ORPTH ADONS DSE of Skin Flashcards

1
Q
  1. Canker sores is another name for
    (a) Herpetic gingivostomatitis
    (b) Shingles
    (c) Recurrent aphthous stomatitis
    (d) Chickenpox
A

(c) Recurrent aphthous stomatitis is one of the most common
oral mucosal pathoses. Allergies, genetic predisposition,
nutritional deficiencies, hematologic abnormalities,
hormonal influences, infectious agents, trauma, stress,
etc. have all been implicated as possible predisposing or
triggering factors. The mucosal destruction appears to
represent a T cell mediated immunologic reaction.

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2
Q
  1. The site where recurrent aphthous ulcer does not commonly
    occur is
    (a) Labial mucosa (b) Tongue
    (c) Gingiva (d) Soft palate
A

(c) Ulcers of recurrent aphthous stomatitis occurs almost
exclusively on the nonkeratinized, movable mucosa of oral
cavity.

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2
Q
  1. Which of these oral structures is not affected in hereditary
    ectodermal dysplasia?
    (a) Enamel
    (b) Bones
    (c) Hair
    (d) Sweat glands
A

(b) As the name suggests hereditary ectodermal dysplasia
represents a group of inherited conditions in which two
or more ectodermally derived anatomic structures fail to
develop. Thus bone being a mesodermal structure is not
affected.

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3
Q
  1. Which of the following statements regarding lichen planus is
    incorrect?
    (a) It is a T cell mediated autoimmune disease
    (b) It is a B cell mediated autoimmune disease
    (c) Wickham’s striae are seen within the lesions in oral cavity
    (d) It is seen most commonly on buccal mucosa
A

(b) Lichen planus is a relatively common, chronic dermatologic disease that often affects the oral mucosa. Current
evidence indicates that this is an immunologically mediated
mucocutaneous disorder mediated by T lymphocytes

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4
Q
  1. Civatte or colloid bodies in lichen planus are derived from
    (a) Degenerating basal cells
    (b) Degenerating mast cells
    (c) Degenerating fibroblasts
    (d) Breakdown of RBCs
A

(a) Degenerating epithelial cells can be seen in the area of the
epithelium and connective tissue interface, i.e. basal layers
and have been termed colloid, cytoid, hyaline, or Civatte
bodies.

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5
Q
  1. One of the following lesions is not considered during the
    differential diagnosis of lichen planus
    (a) Erythema multiforme
    (b) Leukoplakia
    (c) Candidiasis
    (d) White sponge nevus
A

(d) White sponge nevus is a relatively rare genodermatosis
(genetically determined skin disorder) that is inherited as an
autosomal dominant trait and manifests early in life. Other
lesions are caused by environmental factors like tobacco,
drug reaction, immunosuppression, etc.

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6
Q
  1. Auspitz’s sign and Monroe’s abscess are a component of which
    of the following skin lesions?
    (a) Erythema multiforme
    (b) Lupus erythematosus
    (c) Psoriasis
    (d) Pemphigus
A

(c) Psoriasis is a skin disorder characterized by occurrence of
sharply demarcated dry papules covered by a delicate silvery
scales. If deep scales are removed, tiny bleeding points
are noticed (Auspitz’s sign). Munroe’s abscesses refer to
intraepithelial microabscesses.

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7
Q
  1. Stevens-Johnson syndrome is a severe form of
    (a) Lupus erythematosus
    (b) Erythema multiforme
    (c) Pemphigoid
    (d) Lichen planus
A

(b) Significant evidence points to the fact that psoriasis may be
an autoimmune disorder. Lesions of psoriasis are associated
with an increased T lymphocyte activity in the underlying
skin.

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7
Q
  1. Psoriasis is now believed to be a ________ disease.
    (a) Viral
    (b) Autoimmune
    (c) Bacterial
    (d) Mycotic
A

(b) A more severe form of erythema multiforme, StevensJohnson syndrome, is usually triggered by a drug rather than
infection. For such a diagnosis to be made, either the ocular
or genital mucosae should be affected in conjunction with
the oral and skin lesions.

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8
Q
  1. The virus implicated in triggering the immunological derangement
    that produces erythema multiforme is
    (a) Herpes simplex
    (b) Human papilloma virus
    (c) Herpes zoster
    (d) Epstein-Barr
A

(a) Er ythema multiforme is a blistering, ulcerative
mucocutaneous condition of uncertain etiology. This is
probably an immunologically mediated process. In about
50 percent of the cases, the clinician can identify either a
preceding infection, such as herpes simplex or Mycoplasma
pneumoniae, or exposure to anyone of a variety of drugs,
particularly antibiotics or analgesics. These agents may
trigger the immunologic derangement that produces the
disease

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9
Q
  1. Skin lesions of pityriasis rosea clinically resemble
    (a) Secondary syphilis
    (b) Tertiary syphilis
    (c) Primary syphilis
    (d) Tuberculous ulcers
A

(a) Pityriasis rosea is a common benign papillosquamous
disease causing acute skin eruptions probably of viral
etiology, although no single virus is as yet implicated. The
clinical significance lies in the fact that the initial lesion
called “Herald spot” appears strikingly similar to that of
secondary syphilis and is manifested as bright red, 3–4 mm
sized ovoid lesion covered by a silvery scale.

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10
Q
  1. The disease, also known as Darier disease and characterized by
    hyperkeratotic papules and various nail abnormalities is
    (a) White sponge nevus
    (b) Systemic lupus erythematosus
    (c) Keratosis follicularis
    (d) Incontinentia pigmenti
A

(c) Darier disease is characterized by numerous erythematous,
often pruritic, papules on the skin of the trunk and the scalp
that develop during the second decade of life. The palms
and soles often exhibit pits and keratoses. The nails show
abnormalities like longitudinal lines, ridges, or painful splits.

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11
Q
  1. Which one of these is not a genodermatosis?
    (a) Keratosis follicularis
    (b) Incontinentia pigmenti
    (c) Dyskeratosis congenita
    (d) Lichen planu
A

(d) Genodermatoses represent hereditary skin disorders
many of which are accompanied by various systemic
manifestations of different altered enzyme functions. Lichen
planus does not fall into this category, as it is classified as
an autoimmune disease.

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12
Q
  1. Which amongst the following skin diseases has a benign and a
    malignant form?
    (a) Lichen planus
    (b) Acanthosis nigricans
    (c) White sponge nevus
    (d) Warty dyskeratoma
A

(b) Acanthosis nigricans is an acquired dermatologic disease
characterized by development of a velvety, brownish
alteration of the skin. In some instances, this unusual
condition develops in association with gastrointestinal cancer
and is termed malignant acanthosis nigricans. The cutaneous
lesion itself is benign, yet it is significant because it represents
a cutaneous marker for internal malignancy

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13
Q
  1. Nikolsky’s sign is positive in which of the following diseases?
    (a) Cicatricial pemphigoid
    (b) Bullous pemphigoid
    (c) Pemphigus
    (d) Bullous lichen planus
A

(c) Nikolsky’s sign refers to loss of epithelium due to rubbing
of apparently unaffected skin.

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14
Q
  1. Nikolsky’s sign is produced due to
    (a) Perivascular edema
    (b) Prevesicular edema
    (c) Subepithelial split
    (d) Prevesicular erythema
A

(b) It is caused by prevesicular edema which disrupts the
dermal-epidermal junction. Thus when the adjacent,
unaffected skin is rubbed, the epithelium sloughs off over
it.

15
Q
  1. The characteristic Tzanck cells in pemphigus are seen due to
    (a) Acantholysis
    (b) Acanthosis
    (c) Spongiosis
    (d) Hyperkeratosis
A

(a) The cells of the spinous layer of the surface epithelium
typically appear to fall apart, a feature that has been termed
acantholysis, and the loose cells tend to assume a rounded
shape, called Tzanck cells.

16
Q
  1. All except ____________ belong to pemphigus group of diseases.
    (a) Pemphigus vegetans
    (b) Pemphigus foliaceus
    (c) Pemphigus vulgaris
    (d) Familial benign pemphigus
A

(d) Also called Hailey-Hailey disease, it is a chronic autosomal
dominant vesiculobullous disorder, resembling pemphigus
clinically and histologically.

17
Q
  1. Mark the odd one out from amongst the following differential
    diagnoses of pemphigus.
    (a) Herpetic gingivostomatitis
    (b) Psoriasis
    (c) Bullous pemphigoid
    (d) Dermatitis herpetiformis
A

(b) Psoriasis cannot be considered in the differential diagnosis
of pemphigus simply because psoriasis is not a classical
vesiculobullous disorder, but presents as a patches/plaques
covered by silvery scales.

18
Q
  1. Fogo selvagem is another name of
    (a) Epidermolysis bullosa
    (b) Hailey-Hailey disease
    (c) Pemphigus foliaceus
    (d) Paraneoplastic pemphigus
A

(c) Pemphigus foliaceus is a benign variety of pemphigus
characterized by a chronic course with little or no
involvement of mucous membranes, unlike the more severe
pemphigus vulgaris.

19
Q
  1. Sequelae of which vesiculobullous disease include decreased
    vision, blindness, prominent scarring and airway obstruction?
    (a) Bullous pemphigoid
    (b) Hailey-Hailey disease
    (c) Benign mucous membrane pemphigoid
    (d) Pemphigus vulgari
A

(c) Cicatricial pemphigoid represents a group of chronic,
blistering mucocutaneous autoimmune diseases in which
tissue bound autoantibodies are directed against one or
more components of the basement membrane.

20
Q
  1. The major antigens associated with cicatricial pemphigoid are
    _____ and Laminin 5.
    (a) Bullous pemphigoid antigen 2
    (b) Bullous pemphigoid antigen 1
    (c) Cicatricial pemphigoid antigen
    (d) Desmoglein 1
A

(a) Cicatricial or benign mucous membrane pemphigoid is a
blistering, autoimmune disorder that prominently affects
the mucous membranes. The two major antigens associated with cicatricial pemphigoid are bullous pemphigoid
antigen-2 and laminin-5

21
Q
  1. Cicatricial pemphigoid affects primarily the _____ within the oral
    cavity.
    (a) Tongue
    (b) Gingivae
    (c) Lips
    (d) Palate
A

(b) Oral lesions in cicatricial pemphigoid are most consistently
seen on gingivae. Oral vesicles/bullae are thicker-walled and
hence persist for 24–48 hours before rupturing.

22
Q
  1. All of the following vesiculobullous diseases commonly affect
    the mucosal structures except
    (a) Cicatricial pemphigoid
    (b) Pemphigus
    (c) Lichen planus
    (d) Bullous pemphigoid
A

(d) Bullous pemphigoid is a chronic, autoimmune, subepidermal blistering disease that rarely involves the mucous
membranes.

23
Q
  1. Which of the following hereditary skin disease occurs primarily
    in response to mechanical trauma/irritation?
    (a) Epidermolysis bullosa
    (b) Pemphigus vulgaris
    (c) Systemic lupus erythematosus
    (d) Cicatricial pemphigoid
A

(a) The term epidermolysis bullosa describes a heterogeneous
group of inherited blistering mucocutaneous disorders.
Each has a specific defect in the attachment mechanisms of
the epithelial cells,

24
Q
  1. Which of the following diseases is associated with gluten sensitive
    enteropathy?
    (a) Dyskeratosis congenita
    (b) White sponge nevus
    (c) Dermatitis herpetiformis
    (d) Warty dyskeratoma
A

(c) Dermatitis herpetiformis is a rare, benign, chronic, recurrent,
immune mediated blistering disorder often associated with
asymptomatic gluten sensitive enteropathy. Characteristic
skin lesions are extremely pruritic grouped vesicles mostly
on extensor surfaces.

25
Q
  1. The presence of _______ is considered characteristic of dermatitis
    herpetiformis after excluding erythema multiforme, pemphigus
    and epidermolysis bullosa.
    (a) Neutrophils
    (b) Eosinophils
    (c) basophils
    (d) Monocytes
A

(b) Microscopically, dermatitis herpetiformis shows microabscesses within dermal papillae filled with neutrophils and
eosinophils. The connective tissue necroses and separates
from overlying epithelium producing a subepithelial vesicle.
Also, some patients develop an absolute eosinophil count
above 10 percent.

25
Q
  1. The characteristic “Butterfly rash” is seen in
    (a) Pemphigus
    (b) Lichen planus
    (c) Systemic lupus erythematosus
    (d) Pityriasis rosea
A

(c) Systemic lupus erythematosus is a serious multisystem
disease with a variety of cutaneous and oral manifestations.
The skin lesions on face usually appear as erythematous
patches which coalesce to form a roughly butterfly-shaped
patch over the cheeks and across the bridge of nose.

26
Q
  1. Which of the following skin diseases is included in the group of
    the so called collagen diseases?
    (a) Pemphigus
    (b) Lupus erythematosus
    (c) Leukoplakia
    (d) Lichen planus
A

(b) Lupus erythematosus is an example of an immunologically
mediated condition, and is the most common of the so
called “collagen vascular” or “connective tissue” diseases.
There is an increase in the activity of the humoral limb
(B lymphocytes) of the immune system in conjunction with
abnormal function of the T lymphocytes.

26
Q
  1. Spot the disease from the following, which is characterized by
    fixation of epidermis to deeper subcutaneous tissues
    (a) Lupus erythematosus
    (b) Dermatitis herpetiformis
    (c) Lichen planus
    (d) Systemic sclerosis
A

(d) Systemic sclerosis is a systemic connective tissue disease
characterized by vasomotor disturbances, fibrosis, subsequent atrophy of skin, subcutaneous tissues, muscles and
internal organs.