4TH BI Flashcards by SALI BABY

The following is one of the Pemphigus antigen

desmogleins
Keratins
Globulins
Desmosomes

desmogleins

How well did you know this?

Not at all

Perfectly

One of the following has intraepidermal blister.

bullous pemphigoid
cicatrial pemphigus
pemphigus foliaceous
linear IgA dermatosis

pemphigus foliaceous

How well did you know this?

Not at all

Perfectly

A patient is diagnosed to have bullous pemphigoid, his biopsy will present predominantly with the following inflammatory infiltrates

Neutrophils
Eosinophils
Basophils
Lymphocytes

Eosinophils

How well did you know this?

Not at all

Perfectly

Pruritic urticarial lesions and tense large blisters are the manifestations of this disease

paraneoplastic pemphigus
chronic bullous disease of childhood
bullous pemphigoid
pemphigus vulgaris

bullous pemphigoid ?

How well did you know this?

Not at all

Perfectly

A chronic autoimmune subepithelialblistering disease characterized by erosivelesions of mucous membranes and skin thatresult in scarring.

pemphigus foliaceous
paraneoplastic pemphigus
cicatricial pemphigoid
dermatitis herpetiformis

cicatricial pemphigoid ?

How well did you know this?

Not at all

Perfectly

True or False.

There is no laboratory test to support the diagnosis of TEN.

True

How well did you know this?

Not at all

Perfectly

What do you call the process of dislodgement of the epidermis by lateral pressure?

Nikolsky’s sign

How well did you know this?

Not at all

Perfectly

What disease has more than 30% body surface area involvement?

toxic epidermal necrolysis

How well did you know this?

Not at all

Perfectly

What do you call the prognosis scoring constructed for TEN?

Scorten

How well did you know this?

Not at all

Perfectly

What is the most common complication during the acute phase of EN

Sepsis

How well did you know this?

Not at all

Perfectly

Drugs with no increased risk for SJS/TEN

cephalosporins
tetracyclines
valproic acid
NSAIDS

NSAIDS

How well did you know this?

Not at all

Perfectly

Prognosis and clinical course of Epidermal necrolysis

A.epidermal detachment progresses to up to 2 weeks
B. patient may die suddenly of cardiovascular event
C. prognosis is good in under 50 years old patient
D. prognosis is not affected by the type or dose of the drug

D. prognosis is not affected by the type or dose of the drug

How well did you know this?

Not at all

Perfectly

EN is associated with significant fluid loss from erosions, which can result to

A. sepsis
B. digestive complication
C. fluid evaporation
D. electrolyte imbalance

D. electrolyte imbalance

How well did you know this?

Not at all

Perfectly

The typical target lesion in EM is

A. erythematous and edematous in the periphery
B. violaceous and reddish in the periphery
C. edematous in the center
D. measures around 5cm or mor

A. erythematous and edematous in the periphery

How well did you know this?

Not at all

Perfectly

The initial skin lesions of epidermal necrolysis are characterized by

A. several lesions coalescing together
B. irregularly shaped purpuric macules
C. multiple denuded areas
D. purpuric maculopapular lesions

B. irregularly shaped purpuric macules

How well did you know this?

Not at all

Perfectly

Most cases of Erythema multiforme are related to:

A. cytomegalovirus
b. hepatitis B
c. Mycoplasma pneumoniae
d. streptococcus pyogenes

c. Mycoplasma pneumoniae

1st most common-herpes virus
2nd most common-M. pneumonia

How well did you know this?

Not at all

Perfectly

Acneiform eruption is characterized by

A. follicular papules and pustules without
comedones
B. multiple comedones in one area affected can be appreciated
C. pruritic papules and pustules similar to exanthematous reaction can be seen
D. nodulocystic lesions are absent

A. follicular papules and pustules without
comedones

How well did you know this?

Not at all

Perfectly

Therapeutic option in the management of Epidermal necrolysis

A. give prophylactic antibiotics
B. oral antifungal should be started at the beginning of lesion eruption
C. pain reliever should not be given to avoid exacerbation of allergy
D. extensive debridement is not recommended

D. extensive debridement is not recommended

How well did you know this?

Not at all

Perfectly

True of FIXED DRUG ERUPTIONS lesions

A. lesions are very pruritic producing erosions and pigmentation
B. commonly seen in elderly
C. not associated with lymphadenopathy
D. residual grayish or slate-colored hyperpigmentation develops

D. residual grayish or slate-colored hyperpigmentation develops

How well did you know this?

Not at all

Perfectly

True of Epidermal Necrolysis

A. prodromal symptoms precede appearance of mucocutaneous lesions
B. typical target lesions would erupt after 2 weeks of intake of culprit drug
C. may present with severe pruritus
D. high grade fever, chills and abdominal pain may occur

A. prodromal symptoms precede appearance of mucocutaneous lesions

How well did you know this?

Not at all

Perfectly

Cutaneous feature of EM

A. skin lesions erupt abruptly
B. lesions are asymmetric and in flexural areas
C. fever is a common feature
D. severe pruritus

A. skin lesions erupt abruptly

How well did you know this?

Not at all

Perfectly

Prognosis of Epidermal necrolysis

a. systemic organ failure may happen
b. cellulitis and skin infection may occur eventually
c. increase respiratory rate may result to bronchial asthma
d. sepsis can be easily managed

a. systemic organ failure may happen

How well did you know this?

Not at all

Perfectly

A patient diagnosed to have lupus took phenobarbital drug after having tonic-clonic seizure episodes. This patient was rushed to the hospital after having fever, jaundice, swelling of lymph nodes, and the appearance of maculopapular lesions and pustules in the body. What is your consideration?

A. Acute Generalized Exanthematous Pustulosis
B. Drug-induced Subacute LE
C. Hypersensitivity Syndrome Reaction
D. SJS

C. Hypersensitivity Syndrome Reaction

How well did you know this?

Not at all

Perfectly

It is often considered to be an unfavorable prognostic factor but is too rare to have a significant impact on SCORTEN

A. anemia
B. lymphocytosis
c. thrombocytopenia
d. neutropenia

d. neutropenia

How well did you know this?

Not at all

Perfectly

Drug-induced non–IgE-mediated urticaria and angioedema are usually related to this kind of drugs. A. anticonvulsants B. angiotensin converting enzyme (ACE) inhibitors C. calcium channel blockers D. beta blockers

B. angiotensin converting enzyme (ACE) inhibitors

Systemic involvement in epidermal necrolysis A. palpitation and chest pain manifesting heart involvement B. abdominal pain and LBM with increasing severity C. cough and increase respiratory rate D. neurological involvement

C. cough and increase respiratory rate

The typical target lesions of EM consist of one of the following: A. peripheral violaceous area B. infiltrated pale ring C. bullae in the center D. vesicles in the center

B. infiltrated pale ring

Laboratory test in Epidermal Necrolysis A. lymphocytosis is common B. presence of hypereosinophilia C. thrombocytosis can be life threatening D. blood urea nitrogen is a marker of severity

D. blood urea nitrogen is a marker of severity

The biopsy should be taken from a fresh lesion in epidermal necrolysis, preferably from this area A. directly out of a blister B. erythematous margin area C. non lesional skin area D. peripheral crusted plaque area

B. erythematous margin area

Most likely differential diagnosis of Epidermal necrolysis a. generalized bullous fixed drug eruption b. staphylococcal scalded skin syndrome c. linear IgA disease d. paraneoplastic pemphigus

a. generalized bullous fixed drug eruption

The cutaneous lesions of epidermal necrolysis a. distal portion of the arms and legs are relatively spared b. asymmetrically distributed in the extremities c. present with tense blister d. typical target lesions with large tense bullae are present

a. distal portion of the arms and legs are relatively spared

most frequents skin sequlae in epidermal necrolysis a. hypertrophic scar development as a delayed reaction b. atrophic scarss sometimes occur c. hyperpigmentation and hypopigmentation d. no scar formation after healing

c. hyperpigmentation and hypopigmentation

** High- risk** drug in the etiology of Epidermal Necrolysis A. multivitamin B. Allopurinol C. carbocysteine D. paracetamol

B. Allopurinol

If you are the physician of this patient, which of the following is the first best choice of action? A. Treat the patient right away B. Advice to stop the drug C. Comfort the patient D. Identify the culprit drug

B. Advice to stop the drug

A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case a. metoprolol b. ranitidine c. allopurinol d. atorvastatin

c. allopurinol

The nonspecific symptoms such as fever, headache, rhinitis, cough, or malaise may precede the mucocutaneous lesions by how many days/weeks 2 weeks more than 1 week 5 - 7 days 1 - 3 days

1 - 3 days

In a severe case the following can be a manifestation in the above patient being described? (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) photophobia blepharitis painful micturition shedding of nails

shedding of nails

In the above case, the following can be true. (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) a. presence of linear IgA in direct immunofluorescence b. no laboratory test to support the diagnosis c. Neutropenia is always considered to be a good prognostic factor d. eosinophilia is always a finding

b. no laboratory test to support the diagnosis

In the case above, the following can be a differential diagnosis to consider (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) a. varicella b. erythma multiforme major c. phototxic reaction d. generalized bullous fixed drug reaction

a. varicella

In the case above, the following is the most common complication during the acute phase. (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) sepsis congestive heart failure hypoalbuminemia elevated blood urea nitrogen

sepsis

The case above is associated with significant fluid loss from erosions, which can result to the following. (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) chronic kidney disease heart failure electrolyte imbalance hair loss

electrolyte imbalance

The following is true in the above case (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) a. extensive and aggressive debridement of necrotic tissue should be done to clean up b. prophylactic antibiotics are not indicated c. eyes should be examined as needed only d. systemic corticosteroid is the mainstay of treatment

b. prophylactic antibiotics are not indicated

The hypercatabolic state of the above case is responsible for the following complication (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) hyperglycemia hypernatremia hypocalcemia hypokalemia

hyperglycemia

In the above case, massive transdermal fluid loss can result to the following (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) infection hypoalbuminemia hypokalemiai hyponatremia

hypoalbuminemia

the common lesions of the above case are (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) denuded plaques tense blisters flaccid blisters erythematous purpuric nodules

flaccid blisters

In the above case, this correlated with poor prognosis (*A lawyer developed multiple purpuric lesions and few skin desquamation/erosions and blisters in the trunk associated with erosions in the mouth and genitalia. The following is a very common culprit in this case*) presence of diabetes presence of contact dermatitis duration of drug taken amount of drug taken

presence of diabetes

There is a lateral extension of a blister when downward pressure is done. This is noted in blisteringn disorders in which the pathology is above the basement membrane zone a. Asboe-Hansen sign b. Nikolsky sign c. Pseudo-Darier sign d. Fitzpatrick (dimple) sign

a. Asboe-Hansen sign

What is this maneuver when you do la-teral pressure on unblistered skin will result to shearing of the epidermis Asboe–Hansen sign Nikolsky sign Pseudo-Darier sign Apple-jelly sign

Nikolsky sign

True of Erythema Multiforme Relapsing disease very painful very itchy pustule formation is one of the lesions

Relapsing disease

EM is usually called minor when one of the following is present 2 mucosal membranes like eyes and genitalia are involved hemorrhagic crusting of the lips maybe present there is infection of the mucosa involved severe erosions of mucosa membranes

hemorrhagic crusting of the lips maybe present

The most common cause principally in recurrent cases of EM chlamydia infection mycoplasma pneumoniae herpes simples type 1 varicella zoster virus

herpes simples type 1

EM eruptions begin in this period of time after a recurrence of herpes. average of 7days 2weeks approximately 2-3weeks average of 2 weeks

average of 7days

True of Erythema multiforme very painful very itchy can be idiopathic recurrence can be predicted

can be idiopathic

The following are useful mainly if the diagnosis is not definite clinically in patients with EM complete blood count immunoflouresence serology skin biopsy

skin biopsy

The following can be present in EM AUSPITZ SIGN koebner phenomenon Nikolsky sign positive diascopy maneuver

koebner phenomenon

The following may increase the length of hospitalization because of complications in patients with EM. c Corticosteroids High grade antibiotic high oxygen supplement immunosuppressants

Corticosteroids

True of Drug induced linear Ig A disease immune deposits disappear from the skin once the lesions resolve mucosal involvement is very common very itchy painful

immune deposits disappear from the skin once the lesions resolve very itchy from doc

It is a disease that presents with large, tense bullae arising from an erythematous, urticarial base with moderate involvement of the oral cavity. linear Ig A disease bullous pemphigoid Pseudoporphyria DRESS

bullous pemphigoid

Benny took Allopurinol due to his gouty arthritis. He then developed lesions that involved 100% of his body surface area. What is your diagnosis?

toxic epidermal necrolysis

Considered to be the most important in preventing disease progression of leprosy cell mediated immunity humoral mediated increased immune system self immunity

cell mediated immunity

All patients, except those with primary neural leprosy will present these lesions before moving to spontaneous cure or toward one of the poles or borderline forms of the clinical spectrum. erythematous plaques hyperpigmented patches hypopigmented patches hypopigmented macules

**hypo**pigmented **macules**

A special type of lepromatous leprosy that has an even higher bacillary load than the usual lepromatous leprosy, with rafts of bacilli presenting diffuse shiny nodules and papules, and a variable degree of skin infiltration tuberculoid leprosy histoid leprosy borderline leprosy lucio leprosy

histoid leprosy

The following medical dysfunction can possibly be experienced by patients with leprosy osteoporosis pneumonia irritable bowel syndrome Lung atelectasis

osteoporosis

The following is one of the complications of **lepromatous** leprosy Blindness stunted growth fracture viscous rupture

Blindness

To promote dissemination of infection, M. leprae can dedifferentiate and reprogram adult Schwann cells to the following kind of cells merkel like cells stem cell-like cells macrophages granulomatous cell

stem cell-like cells

Lepromatous leprosy patients demonstrate a massive infiltration of the following cells in histopathology lymphocytes neutrophils foamy macrophage epithelioid cells

foamy macrophage

True of **Tuberculoid** leprosy patients presence of CD4 T cells resence of CD8 T cells foamy macrophages more lymphocytes

presence of CD4 T cells

ENL, an immunologic Type III **hypersensitivity** response, occurs with immune complex deposition and influx of these cells in the lesions. lymphocytes foamy macrophages neutrophils epithelioid cells

neutrophils

True of Type 1 reaction or reversal reaction may rapidly evolve to nerve damage Type III hypersensitivity immune response humoral-mediated immunity progressive neuropathy

may rapidly evolve to nerve damage

Cutaneous or subcutis necrotizing vasculitis with presence of fibrinoid necrosis is a manifestation of the disease histoid leprosy erythema necrotisans reversal reaction ENL

erythema necrotisans

A refined tool for nerve function assessment at diagnosis, and to evaluate entrapment syndromes and neuropathic pain. High-resolution ultrasound intraneural Doppler autonomic examination Electroneuromyography

Electroneuromyography

True of Leprosy reactions never occur in Indeterminate patients reactions always occur after therapy reactions seldom occur before therapy can be easily resolved by treatment

never occur in Indeterminate patients

ENL can affect different organs, including the following lungs heart liver Testes

Testes

One of the treatment options of ENL Pentoxyphylline Clopidogrel Doxycycline Isoniazid

Pentoxyphylline

A man diagnosed to have HIV 1year ago developed multiple erythematous painful nodular swellings in both legs associated with high grade fever and malaise. His condition started after intake of multidrug therapy for leprosy treatment 6weeks ago. What is your diagnosis Drug Hypersensitivity reaction Lucio phenomenon Reversal Reaction Erythema nodosum leprosum

Erythema nodosum leprosum

In the case above, what is the possible spectrum or pole is the patient's leprosy? *A man diagnosed to have HIV 1year ago developed multiple erythematous painful nodular swellings in both legs associated with high grade fever and malaise. His condition started after intake of multidrug therapy for leprosy treatment 6weeks ago. What is your diagnosis* borderline tuberculoid lepromatous leprosy borderline-borderline Borderline lepromatous

lepromatous leprosy ??

In the case above, the following can be an extracutaneous involvement alveolitis tonsillitis Neuritis infection

Neuritis ?? alveolitis?

In the case above, what medication is associated with G6PD Rifampicin Clofazimine Dapsone Pentoxyphilline

Dapsone

This disease presents with erosions that can be induced in normal-appearing skin distant from active lesions by pressure or mechanical shear force which is known as the Nikolsky sign. Similar sign can also be found in what disease? Seborrheic dermatitis bullous pemphogoid staphylococcal scalded skin syndrome Drug hypersensitivity syndrome

staphylococcal scalded skin syndrome from doc

True of PEMPHIGUS FOLIACEUS primary lesions of small flaccid blisters are common lesions scattered in a seborrheic distribution during early disease always with mucous membrane involvement generalized involvement is uncommon

generalized involvement is uncommon from doc

This disease presents with painful stomatitis and a polymorphous cutaneous eruption with lesions that may be blistering, lichenoid, or resemble erythema multiforme Pemphigus vulgaris pemphigus foliaceous paraneoplastic pemphigus pemphigus erythematosus

paraneoplastic pemphigus

This disease is characterized by large, tense blisters arising on normal skin or on an erythematous or urticarial base. The following is also its feature. Asboe-Hansen sign is negative Eroded skin lesions heal with scarring Pruritus almost always intense very common in the elderly

Asboe-Hansen sign is negative

Epidermolysis bullosa acquisita is a subepidermal blistering disease associated with autoimmunity to Type VII collagen within anchoring fibril structures that can be found this specific area suprabasal layer hemidesmosomes dermal–epidermal junction subdermal layer

dermal–epidermal junction

This disease is a rare, immune-mediated, blistering skin disease that is defined by the presence of homogeneous linear deposits of IgA at the cutaneous basement membrane. Patients will respond dramatically to this drug prednisone Dapsone azathioprine mycophenolate mofetil

Dapsone dx: linear IgA disease

Related to the question above, the most closely associated drug that can induce this disease is? cotrimoxazole cephalosporins qiunolone vancomycin

vancomycin

Most patients affected of this disease usually can predict the eruption of a lesion as much as 8 to 12 hours before its appearance because of localized stinging, burning, or itching. DH Linear Ig A dermatosis EBA CBDC

Related to the question above, what abnormality is it commonly related to? *(dermatitis herpetiformis* irritable bowel syndrome gluten-sensitive enteropathy crohn's disease atrophic gastritis

gluten-sensitive enteropathy

It is a family of inherited genodermatoses characterized by blistering in response to minor trauma Inherited epidermolysis bullosa epidermolysis bullosa acquisita DH CBDC

Inherited epidermolysis bullosa

True of Psoriasis strong genetic basis involves dermal growth immunologic signaling rare vascular abnormalities

strong genetic basis

The following is a cellular participant in psoriasis that can be found in the upper dermis predominantly and plays a major role in maintaining chronic inflammation in psoriasis. CD8 Tcells T regulatory cells CD4 T cells natural killer cells

CD4 T cells

This cellular participant in psoriasis has long been observed in initial and developing psoriasis lesions and is involved in the reappearance of lesion after discontinuation of topical steroid. mast cells dendritic cells macrophages keratinocytes

mast cells

This cytokine is believed to play a central role in the pathogenesis of psoriasis through its role in maintaining and expanding specific subsets of CD4 T cells. IL6 PEPTIDES IL23 TUMOR NECROSIS FACTOR

IL23

The following when present in the patient's history has been associated with more widespread and recurrent disease. co morbidity diseases like hypertension and diabetes younger age of onset early treatment steroid use

younger age of onset

True of lesions of psoriasis lesions are always large plaques with whitish scales classic lesion is well demarcated asymmetric eruption koebner phenomenon is always present

classic lesion is well demarcated

Auspitz sign is due to erythematous skin scaly skin trauma to dilated blood vessels removal of scales

trauma to dilated blood vessels

It is an all-or-none phenomenon due to traumatic induction of psoriasis isomorphic response Auspitz sign too much sun exposure delayed response

isomorphic response

The following would signify good prognosis psoriasis geographica annular psoriasis psoriasis gyrata small plaque psoriasis

annular psoriasis

It is a kind of psoriasis that involves the skin folds psoriasis gyrata annular psoriasis small plaque psoriaisis flexural psoriasis

flexural psoriasis

Most prominent feature of erythrodermic psoriasis scaling erythema pain generalized involvement

erythema

This is a manifestation of erythrodermic psoriasis shiver itchiness hyperalbuminemia non pitting edema

shiver

Cardiovascular manifestation of psoriasis acute coronary syndrome chronic hypertensive cardiovascular disease essential hypertension high-output cardiac failure

high-output cardiac failure

Manifestation of pustular psoriasis hypothermia large pustules would appear raindrop size of pustules are present sterile pustules

sterile pustules

The following drug may cause pustular psoriasis beta blockers ace inhibitors antibiotics steroid

steroid

Drug that can be given in pustular psoriasis cyclosporine antibiotics pain relievers antihistamine

cyclosporine

The following can be related changes in psoriasis hyponychuim enlargement onychomycosis oncholysis hair brittle

oncholysis

extracutaneous manifestation of psoriasis hair loss nail dystrophy high output heart failure arthritis

arthritis

This laboratory exam in psoriasis is correlated with the extent of lesions and activity of the disease CBC Creatinine Transaminases blood uric acid

blood uric acid

The type of psoriasis that is often self limited psoriasis gyrata annular psoriasis guttate psoriasis small plaque psoriasis

guttate psoriasis

This kind of infection is correlated with onset of guttate psoriasis folliculitis bronchitis throat infection ecthyma

throat infection

Identification 22 year old male developed multiple skin colored nodules in a generalized distribution of 3 months duration

lepromatous leprosy

A 65 year old male diagnosed with borderline leprosy and is on 5th month of MDT followed up because his facial lesions suddenly became swollen and more erythematous. He notes pain on his lesions, and development of new lesions. He also noted swelling and weakness of his left hand.mWhat is the management of the above case? A. Discontinue MDT and give 1 mkd prednisone B. Continue MDT and give 1 mkd prednisone C. MDT only D. Shift MDT to monthly Rifampicin, Ofloxacin, Minocycline regimen

B. Continue MDT and give 1 mkd prednisone

This is a deformity caused by Hansen's disease a. hutchinson teeth B. Mulberry molar C. Rhagades D. Lagopthalmos

D. Lagopthalmos

A 50 year old male consulted because of sudden eruption of multiple erythematous painful nodules over his face, chest, upper and lower extremities. There were swelling and pain of both his lower extremities causing difficulty in walking. He also has fever, and on CBC had leucocytosis with neutrophilia. Past health history revealed that he completed a 2 year MDT course for leprosy at 3 months ago. What is your impression? A. type 2 Jopling's/ ENL B. Type 1 Jopling's/Reversal Reaction C. Lucio Phenomenon d. recurrence of leprosy

A. type 2 Jopling's/ ENL

65 year old male diagnosed with borderline leprosy and is on **5th month of MDT** followed up because his facial lesions suddenly became **swollen and more erythematous**. He notes pain on his lesions, and development of new lesions. He also noted swelling and **weakness** of his left hand. What is your impression? A. Type 2 Jopling's / ENL B. Type 1 Jopling's / Reversal Reaction C. Lucio phenomenon D. Jarish-Herxheimer reaction

B. Type 1 Jopling's / Reversal Reaction

It results from contiguous involvement of the skin overlying another tuberculous process, most commonly tuberculous lymphadenitis, tuberculosis of the bones and joints or tuberculous epididymitis A. Scrofuloderma B. Papulonecrotic tuberculid C. Lupus vulgaris D. Orificial tuberculosis

A. Scrofuloderma

Identification 45/M multiple annular nonpruritic dry annular plaques over trunk and extremities. A lesion over his forearm was anhidrotic, had loss of hair and anesthetic.

Borderline Tuberculoid Leprosy

Term used to describe loss of hair in eyebrows and eyelashes A. Alopecia areata B. Madarosis C. Telogen effluvium D. Moth-eaten alopecia Dermatology

B. Madarosis

There are necrotic lesions in leprosy arising in crops that have serrated margins characteristic of **septic infarcts and are painful** A. Type 2 Jopling's / ENL B. Type 1 Jopling's / Reversal Reaction C. Lucio phenomenon D. Jarish-Herxheimer reaction

C. Lucio phenomenon

Which cells play a major role in the pathogenesis of Psoriasis? A. T cells B. B cells C. NK cells D. Melanocytes

A. T cells

Which subtype of Psoriasis has the strongest association with HLA-CW6? A. Guttate Psoriasis B. Inverse Psoriasis C. Psoriasis vulgaris D. Von Zumbusch Psoriasis

A. Guttate Psoriasis

A 55 year old male consulted because of multiple erythematous non-pruritic lesions which started about 6 months prior to consultation. Lesions were numerous and included macules, papules, plaques and nodules. There were also punched out appearance of some plaques. He also complained of numbness on one annular lesion over his left lower leg. What is your impression? A. Acute miliary Tuberculosis B. Secondary syphilis C. Hansen's disease D. Nodular vasculitis

C. Hansen's disease

Stain for Mycobacterium leprae A. Warthin-Starry silver strain B. Iodine stain C. Modified fite Faraco vs Ziehl-Neelsen stain D. Gram stain

C. Modified fite Faraco vs Ziehl-Neelsen stain

Which of the following is a close differential for Epidermolysis Bullosa Acquisita? A.Seborrheic Dermatitis B. Pemphigus foliaceus C. Porphyria cutanea tarda D. Psoriasis vulgaris

C. Porphyria cutanea tarda

A 39 year old female presented with scaly erosions all over body. What is your clinical diagnosis?

Pemphigus foliaceus

A 40 yo male presented with flaccid bullae all over body. What is your clinical diagnosis?

B. Pemphigus vulgaris

A 30 year old female presented with scaly erosions on **trauma-prone areas of the body**. What is your clinical diagnosis?

Epidermolysis Bullosa Acquisita

An 8 yo female presented with pruritic bullae on many areas of the body. What is your clinical diagnosis?

Chronic Bullous Disease of Childhood

All of the following are accepted treatment for epidermolysis bullosa acquisita EXCEPT: A.IV immunoglobulins B. prednisone C. Dapsone D. Cotrimoxazole

D. Cotrimoxazole

Which of the following clinical presentation will point to a diagnosis of Bullous Pemphigoid? A. A large tense bullae scattered over the trunk of a 60 yo male patient B. Large flaccid bullae scattered over the trunk of a 40 yo male patient C. Small scaly plaques over the face and chest of a 40 yo male patient D. Small scaly papules over the elbows and knees of a 60 year old male patient

A. A large tense bullae scattered over the trunk of a 60 yo male patient

Which of the following is the classic histopathologic findings in Pemphigus vulgaris? A.Suprabasal blister with acantholysis, basal cells forming "row of tombstones" B. Subcorneal pustules with neutrophils and acantholytic epidermal cells in blister cavity C. Interface and lichenoid changes D. None of the above

A.Suprabasal blister with acantholysis, basal cells forming "row of tombstones"

What etiologic agent triggers the lesions of Guttate Psoriasis A. Streptococcus B. Malasezzia furfur C. Human herpevirus D.Human papillomavirus

A. Streptococcus

TRUE about the genetic basis of psoriasis: A. Type 1 psoriasis occurs in patients less than 40 years old and not associated with HLA B. Type 2 psoriasis occurs in patients more than 40 years old and is mostly associated with HLAB27 C. More than half of patients with HLACw6 will develop psoriasis D. Despite multiple wide genetic studies, only PSORS1 is consistently associated with the development of psoriasis

D. Despite multiple wide genetic studies, only PSORS1 is consistently associated with the development of psoriasis

Which of the following is true regarding Psoriasis A Cold climate improves Psoriatic lesions B Drinking 1 glass of wine/week decreases flare-ups C. Cognitive behavior/yoga and other forms of relaxation decreases flare-ups and improves patient quality of life D. Recent infection

C. Cognitive behavior/yoga and other forms of relaxation decreases flare-ups and improves patient quality of life

First line of treatment of psoriasis vulgaris >30% BSA covered with lesion? A. Methotrexate B. Topical steroid C. Systemic steroid D. Calcipotriol

Methotrexate

4TH BI Flashcards

(135 cards)