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RRCCPA Clin Med Exam 4 > Derm Modules > Flashcards

Derm Modules Flashcards

1
Q

The erythematous scaly papules on the face and dorsum of both hands of this 70-year-old gardener are most likely:

A) Actinic keratoses

B) Cherry angiomas

C) Melanocytic nevi

D) Seborrheic keratoses

E) Solar lentigines

A

A) Actinic keratoses

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2
Q

Your patients has an actinic keratosis on the forehead. What treatment would you recommend?

A) Liquid nitrogen cryotherapy

B) Radiation therapy

C) Topical acyclovir

D) Topical mupirocin

E) Ultraviolet light therapy

A

A) Liquid nitrogen therapy

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3
Q

Based on this image of a firm non-healing nodule on the scalp of a balding man, what is the most likely diagnosis?

A) Actinic keratosis

B) Basal cell carcinoma

C) Malignant melanoma

D) Seborrheic keratosis

E) Squamous cell carcinoma

A

E) Squamous cell carcinoma

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4
Q

Your patient is a 55 y/o woman with a history of swuamous cell carcinoma who would like more information about sun protection. What patient education would you provide?

A) Avoid tanning beds

B) Seek shade, especailly during 10AM-4PM when the sun’s rays are the strongest

C) Use extra caution around water, snow, and sand

D) Use a broad spectrum sunscreen with a SPF of 30 or more

E) All of the above

A

E) All of the above

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5
Q

This 78-year-old man comlains of a tender nodule that grew rapidly over the past 4 weeks near his left elbow. Based on the photo below and that history, the most likely diagnosis is:

A) Actinic keratosis

B) Basal cell carcinoma

C) Intradermal nevus

D) Keratocanthoma

E) Seborrheic keratosis

A

D) Keratoacanthoma

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6
Q

The cell of origin in a squamous cell carcinoma is the ________.

A) Basal cell

B) Endothelial cell

C) Keratinocyte

D) Melanocyte

E) Neuron

A

B) Endothelial cell

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7
Q

A 54-year-old man present to the dermatology clinic with a 1cm pink plaque on his right cheek. Based on the image, what is the MOST likely diagnosis?

A) Actinic keratosis

B) Basal cell carcinoma

C) Malignant melanoma

D) Sebaceous hyperplasia

E) Squamous cell carcinoma

A

B) Basal cell carcinoma

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8
Q

Which of the following is most likely a basal cell carcinoma?

A) A bright red round 3mm homogenous papule on the abdomen

B) A fleshy skin-colored pedunculate papule in the armpit

C) A pink translucent papule on the nasal tip that won’t heal

D) A stuck-on verrucous tan flat-topped plaque on the back

E) A yellowish papule on the forehead with a central dell

A

C) A pink translucent papule on the nasal tip that won’t heal

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9
Q

A patient asks about a 5mm pink nodule on the left neck that has been present for a year and sometimes bleeds. What is the next appropriate step in therapy?

A) Application of silver nitrate in clinic

B) Home application of apple cider vinegar

C) Immediate referral for Mohs micrographic surgery

D) Recommend sunscreen use and follow-up in a year

E) Shave biopsy or referral to a dermatologist

A

E) Shave biopsy or referral to a dermatologist

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10
Q

You are taking care of a 53-year-old female patient in the internal medicine clinic. Five years ago, she had a biopsy-proven basal cell carcinoma on her nose that was treated with imiquimod. In the past 6 months, she’s notices a new pink papule in the same spot that won’t heal. What is the next appropriate action?

A) Cryotherapy

B) Excision with 5mm margins

C) Repeat application of imiquimod 5 nights a week for 6 weeks

D) Referral for Mohs micrographic surgery

E) Referral for radiation therapy

A

D) Referral for Mohs micrographic surgery

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11
Q

A 63-year-old patient presents with a lesion on his toe that has doubled in size in the past year. It is non-tender and does not bleed, but his wife says it’s getting bigger and darker on one side. The macule is 7mm in diameter. Which of the following is the best next step?

A) Liquid nitrogen cryotherapy

B) Reassurance and observation

C) Refer to dermatology for biopsy

D) Refer to orthopedics for toe amputation

E) Topical imiquimod cream

A

C) Refer to dermatology for biopsy

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12
Q

Which of the following factors is of most prognostic value indetermining survival rates in patients with cutaneous malignant melanoma?

A) Age of patient

B) Duration from onset to diagnosis

C) Fitzpatrick skin type of patient

D) Tumor diameter

E) Tumor thickness

A

E) Tumor thickness

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13
Q

Your patient’s brother was recently diagnosed with melanoma. She asks about risk factors for melanoma. Which of the following is true?

A) Consistent use of SPF 30 sunscreen has been shown to decrease melanoma incidence

B) Daily sunscreen with SPF 70 or higher is recommended for all wskin types

C) Getting a base tan from indoor tanning reduces your risk of melanoma

D) Most melanoma occur in families with genetic mutations in CDKN2A or BRCA2

E) Performing skin exams at home does not improve melanoma outcomes

A

A) Consistent use of SPF 30 sunscreen has been shown to decrease melanoma incidence

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14
Q

What factors make a lesion concerning for melanoma and should be biopsied?

A

Irregular plaque with multiple colors, asymmetry, larger than 6mm

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15
Q

You are seeing an 86 y/o man with no prior history of skin cancer with a 5mm round, light brown macule on his left deltoid that has a hypopigmented/white center and asymmetry of pigmentation. He’s not sure how long it has been present. Which of the following do you recommend?

A) Cryotherapy for 30 seconds

B) Excision with 1cm margins

C) Observation and clinical follow-up in 6 months

D) Scoop shave biopsy of entire depth and breadth of the lesion

E) Topical imiquimod 5 nights a week for 6 weeks

A

D) Scoop shave biopsy of entire depth and breadth of the lesion

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16
Q

Which of the following patients needs to be seen in dermatolgy every year?

A) A 42 y/o woman with about 15 normal nevi; no personal history of skin cancer

B) A 35 y/o man with history of melanoma in situ 3 years ago

C) A 32 y/o woman with a history of 3 dysplastic nevi that were4 excised

D) A 27 y/o man with 3 dysplastic nevi; no personal or family history of skin cancer

E) A 48 y/o woman with a grandfather who had melanoma in his 70s

A

B) A 35 y/o man with history of melanoma in situ 3 years ago

17
Q

A 14-year-old girl presents to your office with her mother. How would you describe her skin lesions?

A) Nodulocystic acne

B) Primarily comedonal acne

C) Primarily inflammatory acne

D) Rosacea

E) She does not have acne

A

B) Primarily comedonal acne

18
Q

A 15 y/o girl present to your clinic with acne with 30-40 comedones on her forehead, cheeks, and chin with few erythematous papules and no scarring. She reports that topical benzoyl is not working despite using it according to the instructions for 6 months. She has no involvement of chest or back and has normal menstrual periods. Which of the following is the best addition to her acne treatment at this time?

A) Oral isotretinoin

B) Oral minocycline

C) Oral spironolactone

D) Topical antibiotic

E) Topical retinoid

A

E) Topical retinoid

19
Q

When prescribing meds for acne vulgarism, an important step is to establish reasonable expectations with the patient. How long might a patient have to wait before seeing improvements of his/her skin?

A) 1-2 days

B) 1-2 weeks

C) 3-4 weeks

D) 2-3 months

E) 4-6 months

A

D) 2-3 months

20
Q

A 16 y/o boy presents to your office for his health maintenance visit. He has not used any treatment for his acne. The most appropriate initial treatment plan is:

A) Start benzoyl peroxide wash and see him in f/u in 3 months

B) Start oral doxycycline, topical tretinoin and benzoyl peroxide wash and see him in f/u in 3 months

C) Start oral doxy, topical tretinoin, and benzoyl peroxide wash and see him in f/u in 6 months

D) Start topical tretinoin and benzoyl peroxide was and see him in fu in 6 months

E) Start topical clindamycin and benzoyl peroxide wash and see him in f/u in 3 months

A

B) Start oral doxycycline, topical tretinoin and benzoyl peroxide wash and see him in f/u in 3 months

21
Q

An 18 y/o white woman returns to your clinic for acne. She has comedones that have improved with topical retinoid treatemtn and benzoyl peroxide, but still gets pustules and inflammatory papules. She plays field hockey. You decide to prescribe doxy 100mg twice daily. Which of the following side effect to you need to warn her about?

A) Decreased efficacy of birth control pills

B) Hyperpigmentation

C) Hypertriglyceridemia

D) Photosensitivity

E) Staining of the teeth

A

D) Photosensitivity

22
Q

A male patient has been treating the lesions on his hand with OTC salicylic acid solution off and on for one year. He is embarrassed by the appearance of his hands and the lesions are spreading. Which of the following is the most appropriate treatment?

A) Cryotherapy with liquid nitrogen

B) Intralesional triamcinolone acetonide

C) Surgical excision

D) topical calcineurin inhibitor

E) Topical retinoid

A

A) Cryotherapy with liquid nitrogen

23
Q

A 30 y/o man has these lesions on his fingers. They have been present for 3 years. What is the most appropriate morphologic term to describe these lesions?

A) Cyst

B) Nodule

C) Papule

D) Plaque

E) Vesicle

A

C) Papule

24
Q

The patient has the pink papules and plaques seen here. What serotype of HPV is the most likely cause?

A) HPV 1

B) HPV 2

C) HPV 5

D) HPV 6

E) HPV 7

A

D) HPV 6

25
Q

A mother brings in her 10 y/o daughter Sarah for a well-child visit. Sarah also has a plantar wart. You are discussing with her mother the available vaccinations for this disease preventions, including HPV vaccines. Which of the following statements is accurate?

A) The HPV vaccine is FDA-approved for girls her daughter’s age

B) There are no FDA- approved HPV vaccines for males

C) The FDA-approved HPV vaccines inculde serotypes for plantar warts

D) The FDA-approved HPV vaccines have been shown to decrease rates of cervical cancer

E) The FDA-approved HPV vaccines are also labeled as genital wart therapies

A

D) The FDA-approved HPV vaccines have been shown to decrease rates of cervical cancer

26
Q

A 30 y/o man presents to your clinic for this painful plaque on his foot. After examining his hands and feet, you tell him that it’s a wart and it looks like it is the only one. He hasn’t tried to treat it befroe and wants to start treatment. Which of the following is the most appropriate first line treatments?

A) Imiquimod

B) Salicylic acid

C) Shave removal

D) Squaric acid

E) Tretinoin

A

B) Salicylic acid

27
Q

This is an 18 y/o young woman with multiple warts on her hands for the past 4 years. She had them “frozen” by another provider and it hurt so much she is refusing “anything” that hurts. Which of the treatment options below is the best option?

A) No treatment

B) Repeat cryotherapy

C) Surgical excision

D) HPV vaccination

E) Topical salicylic acid

A

E) Topical salicylic acid

RRCCPA Clin Med Exam 4 (20 decks)

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