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Question 1
Incorrect
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Which of the following skin conditions is not associated with diabetes mellitus?
Your Answer: Lipoatrophy
Correct Answer: Sweet's syndrome
Explanation:Diabetic dermadromes constitute a group of cutaneous conditions commonly seen in people with diabetes with longstanding disease. Conditions included in this group are:
– Acral dry gangrene
– Carotenosis
– Diabetic dermopathy
– Diabetic bulla
– Diabetic cheiroarthropathy
– Malum perforans
– Necrobiosis lipoidica
– Limited joint mobility
– Scleroderma
– Waxy skin is observed in roughly 50%. Sweet’s syndrome is also known as acute febrile neutrophilic dermatosis has a strong association with acute myeloid leukaemia. It is not associated with diabetes mellitus. -
This question is part of the following fields:
- Dermatology
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Question 2
Incorrect
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Which one of the following is least associated with photosensitivity?
Your Answer: Herpes labialis
Correct Answer: Acute intermittent porphyria
Explanation:Sunlight, especially its ultraviolet radiation component, can cause increased or additional types of damage in predisposed individuals, such as those taking certain phototoxic drugs, or those with certain conditions associated with photosensitivity, including:
– Psoriasis
– Atopic eczema
– Erythema multiforme
– Seborrheic dermatitis
– Autoimmune bullous diseases (immunobullous diseases)
– Mycosis fungoides
– Smith–Lemli–Opitz syndrome
– Porphyria cutanea tarda
Also, many conditions are aggravated by strong light, including:
– Systemic lupus erythematosus
– Sjögren’s syndrome
– Sinear Usher syndrome
– Rosacea
– Dermatomyositis
– Darier’s disease
– Kindler-Weary syndrome
Acute intermittent porphyria (AIP) belongs to the group inborn errors of metabolism and most patients with AIP are not light sensitive. -
This question is part of the following fields:
- Dermatology
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Question 3
Correct
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A defect in DNA gyrase can lead to which of the following cancerous conditions?
Your Answer: Xeroderma pigmentosum
Explanation:Xeroderma pigmentosum is an X-linked recessive condition, which is caused by mutations in DNA gyrase which further encodes the XP gene. The defect may lead to skin cancer at an early stage of life, especially at photo exposed sites.
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This question is part of the following fields:
- Dermatology
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Question 4
Correct
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A 14-year-old boy presents with a rash on his buttocks and extensor surfaces following a sore throat. What is the most probable diagnosis?
Your Answer: Henoch-Schönlein purpura (HSP)
Explanation:Henoch-Schönlein purpura (HSP) rashes are commonly found on the legs, feet, and buttocks while Immune thrombocytopenia (ITP) rashes manifest predominantly on the lower legs. HSP happens following a sore throat while ITP usually happens following an URTI or Flu. HSP is an inflammation of a blood vessel (vasculitis) while ITP is immune mediated insufficiency of platelets.
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This question is part of the following fields:
- Dermatology
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Question 5
Correct
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A 38-year-old woman has a melanocytic naevi on her left forearm. Which of the following features do not suggest malignant change?
Your Answer: Decrease in size
Explanation:Melanocytic nevi are benign neoplasms or hamartomas composed of melanocytes. Melanocytes are derived from the neural crest and migrate during embryogenesis to selected ectodermal sites (primarily the skin and the CNS), but also to the eyes and the ears.
They tend to appear during early childhood and during the first 30 years of life. They may change slowly, becoming raised, changing color or gradually fading.. Pregnancy can increase the number of naevi as well as the degree of hyperpigmentation.
They may become malignant and this should be suspected if the naevus increases in size, develops an irregular surface or becomes darker, itches or bleeds. -
This question is part of the following fields:
- Dermatology
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Question 6
Correct
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How would you advise your patient to apply an emollient and a steroid cream, in order to treat her eczema?
Your Answer: First use emollient then steroids.
Explanation:If steroid is applied first, applying an emollient after could spread it from where it had been applied. If steroid is applied immediately after the emollient then it cannot be absorbed, this is why there should be a time interval of around thirty minutes between these two treatments in order for them to be effective.
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This question is part of the following fields:
- Dermatology
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Question 7
Incorrect
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A 35 year old soldier presented with a painless, erythematous crusted plaque over the dorsum of his hand, after serving in a hilly area of Columbia for 2 months. The most likely diagnosis will be?
Your Answer: Trichomoniasis
Correct Answer: Leishmaniasis
Explanation:The chief presentation in Leishmaniasis is a non healing, ulcerated, painless and non pruritic plaque, which does not respond to oral antibiotics. It can be classified into cutaneous and visceral forms and is caused by the sand fly. It is more prevalent in the hilly areas. Fusobacterium causes a tropical ulcer which is painful and shallow, while Troanasomiasis causes sleeping sickness.
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This question is part of the following fields:
- Dermatology
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Question 8
Correct
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A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the following is most likely to be a feature of this type of carcinoma?
Your Answer: It is capable of metastasising via the lymphatics
Explanation:Squamous-cell skin cancer usually presents as a hard lump with a scaly top but can also form an ulcer. Onset is often over months and it is more likely to spread to distant areas than basal cell cancer vie the lymphatics. The greatest risk factor is high total exposure to ultraviolet radiation from the Sun. Other risks include prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen’s disease, arsenic exposure, radiation therapy, poor immune system function, previous basal cell carcinoma, and HPV infection. While prognosis is usually good, if distant spread occurs five-year survival is ,34%
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This question is part of the following fields:
- Dermatology
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Question 9
Incorrect
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A 59-year-old woman has an 11mm skin lesion on her right forearm, which bleeds easily on contact and has changed in appearance over the last 11 months.
Your Answer: Malignant melanoma
Correct Answer:
Explanation:Melanoma is more common in men than women. Reasons for the disease includes: UV light and genetic predisposition or mutations. Diagnosis is by biopsy and analysis of any skin lesion that has signs of being potentially cancerous.
Early warning signs of melanoma ABCDE:
Asymmetry
Borders (irregular with edges and corners)
Colour (variegated)
Diameter (greater than 6 mm)
Evolving over time -
This question is part of the following fields:
- Dermatology
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Question 10
Incorrect
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A 72-year-old female presents with tiredness and weakness. On examination, she is pale and has a haemoglobin of 72 g/L with an MCV of 68 fL. Which nail changes may be seen in association with this patient's condition?
Your Answer: Koilonychia
Correct Answer:
Explanation:Koilonychia, known as spoon nails, is a condition of the nails bending inwards, taking the shape of a spoon. This is a strong indication of iron-deficiency anaemia (IDA). The rest of the patient’s symptoms further indicate IDA.
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This question is part of the following fields:
- Dermatology
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Question 11
Incorrect
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A diagnosed case of scabies presented in OPD for some medical advice. Which of the following statements best suits scabies?
Your Answer: It causes itchiness in the skin even where there is no obvious lesion to be seen
Correct Answer:
Explanation:Scabies is an infection caused by a microscopic mite known as Sarcoptes scabies. The chief presenting complaint is itching especially in skin folds and mostly during night. It spreads from one person to another through skin contact, and therefore it is more prevalent in crowded areas like hospitals, hostels and even at homes where people live in close contact with each other. Treatment options include benzyl benzoate, ivermectin, sulphur and permethrin.
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This question is part of the following fields:
- Dermatology
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Question 12
Incorrect
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A 24-year-old female presents with generalised irritation and erythematous skin after sunbathing on the beach. Which is the most appropriate immediate treatment for this patient?
Your Answer: Emollient cream
Correct Answer:
Explanation:Sun burn reactions usually occur after individuals with a light skin tone have prolonged exposure to the sun. The usual symptoms are redness and itching of the skin. The best treatment plan would be further avoidance of sun exposure and the topical application of emollients. These are Ist degree burns and aggressive therapy is not required in such cases.
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This question is part of the following fields:
- Dermatology
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Question 13
Correct
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Which one of the following conditions is least likely to be associated with pyoderma gangrenosum?
Your Answer: Syphilis
Explanation:The following are conditions commonly associated with pyoderma gangrenosum:
Inflammatory bowel disease:
– Ulcerative colitis
– Crohn’s disease
Arthritides:
– Rheumatoid arthritis
– Seronegative arthritis
Haematological disease:
– Myelocytic leukaemia[8]
– Hairy cell leukaemia
– Myelofibrosis
– Myeloid metaplasia
– Monoclonal gammopathy
Autoinflammatory disease:
– Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome)
– Granulomatosis with polyangiitis -
This question is part of the following fields:
- Dermatology
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Question 14
Incorrect
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Which one of the following skin conditions is matched correctly with its treatment?
Your Answer: Psoriasis and Vitamin D analogues
Correct Answer:
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.
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This question is part of the following fields:
- Dermatology
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Question 15
Correct
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A 21 year old patient presents with multiple itchy wheals on his skin. The wheals are of all sizes and they are exacerbated by scratching. The symptoms started after a viral infection and can last up to an hour. What is the most likely diagnosis?
Your Answer: Urticaria
Explanation:Urticaria is a group of disorders that share a distinct skin reaction pattern, namely the occurrence of itchy wheals anywhere on the skin. Wheals are short-lived elevated erythematous lesions ranging from a few millimetres to several centimetres in diameter and can become confluent. The itching can be prickling or burning and is usually worse in the evening or night time. Triggering of urticaria by infections has been discussed for many years but the exact role and pathogenesis of mast cell activation by infectious processes is unclear.
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This question is part of the following fields:
- Dermatology
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Question 16
Correct
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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: 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.
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This question is part of the following fields:
- Dermatology
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Question 17
Correct
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Café-au-lait spots are seen in each of the following, except:
Your Answer: Friedreich's ataxia
Explanation:Café-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 I
McCune–Albright syndrome
Legius syndrome
Tuberous sclerosis
Fanconi anaemia
Idiopathic
Ataxia-telangiectasia
Basal cell nevus syndrome
Benign congenital skin lesion
Bloom syndrome
Chediak-Higashi syndrome
Congenital nevus
Gaucher disease
Hunter syndrome
Maffucci syndrome
Multiple mucosal neuroma syndrome
Noonan syndrome
Pulmonary Stenosis
Silver–Russell syndrome
Watson syndrome
Wiskott–Aldrich syndrome -
This question is part of the following fields:
- Dermatology
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Question 18
Incorrect
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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: Sedation should be avoided in children
Correct Answer:
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.
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This question is part of the following fields:
- Dermatology
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Question 19
Correct
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All of the following are associated with yellow nail syndrome except:
Your Answer: Cardiomegaly
Explanation:Yellow nail syndrome is a very rare medical syndrome that includes pleural effusions, lymphedema (due to under development of the lymphatic vessels) and yellow dystrophic nails. Approximately 40% will also have bronchiectasis. It is also associated with chronic sinusitis and persistent coughing and it usually affects adults.
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This question is part of the following fields:
- Dermatology
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Question 20
Incorrect
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Which features may suggest malignant changes in a melanocytic naevi?
Your Answer: Irregularity of surface
Correct Answer: Decrease in size
Explanation:Melanocytic naevi are skin tumours produced by melanocytes. They usually present in childhood but increase during puberty. The mnemonic A-B-C-D, is used by institutions to assess for suspicion of malignancy. The letters stand for asymmetry, border, colour, and diameter. If a mole starts changing in size, colour, shape or, especially, if the border of a mole develops ragged edges or becomes larger than a pencil eraser, it would be an appropriate time to consult with a physician. Other warning signs include if it begins to crust over, bleed, itch, or become inflamed.
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This question is part of the following fields:
- Dermatology
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SESSION STATS - PERFORMANCE PER SPECIALTY
