Archives: Medical Student Finals

MSFinals-0720

A 28-year-old man who has been experiencing a lot of stress at work lately presents with an itchy, red rash above the right corner of his mouth. The rash appeared 4 months ago, went away briefly, and then returned. He has used a topical corticosteroid to alleviate the symptoms, but had to discontinue it due to a flare-up of his facial acne. He admits to drinking excessive amounts of alcohol recently. On examination, there is a poorly defined red rash on the right side of his face, affecting the nasolabial fold. Additionally, there are fine, oily scales present.

What is the most probable diagnosis?

MSFinals-0721

A 38-year-old man comes to his primary care clinic complaining of an itchy rash on his arm. During the examination, you observe polygonal, violaceous papules on the inner part of his forearm. Some of these papules have merged to form plaques. He has no history of skin disorders and is not presently taking any medications.
What is the most probable diagnosis?

MSFinals-0722

A 6-month-old infant has been diagnosed with diaper rash. What is the best course of action for treating a mild case of diaper rash?

MSFinals-0723

A 42-year-old Irish man presents to the Dermatology clinic with a 3-cm pigmented lesion on his right shin. He also has a Fitzpatrick skin type 1. The lesion appears macular and contains three different shades of pigment. What is the most crucial next step?

MSFinals-0724

A 75-year-old male presented with numerous blisters on his trunk and limbs. Linear IG deposits were observed along the basement membrane in direct immunofluorescence studies. What is the most probable diagnosis?

MSFinals-0725

A 50-year-old woman presents with multiple large, ruptured, eroded plaques on her upper arm, scalp and groin, along with an ulcerated blister on the mucosa of her lower lip. The cause is determined to be pemphigus vulgaris, with the pathogenesis of the disease attributed to IgG autoantibodies against which protein?

MSFinals-0726

A 72-year-old retired farmer has switched his General Practitioner (GP) and comes in for a check-up. During the appointment, he asks for a review of several lesions on his forehead.

Upon examination, he is bald and has multiple scaly, crusted lesions on his mid-frontal scalp, along with a keratinous horn with a smooth base on the helix of his right ear. He mentions that he had similar lesions on his scalp before. These were treated with a cream that made the lesions worse for four weeks before completely resolving when the treatment was finished.

What is the most probable diagnosis?

MSFinals-0727

A 35-year-old woman with uncontrolled psoriasis is returning with deteriorating symptoms. Despite using potent topical treatments, her psoriasis remains uncontrolled.

What is the next appropriate step in managing her condition?

MSFinals-0728

A 58-year-old man comes to the clinic for his regular follow-up of psoriasis. He had been managing it well with phototherapy six months ago, but recently his condition has worsened. He is currently using topical calcipotriol (Dovonex), topical coal tar ointment, and topical hydromol ointment, and is taking amoxicillin for a recent respiratory infection. He is in good health otherwise.

During the examination, he has an erythematosus rash that covers most of his torso, with widespread plaques on his limbs and neck. The rash is tender and warm, and he is shivering. There are no oral lesions. His heart rate is 101 bpm, blood pressure is 91/45 mmHg, and temperature is 37.7 °C.

What is the most crucial next step in treating this man?