2015 Flashcards by Aldwin Arceo

A 6-year old boy presents with a small, moist erythematous plaque surmounted with a golden yellow crust, on the face of a few days duration. He is otherwise well. How should he be treated?
A. Local care plus topical antibiotics
B. Topical plus systemic antibiotics
C. Systemic antibiotics
D. Watchful waiting

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A 42 year-old male complains of a reddish brown slightly scaly patch on both axillae. Infection with Corynebacteria is suspected. Which Wood’s lamp examination finding will help confirm this?
A. Enhanced darkening of the patches
B. No change in the appearance
C. Yellow-green fluorescence
D. Coral-red fluorescence

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A 10 year-old boy presents with multiple crusted lesions on the lower extremities. Removal of adherent crust of a lesion reveals a well-demarcated ulcer. What is the most likely diagnosis?
A. Ecthyma
B. Deep folliculitis
C. Bockhart’s impetigo
D. Multiple furunculosis

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A 42 year-old diabetic complains of a tender erythematous plaque on his right leg of a few days duration. This was preceded by fever and malaise. Examination reveals a large erythematous, warm and swollen plaque with some blisters and crusting on the surface. Closer examination reveals that the borders of the plaque are not distinct and there appears to be a wider erythematous area than initially perceived. What is the most likely diagnosis?
A. Cellulitis
B. Erysipelas
C. Carbuncle
D. Echthyma gangrenosum

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Where is the level of the split in the bullous impetigo located?
A. Sub-epidermal
B. Suprabasal
C. Intraspinous
D. Sub-corneal

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A 16 year-old male athlete presents with multiple, small. Dome-shaped, fragile pustules on his buttocks noted at the beginning at the openings of some hair follicles. He is otherwise healthy with no systemic symptoms. What is the most likely diagnosis?
A. Deep folliculitis
B. Superficial folliculitis
C. Multiple carbuncles
D. Multiple furuncles

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What lesion is considered pathognomonic for scabies?
A. Burrow
B. Maculae cerrulae
C. Inflammatory papules
D. Erythematous nodules

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A patient returns to the clinic because of persistence of pruritus after treatment of scabies with topical scabicide. What is this most likey due to?
A. It unequivocably means treatment failure.
B. It is most likely due to an allergic reaction to the scabicide
C. The patient did not have scabies in the first place and was misdiagnosed
D. This is usually due to reaction to the (dead) mite or its products left behind after its expiration

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Which of the following is true about crusted scabies?
A. This is scabies with several crusted and excoriated lesions
B. This often occurs in immunocompetent patients
C. This is contracted from exposure to dogs with fleas
D. This is highly contagious because of the heavy infestation

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How is permethrin shampoo used in the treatment of pediculosis capitis?
A. The shampoo should be left on the hair overnight and rinsed off the following morning
B. Permethrin shampoo should be combined with a conditioner for ease of application
C. The shampoo is left on the hair and scalp for 10 minutes then rinsed off
D. The shampoo should be used for 3 consecutive nights

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What features help differentiate scabies from pediculosis corporis?
A. The lesions in pediculosis corporis are not itchy
B. Close personal contacts are usually not affected in pediculosus corporis
C. Pediculosis corporis usually presents with excoriated lesions while scabies does not
D. The hands and feet are usually spared in pediculosis corporis whereas these are usually involved in scabies

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Which of the following is true about pediculosis pubis:
A. It involves the pubic area only
B. It occurs almost exclusively among male homosexuals
C. Close personal contact is the only mode of transmission
D. Permethrin may be used in the treatment of pediculosis pubic

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Androgens contribute to acne pathogenesis by stimulating sebaceous gland activity. Aside from this, androgens:
A. Promote thick cyst wall formation in acne conglobata
B. Influence follicular keratinocyte activity
C. Promote chemotaxis of leucocytes
D. Induce atrophic scarring

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After prolonged use of antibiotics, multiple pustules around the mouth and the rest of the face may develop, mimicking acne vulgaris. This condition is called:
A. Rosacea
B. Gram negative folliculits
C. Acneiform eruption
D. Peri-oral dermatitis

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Which cytokine is known to promote follicular hyperkeratinization?
A. IL-8
B. TNF-alpha
C. IL-10
D. IL-1

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The most common acne lesions appearing at adrenarche/menarche is:
A. Comedone
B. Papule
C. Pustule
D. Cyst

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Which of the following is a feature of both rosacea and acneiform eruption but not of acne vulgaris?
A. Does not involve the face
B. Does not have comedonal lesions
C. Has more telangiectatic lesions
D. Are associated with systemic medications

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Acne may be a cutaneous manifestation of which of the following endocrine disorders?
A. Diabetes mellitus
B. Addison’s disease
C. Polycystic ovarian syndrome
D. Hypothyroidism

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Abnormal follicular keratinization is triggered by low levels of which essential fatty acid?
 A. Linoleic acid
B. Methionine
C. Linolenic acid
D. Cystine

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Which of the following drugs may cause acneiform eruption?
A. Paracetamol
B. High dose Vit B1, B6, B12
C. Mefenamic acid
D. Amoxicillin

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Which of the following indicates a severe type of acne?
A. The presence of nodulocystic lesions
B. The presence of premenstrual flare-up
C. The presence of comedones on the trunk
D. The history of neonatal or infantile acne

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In which group of acne patients should hyperandrogenic disease states be highly suspected?
A. Infants 8 months to 1.5 years old
B. Males between 20 and 30 years old
C. Female teenagers with partial response to oral antibiotics
D. Teenagers with more acne lesions on the trunk than the face

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17 year-old Andro consulted the clinic because of 2 months old pruritic scaly plaques, erythematous with advancing borders and central clearing, located on both his inguinal areas. Diagnostic impression would be:
A. intertrigo
B. Monolupus?
C. Tinea cruris
D. Erythrasma

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45 year-old Mrs Cruz consulted the clinic because of multiple erythematous plaques with silvery white scales noted on her scalp, body, elbows, knees, and buttocks area. Lesions were occasionally pruritic. Lesions had been there since 3 years ago, controlled with topical medications but would recur. Diagnostic impression would be:
A. Seborrheic dermatitis
B. Psoriasis
C. Dermatophytosis
D. Hansen’s Disease

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``` 49 year-old Mang Pedro, cancer patient, consulted the clinic because of thick scaly greasy plaques noted on his scalp/ He also has associated scaling of the areas on his glabella, nasolabial folds, and back of his ears. He applied oil but the lesions became worse. Diagnostic impression would be: A. Seborrheic dermatitis B. Psoriasis C. Contact dermatitis D. Tinea capitis/fasciae ```

``` 4 year-old Joshua developed whitish patches in front of his left ear and side of his left eyelid. Lesions were smooth, non-scaly, non-pruritic. These patches were initially noticed last summer after they had an outing in Boracay. Diagnostic impression would be: A. Pityriasis alba B. Pityriasis versicolor C. Pityriasis rosea D. Vitiligo ```

``` 72 year-old Mr Santos developed painful grouped vesicles on his left lower back area radiating to the left lower abdominal area of 1 week duration. Prior to the appearance of the vesicles, he had pain on the said area which he attributed to doing carpentry work during the previous week. There was associated slight fever on the 3rd day of the eruptions. Diagnostic impression would be: A. Bullous pemphigoid B. Varicella C. Herpes zoster D. Contact dermatitis ```

``` 21 year-old Angie, consulted the clinic because of a painful erythematous inflamed nodule with central pustulation growing on her left buttocks area. Lesion had started 4 days prior to present consultation. She felt feverish and could not go to the office because of pain every time she sat down. Diagnostic impression would be: A. Herpes simplex B. Infected insect bite C. Furuncle D. Abscess ```

``` A 6 month-old boy was brought to the clinic because of inability to sleep, crying, due to numerous pruritic papules noted on his hands, feet, especially in between the fingers and toe webs, palms and soles. The body was filled with numerous excoriated papules and pustules especially around his armpit. Umbilicus, and testicular areas. His mom, who was carrying the child, also had similar papules. Diagnostic impression would be: A. Dyshidrosis with id eruptions B. Viral exanthems C. Scabies D. Multiple insect bites ```

``` A 6 month old girl was brought to the clinic because of inability to sleep, irritability, and most of the time crying. Mother noticed the child was always rubbing her face on the pillow thus she developed erythematous dry patches on both her cheek areas, sparing her nasolabial fold. The child also had dry, rough, pruritic, excoriated skin on the extensors of the arms and shin of the legs. Diagnostic impression would be: A. Irritant Contact Dermatitis B. Photocontact dermatitis C. Scabies D. Atopic dermatitis ```

``` Evanescent wheals started to appear on the extremities and body of Roger. This was noticed the day of consultation, upon waking up. The night before, he had a drinking spree with his best friend who was about to get married. Every time he scratched the lesions, the lesions became bigger and more erythematous. However, when he left the lesions alone, they would disappear spontaneously but some would recur. Diagnostic impression would be: A. Food allergy B. Urticaria C. Hypersensitivity reactions D. Erythema multiforme ```

``` 52 year-old Aleg consulted the clinic because of recurrent erythemaouts pruritic plaques noticed on both side of her neck. These first appeared a year ago when she a attended a party of her cousins. She dressed up with all the accessory jewelries and perfume. From then on, every time she attended a special occasion and needed to dress up, the erythematous plaques became bigger and more itchy. Diagnostic impression would be: A. Contact dermatitis B. Atopic dermatitis C. Miliaria due to hyperhidrosis D. Food hypersensitivity reactions ```

``` 25 year-old Anna consulted the clinic because of falling hair of 8 months duration. An ANA test was requested which turned out (+). Further history and PE reveals recurrent stomatitis, a malar rash, recurrent joint/muscle pains and photosensitivity. A sunscreen was prescribed and other lab work-ups requested. Diagnostic impression would be: A. Dermatomyositis B. Lupus Erythematosus C. Scleroderma D. Connective Tissue Disease ```

``` 18 year-old Maria, single mother, consulted at the clinic because of multiple painful erythematous nodules developing on her leg area. Lesions were tender, associated with slight fever. History revealed regular injections of Depo-provera every 3 months to prevent contraception. Diagnostic impression would be: A. Erythema multiforme B. Vasculitis C. Multiple furunculosis D. Erythema nodosum ```

``` In acute atopic dermatitis, what type of T cells proliferate? A. TH1 B. TH2 C. TH3 D. A and B only ```

``` The following are included in the simple criteria for diagnosing atopic dermatitis EXCEPT: A. Dryness of the skin B. Co-existing bronchial asthma C. Eczematous rashes D. Pruritus ```

``` Which of the following is characteristic of atopic dermatitis in children around 7 years of age? A. Involvement of the face B. Involvement of the buttocks C. Involvement of wrist and ankles D. Involvement of limb folds and hands ```

``` An infant presented with an erythematous patch on the right half of her body. V=Diagnostic impression would be: A. Harlequin Color Change B. Lymphatic Malformation C. Miliaria rubra D. Nothing ```

``` Which is the most common cause of diaper dermatitis? A. Bullous Impetigo B. Allergic Contact Dermatitis C. Irritant Contact Dermatitis D. Seborrheic Dermatitis ```

A 3 month-old baby girl presented with a diaper rash. In your examination, you noted presence of blisters and yellow crusting. What would you advice the mother? A. Rash is due to diaper allergy B. Rash has no consequence on the child’s health C. Prompt antibiotic therapy is necessary D. Change diaper more frequently

``` A week old female infant presented with multiple erythematous papules with a “flea bite” appearance over her trunk. What is the most likely diagnosis? A. Transient neonatal pustular melanosis B. Miliaria C. Erythema toxicum neonatorum D. Eosinophilic pustular folliculitis ```

``` From the above case (#41), what would you expect to see on biopsy? A. Neutrophils B. Eosinophils C. Macrophages D. Mixed infiltrate ```

``` Which is the characteristic of lesions of impetigo contagiosa? A. Honeycomb crusting B. Formation of pustules C. Painful blisters D. Vesicles on a dermatomal distribution ```

A 2 month-old boy presented with a rapidly growing bright red mass on the right forearm. What should you advice the parent? A. Your child has a hemangioma and this will need regular follow-up B. Your child has a hemangioma and the lesion should completely resolve C. Your child has a vascular malformation and this will require surgical intervention D. A and B only

``` A 3 year-old boy consulted the OPD due to a 1 week history of multiple abscesses on the lower extremities. The mother applied calamine lotion with no improvement. In the clinic, a swab of the wound was taken and showed gram positive bacteria. What lab test can be used to differentiate a Staphylococcal from a Streptococcal infection? A. Coagulase test B. Catalase test C. KOH mount D. Quellung test ```

A 30 year-old laborer came to the OPD due to a 3 month history of discoloration of the skin on the right forearm. The condition started as a circumscribed, small 2x2 cm which gradually enlarged. It was also described to have no sensation, not itchy, with visible loss of hair. If you are suspecting Paucibacillary Leprosy, which of the following statements is CORRECT? A. CMI is weak. B. The Mycobacterium leprae bacteria are abundant in the affected tissue. C. The lesion will heal spontaneously D. The lesion is not infectious

A 25 year-old college student came from her summer vacation in Boracay and noted that the hypopigmented area on her face intensified. This was also described to be itchy. She applied unrecalled steroid cream with no improvement. If this is tinea versicolor, which of the following statements is CORRECT? A. The skin scrapings can be easily confirmed by LPCB mount B. The organism is hydrophilic C. In hypopigmented lesions, the organism has the ability to diminish melanin synthesis D. Annelide formation is seen in skin scrapings

``` Arnold, a 25 year-old medical student, developed papulovesicular lesions that started from his head to his trunk accompanied by fever. He probably has A. Rubella B. Rubeola C. Varicella D. Variola E. Viral influenza ```

``` His classmates were concerned that they might have been infected. The infectious stage of the patient’s condition begins during the A. Vesicular stage B. Prodromal stage C. Papular stage D. Crusting stage E. Resolution ```

``` He continued to have cough and rashes for over 2 weeks. The most likely complication is A. Sepsis syndrome B. Pneumonia C. Progressive varicella D. Secondary bacterial infection E. Ramsay-Hunt syndrome ```

``` The most effective oral antifungal agent for dermatophytes is A. Ketoconazole B. Itraconazole C. Terbinafine D. Griseofulvin E. Flucytosine ```

``` A 25 year-old stevedore complained if a spreading plaque on his groin. On PE, the lesions were serpiginous and scaly. The most likely diagnosis is A. Tinea cruris B. Granuloma annulare C. Inverse psoriasis D. Allergic contact dermatitis ```

A 30 year-old man developed tingling and shooting pains on his forehead followed by vesicular rashes that involved the top of his nose. On examination, the lesions were mostly crusted Your diagnosis is Herpes Zoster, resolving. You will: A. Give antiviral medications B. Refer to an ophthalmologist C. Give antibiotics D. Assure patient that he is on his way to recovery

A pregnant woman delivered a healthy baby through vaginal means. On delivery, you saw vesicles on the vulvae that she said were severely painful which you failed to notice while she was in labor. You would: A. Not caution her since the baby was healthy B. Neonatal herpes is transmitted through vertical way C. Observe baby for a month for sepsis, vesicles, etc. D. Baby is immune

A pregnant woman, 10 weeks AOG, developed vesicles on her introitus. You diagnosed her to have primary genital herpes. You would: A. Ignore it and just give antiseptics B. Advice caesarian section when she delivers C. Give antiviral drug D. Discuss with the mother complications of Neonatal Herpes

``` How many vesicles should be present outside the primary dermatome in a Disseminated Herpes Zoster? A. 20 or more B. 30 or more C. 10 or more D. 40 or more ```

``` The most effective antifungal agent for Candida albicans is A. Acyclovir B. Imidazole C. Terbinafine D. Griseofulvin E. Fluctosine ```

``` Which general principle of management is embodied in the following statement: “Spend extra time with patients, particularly during initial diagnosis or exacerbation.” A. Referral B. Stress management C. Medical management D. Education E. Empathy ```

``` Which skin disease is commonly associated with the following statement: “Adult patients can have substantial and large expenditures for emollients, topical steroids, oilated or oatmeal baths. Instructions include using soap in genital and axillary regions.” A. Atopic dermatitis B. Psoriasis C. Acne D. Hansen’s Disease ```

``` Which skin disease is commonly associated with the following statement: “ The physician should discuss the importance of reducing stress with stress techniques as deep breathing or medication, yoga, and writing a journal.” A. Atopic dermatitis B. Psoriasis C. Allergic contact dermatitis D. Acne ```

``` The very early phase of tissue repair is largely dominated by: A. Fibroblasts B. Monocytes C. Platelets D. Collagenases E. All of the above ```

``` An important early stimulus for fibroblast activation is: A. Lack of zinc B. Loss of extracellular matrix C. Low oxygen tension D. Keratinocyte movement E. All of the above ```

``` The intermediate phase is composed of: A. Synthesis of collagen B. Hemostasis and inflammation C. Action of collagenases D. Mesenchymal cell proliferation E. All of the above ```

``` Wound contraction is mainly due to: A. Action of macrophages B. Centripetal movement of wound edges C. Work of collagenases D. Deposition of collagen E. All of the above ```

``` The major component of the late phase of wound healing is: A. Collagen B. Extracellular matrix C. Elastic fibers D. Leukocytes E. All of the above ```

``` Angiogenesis is stimulated by: A. Basic pH B. Increased oxygen tension C. High lactate levels D. Low levels of Vitamin C E. All of the above ```

Fibroplasia is defined as: A. Synthesis of fibronectin and proteoglycans in response to injury B. Production of fibrous protein in the wound C. Multiplication of fibroblast in the injury site D. Production of matrix metalloproteinase’s E. All of the above

``` One factor does not directly affect wound healing: A. Anti-inflammatory agents B. Vitamin E C. Zinc D. Hemoglobin E. Oxygen ```

One is NOT a quality of a regenerated epithelium/scar: A. Presence of rete pegs B. Fewer basal cells C. Thicker epithelium at the wound edge D. Abnormal interface between epidermis and dermis E. All of the above

``` Wound remodeling is longer among: A. Patients younger than 3 years old B. Patients between 3-15 years old C. Patients above 15 years old D. Elderly population E. All of the above ```

``` Aling Mimi developed a dry lichenified plaque on her right foot of 8 months duration. A diagnosis of Lichen Simplex Chronicus was given because of the thick lesions which she was constantly scratching. Which of the following topical medications would you suggest: A. Triamcinolone lotion B. Fluocinonide cream C. Fluocinonide ointment D. Zinc oxide paste ```

Mr Castro was confined in PGH ward because of uncontrolled diabetes. On PE, you noted an oozing infected ulcer on his right lower leg. Besides controlling his diabetes systemically, giving systemic antibiotics, and elevating affected leg, you would suggest: A. Supportive stockings B. Zinc oxide paste C. Warm dry compress D. ‘Sandwich’ wet saline compresses on ulcer

``` A medical representative of an ethical pharmaceutical company gave you a sample of least potent anti-inflammatory creams and ointments to try on your patients. You would reserve giving such preparations to your patients whose lesions are indicated for the preparations and whose lesions are located on which of the following areas: A. Arms B. Neck C. Legs D. Scrotum ```

Mrs Ching developed xerotic lower legs after coming from a visit to her daughter. Before? each application of any moisturizers or topical preparations on the affected areas, suggest to her to do the following on her shins: A. Clean with betadine (providone) cleanser B. Cold compresses for 5 minutes C. Warm dry compresses for 5 minutes D. Hydrate/soak in tepid water for 5 minutes

Linda has psoriasis and has been religiously applying her topical antipsoriatic ointment on her lesions after bathing as advised. One of the psoriatic plaques especially noted on her ___ seemed to be slow in improving. You would suggest to avoid trauma on the area, and to do the following: A. Occlude the affected area with plastic dressings after applying the ointment B. Remove the psoriatic scales before applying the ointment C. Apply warm compress to affected area before applying the ointment D. Clean the affected area with alcohol/betadine cleanser before applying the ointment

``` Anna had stopped using her medications for her scalp folliculitis after only 2 days, since her antibiotic ointment had kept sticking to her hair strands instead of her scalp and looked dirty. You would suggest to change the preparation into which: A. Gel B. Cream C. Lotion D. Shampoo ```

``` The most significant barrier to percutaneous drug delivery is in which of the following skin component characteristic? A. Thickness of adipose tissue B. Condition of stratum corneum C. Presence of dermal appendages D. Sufficiency of vascular supply ```

One of the following statements should also be a concern of all dermatologists especially when treating a PGH patient or any patient coming to us for consult: A. Is the dermatoses contagious? B. Is the lesion cancerous? C. Is the treatment cost-effective? D. Will it leave irreversible cosmetic outcome?

[T/F] Patients with severe psoriasis are predisposed to myocardial infarction.

[T/F] Obese patients are usually associated with a severe form of psoriasis.

[T/F] Psoriasis is a TH2 disease.

[T/F] The Auspitz Sign refers to collections of neutrophils in the upper spinous cell layer of the epidermis.

[T/F] Cultures from lesions in patients with guttate psoriasis yield Streptococcus.

[T/F] Sun exposure to the point of sunburn is beneficial for psoriasis.

[T/F] Phototherapy is the first line of treatment for mild, moderate, and sever psoriasis.

[T/F] Oil spots are due to defective keratinization of the proximal nail matrix.

[T/F] Emollients are important in the treatment of psoriasis.

[T/F] Steroids taken orally rather than applied topically facilitate faster clearance of severe psoriasis.

Ill-defined doughy skin of the face A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Well-defined inner margin with ill-defined outer margin and central area of atrophy A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Acid fast bacilli on Fite stain (-) A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Child with solitary hypopigmented anesthetic patch A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Solitary erythematous indurated well-demarcated hypoesthtetic plaque on arm A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Multi-drug treatment of Rifampicin, Clofazimine, Dapsone for 1 year A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Multi-drug treatment of Rifampicin and Dapsone for 6 months A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Hyperesthetic plaques A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Develop type 1 reaction after intake of medications A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

Acid fast bacilli on Fite stain (+6) A. Hansen’s Disease, indeterminate type B. Hansen’s Disease, tuberculoid type (TT) C. Hansen’s Disease, lepromatous type (LL) D. Hansen’s Disease, borderline type (BB)

2015 Flashcards

(98 cards)