Derm- wrong answers

Question 1

which cardiology drug is commonly known to exacerbate plaque psoriasis

Answer 1

beta blockers

Question 2

itchy white spots typically seen on the vulva of elderly women-

Answer 2

lichen sclerosus

Question 3

causes of acanthosis nigricans-

Answer 3

obesity
T2DM
PCOS
cushings
acromegaly
hypothyroidism
prader willi syndrome
GI cancer
drugs- COCP, nicotinic acid

Question 4

iron deficiency anaemia can cause pruritis true/false?

Answer 4

true

Question 5

which type of organism causes ringworm

Answer 5

fungus

Question 6

Which ONE of the following is NOT an appropriate topical therapy for localised chronic plaque psoriasis of trunk and limbs?

Very potent topical steroid
Emollient
Dithranol
Vitamin D analogue
Coal tar solution

Answer 6

very potent topical steroid

Question 7

Creams are more likely than ointments to cause contact sensitisation true/false?

Answer 7

true

Question 8

Dermatitis herpetiformis is managed through adherence to a gluten free diet. Which of the following foods must be excluded from a gluten free diet?

Rice
Sweetcorn
Wheat
Barley
Potatoes
Rye

Answer 8

what
barley
rye

Question 9

Regarding topical steroids, which ONE of the following is TRUE?

They have a vaso-dilatory effect
They cross the plasma membrane by endocytosis
They increase cell proliferation
They are lipophilic
Absorption is greater across hyperkeratotic than atrophic skin

Answer 9

They are lipophilic- true

• they have a vasoconstriction effect
• Steroids passively diffuse through the lipid bilayer due to their lipophilic nature — they do not use endocytosis
• They are anti-proliferatives
• absorption is greater in atrophic (thinner) skin, not hyperkeratotic (thickened) skin

Question 10

what do modulins do

Answer 10

cause damage to the host indirectly

Question 11

what do aggressins do

Answer 11

cause damage to the host directly

Question 12

what do impedins do

Answer 12

enables the organism to be able to avoid host defence mechanisms

Question 13

what do invasins do

Answer 13

enable organism to invade host tissue

Question 14

what do adhesins do

Answer 14

enables binding of organism to host tissue

Question 15

around what percentage of GP appointments are for skin problems?

Answer 15

around 19%- higher number have skin problem that may not require treatment

Question 16

Which of the following are present in the dermis? (You must select ALL correct answers to gain marks)

Fibroblasts
Lymphatics
Keratinocytes
Hemi-desmosomes
Ground substance

Answer 16

fibroblasts
lymphatics
ground substance

• keratinocytes confined to epidermis and hemi-desmosomes found in dermoepidermal junction

Question 17

Which of the following systems are important in maintaining good circulation in the lower limb? (Must select ALL correct answers)

The ‘muscle pump’
Heart rate
Pulse pressure
High diastolic blood pressure
Venous valves
Diabetes
Gravity

Answer 17

the ‘muscle pump’
pulse pressure
venous valves

Question 18

where are langerhans cells formed?

Answer 18

bone marrow

Question 19

what skin layer is associated with Odland bodies

Answer 19

granular layer

Question 20

what skin layer is associated with Corneocytes

Answer 20

keratin layer

Question 21

what skin layer is associated with highly metabolically active small cuboidal cells

Answer 21

basal layer

Question 22

which skin layer is associated with polyhedral cells with lots of desmosomes

Answer 22

prickle cell layer

Question 23

which enzyme is deficient in acute intermittent porphyria

Answer 23

porphobilinogen deaminase

Question 24

which enzyme is deficient in erythropoietic protoporphyria

Answer 24

ferrochelatase

Question 25

which cells are responsible for vitamin d metabolism

Answer 25

keratinocytes

Question 26

which structure stores energy

Answer 26

subcutaneous fat

Question 27

what cells provide tensile strength

Answer 27

collagen

Question 28

in what cells does epidermal proliferation occur

Answer 28

basal cells

Question 29

mucosal membranes are keratinised true/false?

Answer 29

false- they are not keratinised

Question 30

what is the function of Pacinian Corpuscles

Answer 30

pressure sensation

Question 31

what is the function of Meissner's corpuscles

Answer 31

vibration sensation

Question 32

how many days does it take for a cell to migrate from the basal layer to the keratin layer

Answer 32

28 days

Question 33

Nuclei loss starts in the ________ layer and is complete in the _______ layer

Answer 33

granular layer keratin layer

Question 34

About __% of the keratin layer is keratin and filaggrin

Answer 34

80%

Question 35

The granular layer is usually ___ cells thick

Answer 35

2-3 cells

Question 36

what type of ulcer is most likely to occur on the foot or mid-shin

Answer 36

arterial ulcer

Question 37

what type of ulcer is more likely to occur on medial or lateral malleolus

Answer 37

venous ulcer

Question 38

what type of ulcer is most likely to occur over the sacrum, heels, ischea and greater trochanters

Answer 38

pressure ulcer

Question 39

"The tendency to perceptually lock onto salient features in the patient's initial presentation too early in the diagnostic process, and failing to adjust this initial impression in the light of later information" is known as what?

Answer 39

anchoring

Question 40

"The disposition to judge things as being more likely, or frequently occurring, if they readily come to mind" is known as?

Answer 40

availability

Question 41

Definition: When a clinician’s thinking is influenced by prior expectations, stereotypes, or patient characteristics, rather than objective data. Example: Assuming a young male with chest pain is anxious because of his age/gender, and missing myocarditis. what is this known as?

Answer 41

ascertainment bias

Question 42

Definition: When a clinician disregards population-based statistics (epidemiology) because they think their patient is an exception. Example: Not prescribing anticoagulation for an elderly AF patient despite guidelines, because “he seems really fit.” what is this known as?

Answer 42

aggregate bias

Question 43

When excising skin, which of the following methods provides the best aesthetic result. A circular excision with the scalpel cutting at 45 degrees to the surface of the skin An elliptical excision with the scalpel cutting at 45 degrees to the surface of the skin An elliptical excision with the scalpel cutting at 90 degrees to the surface of the skin A circular excision with the scalpel cutting at 90 degrees to the surface of the skin

Answer 43

An elliptical excision with the scalpel cutting at 90 degrees to the surface of the skin