00
Correct
00
Incorrect
00 : 00 : 00
Session Time
00 : 00
Average Question Time ( Secs)
  • Question 1 - In Psoriasis, the following is true with regards to topical treatment: ...

    Incorrect

    • In Psoriasis, the following is true with regards to topical treatment:

      Your Answer:

      Correct Answer: Topical corticosteroid associated side effects include striae, atrophy of the skin, telangiectasia, acneiform rash, and easy bruising

      Explanation:

      Topical treatments are useful in the treatment of mild Psoriasis, or as adjuvant therapy in ultraviolet and systematic treatments. These treatments include moisturisers, dithranol, coal tar, salicylic acid, topical immunomodulators such as calcineurin, topical retinoids, Vitamin D analogues and topical steroids. Topical steroids are known to have a number of side effects such as striae, atrophy of the skin, telangiectasia, acneiform rash, and easy bruising. Localised pustular psoriasis is also associated with topical steroids in higher doses. Use of more than 500 g of hydrocortisone or 50 g clobetasol propionate have been shown to suppress adrenal function. Calcitriol, a vitamin D analogue, is only available as an ointment and does not stain clothes and skin the way dithranol and coal tar are known to.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 2 - Which of the following is true regarding erythema nodosum? ...

    Incorrect

    • Which of the following is true regarding erythema nodosum?

      Your Answer:

      Correct Answer: It is associated with streptococcal infections

      Explanation:

      Erythema nodosum (EN) is an acute, nodular, erythematous eruption that usually is limited to the extensor aspects of the lower legs. Chronic or recurrent erythema nodosum is rare but may occur.Currently, the most common cause of erythema nodosum is streptococcal infection in children and streptococcal infection and sarcoidosis in adults.The eruptive phase of erythema nodosum begins with flulike symptoms of fever and generalized aching. Arthralgia may occur and precedes the eruption or appears during the eruptive phase. Most lesions in infection-induced erythema nodosum heal within 7 weeks, but active disease may last up to 18 weeks. In contrast, 30% of idiopathic erythema nodosum cases may last more than 6 months. Febrile illness with dermatologic findings includes abrupt onset of illness with initial fever, followed by a painful rash within 1-2 days.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 3 - A pregnant woman with atopic eczema and asthma, who has a 5-year-old child...

    Incorrect

    • A pregnant woman with atopic eczema and asthma, who has a 5-year-old child with moderately severe eczema, requests advice about reducing the risk of eczema in her unborn child. Select the MOST appropriate advice from the following:

      Your Answer:

      Correct Answer: Removing certain known food allergens from the mother's diet during pregnancy does not reduce the risk or prevent the onset of atopic eczema

      Explanation:

      Nonspecific triggers of inflammation in patients with atopic dermatitis may include physical or chemical irritants. The following simple measures should be followed in daily life to reduce the frequency and severity of irritant-induced atopic dermatitis flares :Skin care products that contain alcohol and astringents should be avoided.New clothes should be laundered before use to remove formaldehyde and other chemicals.Liquid detergents are preferred over powder detergents for laundering clothes, as liquids are easier to rinse out. A second rinse cycle may also improve removal of residual detergent.Patients should shower immediately after swimming in chlorinated pools and should subsequently apply moisturizer.Fragrance-free skin products that are hypoallergenic or made for sensitive skin may be less irritating than other kinds of skin products.Prenatal and postnatal probiotic supplementation may be helpful in preventing the development of atopic dermatitis in young children. In a 2008 meta-analysis, the most commonly studied probiotic was Lactobacillus rhamnoses GG. Larger, randomized controlled studies are needed to confirm these initial findings.Breastfeeding during the first 4 months of life may reduce the incidence and severity of childhood atopic disease but only modestly and only in those at high risk.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 4 - What is the cause for tinea incognito? ...

    Incorrect

    • What is the cause for tinea incognito?

      Your Answer:

      Correct Answer: Inappropriate treatment with steroid cream

      Explanation:

      Tinea incognitoƄ is a term used to describe a tinea infection modified by topical steroids. It is caused by prolonged use of topical steroids, sometimes prescribed as a result of incorrect diagnosis. Topical steroids suppress the local immune response and allow the fungus to grow easily. As a result, the fungal infection may take on the bizarre appearance seen in this patient.The diagnosis of tinea incognito is simple to confirm by microscopic visualization of branching hyphae and spores typical of dermatophytes in a potassium hydroxide preparation.Treatment of tinea incognito requires cessation of all topical steroid use and implementation of specific antifungal treatment. A low-potency corticosteroid may be used briefly to avoid the flare often associated with abrupt cessation of a potent steroid. Patients should be warned of this possibility so they do not reinstitute use of topical steroids on their own.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 5 - A 16-year-old girl presents to the dermatologist due to an appearance of an...

    Incorrect

    • A 16-year-old girl presents to the dermatologist due to an appearance of an odd patch of skin on her left thigh which has developed over a period of two weeks. Physical examination reveals a firm, slightly indurated pale area of skin with an erythematous border on the upper thigh. the lesion has a glazed appearance and is rather atrophic. From the options provided below, which one is the most likely diagnosis?

      Your Answer:

      Correct Answer: Morphoea

      Explanation:

      Morphea, also known as localized scleroderma, is a disorder characterized by excessive collagen deposition leading to thickening of the dermis, subcutaneous tissues, or both. Morphea is classified into circumscribed, generalized, linear, and pansclerotic subtypes according to the clinical presentation and depth of tissue involvement. Unlike systemic sclerosis, morphea lacks features such as sclerodactyly, Raynaud phenomenon, nailfold capillary changes, telangiectasias, and progressive internal organ involvement. Morphea can present with extracutaneous manifestations, including fever, lymphadenopathy, arthralgias, fatigue, central nervous system involvement, as well as laboratory abnormalities, including eosinophilia, polyclonal hypergammaglobulinemia, and positive antinuclear antibodies.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 6 - A neonate was brought in by her mother, for a skin lesion present...

    Incorrect

    • A neonate was brought in by her mother, for a skin lesion present over the neonate's back which is bluish in colour, but otherwise asymptomatic. The most appropriate course of action will be?

      Your Answer:

      Correct Answer: Reassure

      Explanation:

      A Mongolian spot can be present in new born babies which usually appears over the back and fades with time. There is nothing to worry about.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 7 - A 10-year-old African girl undergoes an open appendicectomy. While being reviewed for an...

    Incorrect

    • A 10-year-old African girl undergoes an open appendicectomy. While being reviewed for an unrelated problem ten months later, the wound site was found to be covered by a shiny dark protuberant scar tissue that projects beyond the margins of the skin incision. Which of the following best describes this skin lesion?

      Your Answer:

      Correct Answer: Keloid scar

      Explanation:

      The skin lesion described is the typical presentation of a keloid scar.Keloid scars extend beyond the limits of the incision.Note:Surgical wounds are either incisional or excisional and either clean, clean-contaminated or dirty. The main stages of wound healing include:- Haemostasis:It occurs minutes to hours following injury. It is characterised by the vasospasm in adjacent vessels, platelet plug formation and generation of fibrin rich clot.- Inflammation: It occurs typically 1-5 days after the injury. Neutrophils migrate into the wound (this is often impaired in diabetes). Growth factors, including basic fibroblast growth factor and vascular endothelial growth factor, are released in this phase. Fibroblasts replicate within the adjacent matrix and migrate into wound, while macrophages and fibroblasts couple matrix regeneration and clot substitution.- Regeneration: It occurs typically between 7-56 days after the injury. The factors that stimulate this phase are platelet-derived growth factor and transforming growth factor. They stimulate fibroblasts and epithelial cells. Fibroblasts produce a collagen network. Furthermore, they cause angiogenesis and thus wound healing.- Remodelling: This is considered the longest phase of the healing process and may last up to one year (or longer). During this phase, fibroblasts become differentiated (myofibroblasts), and these facilitate wound contraction. Collagen fibres are remodelled, and microvessels regress, leaving a pale scar.Clinical correlation:Abnormal scar formation:- Hypertrophic scars:It is the condition where excessive amounts of collagen are produced within a scar. Nodules may be present histologically containing randomly arranged fibrils within and parallel fibres on the surface. The tissue itself is confined to the extent of the wound itself and is usually the result of a full-thickness dermal injury. They may go on to develop contractures.- Keloid scars: This is also a condition where excessive amounts of collagen occur within a scar. A keloid scar will typically pass beyond the boundaries of the original injury. They do not contain nodules and may occur following even trivial injury. They do not regress over time and may recur following removal.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 8 - An 18-year-old female presents to the dermatologist with a pigmented lesion on her...

    Incorrect

    • An 18-year-old female presents to the dermatologist with a pigmented lesion on her back. A melanoma is suspected. What would be the most appropriate initial course of action?

      Your Answer:

      Correct Answer: Excisional biopsy of the lesion

      Explanation:

      Melanoma, a highly malignant tumour arising from melanocytes, is the most common life-threatening dermatological disease. Risk factors include UV radiation exposure, particularly in light-skinned individuals that are easily sunburned, increasing age, family history, and immunosuppression. Lesions that are suspicious for melanoma should be excised with complete margins. Radical excision is not routinely undertaken for diagnostic purposes and therefore if subsequent histopathological assessment determines that the lesion is a melanoma a re-excision of margins may be required.Margins of excision-Related to Breslow thicknessLesions 0-1mm thick – 1cmLesions 1-2mm thick – 1- 2cm (Depending upon site and pathological features)Lesions 2-4mm thick – 2-3 cm (Depending upon site and pathological features)Lesions >4 mm thick – 3cm

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 9 - Which of the following are associated with port wine stains? ...

    Incorrect

    • Which of the following are associated with port wine stains?

      Your Answer:

      Correct Answer: Epilepsy

      Explanation:

      Port-wine stains are a type of vascular birthmark caused by the abnormal development of capillaries in the skin. These pinkish-purplish discolorations present at birth and are associated with medical conditions such as Sturge-Weber syndrome, a neurocutaneous disorder involving the leptomeninges. Port wine stains are therefore associated with epilepsy, glaucoma or intellectual disability common in Sturge-Weber syndrome. Additional complications of Port wine stains include a loss of function if near the eye or mouth due to hypertrophy, or glaucoma if near the eyelid.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 10 - An 18-year-old female suffering from acne vulgaris has been started on isotretinoin. Regarding...

    Incorrect

    • An 18-year-old female suffering from acne vulgaris has been started on isotretinoin. Regarding this treatment, which of the following statements is the most applicable?

      Your Answer:

      Correct Answer: Pregnancy should be avoided during and 1 month after treatment

      Explanation:

      It is recommended that a woman wait one month after stopping isotretinoin before trying to become pregnant. Usually, isotretinoin is no longer found in a woman’s blood 4-5 days after the last dose and most of its by-products should be gone within 10 days after the last dose.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 11 - Which of the following conditions exhibits Koebner's phenomenon? ...

    Incorrect

    • Which of the following conditions exhibits Koebner's phenomenon?

      Your Answer:

      Correct Answer: Vitiligo

      Explanation:

      Koebner’s phenomenon describes skin lesions that occur on damaged skin, usually in a linear fashion at the site of injury. Conditions which exhibit true Koebnerisation include psoriasis, lichen planus, lichen sclerosis, vitiligo, Kaposi sarcoma and SLE. Conditions such as erythema nodosum or multiforme, or Lyme disease and Impetigo do not exhibit Koebner’s phenomenon.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 12 - Cafe-au-lait spots are seen in each of the following, except: ...

    Incorrect

    • Cafe-au-lait spots are seen in each of the following, except:

      Your Answer:

      Correct Answer: Friedreich's ataxia

      Explanation:

      Cafe-au-lait spots is hyperpigmented lesions that vary in colour from light brown to dark brown, with borders that may be smooth or irregular. Causes include:Neurofibromatosis type IMcCune-Albright syndromeLegius syndromeTuberous sclerosisFanconi anaemiaIdiopathicAtaxia-telangiectasiaBasal cell nevus syndromeBenign congenital skin lesionBloom syndromeChediak-Higashi syndromeCongenital nevusGaucher diseaseHunter syndromeMaffucci syndromeMultiple mucosal neuroma syndromeNoonan syndromePulmonary StenosisSilver-Russell syndromeWatson syndromeWiskott-Aldrich syndrome

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 13 - Which one of the following skin conditions is matched correctly with its treatment?...

    Incorrect

    • Which one of the following skin conditions is matched correctly with its treatment?

      Your Answer:

      Correct Answer: Psoriasis and Vitamin D analogues

      Explanation:

      One of the options of Psoriasis treatment is vitamin D analogues i.e. calcipotriol. Acne is exacerbated by steroids. Erythema nodosum can be caused by various diseases and the treatment of the primary condition resolves the symptoms. Lipomas requires surgery, whereas Steven-Johnson syndrome requires use of steroids and eliminating the culprit drug, which is one of the most common causes.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 14 - A 10-year-old girl presented with a sore throat for the past three days....

    Incorrect

    • A 10-year-old girl presented with a sore throat for the past three days. She was taking ibuprofen and paracetamol over the counter for the pain. She was started on phenoxymethylpenicillin V following a diagnosis of tonsillitis.The next day she presents with a painful rash and feels unwell. On examination, she has extensive papular and plaque lesions. On palpation the papules desquamate. What is this sign called?

      Your Answer:

      Correct Answer: Nikolskys sign

      Explanation:

      The sign being elicited in this patient is Nikolsky’s sign. Based on the findings, the patient is suffering from toxic epidermal necrolysis.Nikolskys sign: Rubbing the skin causes exfoliation of the outer layer and usually blistering within a few minutes. Other options:- Cullen’s sign: Periumbilical bruising due to intra-abdominal haemorrhage. If the discolouration is seen in the flanks, it is called Cullen’s sign. Underlying pathology includes ruptured ectopic pregnancy and haemorrhagic pancreatitis. – Forscheimer’s sign: It is a fleeting exanthem that is seen as small, red spots (petechiae) on the soft palate. Associated with rubella and glandular fever. Gorlin’s sign: It is the ability to touch the tip of the nose with the tongue. Increased incidence in children with connective tissue disorder, e.g. Ehler Danlos syndrome. – Auspitzs sign: These are small bleeding points are left behind when psoriatic scales are lifted off. It is not a very sensitive or specific sign. Other cutaneous signs include:- Hair collar sign: It is a collar of hypertrichosis around an area of cranial dysraphism.- Hertoghe’s sign (Queen Anne’s sign): It is the loss of lateral one-third of eye-brows. It is associated with numerous conditions, including lupus, HIV, and hypothyroidism. – Dariers sign: It is the swelling, itching and erythema that occurs after stroking skin lesions of a patient with systemic mastocytosis or urticarial pigmentosa. – Dermatographism: Rubbing the skin causes a raised, urticarial lesion. – Koebners phenomenon: It is the appearance of new skin lesions in areas of trauma.- Breakfast, lunch, and dinner sign: Linear pathway of a group of three to five papules caused by the common bed bug, Cimex lectularius. – Buttonhole sign: In type 1 neurofibromatosis, neurofibromas can be invaginated with the finger back into the subcutis. The nodule will reappear after the release of pressure. The sign is also positive for dermatofibromas. – Crowe’s sign: Axillary freckling seen in type I neurofibromatosis.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 15 - Which of the following statements is true regarding eczema herpeticum? ...

    Incorrect

    • Which of the following statements is true regarding eczema herpeticum?

      Your Answer:

      Correct Answer: Is usually associated with lymphadenopathy

      Explanation:

      Eczema herpeticum (also called Kaposi varicelliform eruption) is a disseminated viral illness usually associated with lymphadenopathy.It is most often caused by Herpes Simplex type 1 or type 2. Occasionally, other viruses such as coxsackievirus A16 may cause eczema herpeticum. Affected children usually develop itchy blisters and fever after coming in contact with an affected individual who may or may not display cold sores.It is characterised by an itchy and sometimes painful cluster of blisters most commonly on the face initially. This spreads over one to several weeks resulting in further crops of blisters which can become confluent. Lymphadenopathy and fever are common in these patients.The severity varies from mild illness to life-threatening, especially in immunocompromised children or young infants. It is markedly more common in children with atopic dermatitis. It is one of the few dermatological emergencies, and oral antivirals are often indicated. Referral to an ophthalmologist may be needed if there is eyelid or eye involvement. Occasionally, superadded skin infections caused by staphylococci and streptococci can occur.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 16 - All of the following are features of tinea corporis EXCEPT? ...

    Incorrect

    • All of the following are features of tinea corporis EXCEPT?

      Your Answer:

      Correct Answer: It is less common on glabrous skin

      Explanation:

      Tinea corporis is a type of dermatophytosis, caused by Trichophyton or Microsporum. The disease is highly contagious and rapidly spreads to all the areas of the body, including the glabrous skin. It produces an erythematous itchy skin rash with a central area of clearance surrounded by raised scaly borders. Lesions can appear as concentric circles that overlap, referred to as tinea imbricate.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 17 - A 16-month-old girl with eczema is on the following treatment regimen: Oilatum in...

    Incorrect

    • A 16-month-old girl with eczema is on the following treatment regimen: Oilatum in baths; Baby' shampoo and soap and E45 cream to affected areas four times daily. Additionally, the mother uses 'non-biological' washing powder.The child often scratches the affected areas, sometimes even in her sleep. On examination, her skin is erythematous, excoriated, and lichenified over the knees, thighs, and flexor surfaces of the elbows.Which of the following would be the most appropriate next step in the management of this child?

      Your Answer:

      Correct Answer: Use E45 cream instead of soap; advise using a greasier emollient and try an antihistamine at night

      Explanation:

      The most appropriate next step in the management of this patient would be to use E45 cream instead of soap. Using a greasier emollient and an antihistamine at night can also be trialled..Management of eczema:Treatment of eczema can be problematic, and thus, parents should be advised regarding simple, everyday measures that can relieve the symptoms. These include:- Using non-biological washing powder- Wearing cotton clothes as opposed to artificial fibres- Avoiding the use of soaps or shampoos and using E45 Cream as an alternative.- Additional use of bath oil (e.g. Oilatum) is found to be beneficial.- Regular emollient use is recommended and essential. The aim is to keep the skin from feeling dry at any time of day. Sedating with older types of antihistamines at night does not help to reduce itching, but when used in large doses, they occasionally provide a sedative effect which may improve sleep. If all these measures are in use, but the eczema is still not controlled, the escalation of treatment would be appropriate. Note: There is no evidence for the benefit of topical antibiotics.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 18 - A 7-month-old baby appears to have experienced a fit. The parents noticed jerking...

    Incorrect

    • A 7-month-old baby appears to have experienced a fit. The parents noticed jerking of one arm followed by generalised shaking. A flat erythematous lesion under the right lower eyelid, which has not changed in size or appearance, has been present since birth.What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Sturge-Weber syndrome

      Explanation:

      Sturge-Weber syndrome (SWS), also called encephalotrigeminal angiomatosis, is a neurocutaneous disorder with angiomas that involve the leptomeninges (leptomeningeal angiomas [LAs]) and the skin of the face, typically in the ophthalmic (V1) and maxillary (V2) distributions of the trigeminal nerve. The hallmark of SWS is a facial cutaneous venous dilation, also referred to as a nevus flammeus or port-wine stain (PWS).Signs and symptoms:SWS is generally diagnosed clinically, based on the typical cutaneous, central nervous system (CNS), and ocular abnormalities associated with it.Neurological signs include the following:Developmental delay/intellectual disabilityLearning problemsAttention deficit-hyperactivity disorderInitial focal seizures progressing to frequent, secondarily generalized seizuresIncreasing seizure frequency and duration despite the use of antiepileptic drugs (AEDs)Increasing duration of a transient postictal deficitIncrease in focal or diffuse atrophy – Determined by serial neuroimagingProgressive increase in calcificationsDevelopment of hemiparesisDeterioration in cognitive functioningPhysical signs of SWS are as follows:Port-wine stainMacrocephalyOcular manifestationsSoft-tissue hypertrophyHemiparesisVisual lossHemianopsiaOcular involvement in SWS may include the following signs:BuphthalmosGlaucomaTomato-catsup colour of the fundus (ipsilateral to the nevus flammeus) with glaucomaConjunctival and episcleral haemangiomasDiffuse choroidal haemangiomasHeterochromia of the iridesTortuous retinal vessels with occasional arteriovenous communications

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 19 - A 15-year-old boy, who has a family history of Gilbert's syndrome, presents with...

    Incorrect

    • A 15-year-old boy, who has a family history of Gilbert's syndrome, presents with signs and symptoms of hepatic dysfunction. Liver function tests reveal raised unconjugated bilirubin levels. Subsequent genetic testing led to a diagnosis of Gilbert's syndrome. What is the reason for the unconjugated hyperbilirubinemia in Gilbert's syndrome?

      Your Answer:

      Correct Answer: Reduced levels of UDP-glucuronosyl transferase-1

      Explanation:

      Gilbert’s syndrome is an autosomal recessive condition that results from defective bilirubin conjugation due to a deficiency of UDP glucuronyl transferase – 1. The prevalence is approximately 1-2% in the general population.The clinical presentation of Gilbert’s syndrome include:- Unconjugated hyperbilinaemia- Jaundice can occur during an intercurrent illnessManagement:Blood investigations usually reveal a rise in bilirubin following prolonged fasting or intravenous nicotinic acid.No treatment required for these patients.Other options:- CYP2C9 deficiency causes reduced warfarin metabolism, and subsequent enhanced drug effects. – Pancreatic disease, cholestasis, excessive alcohol consumption and certain drugs are common causes of raised GGT levels- Defective hepatocyte excretion of conjugated bilirubin is related to the pathophysiology of Dubin-Johnson syndrome- Reduced CYP2C19 levels can lead to the disordered metabolism of clopidogrel and other drugs such as proton-pump inhibitors, anticonvulsants and sedatives.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 20 - Which of the following is true regarding eczema herpeticum? ...

    Incorrect

    • Which of the following is true regarding eczema herpeticum?

      Your Answer:

      Correct Answer: Herpes virus 1 and 2, Ebstein-Barr virus, Cytomegalovirus, and Varicella Zoster virus are all species of Herpesviridae

      Explanation:

      Kaposi varicelliform eruption (KVE) is the name given to a distinct cutaneous eruption caused by herpes simplex virus (HSV) type 1, HSV-2, coxsackievirus A16, or vaccinia virus that infects a pre-existing dermatosis. Most commonly, it is caused by a disseminated HSV infection in patients with atopic dermatitis (AD) and, for this reason, is often referred to as eczema herpeticum (EH).Kaposi varicelliform eruption (KVE) is now known to occur in children of any age and in adults, however, most patients (56%) are aged 15-24 years.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 21 - Which of the following is true of miliaria? ...

    Incorrect

    • Which of the following is true of miliaria?

      Your Answer:

      Correct Answer: Miliaria crystalline causes tiny, fragile clear vesicles

      Explanation:

      Miliaria is a common skin disease caused by blockage and/or inflammation of eccrine sweat ducts. Miliaria is frequently seen in hot, humid or tropical climates, in patients in the hospital, and in the neonatal period. Miliaria is also known as sweat rash.Based on the level of the sweat duct obstruction, miliaria is divided into three subtypes:- Miliaria crystallina (sudamina), caused by obstruction of the sweat ducts close to the surface of the skin (epidermis);- Miliaria rubra, caused by obstruction of the sweat ducts deeper in the epidermis;- Miliaria profunda (tropical anhidrosis), the result of sweat leaking into the middle layer of skin (dermis).Miliaria crystallina appears as 1-2 mm superficial clear blisters that easily break. The blisters can look like beads of sweat. There is no inflammation. The blisters are usually seen widely spread on the head, neck, and upper trunk.Miliaria rubra is the most common type of miliaria results in red, 2-4 mm, non-follicular papules and papulovesicles. They are very itchy. Background erythema is often present. In children, miliaria affects the skin folds of the neck, axilla or groin. In adults, miliaria often affects the upper trunk, scalp, neck and flexures, particularly areas of friction with clothing. Miliaria pustulosa is a variant of milia rubra in which there are pustules.Miliaria profunda describes asymptomatic deep papules. The flesh-coloured, 1-3 mm diameter papules usually arise on the trunk and extremities.Mild Topical steroids can be used as a treatment

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 22 - All of the given conditions are scaly dermatologic pathologies EXCEPT? ...

    Incorrect

    • All of the given conditions are scaly dermatologic pathologies EXCEPT?

      Your Answer:

      Correct Answer: Hand, foot, and mouth disease

      Explanation:

      Skin conditions resulting from excessive epidermal proliferation or inflammation, leading to a production of excessive scales, are referred to as papulosquamous disorders. These disorders can be generalized and localized. Localized causes of scaly lesions include tinea corporis, tinea cruris, tinea pedis, seborrheic dermatitis, psoriasis, pityriasis Versicolor, pityriasis alba, DLE, ichthyosis including Netherton syndrome (a severe form of ichthyosis which is autosomal recessive), and pellagra. Generalized causes include guttate psoriasis and pityriasis rosacea. Hand, foot, and mouth disease is a contagious viral illness that causes blisters in the mouth and on the extremities.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 23 - Which of the following disorders are NOT associated with hypertrichosis? ...

    Incorrect

    • Which of the following disorders are NOT associated with hypertrichosis?

      Your Answer:

      Correct Answer: Psoriasis

      Explanation:

      Among the given options, psoriasis is not associated with hypertrichosis.The causes of hypertrichosis include:- Drugs: minoxidil, ciclosporin, and diazoxide.- Congenital hypertrichosis lanuginosa and congenital hypertrichosis terminalis.- Porphyria cutanea tarda- Anorexia nervosa

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 24 - A new-born at term with no significant family history presents with absent skin...

    Incorrect

    • A new-born at term with no significant family history presents with absent skin on both feet to mid-calf. The most appropriate thing to do is to:

      Your Answer:

      Correct Answer: Cover the affected areas in cling film

      Explanation:

      The baby most probably has dystrophic epidermolysis bullosa, a primarily autosomal dominant disorder associated with keratin 5 and 14 defects. Initial management consists of supportive measures such as protecting the skin.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 25 - Children with eczema herpeticum exhibit which of the following features? ...

    Incorrect

    • Children with eczema herpeticum exhibit which of the following features?

      Your Answer:

      Correct Answer: Atopic children have reduced immunity to the herpes simplex virus

      Explanation:

      Eczema herpeticum is a form of Kaposi varicelliform eruption, characterized by extensive vesicular skin eruptions that arise from a pre-existing skin condition, usually atopic dermatitis. The most common pathogen is the herpes simplex virus type 1, which has a higher propensity of attacking the epidermis already damaged by atopic dermatitis. The incubation period of the illness is 5-14 days. The eruption is initially small, monomorphic, dome-shaped papulovesicles that rupture to form tiny punched-out ulcers. It is diagnosed by taking viral swabs for culture.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 26 - A 9-year-old girl complains of perioral blisters and a burning sensation of her...

    Incorrect

    • A 9-year-old girl complains of perioral blisters and a burning sensation of her face. Some of the blisters are crusted and some are weeping. What is the most likely diagnosis?

      Your Answer:

      Correct Answer: Impetigo

      Explanation:

      Impetigo appears more commonly on the face than other exposed areas like the limbs. Its blisters are clustered and may have a fluid discharge.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 27 - Which of the following descriptions qualifies as a diagnostic criteria for Neurofibromatosis type...

    Incorrect

    • Which of the following descriptions qualifies as a diagnostic criteria for Neurofibromatosis type 1?

      Your Answer:

      Correct Answer: > 6 cafe au lait spots or hyperpigmented macules which are >5mm in children under age 10, and >15mm in children over 10

      Explanation:

      Clinical diagnosis of neurofibromatosis type 1 requires the presence of at least 2 of 7 criteria. Many of these signs do not appear until later childhood or adolescence, and thus confirming the diagnosis often is delayed despite a suspicion of NF1. The 7 clinical criteria used to diagnose NF1 are as follows:- Six or more cafe-au-lait spots or hyperpigmented macules greater than 5 mm in diameter in prepubertal children and greater than 15 mm in postpubertal- Axillary or inguinal freckles (>2) – Two or more typical neurofibromas or one plexiform neurofibroma- Optic nerve glioma- Two or more iris hamartomas (Lisch nodules), often identified only through slit-lamp examination by an ophthalmologist- Sphenoid dysplasia or typical long-bone abnormalities such as pseudarthrosis- A first-degree relative (e.g., mother, father, sister, brother) with NF1

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 28 - An infant presents with a rash to her body consisting of greasy yellow...

    Incorrect

    • An infant presents with a rash to her body consisting of greasy yellow crusted lesions. Her mother complains that the child has been experiencing chronic diarrhoea and recurrent skin infections. She is non-febrile, but her growth chart is highly suggestive of failure to thrive.The constellation of symptoms present in this child suggests which of the following conditions?

      Your Answer:

      Correct Answer: Leiner's disease

      Explanation:

      Based on the patient’s presentation, he’s probably suffering from Leiner’s diseaseLeiner’s disease is a severe generalised form of seborrhoeic dermatitis. It is also associated with recurrent diarrhoea, recurrent skin and internal infections, and failure to thrive.Seborrhoeic dermatitis is a common and self-limiting condition in childhood. Lesions affect the scalp (cradle cap), and sometimes the ear, nose, and eyebrows. It is characterised by greasy yellow or yellow-brown scales.There is an association with Malassezia, and the lesions are a reaction to this yeast, rather than caused by it.It is most common in the 6-12 month age group. Simple brushing with a soft bristle brush, use of oil or emollient, and ketoconazole 2% shampoo are all treatment options.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 29 - A 12-year-old girl presents with a day's history of urticarial rash.While addressing the...

    Incorrect

    • A 12-year-old girl presents with a day's history of urticarial rash.While addressing the parents' query on the cause of the rash, what would be the most appropriate statement?

      Your Answer:

      Correct Answer: The rash may be due to a viral infection

      Explanation:

      The most common cause of acute urticaria is a viral infection. Individual lesions typically are short-lived and last less than 24 hours. Urticaria can be due to or can be made worse by cold temperatures. One of the other causes of urticaria is salicylic acid.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 30 - Hypopigmentation is a clinical feature of all of the given conditions EXCEPT? ...

    Incorrect

    • Hypopigmentation is a clinical feature of all of the given conditions EXCEPT?

      Your Answer:

      Correct Answer: Coeliac disease

      Explanation:

      Hypopigmentation refers to a decrease in the amount of the pigment melanin in the skin, which leads to an abnormally lighter skin tone. Hypopigmentation can be generalized or localized. Generalized hypopigmentation occurs in albinism or can be ethnicity related. Causes of localized hypopigmentation include Incontinentia pigmenti, Lichen planus, Tuberous sclerosis, Piebaldism, vitiligo, and leprosy. Celiac disease is not associated with hypopigmentation.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 31 - A 2 year old child was brought to casualty with recurrent episodes of...

    Incorrect

    • A 2 year old child was brought to casualty with recurrent episodes of eczematoid rash over the cheeks and flexural regions of his body. Which one of the following statement best suit this condition?

      Your Answer:

      Correct Answer: Hydrocortisone 1% ointment should be applied sparingly to areas of active eczema

      Explanation:

      Atopic dermatitis is an allergic condition which is more apparent in those children who have a positive family history in their 1st or 2nd degree relatives. In some cases, there might be a positive history of bronchial asthma. The best treatment option in this case would be topical application of 1% hydrocortisone ointment to the affected areas of the child. We cannot prescribe a strong ointment to the face because it may lead to skin atrophy, telangiectasia and other steroid related topical complications.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 32 - Which of the following pathological criteria carries the greatest prognostic weight for malignant...

    Incorrect

    • Which of the following pathological criteria carries the greatest prognostic weight for malignant melanoma?

      Your Answer:

      Correct Answer: Breslow thickness

      Explanation:

      Breslow thickness is measured from the top of the granular layer of the epidermis (or, if the surface is ulcerated, from the base of the ulcer) to the deepest invasive cell across the broad base of the tumour (dermal/subcutaneous) as described by Breslow.Margins of excision-Related to Breslow thicknessLesions 0-1mm thick – 1cmLesions 1-2mm thick – 1- 2cm (Depending upon site and pathological features)Lesions 2-4mm thick – 2-3 cm (Depending upon site and pathological features)Lesions >4 mm thick – 3cmMarsden J et al Revised UK guidelines for management of Melanoma. Br J Dermatol 2010 163:238-256.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 33 - A 5 week old boy presents for developmental assessment. Clinical examination reveals a...

    Incorrect

    • A 5 week old boy presents for developmental assessment. Clinical examination reveals a bluish, well-circumscribed lesion located on the bridge of the nose. It measures 5 mm in diameter and feels firm to the touch. Parents admit that the mass was not present at birth. They have noticed that the lesion gets bigger when the baby cries and then it gets back to its initial size. Doctors suspect a capillary haemangioma. What would you advise the parents?

      Your Answer:

      Correct Answer: Arrange follow-up for the child in the outpatient clinic to monitor the growth of the lesion over the coming weeks

      Explanation:

      Capillary haemangiomas (strawberry naevi) are very common benign tumours that may appear in infancy. This particular case requires a close follow-up to monitor the naevus’ size and make sure it doesn’t expand or gets bigger, affecting the baby’s visual field.It is more common in preterm babies and girls are 3x more commonly affected than boys. It presents at birth in 30%, and is a focal and solitary in 80% of cases, most commonly found on the head and neck (60%), followed by the trunk (25%) and extremities (15%).

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 34 - A 14 year old girl presented with complaints of acne vulgaris over her...

    Incorrect

    • A 14 year old girl presented with complaints of acne vulgaris over her face. The acne is exacerbated during her menstrual period. The most appropriate treatment option would be?

      Your Answer:

      Correct Answer: Topical benzoyl peroxide

      Explanation:

      Topical benzoyl peroxide is used for the treatment of mild to moderate acne vulgaris. It is actually a peeling agent and it clears the pores and reduces the bacterial cell count.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 35 - A 5 month old boy presents with unilateral jerking of the arm, followed...

    Incorrect

    • A 5 month old boy presents with unilateral jerking of the arm, followed by generalised shaking. Doctors suspect he might have experienced a fit. History taking and clinical examination shows he has a macular erythematous lesion under the right lower eyelid which has been present since birth. The lesion has not changed in size and aspect. Which of the following is the most probable diagnosis?

      Your Answer:

      Correct Answer: Sturge-Weber syndrome

      Explanation:

      Sturge-Weber syndrome is a genetic condition affecting various blood vessels. I causes brain, eye, and skin abnormalities, including three major features: port-wine birthmark, leptomeningeal angioma, and glaucoma. Most people are born with a port-wine birthmark that is usually located on the face, including the eyelid.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 36 - Erythema nodosum is NOT caused by which one of the following? ...

    Incorrect

    • Erythema nodosum is NOT caused by which one of the following?

      Your Answer:

      Correct Answer: Coeliac disease

      Explanation:

      Erythema nodosum is the most common type of inflammation of the subcutaneous fat tissue, referred to as panniculitis. Erythema nodosum appears as painful, erythematous round lumps, usually symmetrically on the anterior aspect of lower extremities. These lesions are self-limiting and tend to resolve within 2-8 weeks without undergoing necrosis. There are various causes of erythema nodosum, but the most important among children is the streptococcal throat infection. Other causes include autoimmune conditions like sarcoidosis, inflammatory bowel disease, mycobacterial infection (TB), and drugs like penicillin and sulphonamides. Coeliac disease is not linked with the formation of erythema nodosum.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 37 - A 10-year-old boy presented to the ophthalmology clinic with a painless swelling on...

    Incorrect

    • A 10-year-old boy presented to the ophthalmology clinic with a painless swelling on the superotemporal aspect of his orbit. It was smooth on examination and produced no visual disturbances. Following excision, it was found to be lined by squamous epithelium and hair follicles.Which lesion is most probably associated with these findings?

      Your Answer:

      Correct Answer: Dermoid cyst

      Explanation:

      The most probable lesion in the patient is a dermoid cyst.Rationale:Dermoid cysts are embryological remnants and may be lined by hair and squamous epithelium (like teratomas). They are often located in the midline and may be linked to deeper structures resulting in a dumbbell shape to the lesion. Complete excision is required as they have a propensity to local recurrence if not excised.Note:Desmoid tumours are a different entity entirely. These lesions most commonly develop in ligaments and tendons. They are also referred to as aggressive fibromatosis and consist of dense fibroblastic lesions (resembling scar tissue). They should be managed in a similar manner to soft tissue sarcomas.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 38 - Which of the following conditions result in a port wine stain? ...

    Incorrect

    • Which of the following conditions result in a port wine stain?

      Your Answer:

      Correct Answer: Sturge-Weber syndrome

      Explanation:

      Various types of birthmarks are commonly seen in children of different age groups. Birthmarks can be broadly classified as pigmented and vascular birthmarks. Port-wine stain (nevus flammeus) is an example of a vascular birthmark, and is characterized by a reddish-purple discoloration of the skin due to abnormal underlying skin vasculature. Port-wine stain has also been associated with vascular diseases like Sturge-weber syndrome, which is a congenital neurocutaneous disorder. In Sturge-weber syndrome, the port-wine stain affects the skin around the ophthalmic branch of trigeminal nerve.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 39 - A 10-year-old girl was brought to the clinic with complaints of a rash...

    Incorrect

    • A 10-year-old girl was brought to the clinic with complaints of a rash around her left wrist. Her mother recalls that the rash started to appear after the child started wearing a new bracelet for the past one week. What is this type of hypersensitivity reaction?

      Your Answer:

      Correct Answer: Type 4

      Explanation:

      According to the Gell and Coombs classification of hypersensitivity reactions, the scenario provided is a type 4 (delayed) reaction.These reactions are mediated by T lymphocytes and cause contact dermatitis. Nickel, commonly found in cheap jewellery, is a common cause of contact dermatitis.Note:There are two main types of contact dermatitis:- Irritant contact dermatitis: It is a common, non-allergic reaction due to weak acids or alkalis (e.g. detergents). These are often seen on the hands. They present typically with erythema, and rarely, crusting and vesicles.- Allergic contact dermatitis: These are type IV hypersensitivity reactions and are often seen on the head following hair dyes.They typically present as acute weeping eczema which predominately affects the margins of the hairline rather than the hairy scalp itself. Treatment is usually with a potent topical steroid.Other options:- Allergic rhinitis is an example of a type 1 (immediate) reaction. It is an IgE mediated. It is a hypersensitivity to a previously innocuous substance.- Type 2 reactions are mediated by IgG and IgM, which binds to a cell, causing cell death. Goodpasture syndrome is an example of a type 2 hypersensitivity reaction.- Immune complexes mediate type 3 reactions. Rheumatoid arthritis is an example of a type 3 hypersensitivity reaction.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 40 - A 4 year old child was brought in by his mother with complaints...

    Incorrect

    • A 4 year old child was brought in by his mother with complaints of vesicular eruption over his palms, soles and oral mucosa for the last 5 days. He was slightly febrile. There were no other signs. The most likely causative organism in this case would be?

      Your Answer:

      Correct Answer: Coxsackie

      Explanation:

      This patient is most likely suffering from hand, foot mouth disease which is caused by coxsackie virus A16. Its incubation period ranges from 5-7 days and only symptomatic treatment is required.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 41 - Which of the following statements is correct regarding erythema nodosum? ...

    Incorrect

    • Which of the following statements is correct regarding erythema nodosum?

      Your Answer:

      Correct Answer: The typical eruption is symmetrical, tender, and with bruise like lesions to the shins, ankles, and knees

      Explanation:

      Erythema nodosum is the most common type of inflammation of the subcutaneous fat tissue, referred to as panniculitis. Erythema nodosum appears as painful, erythematous round lumps, usually symmetrically on the anterior aspect of lower extremities. These lesions are self-limiting and tend to resolve within 2-8 weeks without undergoing necrosis or ulceration. There are various causes of erythema nodosum, but the most important among children is the streptococcal throat infection. Other causes include autoimmune conditions like sarcoidosis, inflammatory bowel disease, mycobacterial infection (TB), drugs like penicillin and sulphonamides, and malignancies like some leukemias and lymphomas.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 42 - A 10-year-old girl presents with hyperkeratotic plaques on the extensor aspects of the...

    Incorrect

    • A 10-year-old girl presents with hyperkeratotic plaques on the extensor aspects of the skin and the scalp margin. A skin scraping KOH mount and fungal culture in Sabouraud Dextrose Agar from the skin and hair revealed no growth.What is the most probable diagnosis for this patient?

      Your Answer:

      Correct Answer: Psoriasis

      Explanation:

      The most probable diagnosis for this patient’s symptoms is psoriasis. Psoriasis:Chronic plaque psoriasis is characterised by pinkish-red hyperkeratotic plaques, which occur mainly on extensor surfaces such as knees and elbows. The lower back, ears and scalp can also be involved. Koebner phenomenon: Psoriasis typically exhibits this phenomenon where new plaques of psoriasis occur particularly at sites of skin trauma. Diagnosis:Skin biopsy of psoriatic plaques reveals acanthosis and parakeratosis, reflecting increased skin turnover. Capillary dilatation within the dermis also occurs, surrounded by a mixed neutrophilic and lymphohistiocytic perivascular infiltrate.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 43 - Which of the following is true of scabies? ...

    Incorrect

    • Which of the following is true of scabies?

      Your Answer:

      Correct Answer: The mite lives in the stratum corneum

      Explanation:

      Scabies is a dermatological condition caused by infestation of the Sarcoptes Scaibie. The tiny mite, often unseen by the naked human eye, is able to burrow into the stratum corneum where it lays its eggs, causing irritation and a rash related to the immune response against the mite and its eggs, saliva and faeces. On examination, the pathognomic small burrows are often seen on the skin along with small red papules and scratch marks; granulomatous nodules may also be seen especially in darker skin types. Other clinical subtypes such as bullous, and Norwegian (crusted) also exist. Common areas of infection include the hands, wrists, and the interdigital spaces. Infestation can also occur on the genital area, the buttocks, feet, ankles, flexor surfaces. First line treatment is with permethrin 5% dermal cream. It is important that all members of the household are also treated at the same time, and that contaminated bedding, clothes and furniture is adequately disinfected. Scabies is usually associated with overcrowded conditions.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 44 - A 16-year-old male presents with complaints of a patch of scaling skin and...

    Incorrect

    • A 16-year-old male presents with complaints of a patch of scaling skin and hair loss on the right side of his head. A skin scraping confirms the diagnosis of tinea capitis. What is the most common organism responsible for tinea capitis?

      Your Answer:

      Correct Answer: Trichophyton tonsurans

      Explanation:

      The most common organism responsible for tinea capitis is Trichophyton tonsurans.Tinea is a term given to dermatophyte fungal infections. There are three types of tinea, depending on what part of the body is infected:- Tinea capitis – scalp- Tinea corporis – trunk, legs or arms- Tinea pedis – feet-Tinea capitis (scalp ringworm): It is a cause for scarring alopecia mainly seen in children. If untreated, it can form a raised pustular, spongy/boggy mass called a kerion. The most common cause of tinea capitis in the UK and the USA is Trichophyton tonsurans. Tinea can also be caused by Microsporum canis acquired from cats or dogs.The diagnosis of tinea capitis and identification of the organism is possible from the skin lesions: – Scalp scrapings and Potassium hydroxide (KOH) mounts.- Wood’s lamp: Microsporum canis produces a green fluorescence under Wood’s lamp examination.Treatment: – Oral antifungals: terbinafine for Trichophyton tonsurans infections.- Griseofulvin for Microsporum infections. – Topical ketoconazole shampoo is recommended for the first two weeks to limit the transmission of the infection.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 45 - A 16-year-old boy is scheduled for a repair of an inguinal hernia. Which...

    Incorrect

    • A 16-year-old boy is scheduled for a repair of an inguinal hernia. Which of the following structures must be divided to gain access to the inguinal canal?

      Your Answer:

      Correct Answer: External oblique aponeurosis

      Explanation:

      External oblique forms the outermost muscle of the three muscles comprising the anterolateral aspect of the abdominal wall. Its aponeurosis comprises the anterior wall of the inguinal canal.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 46 - The severity of psoriasis can be assessed using which of the following tools?...

    Incorrect

    • The severity of psoriasis can be assessed using which of the following tools?

      Your Answer:

      Correct Answer: Psoriasis Area and Severity Index- PASI

      Explanation:

      Psoriasis is a chronic inflammatory skin disease that is mainly due to the interplay between keratinocytes, dermal vascular cells, and antigen-presenting cells. There are five main types of psoriasis based on the type and severity of the lesions it produces. A useful tool to determine the extent and severity of psoriasis is the Psoriasis Area and Severity Index (PASI) score, which takes into account the percentage of a specific area affected by psoriasis in combination with severity, which in turn is assessed by the presence of desquamation, induration, and erythema.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 47 - Which is true regarding the histopathology of psoriasis? ...

    Incorrect

    • Which is true regarding the histopathology of psoriasis?

      Your Answer:

      Correct Answer: Histological features seen in psoriasis include acanthosis and parakeratosis

      Explanation:

      Histology of psoriasis is characterised by parakeratosis (cell nuclei within stratum corneum) and thickened projections of the prickle cell layer of keratinocytes (psoriasiform hyperplasia or acanthosis). Orthokeratosis refers to the formation of a pathological anuclear keratin layer in the skin.The stratum granulosum is actually thinned or absent in patients with psoriasis.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 48 - A 15-year-old girl presented with generalised excessive hair growth, especially on her limbs....

    Incorrect

    • A 15-year-old girl presented with generalised excessive hair growth, especially on her limbs. Which one of the following is the most likely cause for her symptoms?

      Your Answer:

      Correct Answer: She is on phenytoin to control seizures

      Explanation:

      The patient’s symptoms are most likely due to phenytoin intake.Note:Hypertrichosis occurs in 5-12% of patients on phenytoin and is most prominent on the extremities. Other options:- Hypertrichosis is the excess hair growth, whereas hirsutism is the development of male-pattern-dependent hair growth, as seen in polycystic ovarian syndrome. – A Becker’s naevus is associated with localised hypertrichosis in the naevus. – Cyclosporine intake can typically lead to diffuse hair growth that begins within 2-4 weeks of starting the drug. – Hereditary gingival fibromatosis is associated with variable hypertrichosis occurring on the eyebrows, face, limbs and mid-back.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 49 - A 17-month-old boy is brought by his mother to the hospital. She is...

    Incorrect

    • A 17-month-old boy is brought by his mother to the hospital. She is concerned that he is having symptoms of itching, being very upset and unsettled. They hail from a low socioeconomic background and have poor living conditions. On examination, an itchy, papular rash is noted on the palms of his hands specifically in the web spaces between the fingers, as well as in the groin region. He was normothermic. The mother explains that his sister also has similar symptoms.What is the most probable cause of the patient's symptoms?

      Your Answer:

      Correct Answer: Sarcoptes scabiei

      Explanation:

      The most probable cause for the patient’s presenting symptoms is Sarcoptes scabeii.Scabies:The boy in the scenario presents with a pruritic rash affecting the palms of the hands, especially in the web spaces between the fingers. Additionally, the fact that his sister is showing similar symptoms is an indication of its infectivity. The female Sarcoptes scabiei var hominis mite burrows into the webs of fingers and the sides of digits as seen in the child.This parasitic skin infestation presents typically with nocturnal itching. Other options:- Herpes simplex virus type 1 (HSV-1): This can affect this age group but would usually present with a vesicular perioral rash with associated erythema. – Human papillomavirus (HPV): Cutaneous human papillomavirus infection causes warts, which can form a dome and fleshy shaped lesions on the palms of the hands, but these are not usually itchy. Similar to the causative agent in the boy, they are contagious.- Poxvirus: These viruses cause molluscum contagiosum which presents as dome-shaped lesions anywhere on the body, rather than specifically in palms of hands or finger webs as seen in the boy. Poxviruses are also very infectious.- Staphylococcal infection: This causes impetigo, which presents with yellow discharge and underlying erythema. Impetigo is not usually itchy and can present on any part of the body, rather than the specific areas seen in the boy.

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds
  • Question 50 - A 15-year-old girl has a 5-day history of fever, general malaise and headache...

    Incorrect

    • A 15-year-old girl has a 5-day history of fever, general malaise and headache and has developed diffuse raised oedematous papules. These lesions are typical of erythema multiforme. Which one of the following is true?

      Your Answer:

      Correct Answer: The lesions will heal without scarring

      Explanation:

      Erythema multiforme lesions typically heal without scarring. Other options:- In erythema multiforme, lesions are typically symmetrical and acral, i.e. on the hands, feet and limbs. – HSV is a common cause of erythema multiforme in children, accounting for at least 50% of cases; the lesions typically have damaged skin in the centre and are dusky and bullous (in contrast to urticaria, where the centre of the lesion is normal).

    • This question is part of the following fields:

      • Dermatology
      0
      Seconds

SESSION STATS - PERFORMANCE PER SPECIALTY

Passmed