Professional Documents
Culture Documents
3- Tzank smear
MINDMAP pge 3, 4
INVESTIGATION , RED RASH
TYPE IV HYPERSENSITIVITY:
-allergic contact dermatitis
-granulomas
-delayed hypersensitivity reactions
(sunsensitivity)
Staphylococcal infections:
-impetigo
-ecthyma
-furuncolosis(boils)
-carbuncle
-toxic shock syndrome
-scalded skin syndrome
Streptococcal infx:
-erysipelas
-cellulitis
-necrotizing fasciitis
MINDMAP PGE 11
bacterial infx
LOCALIZED SCARRING:
-kerion
-favus
-carbuncles
-lichen planus
-cicacitrial BCC
-SLE
-sarcoidosis
MINDMAP PGE 28, alopecia
LOCALIZED NON-
SCARRING:
-alopecia arreata
-hairpulling habit
-traction alopecia
-non-inflammatory
tinea capitis( BLACK
DOTS)
9) 9 years old presented with common warts over his hands, never
treated before, best 1
st
1- Cryotherapy
MINDMAP PGE 15
viral warts
Pityriasis versicolor
-fungal infx: pityrosporum
-not harmful or passed on through
touching (contagious)
1- +Pityriasis versicolor
2- HSV
3- Molluscum contagiosum
MINDMAP PG 17
FUNGAL INFX
mindma
MINDMAP PG 13
HERPES ZOSTER
MINMD
1- HSV-1
2- Lichen planus
3- Psoriasis
4- +All are true
MINDMAP PG 14.19.21
HERPES simplex,
3- Scabies
4- HIV
5- HBV
Shingles:
-unilateral rash
Body lice:
Mindmap pg 16
Dermatophyte infx (Tinea)
Tinea pedis (Athletes Foot)
most common fungal infx, sharing wash places/ swimming
pool
15) Child presented with patchy hair loss, lesions are scaly. All
are considered in management, except:
Mindmap pg 16
Tinea capitis
1- Topical & oral antifungal
-patchy of red scaly non-scarring hair los
2- +Topical antifungal
-TT systemic (for tinea scalp and nails):
(tinea capitis always systemic treatment)
a) terbinafine (fungicidal)
3- Woods light
b) itraconazole (fungistatic)
c) griseofulvin (DOC tinea capitis)
4- KOH
d) WOODS L: green fluorescent
5- Brother wearing cap is prohibited e) KOH- see hyphae & spores
f) family cannot wear same cap/hats
16) Child presented with patchy hair loss, opening
of hair follicles
can be seen, lesions are scaly. Mostly, the cause of hair loss is:
Mindmap pg 16, 28
Tinea capitis
-patchy of red scaly non-scarring hair los
2- +Tinea capitis
-disease of children
Alopecia arreata:
-non scarring hair loss
17) 50 years teacher presented with generalized
itchy skin. Also his
1- Alopecia areata
wife & son were itching. Which physical finding confirms diagnosis?
1- Excoriation
2- +Rubbery genital nodule
Mindmap pg 31
scabies (Burrows only in scabies)
-after 4-6 weeks, experienced severe itching
-site of burrows: sides of fingers, finger webs, wrist,
nipples& genitals, infancy (affect face)
-On genitals: erythematous rubbery nodules
: family as prescribed. After 6
all
Mindmap pg 3
Dermatology investigations:
Woods light:
-P.versicolor (fungal) golden yellow
-P. rosea (HHV 6&7): clinical dx,
investigations are not normally needed
Papulosquamous disease:
-P. rosea: eruption last 2-10wks (self-limited,
resolves spontaneously)
5- Lichen planus
MINDMAP PG 33,
PEMPHIGOID
-AUTOIMMUNE IgG +
21) All are true about pemphigoid, except: C3 (direct
immunofluorescence)
-elderly
1- Affect elderly
-affect flexures
2- Tense bullae
-good health
3- General health not affected
PEMPHIGUS
4- IgG & C3 deposits along basement membrane
PEMPHIGUS
-poor health
-trunks and
flexures
DERMATITIS
HERPETIFORMIS
-elbow, knees and
buttocks
MINDMAP PG 25
Moderate acne:
papules &pustules
-topical AB, systemic:
AB, ocp,metformin
(PCOS)
Chronic: scars, nodules
and cyst
-isotritenoin
Treatment
is:
ADDISON
-overproduction of ACTH
-generalized or limited to skin folds, creases of
palms, scars and buccal (oral) mucosa
Hunters pg 287
Hunters pg 286
CHLOASMA / MELASMA:
-hypermelanosis on sun exposed skin
-Risk factors: sunlight, pregnancy, estroges &
OCP, scented cosmetics, thyroid dysfx
28) Rash on hands, non-scaly, blanchable, for 6 days all lesions are
persistent:
1- Erythema nodusum (<24hrs)
2- +Erythema multiforme (acrofacial distribution) (1-2 weeks)
3- Urticaria (4-6wks)
Erythema Nodules:
-tender red nodule, URTI can cause it, painful
joints, fever
-tt:
identify and eliminate the cause
bed rest, leg elevation
NSAIDS
Antibiotic
MINDMAP PG 7
REACTIVE ERYTHEMA
2- Staph
31) Child with abdominal pain, red urine, had history of URI, now
has painful non-blanchable nodules, your diagnosis is:
1- +Vasculitis (HSP)
2- Urticaria
3- Erythema nodosum
4- Erythema multiforme
Hunters pg 113
-HSP: small vessel vasculitis, ass with 3P
-painful palpable purpura
-arthritis, abd pain often precede by URTI in
children mostly
MINDMAP pg 18
complications of psoriasis:
arthropathy:
-distal (most characteristic)
-oligoarthritis(most common)
-polyartritis
4- Merkel cell
Slide intro:
granular layer:
1) keratohylin (Ptn)
2) Odland granules (Lipids and hydrolytic
enzymes)
Slide intro:
in prickle cell layer in epidermis:
-desmosomes separation ->
acantholysis
+Desmosomes
EM: MINDMAP PG 7
viral infx (most common):
-Herpes simplex
-Hep a, b , c
URTICARIA
lesions LAST <24 hrs only
EM: 1-2 WEEKS
EN: 4-6 WEEKS
Additions:
-recurrent
-more than 3 mths
-nail involvement
Mindmap alopecia pg 28
5- Renal failure
1- LFT
2- KFT
3- TFT
4- +ANA- for SLE (age of onset 15-45) children and teens
5- CBC
Tt:
topical steroids,
systemic antibiotics,
ointment to lubricate the skin
4- Emollient
51) Using Woods light, the pink color is most likely related to:
1- +Erythrasma
2- Tinea capitis green on hair shaft
3- Tinea pedis -no
4- Pityriasis versicolor golden yellow
Mindmap investigations pg 3
Mindmap rosacea pg 27
*eye-blepharitis, conjunctivitis, keratitis
*rhinophyma
*lymphadema below eyes or forehead
*rebound flare of pustules
Mindmap eczema pg 10
tt: suppressive, topical IMIDAZOLE,
topical LI
HANIM
57) Most common in psoriatic nails:
+Pitting (others: onycholysis, subungual hyperkeratosis, oil
drop sign, splinter haemorrhage)
59) Boy with scalp itching, the cause behind that is:
+Scalp lice-peak between ages of 4 to 11 (ddx: recurrent
impetigo, crusted eczema)
76) Patient with diffuse hair loss and free edges of his nails become
yellow & crumbly with cuticle loss. The least likely diagnosis is:
77) Man with acne, and you want to prescribe him isotretinoin, all
of the following apply, except:
1- His wife reported he had mode change (depression)
2- He may have poor night vision
3- He has to check his lipid profile (hyperlipidemia)
4- He has to decrease exercise (muscle aches)
5- +Tell him that his wife must take contraception
method, because isotretinoin has teratogenic effect
(other S/E: hepatotoxicity, teratogenic, dryness of mm and skin,
hair loss, hearing loss, headache, increase ICP)
78) False about management of scabies:
1- +Dry clean bed sheet with sun heat
2- Treat all family (itching or not)
3- Dry clean clothes with iron heat
4- Treat all body (exclude face; whether itching or not)
5- Will have pruritus even after successful treatment, so given
antihistamine
79) Most common bullous disease:
1-+Bullous pemphigoid
2- Pemphigus vulgaris
3- Dermatitis herpetiformis
1- Drug eruption
2- Cutaneous T cell lymphoma
3- Psoriasis
4- +Erysipelas
85) A patient comes with erythematous swelling over his left leg
with well-defined advancing edge. The other leg is normal. The
most likely causative agent:
1- Staphylococcus aureus
2- +Group A streptococcus
*Here they are talking about Erysipelas indirectly; most common cause is
strep.
1- Topical steroid
2- Topical metronidazole
3- +Topical imidazole, suppressive, topical Li
89) All are treatment for genital warts, except:
1- Imiquimoid
2- Podophyllotoxin
3- Cryotherapy
4- Electrosurgery
5- +Wart paint (for other types of warts)
1- Seborrheic dermatitis
2- +Irritant dermatitis (exogenous)
3- Pompholyx
4- Allergic dermatitis
5- Discoid eczema
95) Adult male came complaining of dry red scaly rash on his
chest & interscapular area for 4 months. How do you treat him?
1- Topical weak steroid
2- Topical potent steroid
3- +Topical antifungal (pityriasis versicolor)
4- Topical antibiotic
Acute: weeping and crusting, blistering vesicles, redness, papules and swelling,
scaling
SYIFAA
113) All are treated by local antifungal, except:
1- Tinea pedis
2- Tinea corporis
3- +Tinea of the nail
4- Tinea mannum
5- Pityriasis versicolor
Acute Eczema
Chronic Eczema
-lichenification
-more likely to fissure
4- Vesicles
5- Bulla
1- Pityriasis versicolor
Blanchable red rash:
2- Pityriasis rosea
-Urticaria
-Erythema Multiforme
3- +Urticaria
4- Psoriasis
5- Lichen planus
116) The most common cause of cuticle loss of the nail is:
1- +Chronic paronychia
2- Alopecia areta
3- Lichen planus
4- Eczema
5- Psoriasis
1- Melanocytes
Hunter
2- +Keratinocytes
th
4 Edition
3- Langerhans cells
4- Merkel cells
1- Thyrotoxicosis
Chapter 13
2- +Lichen planus
Hunter
3- Psoriasis
4th Edition
4- Local trauma
Causes of onycholysis:
-fungal infection
5- Fungal infection
2- Diabetes mellitus
th
4 Edition
3- Leprosy
4- Cutaneous vasculitis
11.Pregnancy
12. Drugs
1- Herpes zoster
2- Herpes simplex
3- +Insect bites
4- Discoid lupus erythromatosus
5- Urticaria
Pg. 35
1- +Papule
Chapter 3
Hunter
2- Patch
4th Edition
3- Macule
4- Plaque
5- Nodule
Elevation, solid
Papule
Plaque (w/o substantial depth)
Macule
Patch
Vesicles
Bulla
Pustule
Abscess/Furuncles
Petechiae (pinhead)
Ecchymosis
Haematoma
Angioedema
Extravasation of blood
into skin
Accumulation of
dermal edema
123) All the following can be detected with direct immunefluorescence, except:
Pg. 121
Chapter 9
1- Pemphigus vulgaris
Hunter
4th Edition
P. Vulgaris: intercellular epidermal deposits
2- Bullous pemphigoid
4- Cutaneous vasculitis
5- Discoid lupus erythromatosus
Pg. 71
Chapter 6
Hunter 4th
Edition
1- Pityriasis rosea
2- Lichen planus
3- Psoriasis
4- Nummular eczema
5- +Erythema multiforme
-psoriasis
-pityriasis rosea
-lichen planus
-pityriasis rubra pilaris
-parapsoriasis and premycotic eruption
-pityriasis lichenoides
-discoid lupus erythematosus => C10
-fungus infection => C16
-seborrheic and nummular discoid eczema => C7
-secondary syphilis => C16
1- Atopy
2- +Thyroid disease
3- Downs Syndrome
4- Ophiasiform type
Pg. 162,
Chapter 12
Hunter 4th
Edition
-blood vessels
-sweat glands (eccrine, apocrine)
Pg. 13
Chapter 2
Hunter 4th
Edition
1- Hemidesmosomes
2- Desmosomes
3- Keratohyalin granules
Odland granules contains lipids & hydrolytic enzymes
-lipid cements between corneocytes provides barrier
-hydrolytic enzymes dissolve lipid leading to desquamation
of old corneocytes
4- +Odland granules
-dendritic
Chapter 2
Hunter 4th
Edition
1- Non-dendritic cell
-synthesis melanin
Merkel cells:
-transducer for fine touch
-non-dendritic at basal layer of epidermis
-has desmosomes
1- Retinoids
Chapter 5
2- Cyclosporine
-Retinoids
Hunter
3- Mycofenolate Mefotil
-Methotrexate
4- +Steroids
-Ciclosporin
th
4 Edition
-PUVA
1- +Colophony
Chapter 7
Hunter
2- Cobalt
Colophony:
Colophony:
th
4 Edition
131) History of patchy hair loss with -ve Wood's light test, spores
are visible inside hair shaft by KOH. Most appropriate treatment:
Pg. 251
Systemic treatment:
Chapter 16
Hunter
1- Local antifungal
2- Oral fluconazole
4th Edition
3- +Oral griseofulvin
4- Antibiotics
Pg. 192
Chapter 13
Hunter
2- Topical antifungal
3- If culture is +ve for candida, give a course of itraconazole
4- +A course of systemic antibiotics
133) History typical for rosacea with red eyes, most appropriate
treatment for the eyes:
Pg. 172
Chapter 12
Hunter
Erythromatotelangiectatic type:
1- Isotretinoin
1-
2-
3-
4-
5-
2- +Metronidazole
6-
th
4 Edition
3- Topical chloramphenicol
Phymatous type:
1-
Ablative lasers
2-
Electrosurgery
Ocular type:
Oral doxycycline, Artifical
tears, Lid cleansing
Topical metronidazole
Topical azeleic acid
Decrease flushing
Cover-up makeup
Colour-correcting gels
(green)
Pulsed dye laser and intense
pulsed light
Papulospustular type:
-Combination of topical agent
with oral antibiotic
-Topical metronidazole
-Topical azeleic acid
-Topical sulfacetamide/sulfur
-Oral tetracyclines
Functions:
1- Keratinocytes
1.
2.
3.
4.
5.
Hunter
2- Melanocytes
4th Edition
3- Langerhans cell
4- Merkel cell
5- +Fibroblasts
135) Elevated skin lesion, less than 0.5 cm, filled with fluid is called:
Pg. 35
Chapter 3
1- Papule
Hunter
4th Edition
2- Macule
3- +Vesicle
Elevation, solid
Papule
Plaque (w/o substantial depth)
Macule
Patch
Vesicles
Bulla
4- Bulla
Pg. 281
Chapter 19
Hunter
4th Edition
1- Pernicious anemia
2- Hypothyroidism
-DM
-thyroid disorders
-pernicious anemia
-Addisons => decrease melanocytes in hair bulbs (white hair)
3- Addison's disease
4- DM
5- +IDA
4 Edition
-autoimmune disease
-elderly
-no precipitating factors
Pg. 121
Chapter 9
Hunter
4th Edition
139) 17 years old male with history of pustules, comedons and papules
over the face and shoulder. Most appropriate investigation:
Acne:
Pg. 166
Chapter 12
Hunter
1- Lipid profile
2- Liver function
th
4 Edition
3- CBC
140) Adult male with history of brown macules and patches in the
groin, well-defined wrinkled with fine sales. The patient is diabetic.
Most likely diagnosis:
Erythrasma: Overgrowth of aerobic diphtheroids
Pg. 221
Chapter 16
Hunter
4th Edition
1- Atopic eczema
2- Seborrheic dermatistis
3- Psoriasis
4- +Erythrasma
1- Burrows
2- +Excoriations
Scabies:
-Sarcoptes scabiei Hominis
-transferred from person to person by CLOSE BODILY CONTACT
-itchiness
Management of scabies:
Chapter 17
Hunter
-ordinary laundry
-mites die in unworn clothes for 1 week
4th Edition
143) A child with history of skin rash covering the trunk mainly and
consisting of papules, vesicles and pustules. His sister developed
the same rash 2 weeks ago. The most important complication of this
condition involves:
1- +Lung
Pg. 239
Chapter 16
2- CNS
Hunter
4th Edition
3- GIT
4- Kidney
Pg. 179
Chapter 13
Hunter
1- Kerion
2- Carbuncle
th
4 Edition
3- +Androgenic alopecia
4- Lichen planus
Pg. 10
Chapter 2
Hunter
th
4 Edition
Pg. 10
Chapter 2
Hunter
4th Edition
Pg. 39
Chapter 3
Hunter
1- Eczema
2- Herpes simplex
th
4 Edition
3- +Vasculitis
4- Disciod lupus
148) A child with history of URI with abdominal pain and red urine
and palpable skin rash on legs and buttock, most likely diagnosis:
Pg. 113
Chapter 8
1- Erythema multiforme
Hunter
2- Erythema nodosum
th
4 Edition
3- +Vasculitis
4- Eczema
149) 14 years old girl presented with skin rash, one of the following
doesn't occur in urticaria:
-non scaly
Pg. 104
Chapter 8
Hunter
th
4 Edition
Urticaria:
-blanchable
1- Impetigo
Ecthyma:
-ulcers forming under a crusted surface infection
2- +Ecthyma
3- Boil
1- Nickel
2- +Colophony
4th Edition
3- Cement
The main cells of the dermis are fibroblasts, but there are
1- Lymphocytes
Pg. 19
Chapter 2
Hunter
4th Edition
2- Keratinocytes
3- +Fibroblasts
4- Microphages
Pg. 108
Chapter 8
1- Hepatitis B
and bacteria.
Hunter
5th Edition
2- Malignancy
3- +DM
4th Edition
155) A patient with scaly lesion, violacous in color, all are true
about the disease except:
Pg. 72
Chapter 6
Hunter
4th Edition
Lichen Planus:
-violaceous/lilac coloured
-intensely itching
Erythrasma:
-Overgrowth of aerobic diphtheroids
Pg. 221
Chapter 16
Hunter
4th Edition
Pg. 41
2- Pemphigoid
Chapter 3
Hunter
4th Edition
3- HSV
4- VZS
5- +Tinea corporis
Pg. 163
Chapter 12
Hunter
4th Edition
1- +Sebum
2- Obstruction of pilosebaceous duct
3- Propionibacterium acnes
4- Cosmetics
http://www.
drugs.com/di
sease-
interactions/t
etracycline.ht
ml
1- Tetracycline
2- +Doxycycline
3- Monocycline
1- Desmin
2- Keratin
4th Edition
3- +Involucrin
1- CXR
2- Continue insulin injection
Hunter
4th Edition
3- IV penicillin injection
4- +NSAID injection
4th Edition
Hunter
4th Edition
3- Ability to differentiate
*Stem cells are found in 3 places: bulge of hair, basal layer, & outer root
sheath of hair. They have ability to differentiate & have unlimited
capacity to renew themselves.
Acute paronychia
-staphylococci
-formation of pus in the nail fold or under the nail
-systemic treatment with flucloxacillin, cephalexin or erythromycin
-surgical drainage
-recurrent acute paronychia: herpes simplex virus infection.
--Notes:
*Tinea corporis:
days-weeks, itchy, unilateral, expanding scale with central clearing.
*Pityriasis rosea:
2-10 weeks, asymptomatic or itchy, mother plaque then few days
the rest of the oval plaques, well-defined.
*Psoriasis:
years, well defined, symmetrical, salmon coloured plaques,
silver scales.
*Lichen planus:
1-2 years, symmetrical, purple flat topped papules, wickham's stria,
well defined, volar wrists and feet, very itchy, leaves brown patches
after healing.
*Pityriasis versicolor:
few weeks-months, asymptomatic or slightly itchy, fine
scales, relatively well defined or well defined.
--Nail changes:
*Psoriasis:
pitting, oil spots, splinter hemorrhage, subungual hyperkeratosis,
onycholysis.
*Lichen planus:
most common (nail thinning), most specific (pterygium), longitudinal
ridging.
*Chronic paronychia:
loss of cuticle, crumbling, yellow discoloration, subungual
hyperkeratosis, ridging, tender swollen nail folds.
--Hypersensitivity reactions:
Pg. 28
Chapter 2
Hunter
4th Edition
Pg. 10
Chapter 2
Hunter
4th Edition
Hunter
4th Edition
Pg. 13
Chapter 2
Hunter
4th Edition
IRA
6. Scales
indicate
problem
in
which
layer?
(scalessecondary lesions, a flake arising from the horny layer,
seen in psoariasis, lichen planus, from mind map)
A. +Basal layer single layer, columnar, here the normal skin mitosis
happens
B. Granular layer containing two types of granules, keratohylin and
odland granules
C. Prickle cell layer spinous, squamous, several layers of cells, tightly
boundedby desmosomes---any prob : acantholysis (pemphigus)
7. All of the following are recognized causes of generalized pruritis,
except:
(hunter, page 323)
Genelized pruritis can be caused by (1) liver disease (2) CRF (3)
iron deficiency (4)Polycythermia (5)thyroid disease (6)diabetes
(7)internal malignancy like Hodgkin disesase (8) neuro like MS and
neurofibromatosis
(9)
diffuse
scleroderma
(10)
elderly
(11)pregnancy (12) drugs
A. Myelodysplasia
B. Hodgkins lymphoma
C. Cholestatic jaundice
D. +Systemic lupus erythematosus
8. An 8 year old boy has yellowish crusted lesions around his mouth.
His mother has asthma and is on inhaler. Which of the following is
used to treat the child? (hunter page 222, case of impetigo)
A. Topical moisturizer
B. Topical steroid
C. +Topical antibiotic
9. A car mechanic is susceptible to which of the following?
A. +Allergic contact dermatitis delayed type 4 HSR,most common to
cause ACD is nickel
B. Irritant contact dermatitis most common type of contact dermatitis
C. Atopic dermatitis exuberant production of IgE occur as a response
to common environmental allergen(hygiene hypothesis)
10. Which of the following is a type IV hypersensitivity reaction?
18. A 42 year old female came with erythematous cheeks. She used
topical steroid creams which helped a little. Her history reveals
bilateral knee pain related to osteoarthritis. Which of the following
is the best to do to reach the diagnosis?
A. Anti-dsDNA
B. +Clinical evaluation (history and examination)
C. Urine metabolites
*not sure about the diagnosis but it could be erythrodermic psoariasis,
due to previous history of topical steroid use, which could be a
treatment for preexisting psoariasis (hence the osteoarthritis)
(HUNTER page 59)
19. A 67 year old male patient has hemorrhagic bullae. He has been
having several skin lesions and went to many doctors and was told he
has late-onset atopic dermatitis resistant to treatment. He has
hypertension and diabetes. Which of the following is false regarding
his condition?
*hemorrhagic bullae differential diagnosis necrotizing fasciitis,
scalded skin syndrome, herpes zoster, bullous pemphigoid,
pemphigoid vulgaris, contact dermatitis
A. His prognosis is good
B. +Indirect immunofluorescence is essential for diagnosis
C. Oral steroids should be prescribed
D. Coagulation profile will be normal
20. A patient who had dental extraction 10 days ago came to you with
non-scaly red rash distributed over the face, trunk and extremities.
Its itchy, appears to almost disappear during the day but recurs at
night. He was on ibuprofen and erythromycin for the last 5 days,
and the rash started 1 day after he stopped them. He didnt have
any problem with these medications before. The rash is blanchable on
diascopy. Which of the following is the likely cause?
A. Reaction to local anesthetic (type 1 hypersensitivity)
B. +Reaction to ibuprofen (other drug that can cause urticarial are aspirin,
nsaids, ACE inhibitor, morphine)
C. Reaction to erythromycin
D. Dental infection
21. An 8 year old female has recurrent impetigo and furunculosis.
She is otherwise normal with no important past history. What is the
27. A 30 year old female who has given birth to a boy 4 months
ago. She has diffuse hair loss. She remembers she was admitted to
the hospital before delivery and received anticoagulation. What is
the likely cause of hair loss?
A. +Telogen effluvium
B. Anticoagulation
C. Alopecia areata
D. Androgenetic alopecia
Telogen effluvium *triggered by (1) bouts of fever (2) hemorrhage (3)
childbirth (4) severe diet.
28. A 12 year old has three patches of hair loss for 2 weeks. On
examination the lesions are non-scaly with visible open hair
follicles. What is true regarding this condition?
*visible open hair follicle means non scaring
*case of alopecia areata
A. +Topical steroid cream can be used for treatment high potency
B. He should not go to school because its infectious
C. Oral antifungals should be started
D. Woods light can be used to show yellowish lesions
29. Very similar case as above (alopecia areata). Which is true?
*cause : immune basis, asso with automimmune thyroid disease,
vilitgo, atopy,inherited (HLADQ3, DR11, DR4) , can also be
triggered by environmental factors
A. KOH can be used for diagnosis
B. +Its non-infectious
C. He shouldnt go to school
30. Regarding scabies, which is true?
A. +All family members should be treated even if they are asymptomatic
B. Its caused by brief close contact
C. Can be transmitted from humans to animals but not vice versa
*treatment of scabies: permethrin, malathion. Second application is a
week after the first (mind map)
30.
A 17 year old who has bilateral facial lesions including
comedones, pustules and papules. What is the best treatment?
*this is moderate acne (pustules, papules). Treatment is well
listed in mind map (:
A. Topical antibiotics
B. Oral isotretinoin
(severe cases)
C. +Oral doxycycline with topical retinoids
D. Topical retinoids only
38. A patient with ulcerative lesion on the right side of the face,
rolled-edges, and visible telengectasia. Which of the following is true?
(HUNTER page 301)
case of basal cell carcinoma, with nodulo-ulcerative presentation(most
common type) which includes glistening translucent lesion, umbilicated,
skin colored papule that slowly enlarge, central necrosis, ulcer with rolled
edge and adherent crust and coarse telangiectatic vessel running across
tumor surface.
A. +Lesions should be biopsied prior to treatment
B. You should look of metastasis to internal organs
C. Radiotherapy is used in treatment (used if
surgery is contraindicated)
D. Cryotherapy should be used first, if failed the lesion is biopsied
39. An old man diabetic who had vesicles and bullae on the inferior
surface of the big toe. What is used to confirm the diagnosis?
*herpes zoster. Incidence increase in weaken normal defense
mechanismold age, hodgkins, AIDS, leukemia
A. Tzanck smear
B. +Patch test
C. KOH microscopy
D. Woods light
40. Which of the following is not regulated by the autonomic
nervous system?
A. Eccrine sweat glands
(HUNTER pg 173)
B. Apocrine sweat glands
(HUNTER pg 176)
C. Arrector pili muscle
D. +Sebaceous gland
E.
Superficial
venous
plexus
*serbaceous glands stimulated by androgenic hormones (HUNTER page
162)
41. Tzanck smear is used to investigate for:
A. +Herpes zoster (multinucleated giant cell)
*tzank smear also for pemphigus (acantholysis) ---from mind map
42. A patient had a red scaly plaque on his right flank. 3 days later
many smaller lesions appeared on his trunk. The face and
extremities are spared. He says he had similar condition previously
that resolved in 6 weeks. Which of the following is false?
*case of psoriasis (guttate) (HUNTER pg 57)
A. The diagnosis is likely the same as his previous condition because it can
recur
B. +Oral acyclovir can speed up recovery because Herpes is the
causative agent
C. No need to take precautions in the family because its not infectious
D. Topical antifungals are not useful in treatment
E. Sun exposure may be beneficial considering the distribution of the rash
43. A female who has bilateral leg nodules, fever of 38 C and feels
weak in general. She takes oral contraceptives. Which of the following
is false?
*case of erythema nodosum
A. She should have a throat swab
B. OCPs might be the cause
C. Treated by NSAIDs, and if not effective by steroids
D. +Treated by oral antibiotics, and if not effective by IV antibiotics
(HUNTER pg 113 : systemic steroids usually not needed)
44. Female, takes oral contraceptives, has left leg swelling, fever.
The leg is tender to touch. Whats your next step?
*case of erythema nodosum (HUNTER pg 113)
A. CBC, throat swab,CXR
B. Coagulation profile
C. Skin bacterial swab
D. Admission and IV antibiotics
45. A patient who has multiple skin-colored rough lesions on his hand.
Some lesions have black central head (case suggestive of warts).
*blackness caused by capillary thrombosis, a sign of healing (HUNTER
pg 237)
Whats the first line treatment?
A. +Salicylic acid paint
B. Cryotherapy
C. Cautery
*wart paint contraindicated in facial wart, anogenital wart and adjacent
eczema
46. A child who has recent viral infection comes with palpable
nonblanchable rash on the lower extremities (very obvious).
Whats the diagnosis?
*red non scaly rash divided into 2, blonchable (reactive erythema)
and non blanchable (hemorrhage and vasculitis)
A. +Vasculitis
48. Which of the following has predilection for the distal part of the
nail?
A. Paronychia proximal and lateral nail folds
B. Lichen planus longitudinal grooves, ptyrigium
C. +Onychomycosis
D. Alopecia areata
E. Psoriasis thimble pitting, onycholysis, subungual hyperkeratosis
49. A female patient who started having growth of terminal hair on
the chin and presternal area with deepening of the voice and
breast atrophy. Her menstrual cycle started becoming less
frequent. You should do all the following investigations, except:
*Polycystic ovarian syndrome, (HUNTER page 166) characterized by
elevated testosterone, androstenedione and dehydroepiandrosterone
sulphate levels, a reduced sex hormone binding level and a LH;FSH
ratio greater than 2.5:1
A. +Serum cortisol
B. Androstendione
C. Testosterone
D. Ultrasound for the ovaries
E. CT abdomen for adrenal glands
50. Well-defined scaly lesion on the extremities in middle to old age:
(HUNTER page 99) limbs of mid aged males, multiple lesion, coin
shaped, vesicular or crusted, itchy plaques, less than 5cm across
A. +Discoid eczema
51. A case of red scaly rashes. What is the most important to look
for on examination?
A. +Margins if its ill definedmost likely eczema! (refer to the beautiful
mind map)
B. Distribution
C. Diascopy
Plaque