Archives: MRCP Part 2

MRCP2-0978

A 50-year-old male from Afghanistan comes to the clinic with a rash covering his entire body. He explains that the rash started as several small, light-colored spots that were not raised or rough. Over time, they have developed into plaques, and some have even become nodular. The patient reports no other symptoms, and his medical history is notable only for a previous case of visceral leishmaniasis that was successfully treated in his home country five years ago.

What is the probable underlying diagnosis for this patient’s condition?

MRCP2-0979

A 35-year-old man visits the Dermatology Clinic with a complaint of persistent cracking of the skin at the corners of his mouth. He adheres to a strict vegetarian diet.
What is the most probable reason for his skin changes?

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?

MRCP2-0981

A 27-year-old male patient complains of a solitary, painless, hardened sore on his penile shaft that has been present for one week. He also reports feeling several small, painless lymph nodes in his groin area on both sides. The patient admits to having had unprotected sexual intercourse with a prostitute three weeks before seeking medical attention.

What laboratory tests can be done to confirm the diagnosis?

MRCP2-0951

A 25-year-old man presents to the Dermatology Clinic with severe acne and is feeling quite distressed about it. He has a history of asthma and has been treated with doxycycline in the past. He is currently using a topical retinoid and benzoyl peroxide. You are considering starting him on oral isotretinoin therapy.
What is the most crucial step to take before initiating isotretinoin in this patient?

MRCP2-0952

Which patient meets the NIH criteria for a diagnosis of neurofibromatosis type 1?

MRCP2-0953

A 70-year-old woman comes to the clinic with her son. Her son is worried about her because he has recently had shingles and is concerned that she may catch it from him. He asks if she can receive a shingles vaccine. The patient is in good health and has no signs of a rash. She has a medical history of diet-controlled type 2 diabetes, high cholesterol, and a previous stroke without any residual weakness. She also had a hip fracture that was repaired with hemiarthroplasty. Her regular medications include aspirin, atorvastatin, and paracetamol.

The patient recalls having chickenpox as a child but is unsure if she has ever had shingles or a shingles vaccine. What is the best course of action?

MRCP2-0954

A 23-year-old woman with a history of persistent back acne that has not responded to topical treatments or oral antibiotics presents to the Dermatology Clinic for evaluation. She has no prior psychiatric history and has researched isotretinoin as a potential treatment option. She is not sexually active at this time.

What is the most suitable course of action to take next?

MRCP2-0955

A 46-year-old female presents to your clinic with widespread lesions on her lower limbs. She reports that it started as a small bump on her left shin which then turned into an ulcer. Over the past year, she has developed numerous ‘cauliflower-like’ growths all over her body. During examination, you observe a painless ulcer with a scab on the anterior left shin, as well as papillomas on her face, trunk, genitalia, and buttocks.

Based on the following test results, what is the most probable diagnosis?

TPHA (Treponema pallidum Haemagglutination test) Positive

MRCP2-0956

A 35-year-old woman presents to the emergency department with a painful rash on her left arm. The burning pain preceded the rash formation and she has been feeling low in energy. The rash is tender to light touch and measures approximately 8 cm in length with small vesicles. Her medical history includes appendicitis at 18 and depression for which she is receiving cognitive behavioural therapy. Upon diagnosis of shingles, she is concerned about infecting others with chickenpox and asks how long she will be contagious. What is the appropriate advice to give her?