ? </li></ul>
  9. 9. Gottron sign in Dermatomyositis <ul><li>It associated with internal malignancy in 7-50%, ass with: </li></ul><ul><li>Lung ca </li></ul><ul><li>Gastric ca </li></ul><ul><li>Ovary ca </li></ul><ul><li>Breast ca </li></ul><ul><li>Child dermatomyositis not ass with malignancy. </li></ul>
  10. 10. <ul><li>42y old man refered by his dentist with these lesions what is the Dx? </li></ul>
  11. 11. Kaposi Sarcoma <ul><li>caused by HSV-8 </li></ul><ul><li>Classical kaposi (Ashkenazi Jews &Mediterranean origin): </li></ul><ul><li>65y age, usually affect lower limbs. </li></ul><ul><li>In HIV and other immunocompromised: </li></ul><ul><li>In younger age affect the face, bronchial tree, GI tract and eyes </li></ul>
  12. 12. <ul><li>36y male HIV patient presented with cough and haemoptysis , what is the Dx ? </li></ul>
  13. 13. Kaposi Sarcoma <ul><li>Pulmonary manifestations include pleural, parenchymal and airway lesions, and recurrent pleural effusions may occur </li></ul>
  14. 14. <ul><li>28y male presented with painful red eye. He has previous tow attacks of shingles, what is the Dx ? </li></ul>
  15. 15. Kaposi sarcoma (eye) <ul><li>In classical KS no Rx needed. </li></ul><ul><li>In AIDS many patient will respond to HAART. </li></ul><ul><li>In fascial lesions local radiotherapy will be effective. Other exposed areas need more extensive radiotherapy and exesion. </li></ul><ul><li>In visceral disease not responding to HAART cytotoxic chemotherapy is indicated. </li></ul>
  16. 16. <ul><li>28y male presented with SOB,fever,cough. His symptoms appeared 3 days after this rash, what is the Dx? Rx ? How to prevent this complication? </li></ul>
  17. 17. Chickenpox & varicella pneumonia <ul><li>Treatment: </li></ul><ul><li>Acyclovir IV 7-10 days </li></ul><ul><li>Corticosteroids as adjunctive therapy </li></ul><ul><li>Prevention : </li></ul><ul><li>VZIG <96 hrs after exposure </li></ul><ul><li>Varicella vaccine < 3 days of exposure ( contraindication in pregenancy ) </li></ul><ul><li>Acyclovir as prophylaxis !! </li></ul>
  18. 18. <ul><li>52y old Greek women presented with DVT, which HLA type associated with this syndrome ? </li></ul>
  19. 19. Behcet Disease <ul><li>Presentation: </li></ul><ul><li>Oral & genital ulcers, Iritis, episceleritis, fever, diarrhea, abd pain, arterial & venous thrombosis, pericarditis. </li></ul><ul><li>HLA association : </li></ul><ul><li>HLA B5 with occular disease </li></ul><ul><li>HLA B12 with recurrent oral ulcers </li></ul>
  20. 20. <ul><li>35 y lady with sickel cell disease presented with abd pain, this her fundus exam what is the Dx? </li></ul><ul><li>What are other diseases associated with this fundus ? </li></ul>
  21. 21. Angioid Streaks <ul><li>This uncommon condition is characterised by breaks in Bruch's membrane which resemble blood vessels </li></ul><ul><li>Causes : </li></ul><ul><li>Pseudoxanthoma elasticum </li></ul><ul><li>Ehlers-Danlos syndrome </li></ul><ul><li>Sickel cell disease </li></ul><ul><li>Acromegally </li></ul><ul><li>Pagets disease </li></ul><ul><li>Lead poisoning </li></ul>
  22. 22. <ul><li>78 y old lady presented with this rash, what is the diagnosis ? </li></ul>
  23. 23. Pemphigoid <ul><li>Large blisters healed without scarring </li></ul><ul><li>It caused by IgG autoantibodies againist the basement membrane. </li></ul><ul><li>The blisters occur in the subdermal level so they are tense and intact </li></ul>
  24. 24. <ul><li>72y lady presented with dysphagia </li></ul><ul><li>What autoantibody is highly specific for this syndrome ? </li></ul>
  25. 25. CREST Syndrome <ul><li>Calcinosis, Raynaud phenomenon, Esophageal dismotility, Sclerodactyly & Telangiectasia </li></ul><ul><li>Anticenteromere Abx strongly associated with CREST syndrome. </li></ul>
  26. 26. <ul><li>What are the diseases associated with this condition? </li></ul>
  27. 27. Acanthosis Nigricans <ul><li>Endocrine : Acromegally, Cushing syndrome, Insuline resistance type 2 Dm </li></ul><ul><li>Idiopathic </li></ul><ul><li>Polycystic ovary disease </li></ul><ul><li>Obesity </li></ul><ul><li>malignancy: </li></ul><ul><li>castric ca , lymphoma </li></ul>
  28. 28. <ul><li>45 y female known with DM, HTN, Hypothyrodism presented with this skin lesion which enlarging over the last 2 months what is the diagnosis ? </li></ul>
  29. 29. Necrobiosis Lipodica Diabeticorum <ul><li>Predominantly affect young women with type 1 DM and retinopathy and neuropathy. </li></ul><ul><li>Usually begins in the pretibial region as erythematous plaque or papules then gradually enlarge, darken, and develop irregular margins with atrophic center and ulceration. </li></ul><ul><li>It may be painful . </li></ul>
  30. 30. <ul><li>58 y female presented with gradually enlarging rash. She has hx of RA. Her urine dipstick was negative and FBS normal. What is the Dx ? </li></ul>
  31. 31. Necrobiosis Lipodica Diabeticorum <ul><li>Predominantly affect young women with type 1 DM and retinopathy and neuropathy. </li></ul><ul><li>Usually begins in the pretibial region as erythematous plaque or papules then gradually enlarge, darken, and develop irregular margins with atrophic center and ulceration. </li></ul><ul><li>It may be painful . </li></ul>
  32. 32. <ul><li>This 40 y male just came from holiday, what is the DX ? What type of therapy is most appropriate to induce remission for this condition ? </li></ul>
  33. 33. Porphyria Cutanea Tarda <ul><li>Cutaneous photosensitivity is the predominant finding with pruritic blisters. </li></ul><ul><li>The cause is deficiency of hepatic uroporphyrinogen decarboxylase. </li></ul><ul><li>Precipitant factors: alcohol, high iron, estrogens </li></ul><ul><li>Rx: venesection ( 450mls/week) until HB 12 g/dl </li></ul><ul><li>Chloroquine can promote porphyrin excretion. </li></ul>
  34. 34. <ul><li>82 y old Jewish lady presented with this rash. What is the DX ? </li></ul><ul><li>What is the RX ? </li></ul>
  35. 35. Pemphigus Vulgaris <ul><li>Blistering disease of elderly. </li></ul><ul><li>Thin wall blisters usually ruptured easly only few can be seen intact ( not like pemphigoid). </li></ul><ul><li>It affect mucosal membranes (not like pemphegoid). </li></ul><ul><li>It is due to IgG deposition in the dermo-epidermal junction. </li></ul><ul><li>Rx: high doses steroids. </li></ul>
  36. 36. <ul><li>65 y old man treated for IHD and heart failure, what are the drugs can cause this condition ? </li></ul>
  37. 37. Gynaecomastia <ul><li>Drugs inhibit testosterone : </li></ul><ul><li>Ketoconazole, Metronidazole, Cimetidine, Etomide, Cisplatin </li></ul><ul><li>Osterogens: </li></ul><ul><li>Digitalis, Oral Contraceptive pills </li></ul><ul><li>Drugs with unknown mechanism: </li></ul><ul><li>Isonizide, Diazepam, Omeprazole, calcium channel inhibitors, ACE inhibitors, tricyclic antidepressant, Busulphan, Marijuana, Heroin, Spironolactone </li></ul>
  38. 38. <ul><li>58 y old male, tall with small testes what is his karyotype ? </li></ul>
  39. 39. Gynaecomastia <ul><li>Klinefelteris Syndrome </li></ul><ul><li>The karyotype 47 XXy </li></ul>

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