MOD1 PART1 Flashcards
Which of the following characterizes the cells in stratum granulosum?
A. Flattened eosinophilic epidermal cell
B. Flattened to cuboidal
C. Flattened polygonal cell
D. Columnar or cuboidal cell
C. Flattened polygonal cell
Slowly adapting receptor that is sensitive to stretching and it contributes to the kinesthetic movement of fingers
A. Pacinian corpuscle
B. Ruffini corpuscle
C. Meissner corpuscle
D. Golgi-mazzoni
B. Ruffini corpuscle
These are circumscribed colored lesions that are flat fading into the surrounding skin measuring 1 inch
A. Papule
B. Macule
C. Patch
D. Plaque
D. Plaque
Which is specifically responsible in helping organisms cope with molecular damage caused by sunlight?
A. Keratinocytes
B. Melanocytes
C. Langerhan cells
D. Melanosomes
D. Melanosomes (feel ko lang)
A flight attendant consults a physician due to multiple erythematous, pruritic lesion which are circumscribed, elevated and contains some fluid superficially. The lesions measures 0.2 to 0.4 cm each. Based on history, what do you call this lesion?
A. Cysts
B. Bullae
C. Pustules
D. Vesicles
D. Vesicles
The lesions eventually contained sero-sanguinous fluid and some contained pus. After a few days, the lesions dried up and developed into these thin, friable, yellowish layers on the skin where the old lesions used to be. What do you call these layers?
A. Plaques
B. Excoriation
C. Crusts
D. Erosion
C. Crusts
In the etiology and pathogenesis of seborrheic dermatitis, which of the following statements is false?
A. Zinc-deficiency is closely related to seborrheic dermatitis such that patients improved with zinc supplementation
B. Several drugs are known to trigger
seborrheic dermatitis eruptions like
griseofulvin, cimetidine, and methyldopa but is not limited to these
C. Cold temperature and low humidity can
cause flare this disease
D. Malasezzia is frequently associated with seborrheic dermatitis but pathogenesis is unknown
A. Zinc-deficiency is closely related to
seborrheic dermatitis such that patients
improved with zinc supplementation
Which of the following is NOT a primary lesion?
A. Macule
B. Ulcer
C. Papule
D. Cyst
B. Ulcer
A 3-inch round, movable, solid mass lesion palpated at the left wrist of patient John. What is most likely the type of the lesion corresponding to its size?
A. Papule
B. Nodule
C. Tumor
D. Pustule
C. Tumor
All of the following are true regarding seborrheic dermatitis, except:
A. It is a common, chronic papulosquamous disorder present in infants and adults alike
B. It is present in regions with sebaceous activity
C. It is the most common dermatoses seen in HIV and AIDS patients
D. Lower incidence in alcoholic patients
D. Lower incidence in alcoholic patients
The prevalence of seborrheic dermatitis in young adult is:
A. 1-5%
B. 5-10%
C. 3-5%
D. 1-3%
C. 3-5%
Several drugs are known to cause seborrheic dermatitis and these include the following except?
A. Cimetidine
B. Methyldopa
C. Haloperidol
D. None of the above
D. None of the above
Seborrheic dermatitis is characterized by the following
A. Occurs during the first few weeks to 3 months of life
B. Self-limited
C. Corresponds to the time when neonate produces sebum
D. All of the above
A. Occurs during the first few weeks to 3
months of life
B. Self-limited
C. Corresponds to the time when neonate
produces sebum
True of Psoriasis, Except
A. It has a universal occurrence
B. It is a chronic Inflammatory skin disease
C. It has a strong genetic basis
D. Its root cause is known
D. Its root cause is known
True about Auspitz sign:
A. Bleeding on the dilated capillaries below the scale
B. This sign refers to traumatic induction of psoriasis to non-lesional skin
C. Accidental scraping of scale causes lesion on previously non affected skin
D. There is increase bleeding on the skin part, causes bleeding points with even just mild injury
A. Bleeding on the dilated capillaries below the scale
Which of the following is TRUE of the isomorphic response of psoriasis?
A. Bleeding points appear when scale is removed
B. It occurs less frequently during flares of the disease
C. It occurs to one part of the body only, affecting new sites of injury
D. This phenomenon is not specific for the disease but can help in making the
diagnosis
D. This phenomenon is not specific for the disease but can help in making the
diagnosis
Which of the following cells are responsible for the suppression of immune response and downregulation of successful response to pathogens?
A. Dendritic Cells
B. Langerhans Cells
C. Regulatory T Cell
D. Natural Killer Cells
C. Regulatory T Cell
This refers to the pathway of keratinocyte differentiation in psoriatic skin
A. Endothelialization
B. Fibrosis formation
C. Fibrotic degeneration
D. Regenerative maturation
D. Regenerative maturation
What clinical pattern of the lesions in psoriasis show gross hyperkeratosis with partial central clearing?
A. Psoriasis gyrata
B. Rupoid psoriasis
C. Annular psoriasis
D. Ostraceous psoriasis
C. Annular psoriasis
Patient presented with erythematous scaling plaques on the scalp particularly affecting hairline with minimal lesion on nasolabial areas and eyebrows. There are no other lesion observed on the skin, so next you checked the nails that would lead you more to suspect psoriasis rather than seborrhic dermatitis. These are:
A. Paronychia, pits, pustules
B. Pits, pterygium formation, ridges
C. Pits, oily spots, onychodystrophy
D. Oily spots, midline pitting , subungal keratosis
C. Pits, oily spots, onychodystrophy
Multiple allele has been associated with psoriasis. But a certain MHC 1 predispose a patient to earlier onset and possible familial disorder. What is it?
A. HLA-B38
B. HLA-B39
C. HLA-Cw6
D. HLA-D37
C. HLA-Cw6
18 yo with sudden onset of allergy. 1cm plaques noted. anti histamine taken with no relief. 1 week prior she experienced fatigability. strep throat and low grade fever
A. Erythrodermic
B. Guttate
C. Inverse
D. Sebo
B. Guttate
A 45 year old female psoriasis patient suddenly developed eruption of pustules measuring 2-3 mm with surrounding erythema. The patient was noted to be febrile with temperature measuring 38.5^C. The pustules were on the trunk, extremities, palms and soles. On history review, the patient was taking oral corticosteroids for asthma but was discontinued. What type of psoriasis did the patient develop?
A. Guttate psoriasis
B. Erythrodermic psoriasis
C. chronic plaque psoriasis
D. von zumbusch type
D. von zumbusch type
What are the predilection sites for inverse psoriasis?
A. Axillae and genitocrural region
B. Face, trunk, feet, hands, extremities
C. Upper trunk and proximal extremities
D. Elbows
A. Axillae and genitocrural region
Topical Calcineurin inhibitor:
A. Contraindicated in pregnancy
B. Pregnancy category B
C. Inhibits ribonucleotide diphosphate reductase
D.47% improvement
E. Effective for facial psoriasis
E. Effective for facial psoriasis
Broad UVB
A. Contraindicated in pregnancy
B. Pregnancy category B
C. Inhibits ribonucleotide diphosphate reductase
D. 47% improvement
E. Effective for facial psoriasis
D. 47% improvement
Methotrexate
A. Contraindicated in pregnancy
B. Pregnancy category B
C. Inhibits ribonucleotide diphosphate reductase
D.47% improvement
E. Effective for facial psoriasis
A. Contraindicated in pregnancy
Hydroxyurea
A. Contraindicated in pregnancy
B. Pregnancy category B
C. Inhibits ribonucleotide diphosphate reductase
D.47% improvement
E. Effective for facial psoriasis
C. Inhibits ribonucleotide diphosphate reductase
Sulfasalazine
A. Contraindicated in pregnancy
B. Pregnancy category B
C. Inhibits ribonucleotide diphosphate
reductase
D.47% improvement
E. Effective for facial psoriasis
B. Pregnancy category B
True of tinea corporis
A. Usually seen in glabrous skin
B. Most commonly caused by T. tonsurans
C. Transmitted from infected human
D. Treated with methotrexate
A. Usually seen in glabrous skin
B. Most commonly caused by T. tonsurans
C. Transmitted from infected human
Which of the following is true regarding stratum granulosum:
- Composed of cuboidal cells
- Contains intense basophilic granules
- Also known as spiny cell layer
- Noted basophilia of the granules due to presence of phosphate groups
- Contains intense basophilic granules
- Noted basophilia of the granules due to presence of phosphate groups
Functions of the dermis:
- Temperature regulation
- Mechanical protection
- Innervation of the skin
- Prevention of dessication
- Temperature regulation
- Mechanical protection
- Innervation of the skin
Distribution common in both infantile and adult seborrheic dermatitis
- Scalp
- Face
- Flexural areas
- Eyelids
- Scalp
- Flexural areas
True regarding guttate psoriasis
- Most common form
- Symmetrically distributed plaques
- It affects all body sites
- It manifests at an early age
- It manifests at an early age
In the epidermis, this layer is made up of translucent and extremely flattened eosinophilic cells with cytoplasm consisting of densely pack keratin filaments embedded in electron dense matrix. This layer is only found in the thick skin
A. Stratum Basale
B. Stratum Granulosum
C. Stratum Lucidum
D. Stratum Corneum
C. Stratum Lucidum
Which of the ff. Is true of sebaceous gland
A. Dying glandular cells release sebum
B. this helps regulate surface skin temp
C. Activity is primarily sex hormone dependent
D. Derivative of embryonic dermal cells
A. Dying glandular cells release sebum
Which of the following is a secondary lesion?
A. Papule
B. Macule
C. Ulcer
D. Crust
D. Crust
This type of lesion is flat topped, pale red papule that is characteristically evanescent, disappearing within 24 hrs. It is due to edema in the papillary body of the dermis
A. Wheal
B. Bullae
C. Patch
D. Scale
A. Wheal
A 20 year old male came in to the ER due to 3 days onset of vesicular rash associated with fever and chills. As a medical clerk who attended the patient first at the ER, what should you do?
A. Ask for history of patient
B. Skin examination
C. Review of systems
D. Ask for his skin allergy
B. Skin examination
What is the cell infiltrate found in the initial macular psoriatic lesion?
A. Mast cells
B. Neutrophils
C. lymphocytes
D. Eosinophils
B. Neutrophils
Cells commonly seen in the upper epidermis known as Munro’s microabscesses
A. Mast cells
B. Neutrophils
C. Langerhan cells
D. Inflammatory dendritic epidermal cells
B. Neutrophils
Which of the following is true of the pathogenesis of psoriasis
A. Psoriasis includes B cell activation and subsequent antibody-mediated response.
B. Psoriasis involves action of several cytokines, chemokines and growth factors
C. The role of eicosanoids (e.g. Leukotrienes) is vital and important for pathogenesis of psoriasis.
D. The adaptive immunity play an important role in stimulating epidermal hyperplasia in psoriasis
B. Psoriasis involves action of several cytokines, chemokines and growth factors
34 y/o presents with skin lesions that you think is psoriasis. There is previous history of streptococcal throat infection that preceded flaring of skin lesions. What type of psoriasis might the patient most likely have?
A. Flexural
B. Plaque type
C. Eruptive
D. Erythrodynamic
C. Eruptive
Which of the following is NOT TRUE of the isosmorphic response in psoriasis
A. It occurs 1-2 weeks after the injury
B. It is the induction of Psoariasis on non-affected skin
C. It is specific for psoriasis and clinches the diagnosis during flares
D. Factors such as infection, emotional stress, and drug effects increases the prevalence of psoriasis.
D. Factors such as infection, emotional stress, and drug effects increases the prevalence of psoriasis.
What type of cellular infiltrate is seen aggregated on the stratum corneum upon histopathologic exam of a psoriatic lesion?
A. Neutrophil
B. Eosinophil
C. Lymphocyte
D. Monocyte
A. Neutrophil
Which of the following is a contraindication in giving vitamin D3 to patients with psoriasis?
A. Hypersensitivity
B. Pregnancy
C. Active skin infections
D. Hypercalcemia
D. Hypercalcemia
Treatment of Guttate Psoriasis
- NB UV
- Vit D3 Analog
- Glucocorticoid
- Systemic Steroid
- NB UV
- Vit D3 Analog
A 28/F was recently diagnosed with psoriasis. The lesions were only visible on both of her elbows which is <10% of her body area. What is the most appropriate management of this patient?
A. Acitretin
B. Systemic steroids
C. Methotrexate
D. Emollients
D. Emollients
Which of the systemic treatments of psoriasis blocks dihydrofolate reductase which leads to inhibition of purine and pyrimidine synthesis?
A. Cyclosporine
B. Methotrexate
C. Acitretin
D. Tazarotene
B. Methotrexate
Common cause of tinea corporis:
A. Microsporum canis
B. Epidermophyton floccosum
C. T. tonsurans
D. T. rubrum
D. T. rubrum
True pathogenesis of dermatophytes
A. The first step of dermatophyte infection is the invasion of
germinating fungal elements
B. Dermatophytes exhibit armamentarium of enzymes that acts as a virulence factors
C. Key position of dermatophytes reflected by the complex response in invasion
D. The degree of host inflammatory response depends on human immune status and not by the habitat of dermatophyte involved
B. Dermatophytes exhibit armamentarium of enzymes that acts as a virulence factors
A 12 year-old male child had erythematous, scaly lesions in his body. Upon skin examination, the physician noted the skin lesions to be suggestive of tinea corporis. What diagnostic procedures could be done to confirm the diagnosis?
A. Skin biopsy
B. Wood’s light
C. Tzanck smear
D. KOH Preparation
A. Skin biopsy
In the previously mentioned case (#21), the attending physician prescribed terbinafine for two weeks. Which of the following pharmacologic feature best describes the drug?
A. It is better absorbed in the presence of food
B. It has less potential to interact with medications
C. It has inhibitory effects on CYP 2D6 subset of cytochrome P450 system
D. Disadvantages include poor compliance related to the length of treatment and its bitter taste in its liquid form
C. It has inhibitory effects on CYP 2D6 subset of cytochrome P450 system
Which of following is the most common type of medium used for dermatophytes?
A. Sabouraud’s agar
B. Blood agar
C. Macconkey agar
D. Nutrient agar
A. Sabouraud’s agar
Which of the ff best describes the classic presentation of tinea corporis?
A. erythema with greasy yellow-brown scale
B. papules and plaques with silvery scale
C. annular plaques with scale across the active erythema border
D. erythema and scale on background of hyperpigmentation
C. annular plaques with scale across the active erythema border
Diagnostic tests are indicated when the cause of a skin lesion or disease is not obvious from history and physical examination alone. Identify the mismatch:
A. Skin scrapings - fungal infection
B. Punch biopsy - deep dermal or subcutaneous tissue to obtain specimen
C. Wedge excision - pigmented lesions
D. Tzanck smear - to distinguish hypo- from hyperpigmentation
D. Tzanck smear - to distinguish hypo- from hyperpigmentation
This is NOT considered a primary skin lesion:
A. Nevus
B. Mongolian spot
C. Cyst
D. Scar
D. Scar
A freckle is an example of which type of primary skin lesion?
A. Lentigo
B. Leukoderma
C. Papule
D. Macule
D. Macule
For Chronic plaque psoriasis, severe with >30% BSA, which topical treatment should be considered as firstline?
A. Tar
B. Dithranol
C. Salicylic acid
D. Emollients
D. Emollients
A 32-year old female presents at OPD with skin rash described as red, scaly, symmetrically distributed plaques. The initial impression by the physician was psoriasis. Which of the following favors psoriasis gyrata?
A. Noted with eruption of small (0.5–1.5 cm in diameter) papules over the upper trunk and proximal extremities
B. Ring-like hyperkeratotic concave lesion
C. Lesions are in the shape of a cone or limpet
D. Lesions extending laterally and become circinate because of the confluence of several plaques
D. Lesions extending laterally and become circinate because of the confluence of several plaques
Leo, 25-year old male, was having small papules over the upper trunk and proximal extremities after having streptococcal throat infection. There was symmetry of the sharply demarcated skin lesions noted at the extensor surface, with silvery scale. What is the management for this patient?
A. PUVA
B. Acitretin
C. Methotrexate
D. No treatment
D. No treatment
Which of the following is the most common form of psoriasis?
A. Flexural psoriasis
B. Psoriasis vulgaris
C. Guttate psoriasis
D. Pustular psoriasis
B. Psoriasis vulgaris
Manuel 36-year old male, hypertensive, was just started on Metoprolol 50mg 1 tablet twice a day when he noted exacerbation on his Psoriasis. What is the cause of the exacerbation?
A. Interference with intracellular cyclic adenosine monophosphate levels
B. Interference with calcium release within keratinocytes
C. Stimulation of IFN alpha production and calcium release to keratinocytes
D. Stimulation of IFN alpha production
A. Interference with intracellular cyclic adenosine monophosphate levels
Which of the following is true in the pathogenesis of psoriasis?
A. Dendritic cells are a major producer of proinflammatory cytokines, chemokines and growth factors
B. B-cell involvement or antibody-mediated process is noted in the development of psoriasis
C. IL-23 plays a central role in the pathogenesis by maintaining and expanding specific subset of CD4+ T cells
D. T-cell responses in psoriasis are nonspecific and reacts to different antigens
C. IL-23 plays a central role in the pathogenesis by maintaining and expanding specific subset of CD4+ T cells
Skin layer responsible for skin color (not to be confused with pigmentation):
A. Stratum corneum
B. Dermis
C. Stratum spinosum
D. Hypodermis
B. Dermis
Blood vessels are located in this part of the skin:
- Dermis
- Epidermis
- Hypodermis
- Muscle layer
- Dermis
- Hypodermis
(A) is a thickened heaped-up lesion while (B) feels thin, slightly indented and
there is absence of skin lines. What are they respectively?
A. Keloid and atrophy
B. Scar and lichenification
C. Scar and atrophy
D. Keloid and lichenification
A. Keloid and atrophy
Guttate Psoriasis is often self-limited. How long does it usually last?
A. 12-16 weeks without treatment
B. 6-8 weeks without treatment
C. 12-16 weeks with treatment
D. 6-8 weeks with treatment
A. 12-16 weeks without treatment
Which of the following describes type I psoriasis?
A. Age of onset is after 40 years
B. Common in elderly patients
C. Noted with HLA association
D. Rare type presents as linear psoriasis
C. Noted with HLA association
This topical treatment for psoriasis promotes keratinocyte differentiation:
A. Clobetasol
B. Betamethasone
C. Methotrexate
D. Calcipotriene
D. Calcipotriene
Which of these etiologic agents exhibit yellow fluorescence when Wood’s lamp is used?
A. Pseudomonas
B. Mycobacterium
C. Corynebacterium minutissimum
D. Microsporum
D. Microsporum
Morbilliform skin eruptions consist of
A. pustules and papules
B. macules and vesicles
C. patches and plaques
D. macules and papules
D. macules and papules
Which of the following secondary lesions is confined to the epidermis?
A. Excoriation
B. Blister
C. Fissure
D. Erosion
D. Erosion
To what specific epidermal layer are these keratin bundles that fill up the cytoplasmic processes seen?
A. Stratum basale
B. Stratum spinosum
C. Stratum granulosum
D. Stratum corneum
B. Stratum spinosum
Which of these following statements is a function of the epidermis?
A. Water content decreases up to 15% at the level of the spiny cell layer predisposing to possible desiccation
B. Langerhans cells intercept and destroy microorganisms in the epidermis
C. The melanin-containing organelles protect the nucleus from potential molecular damage from sunlight
D. The dendritic cells found in the basal cell layer play an important role in blocking the UV light
C. The melanin-containing organelles protect the nucleus from potential molecular damage from sunlight
