IID QUIZ

Mechanism

A Ag:Ab complexes complement activationleukocyte recruitmentrelease of enzymes & other toxic molecules

B IgG, IgM antigen bindingphagocytosis/lysis of target cell by complement or Fc receptors, leukocyte recruitment

C Activated T cellsrelease of cytokinesinflammation and macrophage ativation; T cell-mediated cytotoxicity

D IgEmast cell release of ediatorsrecruitment of inflammatory cells

Example

E Contact dermatitis, Multiple sclerosis, Rheumatoid arthritis

F SLE

G Anaphylaxis, allergies, bronchial asthma

H Transfusion reactions, autoimmune haemolytic anaemia, goodpasture syndrome

Type

Type I (immediate) hypersensitivity

Type II (antibody-mediated) hypersensitivity

Type III (immune complex-mediated) hypersensitivity

Type IV (cell-mediated) hypersensitivity

What condition am I?

• Affects 10-25% of population• Mean onset 9.1 years age• Symptoms include:– Inflammation:

• Itch, sneeze, rhinorrhoea, conjuctivitis, post-nasal drip

– Obstruction• Congestion, dry lips/mouth, sleep disturbance, sinusitis, apnoea

• IgE mediated inflammation of the nose

• Allergic Rhinitis

What condition am I?

• Reaction begins within seconds or minutes of exposure• Clinical features:

– Circulatory: Low blood pressure, low pulse pressure, compensatory tachycardia

– Skin (within minutes): pruritis, erythea, urticaria– Respiratory: Increased RR, Bronchoconstriction, laryngeal

oedema/obstruction• Can be caused by food, drugs, insects and more• Type 1 hypersensitivity reaction to an allergen

– Death may result from hypoxaemia or shock

• Anaphylaxis

Term

1 Bulla

2 Vesicle

3 Excoriation

4 Macule

5 Nodule

6 Onycholysis

7 Papule

8 Plaque

9 Pustule

10 Scale

11 Ulceration

12 Erosion

Match the dermatological term and its definition

Definition

A Raised spherical lesion > 5mm

B Discrete, pus-filled, raised lesion

C Fluid-filled lesion <5mm

D Focal, incomplete loss of epidermis

E Raised flat-topped lesion >5mm

F Flat lesion <5mm

G Loss of nail substance

H Focal, complete loss of epidermis +/- dermis and subcutaneous fat

I Dry, horny, plate-like lesion

J Raised spherical/flat-topped lesion <5mm

K Deep scratch; a traumatic lesion resulting in epidermal breakage

L Fluid-filled lesion >5mm

Name the acute inflammatory dermatosis

Acute Eczematous Dermatitis (Eczema)

Name the acute inflammatory dermatosis

Erythema Multiforme

Name the acute inflammatory dermatosis

Urticaria (Hives)

Name the chronic inflammatory dermatosis

Discoid Lupus Erythematosus

Name the chronic inflammatory dermatosis

Seborrhoeic Dermatitis

Name the chronic inflammatory dermatosis

Psoriasis – now name the 4 forms of psoriasis

1. Psoriasis vulgaris – eruptive (acute), chronic plaque and inverse forms

- peak incidence at 22 years2. Pustular psoriasis – pustules on normal or

inflamed skin3. Psoriatic arthritis – psoriasis of skin/nails with

arthropaty4. Erythrodermic psoriasis – involves nearly entire

skin with constitutional symptoms

Classify burns by depth• Superficial (1st degree)

– Epidermis• Erythema, oedema, tenderness on palpation

• Superficial partial thickness (2nd degree)– Some dermis

• Erythema, moist, blistering, tenderness on palpation– Pigment changes when healed

• Deep partial thickness (2nd degree)– Full dermis

• Painless, pale, dry, non-blanching– Severe scarring, grafting needed

• Full thickness (3rd degree)– Subcutaneous tissue

• Painless, dead appearance, pale/leathery, thrombosed blood vessels

• Subdermal (4th degree)– Underlying muscle

• Charred appearance, dry, brown, painless

– Full thickness and subderma have severe risk of contracture, require grafting

What is parkland formula?

• mL crysalloid in 24 hr = 4 x weight (kg) x % TBSA burned

How is it given? What type of fluid??

• Half in first 8 hrs, half over following 16 hrs• Crystalloid formula

Frontal

Sphenoid

Superior orbital fissure

Optic foramen

Zygomatic bone

Palatine bone

MaxillaInfraorbital groove

Inferior orbital fissure

Lacrimal bone

Ethmoid bone

Draw A, B, C, D