-
Question 1
Correct
-
Café-au-lait spots are seen in each of the following, except:
Your Answer: Friedreich's ataxia
Explanation:Café-au-lait spots are hyperpigmented lesions that vary in colour from light brown to dark brown, with borders that may be smooth or irregular.
Causes include:
- Neurofibromatosis type I
- McCune–Albright syndrome
- Legius syndrome
- Tuberous sclerosis
- Fanconi anaemia
- Idiopathic
- Ataxia-telangiectasia
- Basal cell nevus syndrome
- Benign congenital skin lesion
- Bloom syndrome
- Chediak-Higashi syndrome
- Congenital nevus
- Gaucher disease
- Hunter syndrome
- Maffucci syndrome
- Multiple mucosal neuroma syndrome
- Noonan syndrome
- Pulmonary Stenosis
- Silver–Russell syndrome
- Watson syndrome
- Wiskott–Aldrich syndrome
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 2
Incorrect
-
Which is NOT a prognostic factor for patients with malignant melanoma?
Your Answer: Breslow thickness > 3 mm
Correct Answer: Diameter of melanoma > 6 mm
Explanation:Features that affect prognosis are tumour thickness in millimetres (Breslow’s depth – the deeper the Breslow thickness the poorer the prognosis.), depth related to skin structures (Clark level – the level of invasion through the dermis), type of melanoma, presence of ulceration, presence of lymphatic/perineural invasion, presence of tumour-infiltrating lymphocytes (if present, prognosis is better), location of lesion, presence of satellite lesions, and presence of regional or distant metastasis. Malignant melanoma tends to grow radially before entering a vertical growth phase. The diameter it reaches has not been found to be a prognostic factor.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 3
Correct
-
A 72-year-old with varicose veins complains of swollen, red, itchy legs. Which is the most likely diagnosis?
Your Answer: Varicose eczema
Explanation:Varicose eczema is a common problem, particularly in elderly patients due to stasis or blood pooling from insufficient venous return; the alternative name of varicose eczema comes from a common cause of this being varicose veins. It is often mistaken for cellulitis, but cellulitis is rarely bilateral and is painful rather than itchy.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 4
Correct
-
Which of the following statements regarding psoriasis is incorrect?
Your Answer: Mediated by type 2 helper T cells
Explanation:Psoriasis is a long-lasting autoimmune disease characterized by patches of skin typically red, dry, itchy, and scaly. Psoriasis can affect the nails and produces a variety of changes in the appearance of finger and toe nails including pitting and onycholysis. Nail psoriasis occurs in 40–45% of people with psoriasis affecting the skin and has a lifetime incidence of 80–90% in those with psoriatic arthritis. Psoriasis is mediated by type 1 helper T cells which are involved in the cell mediated response.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 5
Correct
-
Which one of the following is least associated with photosensitivity?
Your Answer: Acute intermittent porphyria
Explanation:Sunlight, especially its ultraviolet radiation component, can cause increased or additional types of damage in predisposed individuals, such as those taking certain phototoxic drugs, or those with certain conditions associated with photosensitivity, including:- Psoriasis- Atopic eczema- Erythema multiforme- Seborrheic dermatitis- Autoimmune bullous diseases (immunobullous diseases)- Mycosis fungoides- Smith–Lemli–Opitz syndrome- Porphyria cutanea tardaAlso, many conditions are aggravated by strong light, including:- Systemic lupus erythematosus- Sjögren’s syndrome- Sinear Usher syndrome- Rosacea- Dermatomyositis- Darier’s disease- Kindler-Weary syndromeAcute intermittent porphyria (AIP) belongs to the group inborn errors of metabolism and most patients with AIP are not light sensitive.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 6
Incorrect
-
Which one of the following conditions is least likely to be associated with pyoderma gangrenosum?
Your Answer: Rheumatoid arthritis
Correct Answer: Syphilis
Explanation:The following are conditions commonly associated with pyoderma gangrenosum:
Inflammatory bowel disease:
- Ulcerative colitis
- Crohn’s disease
Arthritides:
- Rheumatoid arthritis
- Seronegative arthritis
Haematological disease:
- Myelocytic leukaemia
- Hairy cell leukaemia
- Myelofibrosis
- Myeloid metaplasia
- Monoclonal gammopathy
Autoinflammatory disease:
- Pyogenic sterile arthritis, pyoderma gangrenosum, and acne syndrome (PAPA syndrome)
- Granulomatosis with polyangiitis
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 7
Incorrect
-
Which of the following involving the scalp may produce alopecia (hair loss)?
Your Answer: Seborrheic dermatitis
Correct Answer: Discoid lupus erythematosus
Explanation:Causes of hair loss include:
- Dissecting cellulitis
- Fungal infections (such as tinea capitis)
- Folliculitis
- Secondary syphilis
- Demodex folliculorum
- Lupus erythematosus (hair loss may be permanent due to scarring of the hair follicles).
Psoriasis and seborrheic dermatitis commonly involve the scalp but do not produce hair loss.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 8
Correct
-
All of the following features may suggest malignant changes in a melanocytic naevi, EXCEPT?
Your Answer: Decrease in size
Explanation:Melanocytic naevi are skin tumours produced by melanocytes. They usually present in childhood but increase during puberty. The mnemonic A-B-C-D, is used by institutions to assess for suspicion of malignancy. The letters stand for asymmetry, border, colour, and diameter. If a mole starts changing in size, colour, shape or, especially, if the border of a mole develops ragged edges or becomes larger than a pencil eraser, it would be an appropriate time to consult with a physician. Other warning signs include if it begins to crust over, bleed, itch, or become inflamed.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 9
Incorrect
-
Which one of these features is typical of dermatomyositis?
Your Answer: Distal muscle weakness
Correct Answer: Gottron's papules over knuckles of fingers
Explanation:The main symptom of dermatomyositis include skin rash and symmetric proximal muscle weakness (in over 90% of patients) which may be accompanied by pain and tenderness. It occurs more commonly in females. Skin findings include:Gottron’s sign – an erythematous, scaly eruption occurring in symmetric fashion over the MCP and interphalangeal jointsHeliotrope or lilac rash – a violaceous eruption on the upper eyelids and in rare cases on the lower eyelids as well, often with itching and swellingShawl (or V-) sign is a diffuse, flat, erythematous lesion over the back and shoulders or in a V over the posterior neck and back or neck and upper chest, which worsens with UV light. Erythroderma is a flat, erythematous lesion similar to the shawl sign but located in other areas, such as the malar region and the forehead. Periungual telangiectasias and erythema occur.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
-
Question 10
Incorrect
-
Which of the following skin conditions is not associated with diabetes mellitus?
Your Answer: Necrobiosis lipoidica
Correct Answer: Sweet's syndrome
Explanation:Diabetic dermadromes constitute a group of cutaneous conditions commonly seen in people with diabetes with longstanding disease. Conditions included in this group are:- Acral dry gangrene- Carotenosis- Diabetic dermopathy- Diabetic bulla- Diabetic cheiroarthropathy- Malum perforans- Necrobiosis lipoidica- Limited joint mobility- Scleroderma- Waxy skin is observed in roughly 50%. Sweet’s syndrome is also known as acute febrile neutrophilic dermatosis has a strong association with acute myeloid leukaemia. It is not associated with diabetes mellitus.
-
This question is part of the following fields:
- Dermatology
- Medicine
-
SESSION STATS - PERFORMANCE PER SPECIALTY
