Multiple Choice Questions (MCQ)

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Category: Medicine--->Dermatology
Page: 4

Question 16#Print Question

A 45-year-old woman presents with the complaint that her toenails are thick and yellow. She is otherwise healthy and takes no medications. On examination, two toenails on the right foot and the great toenail on her left foot are affected. There is no periungual erythema, and her peripheral pulses are good.

What is the best advice for this patient? 

a. This nail disease will spontaneously remit
b. CBC, comprehensive metabolic profile, chest x-ray, and abdominal CT scan should be ordered to look for underlying malignancy
c. Oral therapies will need to be used for months until the nails have grown out
d. Sampling the nail is unnecessary for definitive diagnosis
e. Topical therapies are as effective as oral agents

Question 17#Print Question

A 33-year-old fair-skinned woman has telangiectasias of the cheeks and nose along with red papules and occasional pustules. She also appears to have conjunctivitis with dilated scleral vessels. She reports frequent flushing and blushing. Drinking red wine produces a severe flushing of the face. There is a family history of this condition.

Which of the following is the most likely diagnosis? 

a. Carcinoid syndrome
b. Porphyria cutanea tarda
c. Systemic lupus erythematosus
d. Rosacea
e. Seborrheic dermatitis

Question 18#Print Question

A 46-year-old construction worker is brought to the clinic by his wife because she has noticed an unusual growth on his left ear for the past 8 months (see photo below). The patient explains that, except for occasional itching, the lesion does not bother him. On physical examination, you notice an 8-mm pearly papule with central ulceration and a few small dilated blood vessels on the border.

What is the natural course of this lesion if left untreated?

a. This is a benign lesion and will not change
b. Local invasion of surrounding tissue
c. Regression over time
d. Local invasion of surrounding tissue and metastasis via lymphatic spread
e. Disseminated infection resulting in septicemia

Question 19#Print Question

A 25-year-old postal worker presents with a pruritic, nonpainful skin lesion on the dorsum of his hand. It began like an insect bite but expanded over several days. On examination, the lesion has a black, necrotic center associated with severe local swelling. The patient does not appear to be systemically ill, and vital signs are normal.

Which of the following is correct? 

a. The lesion is ecthyma gangrenosum, and blood cultures will be positive for Pseudomonas aeruginosa
b. A skin biopsy should be performed and Gram stain examined for gram-positive rods
c. The patient has been bitten by Loxosceles reclusa, the brown recluse spider
d. The patient has bubonic plague
e. The patient has necrotizing fasciitis and needs immediate surgical debridement

Question 20#Print Question

A 25-year-old man who has been living in Washington, DC, presents with a diffuse vesicular rash over his face and trunk. He also has fever. He has no history of chickenpox and has not received the varicella vaccine.

Which of the following information obtained from history and physical examination suggests that the patient has chickenpox and not smallpox? 

a. Vesicular lesions on the palms and soles
b. Vesicular lesions concentrated on the trunk
c. Rash most prominent over the face
d. All lesions at the same stage of development
e. High fever several days prior to the rash

Category: Medicine--->Dermatology
Page: 4 of 5