elective mcq.docx

7/23/2019 elective mcq.docx

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1-A 30-year-old woman presents with a 5-year history of ushing of her facial skin

and a spotty rash. Examination reeals a pustular rash on the cheeks with no

comedones.

!hat is the most likely diagnosis"

a-Acne ulgaris

#-$arcinoid syndrome

c- %ystemic lupus erythematosus &%'E(

d-Allergic contact dermatitis

e- )osacea*

+- A +3-year-old man has a 5-year history of seere acne with scarring. ,is acne

inoles the face shoulders and chest. ,e has #een treated in the past with

multiple courses of topical agents including etinoids #enoyl topical anti#iotics

and oral anti#iotics for 1 year. ,is lesions hae not improed signi/cantly through

these agents. n physical examination the patient has multiple large cysts and

a#scesses that are conuent and form sinus tracts.

!hich of the following options are indicated in the management of this patient"

a- $hange the oral anti#iotic #eing used #ecause the presence of a resistant

organism is ery likely

#-)efer to a physician who is authoried to administer oral isotretinoin to consider

starting this therapy*

c-%tart antiandrogenic therapy &e.g. spironolactone(

d-erform a fungal culture of the lesions to exclude 2alasseia folliculitis

e-)eassure the patient that acne is a disease of adolescents and that his

symptoms should improe in the next few months

3-A 1-year-old man is started on isotretinoin for seere nodulo-cystic acne.

!hich one of the following side-e4ects is most likely to occur"

a-hrom#ocytopaenia

#- )aised plasma triglycerides

c- 6ry skin*

d- 'ow mood


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e- )eersi#le alopecia

7- A 18-year-old #oy has seere inammatory acne that has not responded to

treatment with oral anti#iotics. ,is dermatologist has decided to start him on oral

isotretinoin.

!hich of the following pairs of la#oratory tests are re9uired #efore and during

treatment with oral isotretinoin"

a- %erum electrolytes and lier function tests

#- latelet leels and serum electrolytes

c- 'ier function tests and fasting lipid leels*

d- %erum electrolytes and fasting lipid leels

e- 'ier function tests and platelet leels

5-A 71 year-old woman presents with a 8 month history of pruritic lesions a4ecting

the popliteal fossae. %he notices the lesions are more painful and itchy in the winter.

%he has tried some oer the counter moisturiers that hae only slightly helped.

%he had asthma and mild exema as a child #ut is otherwise healthy and takes no

medications. %he has an older sister with a history of ecema.

!hat is the diagnosis"


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a-:nerse psoriasis

#-Atopic dermatitis*

c-2ycosis fungoides

d- $ontact dermatitis

e-;ummular ecema

8-A +


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d- =ullous pemphgoid.


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6. Addison?s disease

E. 6iscoid lupus erythematosus

:nfection

-A +7 year-old female presents with painful lesions at the corner of her mouth.Eery few months she deelops tingling #urning and erosions to the area and is

9uite frustrated with topical antiiral therapy.

A. :mpetigo

=. Angular cheilitis

$. ,and foot and mouth disease

6. ,erpangina

E. ,erpes simplex*

10-A 3+ year-old male presents with a seen month historyof papules growing and

multiplying on his hand. heyare asymptomatic #ut unsightly.

A. @erruca ulgaris*

=. apular dermatitis


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$. 2olluscum contagiosum

6. $orns

E. Ac9uired digital /#rokeratomas

11-A 5+-year-old o#ese man presents to the with a rash on his inner upper thigh.:t consists of an erythematous pla9ue with a scaling #order. he central part of the

pla9ue appears to #e healing.

!hat diagnosis /ts #est with this clinical picture"

a-inea cruris*

#- :ntertrigo

c- $andidiasis

d-%e#orrhoeic dermatitis

e-soriasis

1+-A 3+-year-old army captain has returned to the BC after a tour of duty with his

men. ,e complains of intense itching a4ecting his /nger-we#s and the exoral

aspect of his wrists. here was some itching around the groin #ut this settled after

repeated #athing.

n examination there appears to #e excoriation in the /nger-we#s.

!hat diagnosis /ts #est with this clinical picture"

a- emphigoid

#-soriasis

c- 6ermatitis herpetiformis

d- %arcoptes sca#iei infection*

e-$ontact dermatitis


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13-A ++-year-old woman presents due to hypopigmented skin lesions on her chest

and #ack. %he has recently returned from the south of Drance and has tanned skin.

n examination the lesions are slightly scaly.


a-ityriasis ersicolor*

#-orphyria cutanea tarda

c-'yme disease

d-soriasis

e-inea corporis

17-A 83 year-old woman presented with a scaly erythematous rash on her el#owsand #uttocks. %he has #een using daily moisturiers and 1 hydrocortisone cream

without much clinical improement. ,er past medical history includes hypertension

and dyslipidemia. %he is currently taking ramipril &AltaceF( atorastatin &'ipitorF(

and a multiitamin on a daily #asis.

he most likely diagnosis is"

A. inea corporis

=. $utaneous lupus erythematosus

$. $hronic form of nummulardermatitis

6. soriasis ulgaris &mild-to-moderate type(*


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E. 2ycosis fungoides

15-An 11 year-old female presents with a + week history of an erythematous mildly

pruritic eruption with mild scaling predominantly on the trunk #ut with some

additional lesions to her thighs. %he is otherwise healthy and has had a normal

childhood deelopment. %he does recall recently haing the GsniHes.I %he has afamily history of ecema and dia#etes.

A. Atopic dermatitis

=. ityriasis rosea*

$. uttate psoriasis

6. inea corporis

E. ;ummular dermatitis

18-A +-year-old man attends your clinic with a 7-year history of a recurrent anditchy

facial eruption that he feels is unsightly. ,e notices the eruption is worse in the

winter

and tends to improe oer the summer. ,e is currently studying for #usiness exams

and


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feels the associated stress has triggered the current are. ,e aoids soaps which

make his

face sore and recently has reduced his alcohol intake in an e4ort to improe his

eruption.

,e is otherwise well and on no medication.

Examination

A full examination is unremarka#le except for the skin of his face neck central

chest and

scalp. here are poorly de/ned erythematous patches with oerlying adherent

greasy scale

a4ecting his naso-la#ial folds and extending onto his cheeks . ,is eye#rows

scalp nape of his neck and central chest are similarly a4ected.

!hat is your diagnosis"

A. se#orrhoeic dermatitis.*

=. Ecyma.$. soriasis.6. Atopic dermatitis

1


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#-'ichen planus* c-'ichen sclerosusd- ityriasis rosea

1>- A 7>-year-old African-American man with a history of dia#etes and hypertension

presents to your clinic complaining of a rash on his leg. :t has #een present for

seeral months and is progressiely getting worse. ,is dia#etes is poorly controlledJ

dia#etic complications include #oth chronic renal insuKciency and retinopathy. n

physical examination you note an > cm atrophic patch with a yellow central area

and enlarging erythematous #orders. his patientLs symptoms are most consistent

with .

which of the following cutaneous manifestationsof dia#etes"

A. Acanthosis nigricans =. ;ecro#iosis lipoidica*

$. %cleroderma 6. Erythrasma

1-A 50-year-old chronic alcoholic presents with a persistent skin rash on his hands

arms neck and face. he rash is red-#rown in colour symmetrical and scaly. ,e also

complains of a poor appetite nausea and diarrhoea.

!hich itamin de/ciency is most likely to hae caused his symptoms"

a- ;iacin#- Dolic acidc- Minc

d-@itamin =8 e-hiamine,ypothyroidism may result in all of the following cutaneous /ndings exceptNA. urpura=. Oellowish hue$. pyoderma gangrenosm*6. :ncrease in the percentage of telogen hairsE. 2adarosis

+0-A patient is admitted under the general physicians with pneumonia. :t is noticed

that he has pronounced palmar erythema #ut no eidence of lier disease. n

reiew the patient states that he has had red hands his whole life and his father has

the same condition. !hich of the following are not recognised causes of palmar

erythemaN

a- familial ariant#- pregnancyc-dia#etis.*d-leukaemiae- systemic lupus.


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+1-A +3-year-old woman is #rought #y am#ulance to the Emergency 6epartment

haing collapsed in a restaurant while eating a curry. ,er friends hae gien a

history of preious allergic reactions to nuts.n admission she is ushed #reathless

and wheey has a pulse rate of 170 #pm and a = of >7P70 mm,g.

!hat is the most appropriate /rst line of treatment"

+7 oxygen and intramuscular epinephrine 500 Qg ,igh-ow oxygen intraenous hydrocortisone and chlorpheniramine ,igh-flow oxygen and intramuscular epinephrine 500 Qg* ,igh-flow oxygen and intraenous epinephrine 500 Qg 1 litre intraenous saline and intraenous chlorpheniramine

++-A female has deeloped a rash on her face in the preious 8 weeks and

complains that it is gradually worsening &1+(. %he also feels unwell tired and weak

and the rash is spreading to other areas of skin. :t is particularly diKcult to com#

her hair and to sit up from the horiontal position. %he /nds that her shoulders andthighs are 9uite tender to the touch.


a-dermatomyositis &62(.*#-systemic lupus.c-%e#orrheic dermatitis.d-6icoid lupus.

+3-A 55-year-old woman has a well-demarcated reddish #rown macular rash on her

arm. he lesion recurs periodically and resoles slowly with some persisting

hyperpigmentation. %he is otherwise healthy and takes no medications except an

occasional laxatie.

!hich of the following is the most likely diagnosis for this patient"a-Brticaria#- 'ichen planusc-emphigusd- Dixed drug eruption*

d-$ontact dermatitis

+7- !hich of the the following disorders due to de/ciency in tyrosinase enyme

a- @itilligo.#- Al#inism*c- =ie#aldismd- henyl ketonuria


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+5-arent with white forlook + of his si#ling has also white fore look and white

patches in the #ody


a-@itilligo.

#-Al#inism

c-=ie#aldism*

d-henyl ketonuria

+8- A 30-year-old man with a history of atopic ecema presents a painful

widespread esicular rash &which he has had for two days( and constitutional upset.


a-Ecema herpeticum*

#-2olluscum contagiosum

c-=acterial infection

d-6rug reaction

e-%eere exacer#ation of atopic ecema

+.3R$ and pulse 1+8 P min.

=lood results showN


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;aS 177 mmolPl

CS 7.+ mmolPl

=icar#onate 1 mmolPl

Brea 13.7 mmolPl

$reatinine 1+1 QmolPl


a-6rug-induced lupus

#-henytoin-induced neutropaenia

c-oxic epidermal necrolysis*

d-%taphylococcal %calded %kin syndrome

e- Cawasaki disease

+>- !hich one of the following complications is most associated with psoralen S

ultraiolet A light &B@A( therapy"

a-2alignant melanoma

#-steoporosis

c-=asal cell cancer

d-%9uamous cell cancer*

e- 6ermoid cysts

+-A 30-year-old woman presents with 10-month history of asymptomatic skin

lesions

deeloping oer her trunk. :nitially the lesions were red oal patches which oer

many

months #ecame hard and the skin white. %he does not hae any Toint pro#lems

there is

no family history of skin disease and she is otherwise well.



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a-morphoea&scleroderma(.*

#-dermatomyositis.

c-licken sclerosis.

d-discoid lupus.

30-A +3-year-old African $ari##ean patient presents with an acute-onset facial rash.

%he has

no rash elsewhere and no preious history of skin pro#lems. %he had taken an

antihistamine

for suspected allergy reaction as her face had #ecome slightly swollen and red.

,er family had #ecome increasingly worried and took her to the local accident and

emergency department. 6uring her assessment she complained of a two-weekhistory of

general malaise fatigue feer and weight loss. n a systems reiew she admitted

to haing

experienced intermittent Toint pains inoling her hands and knees.

a-systemic sclerosis.

#-systemic lupus.*

c-morphea.

d-)oscea.

elective mcq.docx

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