Professional Documents
Culture Documents
MULTIPLE CHOICE
1. Which component of the epidermis initiates immune responses and provides a defense against
environmental antigens?
a. Langerhans cells
b. Merkel cells
c. Keratinocytes
d. Melanocytes
ANS: A
Langerhans cells (a type of dendritic cell) and dermal dendritic cells initiate an immune
response by presenting processed antigen to T cells, thus providing a defense against
environmental antigens. This function is not true of the other options.
PTS: 1
2. Which cells of the dermis release histamine and play a role in the hypersensitivity reactions of
the skin?
a. Histiocytes
b. Fibroblasts
c. Mast cells
d. Macrophages
ANS: C
Only mast cells release histamine and play a role in hypersensitivity reactions in the skin.
PTS: 1
4. Which gland releases secretions that are important in thermoregulation and cooling of the
c. Eccrine
d. Exocrine
ANS: C
The eccrine sweat glands are distributed over the body, with the greatest numbers in the palms
of the hands, soles of the feet, and forehead. These secretions are important in
thermoregulation and cooling of the body through evaporation. This function is not true for
the other options.
PTS: 1
5. Which receptors of the sympathetic nervous system regulate heat loss through the skin?
a. Cholinergic
c. -Adrenergic
b. -Adrenergic
d. Anticholinergic
ANS: C
Heat loss can be regulated by varying blood flow through the skin by opening and closing the
arteriovenous anastomoses in conjunction with evaporative heat loss of sweat. The
sympathetic nervous system regulates vasoconstriction and vasodilation through -adrenergic
receptors only.
PTS: 1
6. What is the first change in the skin that indicates a pressure ulcer?
a. Blanchable erythema of intact skin
b. Nonblanchable erythema of intact skin
c. Blister at the site of pressure
d. Reddish-purple discoloration
ANS: B
Nonblanchable erythema of intact skin, usually over bony prominences, characterizes stage 1
pressure ulcers. This selection is the only option that accurately identifies the initial skin
change indicative of a pressure ulcer.
PTS: 1
Superficial pressure ulcers should be covered with flat, nonbulky dressings that cannot
wrinkle or cause increased pressure or friction. Spontaneous healing will occur more quickly
if the ulcer is kept moist with an occlusive dressing.
PTS: 1
8. What term is used to identify skin lesions that are elevated, rounded, and firm with irregular
a. Psoriasis
b. Dermatitis
ANS: D
Of the options available, only keloids typically send out clawlike prolongations.
PTS: 1
9. Keloids are sharply elevated, irregularly shaped, progressively enlarging scars caused by
excessive amounts of which substance in the corneum during connective tissue repair?
c. Stroma
d. Reticular fibers
a. Elastin
b. Collagen
ANS: B
Abnormal wound healing with excessive fibroblast activity and collagen formation during
dermal connective tissue repair cause keloids. The other options are not associated with keloid
formation.
PTS: 1
10. In allergic contact dermatitis, which cells possess the antigens and present them to T cells?
a. Langerhans cells
c. Keratinocytes
b. Merkel cells
d. Macrophages
ANS: A
In allergic contact dermatitis, only Langerhans cells process the antigen and carry it to T cells
that then become sensitized to the antigen-releasing cytokines and chemokines, leading to
leukocyte infiltration and inflammation.
PTS: 1
11. In latex allergies, which immunoglobulin (Ig) is associated with an immediate reaction?
a. IgA
c. IgG
b. IgE
d. IgM
ANS: B
Latex allergy can be either a type IV hypersensitivity to chemicals used in latex rubber
processing or a type I immediate hypersensitivity, with IgE antibodies formed in response to
latex rubber protein. This selection is the only correct option available.
PTS: 1
12. What medical term is used to identify an inflammatory disorder of the skin that is often
considered synonymous with dermatitis and characterized by pruritus with lesions that have
an indistinct border?
a. Eczema
c. Atopic dermatitis
b. Psoriasis
d. Pityriasis rosea
ANS: A
The most common inflammatory disorder of the skin is eczema, or dermatitis. Eczema and
dermatitis are general terms that describe a particular type of inflammatory response in the
skinthese terms can be used interchangeably. Pruritus, lesions with indistinct borders, and
epidermal changes generally characterize diseases that are considered eczematous. Of the
available options, only eczema is associated with these characteristics.
PTS: 1
13. What clinical manifestations do allergic contact and stasis dermatitis have in common?
a. Petechiae and hyperpigmentation
c. Scaling and crusting of lesions
b. Edema and vesicular lesions
d. Erythema and pruritus
ANS: D
14. Lesions on the elbows and knees that are well demarcated, thick, silvery, scaly, and
a. Plaque
b. Inverse
ANS: A
The description provided is characteristic of only lesions observed in plaque psoriasis. These
lesions are well-demarcated, thick, silvery, scaly, erythematous plaque surrounded by normal
skin.
PTS: 1
15. Which skin disorder begins with a single lesion that is circular, demarcated, and salmon pink,
a. Lichen planus
b. Pityriasis rosea
ANS: B
Of the options available, only pityriasis rosea begins as a single lesion known as a herald
patch. This lesion is circular, demarcated, and salmon pink; it measures approximately 3 to 4
cm in diameter and is usually located on the trunk.
PTS: 1
c. Immunoglobulin G (IgG)
d. Immunoglobulin M (IgM)
ANS: D
17. Which term is used to identify a collection of infected hair follicles occurring most often on
the back of the neck, the upper back, and the lateral thighs that forms a mass and evolves into
an erythematous, painful, and edematous mass and drains through many openings?
a. Erysipelas
c. Carbuncles
b. Furuncles
d. Boils
ANS: C
The term, carbuncle, is used to identify a collection of infected hair follicles occurring most
often on the back of the neck, the upper back, and the lateral thighs. The lesion begins in the
subcutaneous tissue and lower dermis as a firm mass that evolves into an erythematous,
painful, and swollen mass and drains through many openings.
PTS: 1
The same herpesvirusvaricella zoster virus (VZV)causes both herpes zoster (shingles)
and varicella (chickenpox). Varicella is the primary infection, followed years later by herpes
zoster, particularly among those who are immunosuppressed. These statements are not true of
any of the other options.
PTS: 1
Tinea corporis is a fungal infection of the skin. This selection is the only option that accurately
identifies the nature of the infection.
PTS: 1
a. Dermatitis
b. Scleroderma
ANS: C
Scleroderma means sclerosis of the skin and is associated with immune dysregulation and
several autoantibodies. This selection is the only option associated with scleroderma.
PTS: 1
23. What name is given to a benign proliferation of basal cells that produces smooth or warty
elevated lesions on the chest, back, and face that are tan or waxy, yellow, flesh-colored, or
dark brown to black?
a. Basal keratosis
b. Seborrheic keratosis
c. Keratoacanthoma
d. Actinic keratosis
ANS: B
Seborrheic keratosis is a benign proliferation of cutaneous basal cells that produces smooth or
warty elevated lesions. The pathogenetic origin is unknown. Seborrheic keratosis usually
occurs in older people as multiple lesions on the chest, back, and face. The color varies from
tan to waxy, yellow, flesh-colored, or dark brown to black. No other option exhibits these
characteristics.
PTS: 1
24. Lesions that usually have depressed centers with rolled borders and are frequently located on
Of the available options, only basal cell carcinoma has depressed centers with rolled borders.
Lesions are most often observed on people who live in regions with intense sunlight and on
those areas of the skin most exposednamely, the face and neck.
PTS: 1
25. The alteration of which gene is associated with basal cell carcinoma?
a. myc
c. src
b. TP53
d. Ras
ANS: B
Squamous cell carcinoma (SCC) is a tumor of the epidermis and the second most common
human cancer. Two types are characterized: (1) in situ (Bowen disease) and (2) invasive.
Bowen disease is not a form of any of the other options.
PTS: 1
27. A small (less than 1 cm) lesion with regular edges and bristlelike hairs with a color change
that can range from skin tones to light brown characterize which form of nevus?
c. Intradermal
d. Compound
a. Junctional
b. Epidermal
ANS: C
Only intradermal nevus is characterized by a small (less than 1 cm) lesion with regular edges
and bristlelike hairs with a color change that can range from skin tones to light brown.
PTS: 1
Only the endothelial cell is thought to be the progenitor of Kaposi sarcoma, but the specific
origin is elusive.
PTS: 1
Immersion in a warm-water bath (40 to 42 C [104 to 107.6 F]) until frozen tissue is
thawed is the best treatment for frostbite. Rubbing or massaging the area would damage the
traumatized cells. The remaining options have no therapeutic value for frostbite.
PTS: 1
30. What is the purpose of administering ibuprofen to individuals being treated for frostbite?
a. Treating fever
c. Reducing pain
b. Preventing plate aggregation
d. Inhibiting prostaglandins
ANS: D
Ibuprophen is used to inhibit prostaglandins. Although ibuprofen may be administered for the
other reasons stated, those applications are not related to the treatment of frostbite.
PTS: 1
31. What is the medical term for a fungal infection of the nail plate?
a. Paronychia
c. Tinea corporis
b. Onychomycosis
d. Tinea capitis
ANS: B
Onychomycosis is the only term used to identify a fungal or dermatophyte infection of the nail
plate that occurs in 2% to 18% of the population.
PTS: 1
A furuncle, or boil, is used to identify an inflammation of the hair follicles (root) that may
develop from a preceding folliculitis and spread through the follicular wall into the
surrounding dermis.
PTS: 1
MULTIPLE RESPONSE
33. What effect does normal aging have on the wound healing process? (Select all that apply.)
a. Decreased cell proliferation
b. Decreased blood supply
c. Depressed immune responses
d. Depressed appetite
e. Decreased cognitive function
ANS: A, B, C
Decreased cell proliferation, decreased blood supply, and depressed immune responses delay
wound healing in aging skin. The other options are not related to wound healing progress.
PTS: 1
34. Which statements are true regarding a nevus? (Select all that apply.)
a. A nevus is an aggregation of melanocytes
b. Nevi begin to form at the ages of 3 to 5 years.
c. Nevi are characterized by irregular borders.
d. Nevi share a relationship with melanoma.
e. Nevi always warrant being removed.
ANS: A, B, D
A nevus, or mole, is a benign pigmented or nonpigmented lesions that form from melanocytes
beginning at ages 3 to 5 years. Over time the cells move down into the dermis and the nevi
become nodular and symmetrical without irregular borders. Nevi may undergo transition to
malignant melanomas. Nevi repeatedly traumatized, irritated by clothing, or large lesions can
be excised.
PTS: 1
35. Which statements are true regarding Kaposi sarcoma? (Select all that apply.)
a. South America has been the site of the endemic form of Kaposi sarcoma.
b. Kaposi sarcoma is a vascular malignancy.
c. It is associated with drug-induced immunosuppression.
d. Kaposi sarcoma is associated with acquired immunodeficiency syndrome (AIDS).
e. Presentation of the classic form of Kaposi sarcoma is observed on the lower legs of
older men.
ANS: B, C, D, E
Kaposi sarcoma is a vascular malignancy with four different presentations: (1) it is associated
with drug-induced immunosuppression; (2) its endemic form has been found in equatorial
Africa, (3) the classic form appears on the lower legs of older men, and (4) it is associated
with AIDS.
PTS: 1
36. Which medications may exacerbate existing psoriasis? (Select all that apply.)
a. Antibiotics
b. Calcium channel blockers
c. Nonsteroidal antiinflammatory drugs (NSAIDs)
d. Beta blockers
e. Lithium
ANS: C, D, E
Antimalarial drugs, lithium, NSAIDs, and beta-blockers tend to exacerbate existing psoriasis.
This statement is not true of the remaining options.
PTS: 1
37. Which inflammatory mediators are active in frostbite? (Select all that apply.)
a. Leukotrienes
b. Histamine
c. Prostaglandins
d. Bradykinin
e. Thromboxanes
ANS: B, C, D, E
The inflammatory mediators of frostbite are similar to burns and include prostaglandins,
thromboxanes, bradykinin, and histamine. Leukotrienes are not associated with frostbite.
PTS: 1
38. Women who develop hirsutism may be secreting hormones associated with which condition?
a.
b.
c.
d.
e.
ANS: A, C, E
Women who develop hirsutism may be secreting hormones associated with ovarian or adrenal
disease. Such women should be evaluated for polycystic ovaries, adrenal hyperplasia, or
adrenal tumors. Neither Cushing nor Addison diseases are associated with hirsutism.
PTS: 1
MATCHING
Match the descriptions of the skin lesions with the disorder where it is found.
______ A. Elevated, firm circumscribed area less than 1 cm in diameter
______ B. Elevated, firm, and rough lesion with a flat top surface greater than 1 cm in
diameter
______ C. Flat circumscribed area that is less than 1 cm in diameter
______ D. Elevated irregular-shaped area of cutaneous edema; solid and transient with a
variable diameter
______ E. Elevated circumscribed, superficial lesion filled with serous fluid, less than 1
cm in diameter
39.
40.
41.
42.
43.
39. ANS: D
PTS: 1
REF: Page 1621 | Table 46-3
MSC: Urticaria exhibits elevated, irregular-shaped areas of cutaneous edema. Its lesions are solid and
transient with a variable diameter.
40. ANS: E
PTS: 1
REF: Page 1621 | Table 46-3
MSC: Varicella (chickenpox) and herpes zoster (shingles) are elevated circumscribed, superficial
lesions filled with serous fluid and measure less than 1 cm in diameter.
41. ANS: A
PTS: 1
REF: Page 1620 | Table 46-3
MSC: Warts (verruca) or lichen planus are elevated, firm, circumscribed areas less than 1 cm in
diameter.
42. ANS: B
PTS: 1
REF: Page 1620 | Table 46-3
MSC: Psoriasis or seborrheic and actinic keratoses are elevated, firm, and rough lesions with flat-top
surfaces that measure greater than 1 cm in diameter.
43. ANS: C
PTS: 1
REF: Page 1620 | Table 46-3
MSC: A nevus is a flat, circumscribed area that is less than 1 cm in diameter.