Archives: MRCP Part 2

MRCP2-0988

A 23-year-old female presents with a six-week history of generalized pruritus. She reports that the itching has worsened over time and is particularly bothersome at night. She denies any history of rashes or taking prescribed medications. She has no known allergies and has been in good health otherwise. The patient lives with her boyfriend and drinks approximately 12 units of alcohol per week, occasionally smoking cannabis. On examination, there are scratch marks on her shoulders and back, and erythema is present between her fingers. Cardiovascular, respiratory, and abdominal examinations are unremarkable. What is the most appropriate therapy for this patient?

MRCP2-0989

A 19-year-old male college student arrives at the emergency department complaining of severe itching. He has been experiencing worsening itching on his hands and arms for the past three months since moving into a dormitory with two other students. Despite taking over-the-counter chlorphenamine, the itching has become progressively worse and unmanageable. He has no medical history and does not take any regular medications. As an economics student, he has not been exposed to any chemicals. Upon examination, linear burrows are visible on the sides of some of his fingers on both hands, and there is evidence of excessive scratching, but no signs of infection. The doctor prescribes permethrin 5% as treatment. What instructions should be given for its application?

MRCP2-0990

A 68-year-old man presents to the medical clinic with ongoing itching despite treatment for scabies prescribed by his GP two weeks ago. His daughter assisted with the treatment, which included two sessions of permethrin 5% and washing of clothes and bed sheets at high temperature. The patient has a history of heart failure, ischaemic heart disease, and dementia and lives with his daughters. On examination, burrows with track marks are visible on his fingers. What is the best course of action?

MRCP2-0991

A 28-year-old woman presents with a facial rash that has been present for a few weeks. The rash appears erythematous, greasy, and has a fine scale on her cheeks, nasolabial folds, eyebrows, nasal bridge, and scalp. What is the probable diagnosis?

MRCP2-0992

A 68-year-old man comes to the dermatology clinic for evaluation of a suspicious skin lesion. He has noticed that a particular mole has been irritated and rubbing against his shirt. On his back, there is an 11x13mm brown lesion with an irregular border and variation in color. Upon examination with a dermatoscope, there is no telangiectasia, and the lesion appears to have dark pigmented pinprick spots within the brown lesion. What aspect of this description provides reassurance that the diagnosis is more likely to be benign?

MRCP2-0993

An 80-year-old man comes to the Dermatology Clinic with a progressively worsening erythematous rash that has developed over the past six months. The rash appears as concentric erythematous bands, similar to the rings found on a tree trunk. He has a persistent cough, likely due to his history of smoking, which he quit 25 years ago, and underwent surgery for an inguinal hernia five years ago. What is the most probable malignancy underlying his symptoms?

MRCP2-0994

What is the most accurate way to describe a raised lesion measuring 6 cm in diameter that appears erythematous and scaly upon skin examination of a patient with a rash?

MRCP2-0995

How would you describe the multiple, small, raised, slightly dome-shaped lesions containing purulent material observed during a skin examination of a patient?

MRCP2-0996

A 70-year-old man with non-Hodgkin’s lymphoma, currently in remission, was admitted with pneumonia. He was given tazocin intravenous (IV). Three days later, he developed an erythematous maculopapular rash all over his body.

The following day, a trainee nurse urgently calls you to the ward as she noticed that his skin was ‘peeling off’ as she was turning him over. Upon arrival, you see him in a pool of fluid, with large areas of skin loss and other regions of dusky skin necrosis. His conjunctivae are red, and his mouth has multiple blisters.

What is the most probable underlying pathophysiology of this mucocutaneous drug reaction?

MRCP2-0980

A 25-year-old healthy man comes to the Dermatology Clinic for a follow-up appointment. He has been using topical topical adapalene and benzoyl peroxide with oral doxycycline for moderate acne vulgaris for 8 weeks. On evaluation, it seems that his acne has not improved and is at risk of scarring. He has no significant medical history. His BMI is 23 kg/m2.
Before escalating this patient’s treatment to include oral isotretinoin, what is the first step to take?