2013 B Flashcards
Arnold, a 25 year old medical student, developed papulovesicular and crusted lesions that were generalized, starting from the head and trunk and accompanied by fever. He probably has
a. Rubella
b. Rubeola
c. Varicella
d. Variola
e. Viral Influenza
C
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
B
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. Ramsey-Hunt syndrome
B
The most effective oral antifungal agent for dermatophytes is
a. Ketoconazole
b. Itraconazole
c. Terbinafine
d. Griseofulvin
e. Flucytosine
C
A 25 year old stevedore complained of a spreading plaque on his groin. On P.E., the lesions were serpiginous with central clearing. The most likely diagnosis is
a. Tinea cruris
b. Granuloma annulare
c. Inverse psoriasis
d. Allergic contact dermatitis
A
An 80 year old diabetic developed tingling and shooting pains on his forehead followed vesicular rashes that involved the tip of his nose. On examination, the lesions were mostly crusted. Your diagnosis is Herpes Zoster resolving. You will
a. Give ACV/VCV
b. Refer to ophthalmologist
c. Give antibiotics instead
d. Assure patient he is on way to recovery
B
Acyclovir/Valacyclovir (ACV/VCV) to be effective must be converted to a triphosphate form by viral enzyme:
a. Pyruvate kinase
b. Purinase
c. Carboxylase
d. Thymidine kinase
D
A 40 year old diabetic developed multiple erythematous papules and vesicles on his L trunk circling around his nipple that were painful. He also noticed some vesicles on his L thigh. He took NSAID for the pain. The most likely diagnosis is:
a. Herpes zoster
b. Allergic contact dermatitis
c. Bullous drug eruptions
d. Dermatitis herpetiformis
A
How many vesicles on his thigh should be present before a disseminated form is entertained?
a. 20 or more
b. 30 or more
c. 10 or more
d. 40 or more
A
The most effective topical antifungal agent for Candida albicans is
a. Acyclovir
b. Imidazoles
c. Terbinafine
d. Griseofulvin
e. Flucytosine
B
Mang Paul, 75 year old male, consulted the clinic because of a rough, black nodule ‘stucked-on’ his lower back for almost 5 years. He would try reaching for the lesion, carefully scraping the surface with his fingernails, but only able to succeed superficially in some portions. Nodule is now growing in size. Mang Juan probably has:
a. Seborrheic keratosis
b. Squamous cell carcinoma
c. Melanoma
d. Dermatofibroma
A
Tricia stayed up all night reviewing for an exam in her groupmate’s dormitory. In the pm of the next day, she noticed several itchy papules noted on the extensors of her arms, around her legs and feet. Some lesions have wheals and some have ‘halos’. You would think these are:
a. Scabies
b. Mosquito bites
c. Arthropod mites
d. Flea bites
B
Ms. Santos, 54 year old social worker doing community fieldwork, consulted the clinic for multiple rough dry reddish-brown plaques noted on her nose, front of left ear, upper back and upper arms. Lesions are non pruritic. On close PE of her plaques, noted are adherent scales with central atrophy. What would be your initial impression?
a. Hansen’s Disease
b. Photosensitivity reactions
c. Contact dermatitis
d. Discoid lupus erythematosus
A
BJ and friends decided to go to a nearby ‘pub’ after their medical board exams. They took their dinner prior to ordering beer and side dishes of calamares, crispy squid and shrimps. The next day, BJ noted multiple warm transient wheals and hives appearing on his face, body, and becoming generalized. He is developing:
a. Hypersensitivity reactions to insect bites
b. Acute urticaria
c. Contact urticaria
d. Airborne allergy to molds/mites
B
Aling Nilda, our manicurist, travels daily from her home in Pasig to PGH to do ‘nail service’ to residents and interns of PGH. Two months ago, she noticed itchy, erythematous to lichenified plaques on the extensor surfaces of both her arms. She could only recall application of a new St. Yves lotion given to her by her ‘balikbayan’ niece, which she applied on arms, legs, and body. Your initial impression is:
a. Allergic type of Contact Dermatitis
b. Photocontact Dermatitis
c. Phototoxic reaction
d. Irritant type of Contact Dermatitis
A
Mon, a community co-worker of the previous patient, developed reddish brown smooth dry plaques and nodules, noted on the bilateral lobes of her ears, side of the left face, infiltrated, non-pruritic, ‘feels thickened’. For months, she had not been bothered by them except that at present, the lesions are becoming more conspicuous. Your initial impression would be:
a. Contact dermatitis
b. Hansen’s disease
c. Photosensitivity reaction
d. Lupus erythematosus
B
Ange, an LU4 medical student, just completed her community rotation. She was assigned to make a community and physical diagnosis of a group of families staying in the shanties near the railway. There were stray dogs and cats loitering the area. She noticed the appearance of pruritic papules on her wrists, finger webs, buttocks, and thighs during the last week of her rotation. She cannot sleep at night because of the itchiness. Your initial impression is:
a. Dyshidrotic eczemas
b. Arthropod bite reactions
c. Scabies
d. Insect bites
C
Dr. Capito, an OB-Gyne consultant, referred her 35 year old patient confined for ovarian newgrowth because of skin problems and inability to ‘lift her right arm to comb her hair’. On PE, blood chemistries and muscle enzyme studies were requested. You would search for the following skin concerns:
a. Scaly plaques on scalp areas
b. Purplish hue of eyelids
c. Vasculitic lesions on the legs
d. Erythematous multiple discrete papules on the elbows
B
Last weekend, Joni was brought to the clinic for multiple pearly papules and nodules noted by her mom since 2 months ago. Lesions were distributed on her forehead, face and chest. On close examination, some nodules were umbilicated, some were excoriated. The lesions were
a. Multiple milia
b. Molluscum contagiosum
c. Verruca plana
d. Closed comedones
B
Jackie, a 6 year old kid, was brought to the clinic because of “impetigo”. Her lesions were wet, covered with honey colored crust, located beneath her nasal area. Her doctor advised topical corticosteroid which was applied on the area for 2 weeks. Lesions were initially suppressed but later progressed to involve upper and lower eyelids. Lesions worsened because ‘impetigo’ is caused by:
a. Parasites
b. Viruses
c. Fungi
d. Bacteria
D
Besides the skin, itch can also be evoked from the following areas:
a. Hair
b. Adipose tissue
c. Cornea
d. Nails
C
Itch cannot be produced from the following skin disease:
a. Psoriasis
b. Pityriasis versicolor
c. Leprosy
d. Acne
C
Anxious and depressed individuals manifest their conditions with complaints of pruritus usually located in which areas of the body?
a. Nose and lips
b. Palm and soles
c. Throat
d. Anogenital
D
- If one is under stress as manifested by his sweaty hands and feet, tell him to rest and sleep because of the following fact while asleep:
a. Metabolism slows down
b. Thermal sweating ceases
c. Emotional sweating ceases
d. Problems are forgotten.
C
A 16 year old high school senior was brought to the ER because of breathing difficulty and appearance of multiple wheals and hives on face and body. These occurred less than an hour after scouting activities in Mt. Makiling. Of the various mechanism causing urticaria, you would think this is:
a. Immune complex induced
b. IgE dependent
c. Non immunological
d. Immunoglobulin/complement deposition
B
[T/F] Approximately 20% of patients present with arthritis without psoriatic skin lesions.
F
[T/F] Psoriasis vulgaris affects more males than females.
F
[T/F] Oil spots and nail pitting are pathognomonic of psoriasis vulgaris.
F
[T/F] Munro’s microabscesses are collections of neutrophils in the epidermis.
T
[T/F] The most common causative agent for psoriasis vulgaris is S. aureus.
F
[T/F] The most cost-effective diagnostic tool for differentiating psoriasis vulgaris from a dermatophyte infection is the potassium hydroxide test.
T [previous Cheers]
F [explanation in 2013 B]
[T/F] Koebner’s phenomenon is a clinical sign pathognomonic for psoriasis vulgaris.
F
[T/F] Cultures from pustular lesions in patients with generalized psoriasis of von Zumbusch yield Streptococcus.
F
[T/F] Oral steroids are one of the treatment options for psoriasis vulgaris.
F
[T/F] Alefacept and other biologic agents are given to psoriasis patients to boost the immune system.
F
During the late phase of wound healing, the following processes take place, EXCEPT:
a. Collagen synthesis
b. Wound contraction
c. Wound remodeling
d. Synthesis of matrix proteins
C
Which of the following statements is true of neutrophils:
a. It does not appear to have a role in the subsequent events of healing in an uncomplicated wound.
b. Its major function is as an immunoreactant.
c. It releases the neutrophil activating protein.
d. It secretes collagenases and elastases.
A
The most important inflammatory cell in normal wound healing is:
a. Eosinophil
b. Monocyte
c. Lymphocyte
d. Neutrophil
B
Angiogenesis is stimulated by the following EXCEPT:
a. High lactase levels
b. High pH
c. Low pH
d. Low oxygen tension
B
The following statements are true of epithelialization, EXCEPT:
a. The process proceeds sequentially as follows: cellular detachment, migration, proliferation, and differentiation.
b. Regenerated epithelium DOES NOT retain all the functional advantages of normal epithelium.
c. Epithelium becomes thicker at the wound edge, compared to the mid portion of the re-epithelialized area.
d. The most important processes of epithelialization are proliferation, endothelial cell migration, and tube formation.
D
