4TH BI Flashcards
The following is one of the Pemphigus antigen
desmogleins
Keratins
Globulins
Desmosomes
desmogleins
One of the following has intraepidermal blister.
bullous pemphigoid
cicatrial pemphigus
pemphigus foliaceous
linear IgA dermatosis
pemphigus foliaceous
A patient is diagnosed to have bullous pemphigoid, his biopsy will present predominantly with the following inflammatory infiltrates
Neutrophils
Eosinophils
Basophils
Lymphocytes
Eosinophils
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 ?
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 ?
True or False.
There is no laboratory test to support the diagnosis of TEN.
True
What do you call the process of dislodgement of the epidermis by lateral pressure?
Nikolsky’s sign
What disease has more than 30% body surface area involvement?
toxic epidermal necrolysis
What do you call the prognosis scoring constructed for TEN?
Scorten
What is the most common complication during the acute phase of EN
Sepsis
Drugs with no increased risk for SJS/TEN
cephalosporins
tetracyclines
valproic acid
NSAIDS
NSAIDS
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
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
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
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
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
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
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
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
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
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
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
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
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
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
hypopigmented 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
DH
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
