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DERMATOLOGY Questions  1   2   3    

A 16-year-old boy presentes with erythema nodusum. Which of the following should be considered? 

  1. Reiter's Disease

  2. ulcerative colitis

  3. cytomegalovirus infection

  4. toxoplasmosis

  5. Kawasaki's Disease

Answer

A 20 year old male presents with extensive, coalescing, hypopigmented, slightly scaly lesions on his back and chest. The rash had been present for 2 years and had gradually become more extensive. He had otherwise been in good health. The lesions were not symptomatic but he was concerned about their appearance.

What is the most appropriate treatment for his condition?

  1. ketoconasole cream

  2. nystatin cream

  3. oral itraconazole

  4. oral terbinafine

  5. terbinafine cream

Answer

 

A young woman has acne and is taking oral medication. She develops polyarthritis and raised liver enzyme tests. Investigations show

AST

95

ALT

170

bilirubin

16

antinuclear antibodies

strongly positive at 1/640, negative at 1/20

Which of the following drugs is she most likely to have been prescribed?
  1. erythromycin

  2. isotretinoin

  3. minocycline

  4. oxytetracycline

  5. trimethoprim

Answer

A 74-year-old man with a thirty year history of psoriasis presented with generalised erythroderma of 3 days duration. Examination reveals him to be shivering but otherwise is well. He was treated as an inpatient with emollients and attention to fluid replacement and temperature control but failed to improve after five days. What is the most appropriate next treatment? 

  1. oral hydroxychloroquine

  2. oral methotrexate

  3. oral prednisonlone

  4. topical coal tar

  5. topical dithranol

Answer

Which is true regarding Eczema Herpeticum? 

  1. is invarioably fatal if untreated

  2. usually has an indolent onset

  3.  only a single crop of vesicles usually appear

  4. is typically associated with a high fever for over a week

  5. is more severe in reactivation disease

Answer

Which of the following concerning leg ulcers is correct? 

  1. diuretics have been shown to improve ulcer healing when associated with oedema

  2. In diabetic ulcers the dressing should be left in situ for no more than 1 week

  3. Large gravitational ulcers are always painful

  4. Treating superficial infection with antibiotics has been shown to be beneficial

  5. ulcers caused by arterial disease are typically treated by compression bandaging

Answer

Concerning Neurofibromatosis Type 1 (NF1), which one of the following statements is true? 

  1. Bilateral acoustic neuromas are common

  2. Clinical severity in individuals is similar in a given family

  3. New mutations occur rarely

  4. Pigmented spots on the iris are a characteristic feature

  5. The diagnosis is likely if two café-au-lait patches are present

Answer

An 18-year-old woman presents with red, tender lumps on her shins and arthralgia. Chest X-ray shows bilateral hilar lymphadenopathy and clear lung fields. A clinical diagnosis of sarcoidosis is made.

Which one of the following is the most appropriate management plan?

  1. 24 hour urinary calcium measurement

  2. follow up appointment with chest X ray in 3 months

  3. mediastinoscopy and lymph node biopsy

  4. skin biopsy

  5. thoracic CT scan

Answer

Which of the following may be responsible for an acute relapse of Systemic Lupus Erythematosus in a 38 year old female? 

  1. hydralaxine therapy

  2. pregnancy

  3. progesterone only contraceptive pill

  4. salmeterol therapy

  5. winter holiday in Lapland

Answer

Which of the following is true regarding diabetic foot ulceration? 

  1. Autonomic neuropathy results in increased resting blood flow

  2. Callus formation at pressure areas is an important predictor of ulceration

  3. Plantar ulceration is most commonly due to atherosclerosis

  4. Skin infection is the most common initiating event in ulceration

  5. Radiography can readily distinguish between Charcot’s joint and osteomyelitis

Answer

A 23 year old obese female with known Tuberculosis presents with ulcerating nodules on the back of her legs. Which of the following is the most likely diagnosis?

  1. erythema marginatum

  2. erythema nodosum

  3. erythema induratum

  4. lupus vulgaris

  5. lupus pernio

Answer

A 24 year-old female attends clinic complaining of numerous depigmented areas on the arms and legs.

Which of the following diseases is most likely to accompany this skin condition?

  1. addison's disease

  2. tuberous sclerosis

  3. hypoparathyroidism

  4. pernicious anemia

  5. systemic lupus erythematosus

Answer

A 26 year old male epileptic is admitted with temperature and rash. Over the last one week a rash has developed and he has become iller. Recently he has had some problems with epileptic control and has commenced carbamazepine with valproate.

Examination reveals an unwell patient with a temperature of 39oC, a diffuse erythematous, painful rash with evidence of some lateral sliding of these erythematous areas on palpation. There is also blistering and inflammation of the oral cavity.

What is the likely diagnosis?
  1. exfoliative dermatitis

  2. erythema elevatum diutinum

  3. pustular psoriasis

  4. toxic epidermal necrolysis

  5. toxic shock syndrome

Answer

A 58-year-old man has a history of obesity, gastro-oesophageal reflux disease, low back pain and IHD. He presents with large, itchy wheals over the trunk and limbs and a sensation of tightness in the throat. Which one of the following drugs is the most likely to have triggered this skin eruption?

  1. aspirin

  2. GTN (nitrate) spray

  3. omeprazole

  4. paracetamol

  5. simvastatin

Answer

35 year-old woman presents with a facial rash which had been present for one year. On examination she had erythematous, scaly, indurated plaques on both cheeks with areas of scarring alopecia. Hyperkeratosis over dilated hair follicles was also seen. 

  1. acne rosacea

  2. discoid lupus erythematosis

  3. lupus pernio

  4. impetigo

  5. psoriasis

Answer

A 17 year old boy is diagnosed with scabies. Which of the following statements regarding scabies is correct?

  1. Typically affects the face

  2. It causes itchiness in the skin even where there is no obvious lesion to be seen

  3. It is caused by Staphylococcus aureus

  4. Is best treated by salicylate emulsion

  5. It can be spread by a droplet infection

Answer

A 70-year-old woman complained of a rash that had developed over a month. She had otherwise been fit and well. On examination, there were numerous tense, fluid filled blisters over the trunk and limbs, but no mucosal involvement was evident.
What is the most likely diagnosis?

  1. dermatitis herpetiformis

  2. erythema multiforme

  3. herpes simplex

  4. pemphigoid

  5. pemphigus vulgaris

Answer

A 38 year old female presents with red target lesions confined to the hands and is diagnosed with erythema multiforme. Which of the following could be the cause?

  1. cytomegalovirus infection

  2. ureaplasma urealyticum

  3. group B streptococci

  4. Langerhan's cells histiocytosis

  5. penicillin V

Answer

Which of the following statements regarding Psoriasis is correct?

  1. The prevalence in the UK is 10%

  2. Psoriasis is more common at lower geographical altitudes

  3. Guttate psoriasis is the most common form of the disease

  4. 1% of patients have associated psoriatic arthropathy

  5. Psoriatic arthropathy precedes cutaneous lesions in 29% of cases

Answer

A 22 year old woman complains of haemoptysis, abdominal pains and pyrexia for a month.

She is admitted to hospital and found to be apyrexial and not distressed. There are numerous crusted, linear lesions on her forearms.

What is the most likely diagnosis?
  1. acute intermittent porphyria

  2. factitious disorder

  3. systemic lupus erythematosus

  4. TB

  5. Wegener's granulomatosis

Answer

 

 

 

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