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Question 1
Correct
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Which of the following skin conditions is not associated with diabetes mellitus?
Your 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.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 2
Incorrect
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A 52-year-old man has squamous-cell carcinoma of his lower lip. Which of the following is most likely to be a feature of this type of carcinoma?
Your Answer: It is unrelated to sun exposure
Correct Answer: It is capable of metastasising via the lymphatics
Explanation:Squamous-cell skin cancer usually presents as a hard lump with a scaly top but can also form an ulcer. Onset is often over months and it is more likely to spread to distant areas than basal cell cancer vie the lymphatics. The greatest risk factor is high total exposure to ultraviolet radiation from the Sun. Other risks include prior scars, chronic wounds, actinic keratosis, lighter skin, Bowen’s disease, arsenic exposure, radiation therapy, poor immune system function, previous basal cell carcinoma, and HPV infection. While prognosis is usually good, if distant spread occurs five-year survival is ,34%
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 3
Incorrect
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Which is NOT a prognostic factor for patients with malignant melanoma?
Your Answer: Surface ulceration
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.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 4
Incorrect
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Which one of the following interventions has the least role in management of acne rosacea?
Your Answer: Camouflage creams
Correct Answer: Low-dose topical corticosteroids
Explanation:Mild cases are often not treated at all, or are simply covered up with normal cosmetics and avoiding sun exposure. Therapy for the treatment of rosacea is not curative, and is best measured in terms of reduction in the amount of facial redness and inflammatory lesions. The two primary modalities of rosacea treatment are topical and oral antibiotic agents (including metronidazole and tetracyclines). Laser therapy may be appropriate for patients with prominent telangiectasia.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 5
Incorrect
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Which one of these features is typical of dermatomyositis?
Your Answer: Heliotrope rash around external auditory meatus
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.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 6
Incorrect
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Which is NOT true of vitiligo?
Your Answer: It is associated with autoimmune disease
Correct Answer: A positive family history is not a risk factor
Explanation:The cause of Vitiligo is typically unknown. It is believed to be due to genetic susceptibility that is triggered by an environmental factor such that an autoimmune disease occurs. This results in the destruction of skin pigment cells. Risk factors include a family history of the condition or other autoimmune diseases, such as hyperthyroidism, alopecia areata, and pernicious anaemia. Vitiligo is classified into two main types: segmental and non-segmental. Most cases are non-segmental meaning they affect both sides and typically get worse with time. The prevalence of vitiligo is 0.5-1% of populations worldwide. Typical sites include backs of hands, wrists, knees, neck and around body orifices. The Koebner phenomenon refers to skin lesions appearing on lines of trauma. This occurs in vitiligo secondary to scratching.
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 7
Correct
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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
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 8
Correct
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Which one of these features is typical of dermatomyositis?
Your Answer: Gottron's papules over knuckles of fingers
Explanation:Dermatomyositis is a long-term inflammatory disorder which affects muscles. Its symptoms are generally a skin rash and worsening muscle weakness in the proximal muscles (for example, the shoulders and thighs) over time. These may occur suddenly or develop over months. Other symptoms may include weight loss, fever, lung inflammation, or light sensitivity. Complications may include calcium deposits in muscles or skin.The skin rash may manifest as aheliotrope (a purplish color) or lilac, but may also be red. It can occur around the eyes along with swelling, as well as the upper chest or back ( shawl sign) or V-sign above the breasts and may also occur on the face, upper arms, thighs, or hands. Another form the rash takes is called Gottron’s sign which are red or violet, sometimes scaly, slightly raised papules that erupt on any of the finger joints (the metacarpophalangeal joints or the interphalangeal joints)
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 9
Incorrect
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Which of the following statements regarding psoriasis is incorrect?
Your Answer: Phototherapy is a form of treatment
Correct Answer: Mediated by type 2 helper T cells
Explanation:Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin. These skin patches are typically red, itchy, and scaly commonly on the extensor surfaces. Psoriasis is associated with an increased risk of psoriatic arthritis, lymphomas, cardiovascular disease, Crohn’s disease, and depression. Psoriatic arthritis affects up to 30% of individuals with psoriasis. Psoriasis is mediated by type 1 helper T cells which are involved in the cell mediated response, rather than type 2 helper T cells
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This question is part of the following fields:
- Dermatology
- Medicine
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Question 10
Incorrect
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All of the following features may suggest malignant changes in a melanocytic naevi, EXCEPT?
Your Answer: Bleeding
Correct 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.
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This question is part of the following fields:
- Dermatology
- Medicine
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SESSION STATS - PERFORMANCE PER SPECIALTY
