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DERMA 4TH BI RECALLS > 4TH BI > Flashcards

4TH BI Flashcards

1
Q

The following is one of the Pemphigus antigen

desmogleins
Keratins
Globulins
Desmosomes

A

desmogleins

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2
Q

One of the following has intraepidermal blister.

bullous pemphigoid
cicatrial pemphigus
pemphigus foliaceous
linear IgA dermatosis

A

pemphigus foliaceous

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3
Q

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

Neutrophils
Eosinophils
Basophils
Lymphocytes

A

Eosinophils

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4
Q

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

paraneoplastic pemphigus
chronic bullous disease of childhood
bullous pemphigoid
pemphigus vulgaris

A

bullous pemphigoid ?

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5
Q

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

pemphigus foliaceous
paraneoplastic pemphigus
cicatricial pemphigoid
dermatitis herpetiformis

A

cicatricial pemphigoid ?

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6
Q

True or False.

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

A

True

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7
Q

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

A

Nikolsky’s sign

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8
Q

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

A

toxic epidermal necrolysis

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9
Q

What do you call the prognosis scoring constructed for TEN?

A

Scorten

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10
Q

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

A

Sepsis

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11
Q

Drugs with no increased risk for SJS/TEN

cephalosporins
tetracyclines
valproic acid
NSAIDS

A

NSAIDS

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12
Q

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

A

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

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13
Q

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

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

A

D. electrolyte imbalance

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14
Q

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

A. erythematous and edematous in the periphery

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15
Q

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

A

B. irregularly shaped purpuric macules

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16
Q

Most cases of Erythema multiforme are related to:

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

A

c. Mycoplasma pneumoniae

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

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17
Q

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

A. follicular papules and pustules without
comedones

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18
Q

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

A

D. extensive debridement is not recommended

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19
Q

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

A

D. residual grayish or slate-colored hyperpigmentation develops

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20
Q

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

A. prodromal symptoms precede appearance of mucocutaneous lesions

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21
Q

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

A. skin lesions erupt abruptly

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22
Q

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

a. systemic organ failure may happen

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23
Q

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

A

C. Hypersensitivity Syndrome Reaction

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24
Q

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

A

d. neutropenia

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25
Q

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

A

B. angiotensin converting enzyme (ACE) inhibitors

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26
Q

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

A

C. cough and increase respiratory rate

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27
Q

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

A

B. infiltrated pale ring

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28
Q

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

A

D. blood urea nitrogen is a marker of severity

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29
Q

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

A

B. erythematous margin area

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30
Q

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

a. generalized bullous fixed drug eruption

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31
Q

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

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

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32
Q

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

A

c. hyperpigmentation and hypopigmentation

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33
Q

** High- risk** drug in the etiology of Epidermal Necrolysis

A. multivitamin
B. Allopurinol
C. carbocysteine
D. paracetamol

A

B. Allopurinol

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34
Q

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

A

B. Advice to stop the drug

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35
Q

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

A

c. allopurinol

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36
Q

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

A

1 - 3 days

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37
Q

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

A

shedding of nails

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38
Q

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

A

b. no laboratory test to support the diagnosis

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39
Q

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

a. varicella

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40
Q

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

A

sepsis

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41
Q

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

A

electrolyte imbalance

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42
Q

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

A

b. prophylactic antibiotics are not indicated

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43
Q

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

A

hyperglycemia

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44
Q

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

A

hypoalbuminemia

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45
Q

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

A

flaccid blisters

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46
Q

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

A

presence of diabetes

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47
Q

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

a. Asboe-Hansen sign

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48
Q

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

A

Nikolsky sign

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49
Q

True of Erythema Multiforme

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

A

Relapsing disease

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50
Q

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

A

hemorrhagic crusting of the lips maybe present

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51
Q

The most common cause principally in recurrent cases of EM

chlamydia infection
mycoplasma pneumoniae
herpes simples type 1
varicella zoster virus

A

herpes simples type 1

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52
Q

EM eruptions begin in this period of time after a recurrence of herpes.

average of 7days
2weeks
approximately 2-3weeks
average of 2 weeks

A

average of 7days

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53
Q

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

A

can be idiopathic

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54
Q

The following are useful mainly if the diagnosis is not definite clinically in patients with EM

complete blood count
immunoflouresence
serology
skin biopsy

A

skin biopsy

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55
Q

The following can be present in EM

AUSPITZ SIGN
koebner phenomenon
Nikolsky sign
positive diascopy maneuver

A

koebner phenomenon

56
Q

The following may increase the length of hospitalization because of complications in patients
with EM. c

Corticosteroids
High grade antibiotic
high oxygen supplement
immunosuppressants

A

Corticosteroids

57
Q

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

A

immune deposits disappear from the skin once the lesions resolve

very itchy from doc

58
Q

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

A

bullous pemphigoid

59
Q

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

A

toxic epidermal necrolysis

60
Q

Considered to be the most important in preventing disease progression of leprosy

cell mediated immunity
humoral mediated
increased immune system
self immunity

A

cell mediated immunity

61
Q

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

A

hypopigmented macules

62
Q

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

A

histoid leprosy

63
Q

The following medical dysfunction can possibly be experienced by patients with leprosy

osteoporosis
pneumonia
irritable bowel syndrome
Lung atelectasis

A

osteoporosis

64
Q

The following is one of the complications of lepromatous leprosy

Blindness
stunted growth
fracture
viscous rupture

A

Blindness

65
Q

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

A

stem cell-like cells

66
Q

Lepromatous leprosy patients demonstrate a massive infiltration of the following cells in histopathology

lymphocytes
neutrophils
foamy macrophage
epithelioid cells

A

foamy macrophage

67
Q

True of Tuberculoid leprosy patients

presence of CD4 T cells
resence of CD8 T cells
foamy macrophages
more lymphocytes

A

presence of CD4 T cells

68
Q

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

A

neutrophils

69
Q

True of Type 1 reaction or reversal reaction

may rapidly evolve to nerve damage
Type III hypersensitivity immune response
humoral-mediated immunity
progressive neuropathy

A

may rapidly evolve to nerve damage

70
Q

Cutaneous or subcutis necrotizing vasculitis with presence of fibrinoid necrosis is a manifestation of the disease

histoid leprosy
erythema necrotisans
reversal reaction
ENL

A

erythema necrotisans

71
Q

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

A

Electroneuromyography

72
Q

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

A

never occur in Indeterminate patients

73
Q

ENL can affect different organs, including the following

lungs
heart
liver
Testes

A

Testes

74
Q

One of the treatment options of ENL

Pentoxyphylline
Clopidogrel
Doxycycline
Isoniazid

A

Pentoxyphylline

75
Q

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

A

Erythema nodosum leprosum

76
Q

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

A

lepromatous leprosy
??

77
Q

In the case above, the following can be an extracutaneous involvement

alveolitis
tonsillitis
Neuritis
infection

A

Neuritis
??
alveolitis?

78
Q

In the case above, what medication is associated with G6PD

Rifampicin
Clofazimine
Dapsone
Pentoxyphilline

A

Dapsone

79
Q

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

A

staphylococcal scalded skin syndrome
from doc

80
Q

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

A

generalized involvement is uncommon

from doc

81
Q

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

A

paraneoplastic pemphigus

82
Q

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

A

Asboe-Hansen sign is negative

83
Q

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

A

dermal–epidermal junction

84
Q

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

A

Dapsone

dx: linear IgA disease

85
Q

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

cotrimoxazole
cephalosporins
qiunolone
vancomycin

A

vancomycin

86
Q

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

A

DH

87
Q

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

A

gluten-sensitive enteropathy

88
Q

It is a family of inherited genodermatoses characterized by blistering in response to minor trauma

Inherited epidermolysis bullosa
epidermolysis bullosa acquisita
DH
CBDC

A

Inherited epidermolysis bullosa

89
Q

True of Psoriasis

strong genetic basis
involves dermal growth
immunologic signaling
rare vascular abnormalities

A

strong genetic basis

90
Q

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

A

CD4 T cells

91
Q

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

A

mast cells

92
Q

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

A

IL23

93
Q

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

A

younger age of onset

94
Q

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

A

classic lesion is well demarcated

95
Q

Auspitz sign is due to

erythematous skin
scaly skin
trauma to dilated blood vessels
removal of scales

A

trauma to dilated blood vessels

96
Q

It is an all-or-none phenomenon due to traumatic induction of psoriasis

isomorphic response
Auspitz sign
too much sun exposure
delayed response

A

isomorphic response

97
Q

The following would signify good prognosis

psoriasis geographica
annular psoriasis
psoriasis gyrata
small plaque psoriasis

A

annular psoriasis

98
Q

It is a kind of psoriasis that involves the skin folds

psoriasis gyrata
annular psoriasis
small plaque psoriaisis
flexural psoriasis

A

flexural psoriasis

99
Q

Most prominent feature of erythrodermic psoriasis

scaling
erythema
pain
generalized involvement

A

erythema

100
Q

This is a manifestation of erythrodermic psoriasis

shiver
itchiness
hyperalbuminemia
non pitting edema

A

shiver

101
Q

Cardiovascular manifestation of psoriasis

acute coronary syndrome
chronic hypertensive cardiovascular disease
essential hypertension
high-output cardiac failure

A

high-output cardiac failure

102
Q

Manifestation of pustular psoriasis

hypothermia
large pustules would appear raindrop size of pustules are present
sterile pustules

A

sterile pustules

103
Q

The following drug may cause pustular psoriasis

beta blockers
ace inhibitors
antibiotics
steroid

A

steroid

104
Q

Drug that can be given in pustular psoriasis

cyclosporine
antibiotics
pain relievers
antihistamine

A

cyclosporine

105
Q

The following can be related changes in psoriasis

hyponychuim enlargement
onychomycosis
oncholysis
hair brittle

A

oncholysis

106
Q

extracutaneous manifestation of psoriasis

hair loss
nail dystrophy
high output heart failure
arthritis

A

arthritis

107
Q

This laboratory exam in psoriasis is correlated with the extent of lesions and activity of the disease

CBC
Creatinine
Transaminases
blood uric acid

A

blood uric acid

108
Q

The type of psoriasis that is often self limited

psoriasis gyrata
annular psoriasis
guttate psoriasis
small plaque psoriasis

A

guttate psoriasis

109
Q

This kind of infection is correlated with onset of guttate psoriasis

folliculitis
bronchitis
throat infection
ecthyma

A

throat infection

110
Q

Identification

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

A

lepromatous leprosy

111
Q

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

A

B. Continue MDT and give 1 mkd prednisone

112
Q

This is a deformity caused by Hansen’s disease

a. hutchinson teeth
B. Mulberry molar
C. Rhagades
D. Lagopthalmos

A

D. Lagopthalmos

113
Q

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

A. type 2 Jopling’s/ ENL

114
Q

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

A

B. Type 1 Jopling’s / Reversal Reaction

115
Q

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

A. Scrofuloderma

116
Q

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.

A

Borderline Tuberculoid Leprosy

117
Q

Term used to describe loss of hair in eyebrows and eyelashes

A. Alopecia areata
B. Madarosis
C. Telogen effluvium
D. Moth-eaten alopecia Dermatology

A

B. Madarosis

118
Q

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

A

C. Lucio phenomenon

119
Q

Which cells play a major role in the pathogenesis of Psoriasis?

A. T cells
B. B cells
C. NK cells
D. Melanocytes

A

A. T cells

120
Q

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

A. Guttate Psoriasis

121
Q

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

A

C. Hansen’s disease

122
Q

Stain for Mycobacterium leprae

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

A

C. Modified fite Faraco vs Ziehl-Neelsen stain

123
Q

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

A

C. Porphyria cutanea tarda

124
Q

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

A

Pemphigus foliaceus

125
Q

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

A

B. Pemphigus vulgaris

126
Q

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

A

Epidermolysis Bullosa Acquisita

127
Q

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

A

Chronic Bullous Disease of Childhood

128
Q

All of the following are accepted treatment for epidermolysis bullosa acquisita EXCEPT:

A.IV immunoglobulins
B. prednisone
C. Dapsone
D. Cotrimoxazole

A

D. Cotrimoxazole

129
Q

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

130
Q

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

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

131
Q

What etiologic agent triggers the lesions of Guttate Psoriasis

A. Streptococcus
B. Malasezzia furfur
C. Human herpevirus
D.Human papillomavirus

A

A. Streptococcus

132
Q

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

A

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

133
Q

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

A

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

134
Q

First line of treatment of psoriasis vulgaris >30% BSA covered with lesion?

A. Methotrexate
B. Topical steroid
C. Systemic steroid
D. Calcipotriol

A

Methotrexate

135
Q
A

DERMA 4TH BI RECALLS (1 decks)

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