Dermatology Objective type Questions and Answers List
1- Which of the following concerning leg ulcers is correct?1) Diuretics have been shown to be of benefit in the treatment of associated oedema.
2) In diabetic ulcers the dressing should be left in situ for no more than 1 week
3) Large gravitational ulcers are always painful
4) Treating superficial infection with antibiotics has been shown to be beneficial
5) ulcers caused by arterial disease are typically treated by compression bandaging
Answers-2
Diuretics are only of value if ulceration is associated with oedema. Gravitational ulcers are not usually painful. If there is no obvious features of surrounding cellulitis, antibiotic therapy is usually unnecessary and has not been shown to improve healing in superficial infection which is common in ulceration.
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| Dermatology Objective type Questions and Answers |
1) Pellagra
2) Acne vulgaris
3) Psoriasis
4) Acute Intermittent porphyria
5) Xeroderma Elasticum
Answers-1
Exacerbation or localization of other dermatoses is characteristic of pellagra, Hartnup's disease, lupus erythematosus, Darier's disease, rosacea, scleroderma,
actinic lichen planus, and lymphocytoma.
3- A 22 year old woman complains of haemoptysis, abdominal pains and pyrexia for a month. She is admitted to hospital and found to be apyrexial and not distressed.
There are numerous crusted, linear lesions on her forearms.
What is the most likely diagnosis?
1) Acute intermittent Porphyria
2) Factitious disorder
3) Systemic lupus erythematosus
4) TB
5) Wegener's granulomatosis
Answers-2
The history is very vague and the patient has no clinical features other than a rash which sounds typical of dermatitis artifacta.
4- Which of the following concerning Pityriasis rosea is correct?
1) It is due to a fungal infection
2) It is characterised by flat scaly patches
3) It is frequently associated with oro-genital itching
4) May be preceded by intense itching
5) Tends to recur after apparent cure
Answers-2
5- A young woman has acne and is taking oral medication. She develops polyarthritis and raised liver enzyme tests. Investigations show
AST 95
ALT 170
bilirubin 16
antinuclear antibodies strongly positive at 1/640, negative at 1/20
Which of the following drugs is she most likely to have been prescribed?
1) erythromycin
2) isotretinoin
3) minocycline
4) oxytetracycline
5) trimethoprim
Answers-3
6- Which of the following suggests a diagnosis of molluscum contagiosum rather than chickenpox?
1) Presence of macules and papules
2) Absence of erythema surrounding lesions
3) Lesions disappearing within a month
4) Presence of pruritis
5) Positive contact history
Answers-2
7- An 18-year-old woman presents with red, tender lumps on her shins and arthralgia. Chest X-ray shows bilateral hilar lymphadenopathy and clear lung fields. A clinical diagnosis of sarcoidosis is made.
Which one of the following is the most appropriate management plan?
1) 24 hour urinary calcium measurement
2) follow up appointment with chest X-ray in three months
3) mediastinoscopy and lymph node biopsy
4) skin biopsy
5) thoracic CT scan
Answers-2
8- Which of the following is true regarding diabetic foot ulceration?
1) Autonomic neuropathy results in increased resting blood flow
2) Callus formation at pressure areas is an important predictor of ulceration
3) Plantar ulceration is most commonly due to atherosclerosis.
4) Skin infection is the most common initiating event in ulceration.
5) Radiography can readily distinguish between Charcot’s joint and osteomyelitis.
Answers-2
9- A 75-year-old female presents with chronic leg ulceration which is a consequence of venous insufficiency.
Which one of the following is the most appropriate management?
1) Appropriate systemic antibiotic in preparation for skin grafting
2) Compression bandaging
3) Improve the venous return by limb elevation
4) Skin biopsy to exclude neoplasm
5) Vein surgery Exclusion of neoplasm by skin biopsy
Answers-2
10- A 68-year-old woman presents with a 2 month history of a widespread pruritic rash. Examination reveals widespread erythema with several small blisters containing straw-coloured fluid and one or two larger serosanguinous blisters.
What is the most likely diagnosis?
1) bullous impetigo
2) bullous pemphigoid
3) Insect bite
4) scabies
5) urticarial vasculitis
Answers-2
The causes of a vesicular eruption are rather few but include pemphigoid, Erythema Multiforme and Herpes. This is a classic description of pemphigoid.
11- A 50-year-old man presented in the summer complaining of itching and blistering of his hands and forehead. On examination there were small areas of excoriation on the backs of his hands. What is the most likely diagnosis?
1) dermatitis herpetiformis
2) lupus erythematosus
3) pemphigoid
4) pemphigus
5) porphyria cutanea tarda
Answers-5
The distribution of the lesions suggests a photosensitive element. Both lupus erythematosus and PCT are associated with a photosensitive elements, however
this is more typical of PCT. PCT causes blistering of the hands and the forehead which usually heal with small scar and milia formation. It is also associated with an
excessive alcohol intake.
12- A 40-year-old female presents with a six month history of pruritic papules, vesicles and excoriations on the elbows, knees, buttocks and scalp. Her GP has prescribed topical betamethasone therapy which has been unhelpful. What is the most likely diagnosis?
1) Atopic dermatitis (Eczema)
2) Dermatitis herpetiformis
3) Hennoch-Schonlein purpura
4) Psoriasis
5) Scabies
Answers-2
Answer-1
13- A 26-year-old man is noted to have cyanosis of the lower limbs and clubbing of the toes but not the fingers. Which of the following statements is true?
1) He has Eisenmenger's syndrome.
2) He has coarctation of the aorta.
3) He is likely to have a loud continuous 'machinery' murmur below the left clavicle.
4) He is likely to need urgent surgery.
5) He has had a Blalock shunt operation.
14- A previously fit, 30-year-old female presents with a four day history of intractable pruritus and urticaria. What is the most appropriate initial
management?
1) Chlorpheniramine
2) Prednisolone
3) Ranitidine
4) Topical hydrocortisone
5) topical mepyramine
Answers-1
15- Which of the following is a true of cutaneous anthrax?
1) causes a black eschar which overlies pus
2) lesions are usually painful and tender
3) lesions are associated with marked oedema
4) Mortality is approximately 20% despite antibiotic therapy
5) Is very likely to occur in subjects exposed to anthrax spores
Answers-3
Anthrax is caused by B Ahtracis a gram positive rod. Cutaneous anthrax is associated with a black eschar without pus, tend to be painless and have widespread oedema. Without antibiotics mortality is of the order of 20%, but with antibiotics, mortality is low, which contrasts with pulmonary anthrax.
16- A 22 year old male presents with generalised pruritus of six weeks duration. Examination reveals little except for erythematous papules between the fingers. Which ofthe following therapies would be most appropriate for this patient?
1) Astemizole
2) Calamine lotion
3) Chlorpromazine
4) Ciprofloxacin
5) Permethrin cream
Answers-5
This patient has scabies, a highly contagious disease caused by the mite, Sarcoptes Scabiei. Appropriate treatment includes Permethrin cream topical Benzyl Benzoate or malathion.
17- A 40-year-old man presented with pityriasis versicolor. What is the most appropriate treatment?
1) methotrexate
2) oral terbinafine
3) psoralen with ultraviolet light (PUVA) therapy
4) topical selenium sulphide
5) phototherapy with ultraviolet light (UVB)
Answers-4
Pityriasis versicolor (also called tinea versicolor) is a skin lesion cause by a fungus called Malassezia furfur. The treatment is topical selenium sulphide. Oral
Itraconazole is also effective.
18- Which of the following is a feature of hereditary haemorrhagic telangiectasia?
1) a good response to oestrogen therapy
2) cerebral arteriovenous malformations
3) GI haemorrhage as the usual presenting feature
4) telangiectasia of the mucous membranes, but not the skin
5) tendency of lesions to become less obvious with age
Answers-2
In hereditary haemorrhagic telangiectasia there may also be pulmonary AV malformations.Epistaxis, not GI haemorrhage, is the usual presenting feature. Lesions become more obvious with age and affect mucuous membranes as well as skin. Oestrogen therapy is sometimes advocated but the effect, if any, is small.
19- Concerning Neurofibromatosis Type 1 (NF1), which one of the following statements is true?
1) Bilateral acoustic neuromas are common
2) Clinical severity in individuals is similar in a given family
3) New mutations occur rarely
4) Pigmented spots on the iris are a characteristic feature
5) The diagnosis is likely if two café-au-lait patches are present
Answers-4
20- A 30 year old woman presents with a skin rash. On applying pressure to an unaffected area of skin it was relatively easy to induce trauma.
Increased fragility of the skin is characteristic of which of the following conditions?
1) acute intermittent porphyria
2) epidermolysis bullosa
3) neurofibromatosis
4) pseudo-xanthoma elasticum
5) tuberous sclerosis
Answers-2
21- A 50-year-old man presented in the summer complaining of itching and blistering of his hands and forehead. On examination there were small areas of excoriation on the backs of his hands. What is the most likely diagnosis?
1) dermatitis herpetiformis
2) lupus erythematosus
3) pemphigoid
4) pemphigus
5) porphyria cutanea tarda
Answers-5
22- What is the most common presenting feature of porphyria cutanea tarda?
1) acute blistering crises affecting the trunk and limbs
2) acute redness and swelling following sun exposure
3) erythroderma
4) generalised hypertrichosis
5) skin fragility and blistering affecting the hands, face and scalp
Answers-2
Development of vesicles and bullae on sun exposed areas like the face, dorsa of the hand, feet, forearm and legs is the commonest feature.
23- A 24 year old female presents with vague frontal headaches and visual disturbance. She has a past history of acne for which she is receiving treatment. Examination reveals her to be obese with a blood pressure of 110/70 mmHg. There is absence of the central retinal vein pulsation on fundoscopic examination. Which of the following drugs account for these findings?
1) Isotretinoin
2) Ampicillin
3) Topical tetracycline
4) Dianette
5) Erythromycin
Answers-4
Dianette, like any oral contraceptive may be associated with Benign Intracranial Hypertension. Topical tetracycline is not associated with BIH. Rarely BIH has been
associated with isotretinoin but usually in combination with a tetracycline.
24- A 74-year-old man with a thirty year history of psoriasis presented with generalised erythroderma of 3 days duration. Examination reveals him to be shivering but otherwise is well. He was treated as an inpatient with emollients and attention to fluid replacement and temperature control but failed to improve after five days. What is the most appropriate next treatment?
1) Oral hydroxychloroquine
2) Oral methotrexate
3) Oral prednisolone
4) Topical coal tar
5) Topical dithranol
Answers-2
25- A 43 year old woman with atopic dermatitis (atopic eczema) presented with an acute generalized exacerbation of her disease. She was admitted to hospital but failed to improve with emollients, topical betamethasone-17-valerate and oral antihistamine. Which one of the following drugs is the most appropriate treatment?
1) Acitretin
2) Amoxycillin
3) Ciclosporin
4) Colchicine
5) Dapsone
Answers-3
26- Which of the following is a recognised feature of psoriasis?
1) Angular stomatitis
2) Iridocyclitis
3) Koebner Phenomenon
4) Loss of hair
5) Response to chloroquine
Answers-3
27- Which is true regarding Eczema Herpeticum?
1) Is invariably fatal if untreated.
2) Usually has an indolent onset.
3) Only a single crop of vesicles usually appear.
4) Is typically associated with a high fever for over a week.
5) Is more severe in reactivation disease.
Answers-4
28- A 16-year-old boy presentes with erythema nodusum. Which of the following should be considered?
1) Reiter's Disease
2) Ulcerative colitis
3) Cytomegalovirus infection
4) Toxoplasmosis
5) Kawasaki Disease
Answers-2
29- A 58-year-old man has a history of obesity, gastro-oesophageal reflux disease, low back pain and IHD. He presents with large, itchy wheals over the trunk and limbs and a sensation of tightness in the throat. Which one of the following drugs is the most likely to have triggered this skin eruption?
1) aspirin
2) GTN (nitrate) spray
3) omeprazole
4) paracetamol
5) simvastatin
Answers-1
In hypersensitive patients aspirin can cause angioedema, bronchospasm and urticaria(skin rashes).
30- Which statement regarding tinea capitis is correct?
1) It is most commonly caused by the fungus microsporum canis.
2) Its presence should suggest immunological deficiency.
3) It often results in permanent alopecia.
4) It causes patches that fluoresce dull green under Wood's lamp.
5) It is effectively treated with topical Nystatin ointment.
Answers-4
31- Which of the following may be responsible for an acute relapse of Systemic Lupus Erythematosus in a 38 year old female?
1) hydralazine therapy
2) Pregnancy
3) Progesterone only contraceptive pill
4) Salmeterol therapy
5) Winter holiday in Lapland
Answers-2
32- A 38 year old female presents with red target lesions confined to the hands and is diagnosed with erythema multiforme. Which of the following could be the cause?
1) Cytomegalovirus infection
2) Ureaplasma urealyticum
3) Group B Streptococci
4) Langerhan's cells histiocytosis
5) Penicillin V
Answers-5
