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OSCE Derma

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PREVIOUS OSCE EXAMS OF
DERMATOLOGY &
ANDROLOGY
1-Describe the lesion
•
shiny pearly white, dome shape, sessile papules that are variable in
size.
•
The surface may be umbilicated which is diagnostic for molluscum
contagiosum.
•
On squeezing the lesion, white cheesy material can be expressed
2- Diagnosis
Molluscum Contagiosum
3- Mode of infection
Contact with patient or contaminated objects
Auto inoculation.
4-Treatment
destruction of lesions by:
Curettage
Electrocautry.
Cryotherapy.
Caustics, e.g, silver
nitrate, phenol.
1- Describe the lesion
Asymptomatic, sessile, firm, dome-shaped papule skin-colored
with rough surface
2- Diagnosis
Common wart
3- Other types
•
•
•
•
•
Plane wart.
Filiform wart.
Digitiform wart.
Plantar wart.
Genital wart (condyloma accuminatum).
4- Mention 3 lines of treatment
• Electrocautry: used in painful and resistant warts, but carries risk of
scarring
• Cryotherapy: tissue freezing with solid carbon dioxide or liquid nitrogen
• Chemical cautry
• Other methods
Topical retinoic acid: in plane warts
Levamizole tab.
Interferon
1- Describe the lesion
Well circumscribed round to oval areas of alopecia without
evidence of inflammation or scarring. Alopecia extends in a
band along the scalp margin
2- Diagnosis
Alopecia areata (ophiasis)
3- Mention 2 bad prognostic factors
1- Ophiasis.
2- Total and universal alopecia.
3- Alopecia areata in atopic patient.
4- Presence of nail changes.
4- Mention 2 lines of topical treatment
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Topical minoxidil 2% solution
•
Topical or intralesional steroid for localized lesion
1- Diagnosis
Herpes zoster
2- Treatment
➢ Topical: antiseptic, antibiotic.
➢ Systemic: Acyclovir (dose: 800mg five times daily for 7 days)
➢ For neuralgic pain:
a) Carbamazepine (Tegretol tab) 200 - 800 mg / day.
b) Amitriptyline (Tryptizol tab) 25 - 100 mg / day.
c) Neurosurgical advice is required if severe pain persists.
3- Complications
1- Secondary bacterial infection.
2- Keratitis in ophthalmic HZ may result in impairment of vision.
3- Facial palsy (Ramsay-Hunt syndrome): Affection of geniculate
ganglion leading to ear pain, vesicles on ear pinna and external auditory
canal and facial palsy.
4- Post herpetic neuralgia: Persistence of pain or parasthesia after
healing of the lesions is usually seen in elderly.
5- Motor palsy and encephalitis are rare.
1- Describe the lesion
well-defined plaques with active spreading raised border
covered with scales
The center of the lesion is clearer giving the lesion a circinate
appearance
2- Diagnosis
Tinea corporis (tinea circinata)
3- D.D
1. Circinate impetigo.
2. Pityriasis rosea.
3. Circinate psoriasis.
4. Annular lichen planus.
5. Discoid eczema.
4- Treatment
1- Describe the lesion
Discrete erythematous papules rapidly change to tense clear vesicles
surrounded by red areola.
The lesions occur in successive crops and thus all stages of
development may be seen within one area (polymorphic).
2- Diagnosis
Chickenpox (Varicella)
3- Complications
1- Secondary infection.
2- Cutaneous gangrene.
3- Purpura.
4- Pneumonia.
5- Encephalitis (rare).
6- Foetal damage if infection occurs early in pregnancy.
4- Treatment
a- Antipyretic for fever.
b- Antihistamine for itching.
c- Antibiotic for secondary infection.
d- Topical antiseptic.
Systemic acyclovir (dose: 800mg five times daily for 7 days)
1- Describe the lesion
Well-defined, red papules and plaques covered with silvery
white scales. Removal of scales by scraping gives rise to small
bleeding points (Auspitz sign) which is pathognomonic for
psoriasis
2- Diagnosis
Psoriasis vulgaris
3- Pathology
1- Hyperkeratosis, parakeratosis and acanthosis.
2- Absent granular layer.
3- Munro micro abscesses: collection of neutrophiles in the horny layer.
4- Dermis: Papillary blood vessels are dilated and tortuous. Dermal
papillae are elongated, club shape with thin suprapapillary epidermis.
Cellular infiltrate of lymphocytes and neutrophiles in the upper dermis.
4- Clinical types
o Psoriasis vulgaris.
o Erythrodermic psoriasis.
o Pustular psoriasis.
o Arthropathic psoriasis
5- Treatment
6- D.D
Lichen planus – Tinea corporis – Discoid eczema- Pityriasis
rosea – Seborrheic dermatitis & pityriasis drug eruption
1- Describe the lesion
flat topped; polygonal violaceous papules. The surface of the papule
shows white fine dots
2- Diagnosis
Lichen planus
3- Clinical verities
➢ Actinic lichen planus
➢ Hypertrophic lichen planus
➢ Linear lichen planus
➢ Follicular lichen planus
➢ Bullous lichen planus
4- Treatment
1- Describe the lesion
There are ruptured vesicles on erythematous base forming yellowish
crusts
2- Diagnosis
Non bullous impetigo
3- Treatment
1. Topical: for mild and localized infection
➢ Gentle removal of the crust by olive oil
➢ Antiseptic cleansing and drying lotions, e.g., K. permanganate
➢ Antibiotics, e.g., neomycin, bacitracin, sodium fusidate or
garamycin
2. Systemic antibiotic
➢ Penicillinase-resistant penicillin
➢ Erythromycin if the patient is sensitive to penicillin
3. Treatment of predisposing factors
Any pre-existing skin disease should be treated
When pediculosis is present, it should be treated after control of impetigo because
pediculocidal drugs are toxic and cannot be applied on raw areas
1- Describe the lesion
Well-defined milky white (depigmented) macules and patches
2- Clinical types
1- Focal: macules in a single area but not segmental.
2- Segmental: unilateral macules in a dermatomal distribution.
3- Acrofacial: Involving distal extremities and face.
4- Generalized: Scattered macules and patches affecting up to 50%
of skin.
5- Universal: disease affects more than 50% of skin surface.
3- D.D
• Albinism
• pityriasis alba,
• hypopigmented pityriasis versicolor,
• hypopigmented macules of tuberculoid leprosy,
• post inflammatory hypopigmentation,
• chemical depigmentation after exposure to phenolic
chemicals.
4- Treatment )‫(من الكتاب‬
1- Describe the lesion?
Boggy swelling with rough surface and multiple follicular
pustules the hairs overlying the swelling are loose and when
removed seropus comes out.Thick crusting with matting of
adjacent hair together
2- Diagnosis
Tinea capitis Inflammatory type (Kerion)
3- D.D
Pyogenic abscess but kerion chr. By
Rough surface
Less pain and absence of constitutional symptoms
It contains no pus if incised by mistake
1- Describe the lesion
The affected area shows loss of hair and is studded with
black dots due to breaking off hair shafts at the skin surface
2- Diagnosis?
Tinea capitis Black dot type
3- Causative organism?
Trichophyton tonsurans + violaceum
4- D.D?
Alopecia areata
1- Describe the lesion
Well defined patch with grayish fine scales, the hairs are
broken at varying length and are lustreless, dull grey in color.
2- Causative organism?
a. Microsporum canis + audouinii
3- Diagnosis?
Tinea capitis scaly type
4- D.D
1- Psoriasis
2- Seborrheic dermatitis
3- PRP
4- Alpecia areata
1- Describe the lesion
Well defined whitish hypopigmented macules and patches of
different sizes and shapes
2- Causative organism
a. Malassezia furfur
3- Diagnosis
Hypopigmented pityriasis versicolor
4- D.D
1- Hypopigmentation
a. Vitiligo (non-scaly depigmented macules and
patches)
b. Pityriasis alba (ill-defined scaly hypopigmented
patches)
2- Hyperpigmentation
a. Erythrasma (coral red)
b. Seorrheic dermatitis
1- Describe the lesion?
The is purulent irregular ulcer may be due to removal of thick
crust that follow ruptured vesicles.
2- Diagnosis?
Ulcerative impetigo (Ecthyma)
3- Complications?
Post streptococcal glomerulonephritis
4- Treatment )‫(من الكتاب‬
1- Describe the lesion?
The lateral toe cleft is sodden , white ,macerated and
fissured
2- Diagnosis?
Macerated toe web infection most probably Interdigital
Tinea pedis
3- Other clinical types?
a. Scaly hyperkeratotic type
b. Vesiculo bullous type
4- D.D?
1- Erythrasma
2- Candidiasis
3- Pseudomonas
4- Psoriasis
5- Contact dermatitis
Andrology
➢ Semen analysis of a patient has asthenospermia
Comment on the following
1- Microscopic features
2- Causes of this case
3- Investigations
4- Treatment
➢ A man with 1ry infertility and his semen analysis shows no
sperms
Comment on the following
1- Diagnosis
2- Testicular causes
3- Other investigations
➢ Case of a patient has difficulty in attaining normal erection
for 2 years ago
1- List 4 causes of this case
2- List 4 investigations
3- Mentions 4 lines of treatment
➢
123-
Erectile dysfunction
Diagnosis
Investigations
Treatment
➢ Case of gonorrhea
‫في راوند جالهم حالة عنها بس مش عارف األسئلة اللي كانت عليها‬
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