Dermatology MCQs Flashcards
What is this?
Acanthosis Nigricans
Hyperpigmentation in folds, associated with obesity
Is fungal infection of the scalp leading to hair loss more common in children or adults?
Children aged 3-7 most commonly
What is the excision margin for melanoma?
Hard - for diagnosis/suspect it is 2mm
Then if confirmed, wide excision depends on Breslow thickeness. It is up to 2cm
Old man has generalised blisters. The blisters are subepithelial and immunofluorescence shows IgG and c3. Which of the following answers are correct?
The is pemphigus vulgaris, associated with increase in mortality
This responds well to topical antibiotics
This condition is easily recognised based on its distinctive appearance
This condition can come and go and requires treatment over many years
? treating with high dose tetracycline
Think this is describing bullous pemphigoid (subepithelial, IgG + C3 in liner line - bm)
Therefore:
F
F
Hmm - yes for elderly, no for younger, needs biopsy
T
T
Young woman with rash around her nose, mouth, and face. Which are the correct answers? (select multiple)
This is rosacea
This is perioral dermatitis.
It is much more likely in women than men, and can sometimes be brought on by steroid use/withdrawal
This should be treated with a 6 week course of tetracycline antibiotics
F
T
T
T
Picture of contact allergic dermatitis. Which of the following are true?
This condition should be investigated using patch testing
This is fungal infection of the hand, because it is present in both hands
This could be atopic or contact allergic dermatitis
T (if the allergen not obvious)
F
Prob T
Which of the following are true regarding patch testing?
Takes 72 hours to show results
Can test over 30 different allergens at once
Use a needle to inject the allergen into the skin
Produces an urticarial response
Produces a type 1 hypersensitivity response
Checked at 48 hours, checked again in 2 more days, then again 2-3 days later
T
F (just on the disc)
F (bulloid)
F (type 4)
Picture of seborrheic keratoses
This is seborrheic keratoses, only needs to be removed for symptomatic or cosmetic reasons
T - it is benign
Picture of ?psoriasis on the hands. What is the best treatment?
Cryotherapy
Topical Antibiotics
Calcipotriol cream
F
F
T
generally mild steroid creams
Coal tar creams
Calcipotriol ointment
Methotrexate, acitertrin - SEVERE
Picture of discoid lesion on upper arm
Diagnosis
Treatment - cryotherapy or topical steroids
if DLE Diagnosis is biopsy, ANA negative
Treatment = steroids ,sun protection, HCQ, topical retinoids
If discoid eczema - steroids
Picture of lichenified palm
treatment
Steroid - tolerates pretty high for several weeks
- 49 F gets a rash on her left cheek. No PMHx. What is the correct answer? Select 1 option
This is due to chronic sun damage
More common in europeans
This is discoid lupus, and it is probably systemic
This is discoid lupus and ?scalp scarring
F - it can be following sun exposure
F - Maori + Pacifica
F - usually just localised
DLE can cause scarring alopecia
- Picture of ?acne. What is correct?
This can be treated with topical retinoids
T
- This is a patch test, and the patient will need to make a total of 3 visits to complete the test
- This is a scratch chamber test, and it is necessary to expose the test substances to ultraviolet at 48 hours.
- This is a patch test, and it is used to detect Type l allergic reactions
- A positive reaction will usually appear as an urticarial area, and the strength of the reaction is graded by measuring the diameter of the urticaria
- This test should be routinely performed in all adults with atopic eczema.
T
F
F
I think this is F, that is a skin prick test not a patch test
F - contact not atopic
- Bowens disease (Squamous Cell Carcinoma in situ) will usually transform into invasive Squamous Cell Carcinoma within a year or two of diagnosis (true/false)
FALSE only 5% risk
This condition rarely occurs on the trunk in females
Dalacin T (topical clindamycin is likely to be effective)
Scarring will only occur if lesions are picked at or squeezed
Isotretinoin is highly effective, but can cause problems with fertility
Hypertryglyceridemia may occurs with isotretinoin treatment
F - often on back
F - only 50% effective
F can have scarring anyway
T
T
Select one:
* Comedones may respond to intralesional steroid
* It is related to blockage in the pilosebaceous ducts
* Both sebaceous and eccrine glands are affected
* The condition resolves spontaneously by the age of 40
* Diet is a significant factor
It is related to blockage in the pilosebaceous ducts
- This woman had a sudden onset of an itchy, red, scaly rash on the lower face, neck, yolk of the neck forearms, and dorsa of the hands. She has no previous history of skin problems. She had spent previous days outdoors but had worn a hat and used sunscreen. Which of the following statements is true?
- She will need to take time off work because it is contagious
- This is a lymphoma and will require aggressive chemotherapy
- This is most likely to be Photoaggravated psoriasis
- One should consider allergy to her suncscreen in the differential diagnosis
- This is intertrigo, and will respond to a mild steroid cream
- This is most likely to be Photoaggravated psoriasis
- This man’s amelanosis affects only the face. Which one or more of the following statements are correct?
Select one or more:
* This condition usually occurs in childhood, and only infrequently involves sites other than the face.
* This is most likely to be pityriasis alba.
* This condition may display the Koebner phenomenon
* This condition may respond to PUVA or narrow band UVB phototherapy.
* This condition is caused by an abnormal host response to a commensal yeast called Malassezia furfur.
* Significant spontaneous repigmentation is commonplace
F - vitiligo usually before 20 but common in lots of places
T
T
F
F - it is usually slowly progressive
- Melanomas are more common in those people who have hundreds of moles (true/false)
True
- Dermatofibromas usually occur in childhood and are frequently multiple and often itchy (true/false)
F - usually early adulthood, itchiness not hallmark, generally just one
- Trichophyton rubrum
- Corynebacterium
- Mycobacterium leprae
- Staphylococcus aureus
- Malassezia globose
Trichophyton rubrum
- This is discoid eczema, and the treatment of choice is cryotherapy with liquid nitrogen.
- This condition is called vitiligo.
- This is discoid eczema, and a midpotency steroid cream could be used.
- The most likely diagnosis is an amelanotic melanoma, and the treatment of choice is imiquimod cream.
- The most likely diagnosis is erythroderma
F (Cyrotherapy lol)
F
T
F
F
- Which of the following is a true statement about chrondrodermatitis nodularis/chronica helicis?
Select one:
* The patient usually complains of pain when they lie on the affected part in bed.
* It typically affects young women.
* Untreated, it frequently transforms into squamous cell carcinoma.
* It results from a type IV hypersensitivity reaction to methacrylates.
* It is caused by a yeast called Malassezia furfur
The patient usually complains of pain when they lie on the affected part in bed.
- This 49-year-old lady has developed a rash on the face. It is not itchy. She has no previous history of skin conditions. She is otherwise well and on no medications. There is follicular hyperkeratosis. Which of the follwing statements is true about this condition?
Select one:
* It is Discoid Lupus Erythematosus, and there is a significant risk of systemic involvement
* It is solar Keratosis and should be frozen with liquid nitrogen
* It is usually seen in fair skinned Europeans
* If it affects the scalp it will cause a scarring alopecia
* It is a result of chronic sun damage
F
F
F
T
F (just can follow sun)
- This young woman has had on the face for several months. It only to the shown in the photo.
She has had no treatment for it. Which of the following statements are correct?
- This is mostly to be a perioral dermatitis, and it should respond to treatment with a tetracycline antibiotic
- This could be a contact allergic dermatitis and she should have a patch test
- This condition is much more common in women than in men, in some patients it occurs as a result of topical steroid use
- This is most likely to be rosacea, and a scraping will confirm the diagnosis
- This is mostly candida infection and it should respond to an imidazole cream
T
F
T
F
F
Treatment?
This is a type of eczema - try potent steroid e.g. Hydrocortisone locoid cream
What dis
Sebborheic keratosis
(Nodular)BCC
Bullous phemigoid
What dis + treatment
Fungal infection
skin scrapings - microscopy + culture
- T/F - Streptococcal infection precipitates guttate psoriasis eruption
True
Second one
Keratosis pilaris
superficial BCC
Solar keratoses
T
F (brittle, splitting)
F
F
F
T
T
F
F
F
T
F
F (fungus)
F
F
Patch test
.
This is tinea versicolor therefore
F
F
F
F
F
T
F
F
F
T
MC#14 A 45 year old Chinese man with a one year history of skin trouble, which his GP has diagnosed as “hand dermatitis’. Examination reveals powdery scaling on the palmar surface of one hand. The dorsal surface is unaffected, and the other hand is entirely normal. Both soles are slightly scaley. He is a horticulturalist. There is no previous history of skin disease nor atopic conditions. The best treatment for this condition would be:
Clobetasol propionate 0.05% cream (Dermovate ), daily
UVA phototherapy
Itraconazole 200mg twice daily for one week each month for 2 months
Hydrocortisone 1% ointment daily
Dapsone 100mg daily for 2 weeks.
Itraconazole 200mg twice daily for one week each month for 2 months
Contact allergic
Tetracyclines common
