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Pass Medicine

Pass Medicine

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Published by kdwazir

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Published by: kdwazir on Apr 10, 2010
Copyright:Attribution Non-commercial


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Question 79 of 86Which one of the following statements regarding fungal nail infections is incorrect?ia A.A
accounts for less than 10% of casesia B.ADiagnosis should be confirmed by microbiology beforestarting treatmentia C.A Treatment is successful in around 85% of peopleia D.A Thickened, rough, opaque nails are typicallyia E.ASuitable investigations include nail clippingsia 
Fungal nail infectionssqweqwesf erwrewfsdfs adasd dheOnychomycosis is fungal infection of the nails. This may be caused by
dermatophytes - mainly Trichophyton rubrum, accounts for 90% of cases
yeasts - such as
non-dermatophyte mouldsFeatures
'unsightly' nails are a common reason for presentation
thickened, rough, opaque nails are the most common findingInvestigation
nail clippings
scrapings of the affected nailManagement
treatment is successful in around 50% of people
diagnosis should be confirmed by microbiology before starting treatment
dermatophyte infection: oral terbinafine is currently recommended first-line with oralitraconazole as an alternative. Six weeks therapy is needed for fingernail infections whilsttoenails should be treated for 12 weeks
infection: mild disease should be treated with topical antifungals (e.g. amorolfine)whilst more severe infections should be treated with oral itraconazole for a period of 12 weeks
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Question 80 of 86A 19-year-old man is started on isotretinoin for severe nodulo-cystic acne. Which one of the followingside-effects is most likely to occur?ia A.ALow moodia B.A Thrombocytopaeniaia C.ARaised plasmatriglyceridesia D.AReversible alopeciaia E.ADry skinia 
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 Dry skin is the most common side-effect of isotretinoinIsotretinoin
sqweqwesf erwrewfsdfs adasd dheIsotretinoin is an oral retinoid used in the treatment of severe acne. Two-thirds of patients have a long term remission or cure
following a course of oral isotretinoinAdverse effects
teratogenicity: females MUST be using two forms of contraception (e.g. combined oralcontraceptive pill and condoms)
dry skin, eyes and lips: the most common side-effect of isotretinoin
low mood
raised triglycerides
hair thinning
nose bleeds (caused by dryness of the nasal mucosa)
benign intracranial hypertension: isotretinoin treatment should not be combined withtetracyclines for this reason
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Question 81 of 86Which of the following skin conditions associated with malignancy are not correctly paired?ia A.AErythroderma and lymphomaia B.ANecrolytic migratory erythema andgastrinomaia C.AAcanthosis nigricans andgastrointestinal canceria D.ASweet's syndrome and myelodysplasiaiaE.AErythema gyratum repens and lungcanceria 
ensureformsentSubmit answer 
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