Derma Past Paper PDF

1.) The skin is the largest organ in the body in surface area and weight a) true b) false 2.) Mark the true statement (more than one answer is correct= a) The skin is an organ of protection b) The skin is an organ sensation c) The skin is an organ of thermoregulation 3.) Localized discoloration of the skin smaller than 1cm is called a) urtica i) wheal or hive, is a raised, often itchy, area of skin ii) resulting from an allergic reaction or irritation. iii) appears pale with a surrounding area of redness iv) is not classified as discoloration alone, since it involves elevation and swelling b) bulla i) fluid-filled blister ii) larger than 1 cm in diameter iii) raised lesion containing clear fluid - which distinguishes it from a macule c) ulcer i) open sore or lesion that goes deeper than the epidermis, ii) often involving tissue breakdown and loss iii) has an indentation or depth and is associated with tissue damage, d) macule i) small, flat, and circumscribed area of skin discoloration ii) typically less than 1 cm in diameter iii) do not involve any change in skin texture, thickness, or elevation—they are purely a change in color, often seen in conditions such as freckles or small rashes. e) crust i) dried serum, blood, or pus on the skin surface ii) often seen as a scab following an injury or infection. iii) Crusts are textured and raised 4.) What does the term veneerology mean? a) science about skin appendages b) science about STD 5.) Scar belongs to - considered a secondary skin lesion because it results from the healing of a primary skin lesion, such as an injury or an infection a) primary skin lesions i) Primary lesions are the initial, direct result of a disease or physical injury to the skin, such as a macule, papule, or vesicle. b) secondary skin lesions c) final stages i) While a scar does represent the healing or final stage of a skin injury, this is not a standard classification in dermatology terminology. 6.) Scale belongs to primary skin lesions - Scales result from the accumulation or shedding of dead epidermal cells and are often seen in skin conditions involving chronic inflammation or dryness, such as psoriasis or eczema. - Primary skin lesions - include direct changes in the skin caused by underlying pathology, like macules, papules, or vesicles. - Secondary skin lesions - occur as a result of the evolution or healing of primary lesions a) false b) true 7.) Epidermis is avascular - The epidermis is avascular, meaning it does not contain blood vessels. - Nutrients reach the cells of the epidermis by diffusing from the underlying dermis, which is rich in blood vessels. a) true b) b) false 8.) Macule belongs to primary skin lesions a) true b) false 9.) The main difference between bulla and vesicle is in a) size b) content 10.) Physical process of keratinization takes a) 28 hours b) 28 days c) 28 minutes 11.) Erythroderma is - severe, widespread redness of the skin often linked to inflammatory skin diseases - psoriasis - eczema - drug reactions - This condition involves nearly the entire skin surface and can be life-threatening due to its impact on body temperature regulation, hydration, and increased infection risk a) Intense and usually widespread reddening of the skin due to inflammatory skin disease b) synonym to itching i) itching (pruritus) 12.) Stratum corneum, lucidum, granulosum, spinosum, basale are the sublayers of a) epidermis b) dermis i) The dermis lies beneath the epidermis and includes structures such as hair follicles, sweat glands, and blood vessels. c) subcutis i) hypodermis ii) deepest skin layer iii) composed mostly of fat and connective tissue, helping to insulate the body and cushion underlying structures 13.) Erythroderma can be due to ??? - widespread and intense redness of the skin, often covering large areas of the body - severe, inflammatory condition that can arise as a result of various underlying diseases, including inflammatory skin disorders, infections, and certain types of eczema a) Bullous pemphigoid i) autoimmune skin disease is characterized by large, fluid-filled blisters rather than extensive redness or erythroderma. ii) While inflammation is present, it does not usually cause the widespread redness associated with erythroderma. b) erysipelas i) acute bacterial infection of the skin involving the upper dermis and lymphatics, often caused by Streptococcus bacteria. ii) Although it can cause redness and swelling, erysipelas is usually localized rather than diffuse like erythroderma c) atopic eczema i) also known as atopic dermatitis ii) chronic skin condition that can occasionally lead to erythroderma, iii) especially in severe, poorly controlled cases or flare-ups. d) dyshidrotic eczema i) This type of eczema is primarily associated with small, itchy blisters on the hands and feet. ii) It does not typically cause widespread skin reddening that would lead to erythroderma. e) pemphigus vulgaris i) autoimmune condition causes painful blistering on the skin and mucous membranes. ii) Like bullous pemphigoid, pemphigus vulgaris does not generally lead to erythroderma but instead to localized blistering and skin erosion 14.) Margins of the ulcer a) are not well defined b) can be elevated c) never change d) are not described e) can be mixed i) margins of an ulcer vary based on the type and cause of the ulcer. ii) Ulcers can present with different types of edges or borders, and they may not be uniform 15.) Loss of part of epidermis; depressed, moist, glistening; follows rupture of a vesicle or bulla in a) echara i) scab or a type of necrotic tissue found in deeper ulcerative lesions, especially in cases like burns or gangrene b) erosion i) accurately describes a lesion that involves the loss of part of the epidermis, ii) leaving a moist and glistening surface, often resulting from the rupture of a vesicle or bulla c) crust i) forms when dried exudate, serum, or blood covers a lesion ii) typically rough and hardened iii) represents a different healing stage than erosion d) telangiectasia i) visible, dilated superficial blood vessels ii) to related to epidermis e) cyst i) is a closed sac containing fluid or semisolid material located deeper in the skin layers, often in the dermis or subcutaneous tissue 16.) Elevated, circumscribed, superficial, not into dermis; filled with serous fluid; more than 1cm in diameter is a) vesicle i) smaller, typically less than 1 cm in diameter b) cyst i) closed sac that can be located in deeper skin layers (dermis or subcutaneous tissue) and is usually filled with fluid or semisolid material ii) it is not a superficial structure c) bulla i) Elevated, raised above the skin surface. ii) circumscribed = clearly defined edges. iii) superficially located in the epidermis and does not extend into the dermis. iv) Filled with serous fluid: Clear or pale-yellow fluid, often giving a blister-like appearance. v) More than 1 cm in diameter: The key distinction between a bulla and a vesicle is size. A bulla is larger than 1 cm, while a vesicle is 1 cm or smaller. d) papule i) solid, raised lesion less than 1 cm in diameter ii) it contains no fluid e) tuber 17.) Macule is primary lesion seen in ??? - flat, discolored spot on the skin, usually less than 1 cm in diameter. - It does not have a raised or depressed surface and is often a color change without any texture change a) impetigo i) bacterial skin infection, ii) typically caused by Staphylococcus aureus or Streptococcus pyogenes. iii) presents with vesicles or pustules that can rupture, forming golden-crusted lesions b) acne i) characterized by comedones (blackheads and whiteheads), papules, pustules, and nodules. ii) These are all raised lesions, often involving the sebaceous glands and hair follicles c) folliculitis i) infection of hair follicles, usually by bacteria. ii) It manifests as papules or pustules, which are raised, often with a central hair in the middle d) drug eruption i) exanthematous reactions that appear as a maculopapular rash (composed of both macules and papules) ii) This is a typical presentation in many drug reactions, where flat, discolored macules appear along with raised lesions. e) herpes i) HSV typically presents with vesicles or blisters, often on a red base, which are raised fluid-filled lesions 18.) What is typical for superficial fungal infections? - Superficial fungal infections primarily affect the outermost layers of the skin, hair, and nails. - The most common fungal pathogens responsible for these infections are dermatophytes, which target the stratum corneum (the outermost layer of the epidermis), as well as hair and nails. - These fungi cause infections like tinea (ringworm) that affect these areas. a) severe subjective symptoms i) Superficial fungal infections typically cause mild to moderate symptoms like itching, scaling, and redness. ii) While they can be uncomfortable, they usually don’t cause severe symptoms (such as pain or systemic illness). b) involving stratum corneum, hairs, nails c) so called mycosis fungoldes i) Mycosis fungoides is a type of cutaneous T-cell lymphoma (a form of skin cancer) and is not a fungal infection at all. d) always treated topically i) topical antifungal treatment is often sufficient for many superficial fungal infections, ii) there are cases where systemic treatment is necessary, especially when the infection is extensive, involves the nails (e.g., onychomycosis), or does not respond to topical therapies e) always treated systemically i) Not all superficial fungal infections require systemic treatment. ii) Most can be effectively treated with topical antifungal medications (like creams or ointments), especially if the infection is localized. 19.) Impetigo is a common, highly contagious, superficial skin infection produced by - Impetigo is a highly contagious, superficial skin infection that is most commonly caused by the bacteria Staphylococcus aureus and Streptococcus pyogenes. - These bacteria are responsible for the characteristic appearance of impetigo, which includes crusted sores, usually around the nose and mouth, and sometimes on other parts of the body. a) staphylococcus aureus, streptococcus pyogenes i) Staphylococcus aureus 1) Often produces pustules, vesicles, and honey-colored crusts, characteristic of impetigo. ii) Streptococcus pyogenes 1) This bacteria is also a frequent cause of impetigo and can lead to bullous impetigo (larger, fluid-filled blisters) b) streptococcus pyogenes, streptococcus agalactiae i) Streptococcus pyogenes is one of the most common causes of impetigo, but Streptococcus agalactiae (Group B Streptococcus) is not typically associated with impetigo. ii) Streptococcus agalactiae is more commonly linked to neonatal infections or infections in immunocompromised individuals. c) staphylococcus aureus, streptococcus agalactiae d) staphylococcus epidermis, propionibacterium acnes i) Staphylococcus epidermidis is a bacteria normally found on the skin and is more commonly associated with infections related to indwelling medical devices or prosthetic devices (such as catheters or heart valves). ii) Propionibacterium acnes = Cutibacterium acnes is typically associated with acne. e) staphylococcus epidermis, staphylococcus aureus 20.) Condylomata lata - Condylomata lata are soft, flat, moist, wart-like lesions that occur as a manifestation of secondary syphilis, which is caused by the bacterium Treponema pallidum. - These lesions are typically found in the genital, anal, or oral regions and can appear during the secondary stage of syphilis, often a few weeks to a few months after the initial infection. a) disease of viral etiology i) They are caused by the bacterium Treponema pallidum. b) are non-infectious epitheliomas i) Condylomata lata are infectious lesions, not non-infectious. ii) They are associated with syphilis, which is a bacterial infection. They can spread through direct sexual contact. c) manifestation appears in early state of secondary syphilis d) diseases of fungal etiology i) Condylomata lata are not caused by fungi; they are caused by a bacterial infection. ii) Fungal infections would typically result in different types of skin lesions (such as ringworm or candidiasis). e) are infected epitheliomas caused by HPV i) HPV, on the other hand, causes condylomata acuminata (genital warts), which are different from condylomata lata both in appearance and etiology. 21.) Choose true statement for scabies - Scabies is a skin infestation caused by the Sarcoptes scabiei mite. - It presents with intense itching (pruritus) and a characteristic rash. a) vesicles are usually on the trunk wheals with hemorrhagic dots are i) Vesicles (small fluid-filled blisters) are not typically found on the trunk in scabies. ii) The rash in scabies is often characterized by burrows, papules, and excoriations (scratches), especially in areas where the mites have burrowed (e.g., the wrists, elbows, and between fingers). iii) Vesicles are more commonly seen in conditions like herpes or contact dermatitis b) papules are predominantly on extensor parts of the limbs i) In scabies, papules (raised, red, itchy bumps) are more commonly found in flexural areas such as the wrists, elbows, axillae, webs between fingers, and genital areas, rather than predominantly on the extensor parts of the limbs. ii) Extensor surfaces (like the outer parts of elbows and knees) are not the most common locations for papules in scabies. c) excoriated papules on the wrists are present d) typical are wheals with vesicles i) Wheals with hemorrhagic dots are not typical of scabies. ii) While scabies can cause papules and wheals due to allergic reactions to the mite's presence, hemorrhagic dots are more characteristic of vascular conditions or petechial rashes (due to blood vessel leakage). 22.) What medications are usually used as the first choice for treatment of hives? - Hives (also known as urticaria) are raised, red, itchy welts on the skin that occur due to an allergic reaction or other triggers such as stress, temperature changes, or infections. - The treatment of hives primarily focuses on relieving itching and reducing inflammation. a) allergy shots (immunotherapy) i) Allergy shots (immunotherapy) are not used to treat acute hives, but rather for long-term treatment of allergies (such as hay fever, pollen allergies, or insect stings). b) antihistamines i) first-line treatment for hives because they block the action of histamine, a chemical released during allergic reactions that causes the symptoms of hives, such as itching and swelling. ii) Antihistamines help reduce these symptoms quickly and effectively. iii) Non-sedating antihistamines, such as loratadine or cetirizine, are typically used since they are less likely to cause drowsiness. c) topical creams i) such as corticosteroid creams, may provide some relief for mild rashes or itching but are generally not effective for treating acute hives d) steroid injections i) for severe cases of hives, especially in cases where the hives do not respond to antihistamines or if the hives are associated with anaphylaxis or other serious allergic reactions e) anti-inflammatory medications like Ibuprofen i) Ibuprofen is an anti-inflammatory medication that can help reduce swelling and pain. ii) However, it does not address the underlying cause of hives, which is the release of histamine. 23.) Epidermal barrier in atopic dermatitis - In atopic dermatitis (AD), the epidermal barrier is compromised. - In atopic dermatitis, this barrier function is impaired, which leads to increased susceptibility to irritants and allergens, contributing to the inflammation and itching associated with the condition. a) allows better lipids absorption i) In atopic dermatitis, the barrier is impaired, ii) the skin has trouble retaining moisture and maintaining a proper balance of lipids. iii) the lipid composition in the stratum corneum (outermost skin layer) is altered and typically decreased in atopic dermatitis. b) is equivalent to healthy skin i) atopic dermatitis, the epidermal barrier is not equivalent to healthy skin ii) skin in atopic dermatitis is more permeable, which allows irritants, allergens, and microbes to enter more easily, iii) leading to inflammation and exacerbating symptoms c) is not impaired i) atopic dermatitis, the epidermal barrier is impaired, which is a central feature of the condition d) allows entrance of irritants e) lipids is epidermal barrier are increased i) atopic dermatitis, the lipid content in the epidermal barrier is often decreased or altered ii) reduction in lipids, particularly ceramides (important lipid molecules), contributes to a weaker skin barrier and increased water loss, which is why people with atopic dermatitis have dry, cracked skin 24.) Mark the correct statement about the patch testing ??? - Patch testing is a diagnostic method used to identify delayed-type hypersensitivity (Type IV) allergic reactions—a form of contact dermatitis. - During patch testing, specific allergens are applied to the skin to check for allergic reactions that develop over time, - typically 48 to 72 hours after exposure. a) it is used to validate irritant contact dermatitis i) Patch testing is used for allergic contact dermatitis, not for irritant contact dermatitis. ii) Irritant contact dermatitis is caused by direct irritation from chemicals or physical factors, iii) whereas allergic contact dermatitis results from an immune system response to specific allergens. b) used to validate an immediate type allergy to inhalant allergens i) Patch testing is not used for immediate-type allergic reactions (Type I hypersensitivity), such as those involving inhalant allergens (e.g., pollen, dust mites). ii) Skin prick tests or intradermal tests are used for diagnosing immediate-type allergies, not patch testing. c) the substances are applied on the skin surface d) it is used to validate an immediate type allergy to food allergens i) Similar to inhalant allergens, food allergens are typically tested using skin prick tests or specific IgE blood tests, not patch testing. ii) Patch testing is specifically for delayed-type (Type IV) hypersensitivity reactions, not immediate-type reactions. e) the least substances are applied into dermis with the injection needle i) Patch testing involves placing allergens on the skin's surface (on the epidermis), not injecting them into the dermis. 25.) Which clinical feature are characteristic for lichen planus? a) Herald patch i) seen on pityriasis rosea b) Wickham striae i) fine, white lacy lines seen on purple, polygonal papules or plaques in lichen planus ii) most characteristic feature of the disease iii) due to focal areas of hypergranulosis in epidermis c) Auspitz sign i) Auspitz sign is associated with psoriasis. When scales are scraped off the psoriatic plaque causing pinpoint bleeding. d) Carpet tack sign i) associated with discoid lupus erythematosus (DLE) ii) keratin spikes are seen on the under surface of scale when removed from DLE lesions e) Collarette scales i) This feature is also seen in pityriasis rosea. ii) These are fine rings of scaling around the lesions 26.) The important features of psoriasis is a) scaling i) also called hyperkeratosis ii) scaling in red inflamed plaques which are silvery-white and can be easily removed iii) underlying skin may show Auspitz sign b) scarring i) The plaques in psoriasis do not usually result in a scar formation when they resolve. ii) Might happen only in severe cases or with secondary infection or trauma. c) crusting i) Crusting is more commonly seen in impetigo (bacterial skin infection) or eczema with secondary infection. d) Lichenfication i) Is commonly associated with eczema, contact dermatitis or certain infections. e) oozing i) Psoriasis lesions are typically dry rather than moist or oozing. 27.) Treatment of psoriasis includes a) systemic steroids i) generally not recommended for treating psoriasis, they carry a high risk of severe rebound psoriasis when discontinued. b) terbinafine i) antifungal medication for onychomycosis (fungal nail infection) and tinea (ringworm) c) antihistamines i) used primarily to relieve itching causes by allergic reactions or conditions like hive = urticaria d) methotrexate i) is commonly used systemic treatment for moderate to severe psoriasis ii) works as an immunosuppressant which slows down the rapid skin turnover and reduces inflammation associated with psoriasis iii) effective when topical treatment or phototherapy was not successful e) vitamin B analogue i) Vitamin D analogues (calcipotriol, calcitriol) are commonly used topically. It helps to slow down skin cell production. 28.) Intraepidermal bullas are seen in a) pityriasis versicolor i) superficial infection caused by Malassezia species ii) scaly, hypopigmented or hyperpigmented patches - NO formation of blisters b) dermatitis herpetiformis Duhring i) AI blistering disorder associated with celiac disease ii) small, intensely papules and vesicles, usually in a clustered pattern iii) subepidermal blisters iv) IgA deposits are found in dermal papillae (difference from pemphigus vulgaris) c) pemphigus vulgaris i) AI blistering disorder which is characterized by the presence of intraepidermal bullae (blisters within epidermis) due to formation of Abs against desmosomes (desmoglein). When these proteins are disrupted, the skin cells lose adhesion, leading to formation of bullae within epidermal layer. d) pityriasis rosea Gilbert i) self-limiting skin condition usually presents as Herald patch followed by generalized rash with scaly, oval lesions on the trunk. ii) No blisters e) bullous pemphigoid i) AI blistering disorder ii) involves subepidermal bulla, blisters from below the epidermis iii) Auto-Abs target hemidesmosomes which attach the epidermis to basement membrane iv) subepidermal location = main difference 29.) Tzanck smear 30.) Melanocytes are present in a) lower part of dermis i) fibroblasts ii) mast cells iii) macrophages iv) adipocytes v) blood vessels and nerve cells b) stratum lucidum i) keratinocytes c) stratum granulosum i) keratinocytes d) stratum corneum i) corneocytes e) stratum basale i) stratum basale = basal layer of epidermis ii) deepest part of epidermis just above the dermis iii) keratinocytes, melanocytes, merkel cells, langerhans cells 31.) Which of the following is secondary efflorescence? - secondary efflorescences are changes or complications that arise from primary lesions due to external factors, scratching, infection or other influences a) bulla i) primary efflorescence ii) larger blister with more than 0.5cm in diameter filled with clear fluid and arises directly as a primary lesion without any secondary causes b) pustule i) primary efflorescence ii) small, elevated lesion filled with pus and often appears in conditions like acne, folliculitis or pustular psoriasis iii) they form as a primary lesion due to infection or inflammation c) lichenification i) is a form of secondary efflorescence that occurs as a result of chronic rubbing or scratching leading to thickening of the skin with accentuated skin lines ii) it is secondary because it develops as a consequence of primary skin lesion (e.g., eczema or chronic dermatitis) that has been subjected to repetitive trauma or irritation over time d) tuber i) tuber or nodule is primary efflorescence ii) solid, raised lesion, larger than 1cm iii) extends into deeper dermis iv) caused by infections, inflammation, neoplasms 32.) Mark the correct statement about petechiae a) circumscribed ulcerated lesion >1cm i) chronic venous ulcers, pyoderma gangrenosum ii) these two lesions are larger than 1 cm and are characterized by tissue breakdown and ulceration b) circumscribed discoloration >1cm i) ecchymosis, purpura ii) These lesions are larger than petechiae and often present as bruising or larger areas of bleeding. c) circumscribed eroded lesions > 1 cm i) erosive lichen planus, aphthous ulcers, herpetic lesions d) circumscribed spotty lesion < 1cm i) petechiae are small, pinpoint, red or purple spots on the skin that are less than 1 cm big, usually 1-2 mm ii) as a result of minor bleeding from capillaries under the skin iii) flat, non-blanching iv) commonly associated with conditions that affect blood clotting or cause capillary fragility e) circumscribed elevated lesion > 1 cm i) types of nodules (lipoma, sebaceous cyst, dermatofibroma) ii) elevated lesions that are larger than 1 cm are usually nodules or plaques 33.) Papillomatosis is a sign of - Papillomatosis = formation of papillomas = benign epithelial growths that cause skin or mucous membranes (warty or nipple-like appearance) - characterized by an increase in number and size of dermal papillae which results in the formation of elevated, often rough or wart-like surfaces a) verruca vulgaris i) common warts ii) caused by HPV and results in wart-like growths on skin iii) this growth exhibit papillomatosis with the characteristic rough surface, raised papillae and hyperkeratosis b) condylomata accuminata i) genital warts ii) caused by HPV iii) wart-like growths in genital and perianal areas iv) warts show papillomatosis with a cauliflower-like appearance as dermal papillae are elevated and become more pronounced c) pemphigus vegetans i) variant of pemphigus = AI blistering disease ii) vegetative plaques which show papillomatosis which is part of the formation of verrucous-like lesion iii) plaques also have a warty appearance d) fibroma molle i) skin tags ii) soft, benign growths of skin often in areas of skin folds iii) pedunculated and elevated - papillomatosis e) all of the above 34.) Fine, irregular red lines produced by capillary dilation a) telangiectasia i) refers to fine, visible, red or purple lines on the skin caused by dilated capillaries or small blood vessels ii) thin and irregular, appearing most commonly on areas exposed to the sun or due to certain skin conditions (rosacea, liver disease, CT disorders) iii) fine, web-like appearance b) excoriation i) linear scratches or abrasions on the skin ii) caused by scratching or trauma iii) not related to capillary dilation and they also do not present as red lines iv) excoriations appear as breaks or erosions in the skin's surface c) patch i) is a large, flat area of skin discoloration that is greater than 1 cm ii) patches are usually caused by pigment changes (vitiligo, Cafe-au-lait spots) rather than capillary dilation. d) macule i) small, flat, circumscribed area of discoloration less than 1cm in diameter ii) caused by changes in skin pigmentation e) keloid i) overgrowth of scar tissue ii) that forms a raised, thickened area on the skin usually flesh-colored, pink red 37.) Following statements about kerion are true except a) is associated with systemic manifestations i) kerion is a severe inflammatory reaction to a fungal infection (usually tinea capitis) of the scalp ii) swollen, inflamed mass that resembles an abscess iii) systemic symptoms such as fever or widespread illness are typically not associated with kerion as it is a localized infection of the scalp b) may lead to scarring alopecia i) kerion causes intense inflammation which damage hair follicles permanently leading to scarring alopecia = permanent hair loss in the affected area if not treated properly c) involves scalp i) kerion is most commonly associated with tinea capitis = scalp ringworm ii) specifically affects the scalp often with painful swelling, pustules and possible hair loss in infected area d) is usually caused by fungi of animal origin i) keroin is often caused by zoophilic dermatophytes, which are fungi that originate from animals ii) microsporum canis - commonly transmitted by cats and dogs iii) trichophyton verrucosum - often transmitted from cattle e) is a swelling simulating an abscess i) kerion appears as a swollen, pus-filled lesion on the scalp, resembling an abscess ii) lesions are often painful and inflamed iii) with areas of oozing and crusting 36.) Mark the disease in which the virus as an etiological agent has not been proved so far a) condylomata accuminata i) caused by HPV type 6 and 11 ii) virus leads to growth of genital warts or condyloma acuminata b) herpes simplex i) caused by HSV-1 and HSV-2 leading to blistering lesions on mouth or genital areas c) warts i) common warts caused by HPV d) mollouscum contagiosum i) caused by mollouscum contagiosum virus (MCV) member of poxvirus family ii) the virus leads to small, raised, pearly lesions on the skin e) dermatitis herpetiformis i) chronic, itchy skin conditions ii) clusters of small blisters and bumps iii) strongly associated with celiac disease = thats why it is though to be an AI condition iv) AI Abs deposits in the skin, triggering an immune response and characteristic lesions 37.) Favorite affected are of ecthyma simplex is - ecthyma simplex = ecythyma is a skin infection typically affecting lower extremities - considered as a deeper form of impetigo and usually occurs when superficial skin infections progress to involve the dermis - ulcerative lesions with a punched-out appearance + often covered by a thick crust a) on hand i) contact dermatitis ii) Hand Eczema (Dyshidrotic Eczema) iii) Scabies iv) Warts (Verruca Vulgaris) v) Paronychia (infection around nail folds) b) on scalp i) Tinea capitis (scalp ringworm) ii) seborrheic dermatitis iii) folliculitis iv) psoriasis v) Head Lice (Pediculosis Capitis) c) on face i) Acne vulgaris ii) Rosacea iii) Impetigo iv) Melasma (Hyperpigmentation on face, usually due to hormonal changes, sun exposure, or genetics, appearing as dark, irregular patches) v) Cold Sores (Herpes Simplex Virus) d) on dorsum of foot i) The skin infection typically affects the lower extremities, particularly dorsum of foot and lower legs e) on shins i) erythema nodosum ii) varicose veins and venous stasis dermatitis iii) pretibial myxedema (seen in Grave´s disease/ hyperthyroidism) resulting in thickened skin with a waxy appearance on shins. iv) lichen simplex chronicus (often on shins as a result of chronic scratching or rubbing, leading to thickened, leathery skin) 38.) Choose the group of people in which microsporum gypsum causes a disease most frequently - Microsporum gypseum is a zoophilic and geophilic dermatophyte (found in soil) and infects animals - Causes tinea infections in humans typically from direct contact with contaminated soil or through animals that carry the fungus. a) Gardeners i) at higher risk of infection due to their frequent contact with soil b) Children i) Children are more frequently affected by anthropophilic dermatophytes by Microsporum canis (household pets) and Trichophyton tonsurans (spreads between human) ii) They are not exposed to soil as consistently as gardeners c) Housewives i) generally not in regular contact with soil ii) risk of dermatophyte infection comes form household pets or contact with other family members d) Confections e) adolescents i) Adolescents are more commonly exposed to anthropophilic (human-adapted) fungi like Trichophyton tonsurans, especially in communal settings such as sports or school activities. ii) While adolescents can get soil-based infections, they are not exposed to soil as consistently as gardeners. 39.) What is the most common cause of an allergy to jewelry? a) silver b) stainless steel i) Stainless steel is generally hypoallergenic. c) soap getting stuck under jewelry with hand washing d) gold i) Pure gold (24-karat) is generally hypoallergenic, but many gold jewelry pieces are alloys containing small amounts of nickel or other metals. e) nickel i) Nickel allergy, also known as allergic contact dermatitis, is highly prevalent and can cause itching, redness, swelling, and even blistering in areas where nickel-containing jewelry comes into contact with the skin. ii) Many people have a sensitivity or allergy to nickel, which makes it the most frequent allergen associated with jewelry. 40.) Which changes can be found in chronic allergic dermatitis in local findings? a) small blisters i) typically seen in acute allergic dermatitis rather than chronic cases ii) blisters may appear due to immediate inflammation, but in chronic dermatitis, the skin is more likely to show thickening and scaling. b) hyperkeratosis and scaling i) In chronic allergic dermatitis = chronic allergic contact dermatitis), hyperkeratosis (thickening of the outer skin layer) and scaling are common findings. ii) Chronic exposure to an allergen leads to continuous inflammation and irritation, resulting in changes like thickened, scaly skin in the affected area. iii) The skin often appears rough and leathery, a condition called lichenification, which develops as a response to ongoing scratching and rubbing. c) impregnation d) exfoliation i) shedding of dead skin cells, ii) not a primary feature of chronic allergic dermatitis e) meditation 41.) What is the meaning of the term phototoxic dermatitis? - occurs when certain substances (photosensitizers) in the skin interact with UV radiation (or sunlight) and cause an inflammatory response similar to a sunburn. - These photosensitizing substances can come from medications (like tetracyclines, sulfonamides, or some NSAIDs), plants, or other chemicals. - The reaction is dose-dependent. - It usually results in redness, swelling, and sometimes blisters, resembling a sunburn. a) reaction of skin caused by direct interaction of radiation and photosensitizing substance producing a type of sunburn reaction b) reaction of skin after too intense exposition to infrared radiation i) thermal burns or heat-induced skin damage, which is different from phototoxic dermatitis, which involves UV radiationand photosensitizers, not infrared radiation c) reaction of skin to UV-radiation as a consequence of genetic higher sensibility i) photosensitivity or conditions like xeroderma pigmentosum (genetic disorders), which cause abnormal sensitivity to UV radiation, but not phototoxic dermatitis d) reaction of skin when because of sun radiation arise metabolites, that cause abnormal inflammatory reaction i) this refers to photoallergic dermatitis, ii) skin's immune system responds to metabolites formed under UV exposure iii) involves an immune-mediated response rather than a direct toxic effect of the radiation on skin cells e) reaction of skin after long term exposition to intense sun radiation i) chronic sun damage or photoaging (e.g., wrinkles, hyperpigmentation), not phototoxic dermatitis, which is an acute reaction due to a photosensitizer and UV exposure 42.) Which form of psoriasis do you know? a) hair psoriasis i) scalp psoriasis ii) scalp, leading to thick, silvery scales that may be difficult to distinguish from dandruff iii) scalp is a common site for psoriasis, and it can range from mild to severe b) bullous psoriasis i) rare and severe form of psoriasis ii) large, fluid-filled blisters (bullae) iii) can appear on top of existing plaques, and it may be associated with other conditions or infections that complicate the psoriasis c) inverse psoriasis i) flexural psoriasis, this form affects the skin folds (armpits, groin, under the breasts, and in the belly button) ii) It presents as smooth, red, and inflamed patches, which can be aggravated by friction or sweating d) vesicular psoriasis i) small, pus-filled blisters (vesicles) on the skin ii) often on the palms of the hands or soles of the feet iii) rarer form e) all of the above 43.) All are presentation of psoriasis except a) nail changes i) common in psoriasis ii) pitting (small depressions in the nails), onycholysis (nail separation), and subungual hyperkeratosis (thickening of the skin beneath the nail) b) CNS involvement i) Psoriasis is not generally associated with neurological issues c) hypercholesterolemia i) known comorbidity in psoriasis patients. ii) People with psoriasis, particularly those with severe forms, are at increased risk of cardiovascular disease, and high cholesterol is often seen in these individuals due to chronic inflammation. d) arthritis i) Psoriatic arthritis is a common comorbidity of psoriasis ii) inflammation of the joints and can occur in up to 30% of people with psoriasis iii) can cause joint pain, swelling, and stiffness, often affecting the fingers, toes, and spine. e) skin involvement i) hallmark of psoriasis ii) presence of raised, red, scaly patches of skin iii) often on the elbows, knees, scalp, and lower back iv) Skin involvement is essential to the diagnosis of psoriasis 44.) Which of the following is in the group of erythematosquamous diseases? - Erythematosquamous diseases are a group of skin conditions characterized by erythema (redness) and scaling. - These diseases typically present with red, inflamed skin lesions that are often covered with scales. a) urticaria i) raised, red, itchy welts or hives that appear suddenly on the skin. ii) primarily a vascular reaction involving blood vessel dilation, not an erythematosquamous disease iii) no scaling involved in urticaria b) dermatitis herpetiformis i) autoimmune blistering skin disease ii) often associated with celiac disease iii) causes intensely itchy, grouped blisters and is more accurately classified as a blistering or vesicular disorder c) contagious impetigo i) autoimmune blistering skin disease ii) often associated with celiac disease iii) intensely itchy, grouped blisters iv) blistering or vesicular disorder d) pityriasis rosea i) typically presents with a herald patch (a single, large scaly red patch) followed by smaller lesions, often in a Christmas tree pattern ii) lesions are red and covered with fine scales e) pemphigus vulgaris i) autoimmune blistering disorder ii) causes flaccid blisters and erosions on the skin and mucous membranes. iii) classified as a blistering disease 45.) Which condition is typical in pemphigus erythematosus NOCHMAL - also known as Senear-Usher syndrome is a variant of pemphigus vulgaris. - It shares some features with both pemphigus vulgaris and lupus erythematosus, hence the overlap of autoantibodies a) subepidermal bulla i) Pemphigus erythematosus is a blistering disorder that involves intraepidermal blister formation, not subepidermal. ii) Subepidermal bullae are characteristic of diseases like bullous pemphigoid, not pemphigus erythematosus. b) vegetating lesions c) frequently occurs on areas of friction d) intradermal bulla e) ANA positive in 30-80% of cases 46.) Bullous pemphigoid is characterized by … 47.) (...) typical white net a) inflamed hypertrophic red plaques on the (...) b) vesicles in final phase c) subjective symptom is dry mouth d) subjective symptom is burning sensation 48.) Kobner´s phenomenon is seen in - Koebner's phenomenon (also known as the isomorphic response) refers to the development of new skin lesions at sites of trauma or injury in patients with certain skin conditions. - Essentially, it is the phenomenon where trauma (e.g., scratching, cuts, sunburn, pressure) triggers the formation of lesions that resemble the patient’s underlying skin condition. a) urticaria i) Urticaria (hives) is a condition characterized by wheals or welts that are usually caused by an allergic reaction. ii) While physical triggers (like pressure or heat) may worsen urticaria, b) Herpes simplex i) Herpes simplex virus (HSV) infection can be triggered or worsened by physical stress or trauma, but Koebner's phenomenon is not a characteristic feature of herpes simplex. ii) HSV can cause herpetic lesions at sites of injury or pressure. c) Human papillomavirus infection i) HPV infections, which lead to warts, are not typically associated with Koebner's phenomenon. ii) Warts may appear in areas of trauma or infection, but the development of new warts at the site of trauma is not classified as Koebner's phenomenon. d) psoriasis i) Psoriasis is one of the most well-known conditions where Koebner's phenomenon occurs. ii) Trauma to the skin (such as scratching, cuts, or sunburn) in a person with psoriasis can induce the development of new psoriatic lesions at the site of the injury e) all the above 49.) Comedones are characteristics of - Comedones are a primary lesion in acne vulgaris, and they are formed when hair follicles (pores) become clogged with keratin (skin cells) and sebum (skin oil). - Comedones can either be open (blackheads) or closed (whiteheads) based on whether the pore is open or blocked. a) rosacea i) Rosacea is a chronic skin condition that involves redness, visible blood vessels, and sometimes pustules and papules(bumps), particularly on the face. b) impetigo i) Impetigo is a bacterial skin infection, usually caused by Staphylococcus aureus or Streptococcus pyogenes. ii) It leads to the formation of honey-colored crusts over lesions, commonly around the mouth or nose. c) acne vulgaris i) The presence of comedones (blackheads and whiteheads) is a hallmark feature of acne. ii) Acne occurs due to the overproduction of sebum, hormonal changes, and bacterial growth in hair follicles, leading to the formation of comedones. d) (...) 50.) (...) is increases a) fluoridated mouthwash, dyspeptic issues b) is not fixed to follicles c) is leaving out perioral area d) involving the skin around the mouth 51.) What causes blockage of sebum in the hair follicle in acne? - The primary cause of blockage of sebum in the hair follicle in acne is follicular plugging by hyperkeratosis. - In acne vulgaris, the hair follicles become blocked due to the abnormal shedding of skin cells (keratinocytes) within the follicle. This process is referred to as hyperkeratosis. - As the cells shed and accumulate, they mix with excess sebum (skin oil) produced by sebaceous glands, leading to the formation of a plug. - This blockage results in comedones (blackheads and whiteheads), which can develop into inflammatory acne lesions if bacteria are involved. a) applied products to the skin i) Certain cosmetics or topical products (especially those that are comedogenic, meaning they tend to clog pores) can exacerbate acne by contributing to follicular blockage. ii) It is not the primary source. b) colonization by streptococcus pyogenes i) Streptococcus pyogenes is not a major contributor to acne. ii) Acne vulgaris is primarily associated with the colonization of the hair follicle by Propionibacterium acnes (now known as Cutibacterium acnes), a bacterium that thrives in the oily, clogged environment of the follicle. iii) Streptococcus pyogenes is a bacterium associated with impetigo and other infections. c) all answers are correct d) colonization by propionibacterium acnes i) Propionibacterium acnes = Cutibacterium acnes does play a role in the development of acne, but it is secondary to follicular plugging. ii) P. acnes bacteria feed on sebum in clogged follicles and produce inflammatory substances, which contribute to the inflammation of acne lesions. e) follicular plugging by hyperkeratosis 52.) Perioral dermatitis may be induced by - Perioral dermatitis is a facial rash that typically occurs around the mouth, and it can also affect the eyes and nose. - It is characterized by red papules, pustules, and sometimes scaling, without the formation of comedones (as seen in acne). a) fluorinated toothpaste i) One of the key triggers for perioral dermatitis is the use of fluorinated toothpaste (toothpaste containing fluoride). ii) This is a well-documented cause, as fluoride can be irritating to the skin, especially in individuals who are predisposed to perioral dermatitis. iii) It’s thought that the fluoride may act as an irritant or exacerbate underlying inflammation. b) bacterial infection i) While bacterial infections can sometimes be associated with secondary infection of perioral dermatitis (for example, with Staphylococcus), bacterial infection itself is not a primary cause. c) acquired immune disorder i) Acquired immune disorders (such as autoimmune diseases) are not typical causes of perioral dermatitis. ii) Although some systemic conditions, like rosacea, may have immune system components contributing to their development, perioral dermatitis is not primarily an immune disorder. iii) It is more commonly triggered by irritants, topical treatments, or environmental factors. d) herpes simplex i) While herpes simplex virus (HSV) can cause lesions around the mouth (cold sores), it does not typically cause perioral dermatitis. ii) HSV infections are different from the inflammatory condition of perioral dermatitis. e) cold weather and frost i) Cold weather and frost may exacerbate the symptoms of perioral dermatitis by causing dryness or irritation of the skin, but they are not a direct cause. ii) Environmental factors like weather changes can trigger or worsen perioral dermatitis in some individuals, but they are not the primary cause of the condition. 53.) Acne fulminans is characterized by ??? - Acne fulminans is a severe, acute form of acne vulgaris that is often associated with systemic symptoms and more intense inflammation. a) inflammatory nodular acne on the chest only i) Acne fulminans is not limited to the chest. ii) It often affects the upper trunk, back, shoulders, and face, and it can involve large, painful nodules and ulcerations. b) angioedema i) can occur in some inflammatory conditions or as an allergic reaction, it is not typical of acne fulminans c) slow onset i) Acne fulminans has a rapid onset and can appear suddenly with severe, inflammatory symptoms. ii) This differentiates it from more typical forms of acne vulgaris, which develop more gradually. d) fluctuating fever e) rasion on upper trunk 55.) Irritant contact dermatitis is characterized by ??? a) severe itching i) ICD usually causes burning, stinging, or pain rather than intense itching. ii) Severe itching is more common in allergic contact dermatitis due to the immune response it triggers. b) lesions spread to surrounding i) lesions do not spread beyond the area of exposure because the reaction is directly due to skin barrier disruption by the irritant. ii) Spread to surrounding areas is more typical of allergic contact dermatitis (ACD) c) lesions occur only in the location of the irritant i) ICD occurs due to direct damage to the skin from contact with an irritating substance, causing a localized inflammatory reaction. ii) reaction is strictly limited to the area of direct exposure to the irritant. iii) Unlike allergic contact dermatitis, where the immune system can cause a reaction beyond the initial area of contact d) non well demarcated edges of the lesion i) edges of ICD lesions are typically well-demarcated, reflecting the exact area of contact with the irritant, especially with physical or chemical exposures. ii) Non well-demarcated edges would be more likely in cases where a substance is smeared or diffuses on the skin e) polymorphic lesions are distributed evenly around the area i) Polymorphic lesions are more typical of allergic contact dermatitis or other rashes with varied lesion types. 55.) Individuals with atopic dermatitis are prone to develop ??? a) bacterial infections (according to past paper) i) Bacterial infections are indeed the most common secondary infections in AD, particularly with Staphylococcus aureus. ii) Studies show that over 90% of people with AD have Staph colonization on the skin, which can lead to infection and exacerbations of dermatitis symptoms. b) viral infections c) fungal infections d) allergic rhinitis e) all of the above 56.) Hydrocortisone is good to treat - Hydrocortisone is primarily used to treat allergic dermatitis due to its anti-inflammatory and anti-itch properties, which help relieve symptoms. a) allergic dermatitis b) bacterial infection i) Hydrocortisone has no antibacterial properties. c) tinea pedis i) Tinea pedis is a fungal infection, and hydrocortisone does not have antifungal effects. ii) Using it alone may worsen the infection, as fungi can proliferate with immune suppression. d) viral infection i) Hydrocortisone is not effective for viral infections, as it does not have antiviral properties and could potentially allow the virus to spread further by reducing the body’s natural immune response in the affected area. e) xerosis i) While hydrocortisone can reduce inflammation associated with dry skin, moisturizers are typically the primary and more appropriate treatment for xerosis. ii) Hydrocortisone is not generally indicated solely for dry skin. 57.) Signs of contact toxic dermatitis include ??? a) lesions do not spread beyond with contact allergen b) lesions are well circumscribed i) In contact toxic dermatitis (irritant contact dermatitis), lesions usually appear in areas where the irritant has directly contacted the skin, ii) resulting in well-defined, well-circumscribed lesions. iii) This occurs because the damage is limited to the site of direct exposure to the irritant, leading to clear boundaries around the affected area. c) lesions are not well circumscribed d) lesions are monomorphous e) lesions are painful 58.) Which condition belongs to endogenous eczemas ??? - Endogenous eczemas refer to types of eczema that originate from within the body rather than from an external allergen or irritant. a) allergic contact dermatitis i) This is an exogenous eczema ii) it is triggered by external contact with an allergen or irritant. b) pityriasis rubra pilaris i) This is a distinct skin disorder that causes scaly, red patches on the skin. ii) It is not considered a type of eczema. c) hyperhidrosis i) Hyperhidrosis is a condition of excessive sweating and is not an eczema. ii) While it can contribute to skin irritation, it is not a form of eczema itself. d) dyshidrotic eczema i) Dyshidrotic eczema, = pompholyx, is considered an endogenous form of eczema because it is often related to internal factors such as genetic predisposition, stress, or sweating, rather than external contact with an allergen. e) anhidrosis i) Anhidrosis refers to an inability to sweat normally and, like hyperhidrosis, it is not a form of eczema. 59.) (...) a) pitting of hair plate is most common b) oily spots of nail plate are most common c) Wickham striae d) Violaceous lesions on mucous membrane 60.) Impetigo herpetiformis is a form of - Impetigo herpetiformis is actually a rare and severe form of pustular psoriasis, not related to a bacterial, viral, or herpetic infection. - It typically occurs during pregnancy and is characterized by widespread pustules, fever, and systemic symptoms. a) bacterial infection b) herpetic infection i) this condition has no connection to the herpes virus c) eczema herpeticum i) Eczema herpeticum is a viral infection caused by the herpes simplex virus in patients with eczema. ii) Impetigo herpetiformis is not related to viral infection or eczema. d) psoriasis e) herpes zoster i) Herpes zoster = shingles is caused by reactivation of the varicella-zoster virus, unrelated to impetigo herpetiformis. 61.) Histopathology in lichen planus reveals - In lichen planus, a common finding on histopathology is "saw-tooth" acanthosis, which refers to the irregular, pointed appearance of the rete ridges (the downward projections of the epidermis into the dermis). a) finger-like papillomatosis i) Finger-like papillomatosis refers to finger-like projections in the epidermis and is more characteristic of conditions like verrucae (warts) and seborrheic keratosis. b) saw-tooth acanthosis c) infiltration by mast cells in the dermis i) lichen planus does show a band-like inflammatory infiltrate in the upper dermis, it primarily consists of lymphocytes d) Munro´s miroabscesses in the epidermis i) Munro's microabscesses are clusters of neutrophils in the stratum corneum and are characteristic of psoriasis. e) none of the above 62.) Dermatophytes cause infection of - Dermatophytes are fungi that cause infections in keratinized tissues, including non-hairy (glabrous) skin, hair, and nails. Dermatophytes are specifically adapted to infect keratinized tissues, which contain keratin—a protein they utilize as a nutrient source. a) non-hairy skin b) hairs c) nails d) a,b e) a,b,c 63.) Which disease fluoresces under Wood´s light? a) Pityriasis rubra pilaris i) Pityriasis rubra pilaris is a chronic skin disorder that does not fluoresce under Wood's light. b) Pityriasis rosea i) Pityriasis rosea is a self-limiting skin condition, often viral in origin, and does not show fluorescence under Wood's light. c) Erythrasma i) Erythrasma is a bacterial skin infection caused by Corynebacterium minutissimum. ii) Under Wood's light (a UV light source), it fluoresces a characteristic coral-red color due to the presence of porphyrins produced by the bacteria. iii) This fluorescence is a helpful diagnostic feature that differentiates erythrasma from other similar-appearing conditions. d) Erysipelas i) Erysipelas is a bacterial infection of the dermis caused by Streptococcus pyogenes and does not fluoresce under Wood's light. e) Scabies 64.) Mark the true statement about scrophuloderma ??? - Scrofuloderma is a form of cutaneous tuberculosis that occurs due to a direct extension of Mycobacterium tuberculosisinfection from an underlying lymph node, bone, or joint to the skin. a) There is no previous contact with mycobacterium i) Scrofuloderma is directly associated with Mycobacterium tuberculosis infection. b) histological examination is not specific i) While histology may show granulomatous inflammation that can be seen in other infections, additional tests (like staining and culture) are usually able to confirm Mycobacterium tuberculosis. c) Tuberculin test is positive d) Lesions are very contagious i) The lesions of scrofuloderma are generally not highly contagious. ii) Cutaneous tuberculosis has a lower risk of transmission compared to pulmonary tuberculosis. e) Tuberculin test is negative 65.) Angiolupoid sarcoidosis is characterized by ??? - Angiolupoid sarcoidosis is a rare form of cutaneous sarcoidosis that is characterized by the development of soft, reddish-brown nodules on the skin. - Usually found on the face, neck, and upper extremities and are typically soft to the touch. - The color of the nodules can range from reddish to brown, and they may have a somewhat smooth or irregular surface. a) typical localization on fingers i) While sarcoidosis can affect the skin, it does not specifically localize to the fingers in the form of angiolupoid sarcoidosis. ii) This is more typical of sarcoid granulomas seen in other cutaneous forms of the disease. b) teleangiectasia i) Telangiectasia, or small dilated blood vessels, is not a characteristic of angiolupoid sarcoidosis. ii) Instead, it is seen in other conditions like systemic sclerosis or rosacea. c) soft reddish-brown nodules d) typical localization in oral cavity i) The oral cavity can be affected by sarcoidosis, but this is not typical of angiolupoid sarcoidosis. ii) The oral lesions in sarcoidosis are more likely to be granulomatous or mucosal-based. e) solid yellow nodules i) Yellow nodules are more characteristic of conditions like xanthomas or cutaneous lymphoma, not sarcoidosis. 66.) Which test is used in pityriasis versicolor? - Pityriasis versicolor = tinea versicolor, is a superficial fungal infection caused by Malassezia species, which are part of the normal skin flora but can proliferate under certain conditions, leading to the characteristic patches of hypopigmentation or hyperpigmentation. - Wood's light examination is commonly used for diagnosing pityriasis versicolor. a) preparation stained by Giemsa i) Giemsa staining is typically used for blood smears and cytology, not for diagnosing fungal infections. b) Wood´s light examination i) Wood's light examination: When the skin is examined under a Wood's lamp (a UV light), the affected areas often show a characteristic yellow-green fluorescence due to the presence of Malassezia organisms. ii) This test helps highlight the affected areas that might not be as apparent under normal lighting. c) Dermatoscopy i) Dermatoscopy is a tool for examining skin lesions, particularly useful for assessing moles or other pigmented skin conditions like melanoma. d) Serological test i) Serological tests are generally used to diagnose systemic infections or to assess immune response to certain pathogens. ii) Pityriasis versicolor is a superficial fungal infection, and serological tests are not used for its diagnosis. e) Examination in dark field i) Dark field microscopy is used to detect spirochetes bacteria. 67.) Grouped vesicles on an erythematous base with common recurrences at the same site is typical for ??? a) Herpes simplex i) Herpes simplex virus (HSV) infections are characterized by grouped vesicles on an erythematous base. ii) These vesicles often appear as clusters or groups of small blisters on a red, inflamed skin base. iii) This appearance is highly typical of herpes simplex, especially in the context of recurrent episodes at the same site. b) Allergic contact dermatitis i) Allergic contact dermatitis presents with itchy, inflamed, and sometimes blistered skin, but the blisters are usually not grouped and do not tend to recur in the same location once the allergen is removed. ii) It’s more of a localized reaction to an allergen, and the lesions are typically red, swollen, and can be weepy or crusted. c) Herpes zoster i) While herpes zoster (shingles) also involves vesicles on an erythematous base, the lesions are typically unilateral and follow a dermatomal distribution (i.e., along a specific nerve pathway). d) Pemphigus vulgaris i) Pemphigus vulgaris involves flaccid blisters that are usually larger and less grouped compared to herpes simplex. ii) These blisters occur on non-erythematous skin and are often more widespread. e) Bullous impetigo i) Bullous impetigo, caused by Staphylococcus aureus, typically presents with large, fluid-filled blisters on an erythematous base, but these are more isolated and not grouped like those in herpes simplex. ii) The lesions can break open and crust over but do not follow a recurrent pattern at the same site like herpes simplex does. 68.) The four cardinal signs of cellulitis do not include - Cellulitis is a bacterial skin infection typically caused by Streptococcus or Staphylococcus bacteria. The four cardinal signs of cellulitis are: a) Pain: Cellulitis is often painful, especially when touched or moved, due to inflammation and infection. b) Redness: The skin affected by cellulitis is usually erythematous (red) as a result of the body's inflammatory response. c) Swelling: The affected area becomes swollen due to fluid accumulation and inflammation caused by the infection. d) pain e) redness f) itch i) However, itching (or pruritus) is not a cardinal sign of cellulitis. g) swelling h) all of the above 69.) Erythema induratum is usually caused by - Erythema induratum = erythema induratum of Bazin - is a rare, chronic skin condition characterized by deep, tender, erythematous nodules that typically appear on the lower legs, often in women. - It is most commonly associated with tuberculosis. - The nodules result from a hypersensitivity reaction to mycobacterial infection (specifically Mycobacterium tuberculosis), and they are often seen in patients with latent or active tuberculosis. - Erythema induratum is considered a type IV hypersensitivity reaction to the bacteria. a) sarcoidosis i) Sarcoidosis is a systemic granulomatous disease that can affect the skin. ii) It more commonly presents with sarcoid granulomas and conditions like lupus pernio or maculopapular lesions. b) tuberculosis c) cutaneous lymphoma i) Cutaneous lymphoma is a cancer of the skin's lymphatic tissue, and while it can cause various skin lesions, it does not typically present as erythema induratum, which is specifically associated with tuberculosis. d) non-Langerhans histiocytosis i) This is a type of histiocytic disorder, and while these conditions can affect the skin, they do not commonly cause erythema induratum, which is more characteristic of tuberculosis. e) none of the above 70.) Surface of verrucae vulgares is a) Gradually cornifies and becomes rough and verrucous i) The surface of common warts typically starts as smooth but becomes progressively rough, thickened, and verrucous(wart-like) as the skin layers increase in thickness. ii) The surface can have a papillomatous texture, often described as a cauliflower-like appearance, with areas of keratinization (thickened, cornified skin). b) smooth with depression i) Warts usually have a raised surface, not a smooth one with a depression. c) smooth with pearl appearance i) This describes a characteristic of pearly lesions, which may be seen in conditions like basal cell carcinoma, not common warts. d) smooth only initially i) While verrucae vulgares may appear somewhat smooth when they first form, they generally become rough and verrucous over time due to keratinization, which is more characteristic of the wart's progression. e) surface is not characteristic i) the surface of verrucae vulgares is indeed characteristic, becoming rough, thickened, and verrucous 71.) For which population is varicella zoster virus most dangerous a) young healthy individuals i) For most healthy individuals, VZV infection (chickenpox) tends to be mild, particularly in children, and generally does not cause severe complications. b) patients with verruca vulgaris i) Verruca vulgaris (common warts) is caused by human papillomavirus (HPV), which is unrelated to VZV. ii) There is no known increased risk for VZV complications in people with warts. c) pregnant women i) Varicella zoster virus (VZV), which causes chickenpox (primary infection) and shingles (reactivation), can be particularly dangerous for pregnant women, as well as immunocompromised individuals. ii) Infection during pregnancy can lead to serious complications for both the mother and the fetus. iii) For pregnant women, primary VZV infection (chickenpox) can result in a higher risk of severe complications, such as pneumonia and, in rare cases, encephalitis. d) individuals with strong immune system i) People with strong immune systems typically handle VZV infections well. ii) Healthy adults may experience a more intense reaction than children but usually do not face serious complications. e) none of the above 72.) Mark the correct statement about molluscum contagiosum - Molluscum contagiosum is a skin infection caused by the molluscum contagiosum virus (a poxvirus). - Firm, smooth, umbilicated papules: These lesions are usually 2-6 mm in diameter and have a characteristic central umbilication or indentation. They are flesh-colored or pearly and have a smooth surface. - The lesions are often seen in clusters on areas like the face, neck, arms, and trunk in children, and in the genital area in adults. a) papule is form and smooth umbilicated usually 2-6mm in diameter b) manifestations are painful i) molluscum contagiosum lesions are typically painless. While they can sometimes become itchy or irritated c) HPV is a trigger i) Molluscum contagiosum is caused by a poxvirus, not the human papillomavirus (HPV). ii) HPV causes different types of lesions, such as warts. d) clear vesicles are seen i) Molluscum contagiosum lesions are solid papules rather than vesicles, and they are not filled with clear fluid. ii) They have a firm and solid consistency. e) papular and pustular lesions are typical i) Molluscum contagiosum lesions are papular but typically not pustular. ii) The lesions are usually flesh-colored or slightly pink and do not contain pus unless they become secondarily infected. 73.) Choose the appropriate treatment of candidiasis - Candidiasis is a fungal infection caused by Candida species, commonly Candida albicans. - Fluconazole is an antifungal medication and is one of the appropriate treatments for candidiasis. - It works by inhibiting the fungal enzyme responsible for producing ergosterol, an essential component of the fungal cell membrane. - Fluconazole is effective for various types of candidiasis, including oral, vaginal, and systemic infections. a) corticosteroids i) Corticosteroids are anti-inflammatory drugs that may actually worsen candidiasis by suppressing the immune response, potentially allowing the infection to proliferate further. b) erythromycin i) Erythromycin is an antibiotic effective against certain bacteria but is not effective against fungi like Candida. ii) Antibiotics can sometimes predispose individuals to candidiasis by altering normal bacterial flora, especially if used excessively. c) tetracycline i) Tetracycline is another antibiotic that works against bacteria but is ineffective against fungal infections like candidiasis. ii) It also may increase the risk of candidiasis by disrupting normal bacterial balance. d) fluconazole e) sulfonamides i) Sulfonamides are a class of antibiotics effective against certain bacterial infections but have no effect on fungi and, therefore, are not appropriate for treating candidiasis. 74.) Candidal paronychia et onychia is most common in - Candidal paronychia and onychia are infections caused by Candida species that affect the nail fold (paronychia) and nail plate (onychia). - These infections are more common in individuals whose hands are frequently exposed to moisture and sugary substances, creating an environment that encourages fungal growth. - Confectioners (people who make sweets, baked goods, and other sugary foods) frequently have their hands in damp, sugary environments, which are ideal for the growth of Candida. a) infants i) While infants can experience candidiasis, they are not at high risk for candidal paronychia or onychia since they typically are not exposed to occupational conditions that promote these infections. b) adolescents i) Adolescents can develop candidal infections, but they are not particularly at risk for paronychia or onychia unless they have specific exposures. ii) This age group usually does not have frequent, prolonged contact with moisture and sugars that would make them prone to these types of infections. c) masons i) Masons often have their hands in water and cement, which can cause skin irritation and chapping, potentially leading to bacterial paronychia rather than candidal infections. ii) Cement exposure can actually make the skin more alkaline, which is less favorable for fungal growth. d) students i) Students generally do not have occupational exposure to the constant wet and sugary conditions that predispose individuals to candidal paronychia and onychia. e) confectioners 75.) Human papillomavirus - HPV is a DNA virus that infects the skin and mucous membranes, often causing warts on areas such as the hands, feet, and genitals. - HPV has over 100 different types, with some strains causing benign warts and others associated with malignancies, particularly in the anogenital region and the oropharynx. a) it infects skin and mucous membranes with warts b) it can not be sexually transmitted i) This is incorrect. HPV is one of the most common sexually transmitted infections (STIs). c) it induced molluscum contagiosum i) Molluscum contagiosum is caused by a poxvirus (molluscum contagiosum virus), not HPV. ii) While both infections cause lesions on the skin, they are distinct viruses. d) HPV infection never develops into the malignancy i) While many HPV infections are benign, certain high-risk types (e.g., HPV 16 and 18) are well-known causes of cervical cancer, as well as other types of anogenital and oropharyngeal cancers. ii) Persistent infection with high-risk HPV types is a major risk factor for the development of these malignancies. e) It is RNA virus i) HPV is a DNA virus, specifically a double-stranded DNA virus within the Papillomaviridae family. 76.) Molluscum contagiosum is caused by - Molluscum contagiosum is caused by the molluscum contagiosum virus (MCV), which is a poxvirus. - This virus specifically affects the skin and sometimes mucous membranes, leading to small, firm, dome-shaped papules with a characteristic central umbilication (depression). - Molluscum contagiosum is typically spread by direct skin-to-skin contact or through contaminated objects. a) HPV i) HPV causes warts on the skin and mucous membranes, but it does not cause molluscum contagiosum. ii) HPV belongs to the Papillomaviridae family, not the Poxviridae family. b) Coxsackie virus i) Coxsackie virus is an enterovirus that can cause hand, foot, and mouth disease, herpangina, and other viral exanthems, but it is unrelated to molluscum contagiosum. c) Poxvirus d) EBV i) EBV is a member of the Herpesviridae family and is the cause of infectious mononucleosis. e) Cytomegalovirus i) CMV is also a herpesvirus and can cause infections in immunocompromised individuals, such as congenital infections and retinitis, but it is not related to molluscum contagiosum. 77.) Pustule is - A pustule is a small, raised, pus-containing lesion on the skin. - Pus is typically a thick, yellowish or white fluid made up of dead white blood cells, bacteria, and tissue debris, and it is commonly associated with infections or inflammatory skin conditions. - Pustules are characteristic of conditions like acne, folliculitis, and pustular psoriasis. a) fluid-containing elevation i) Fluid-containing elevation: While this describes a general blister or vesicle (such as in burns or viral infections like herpes). b) pus-containing elevation c) small soft elevation i) This could describe other types of lesions, such as papules or nodules. d) small hard elevation e) fluid containing elevation with (...) 78.) Mark the correct statement about ecchymosis - Ecchymosis refers to a larger area of bleeding under the skin that results in a bruise-like discoloration. - This bleeding is generally greater than 1 cm in diameter and can appear dark purple, blue, or green as it heals. - Unlike petechiae (which are smaller, pinpoint hemorrhages < 1 cm), ecchymoses cover a larger area and are often caused by trauma, bleeding disorders, or certain medical conditions. a) spotty bleeding into a skin < 1cm i) This describes petechiae, not ecchymosis. ii) Petechiae are smaller, pinpoint red or purple spots under the skin, each measuring less than 1 cm in diameter. b) nodule i) A nodule is a raised, firm lesion that is solid rather than caused by bleeding under the skin c) papule i) A papule is a small, raised bump on the skin, typically less than 1 cm in size. ii) Like a nodule, it is a solid lesion. d) ulcer i) An ulcer is an open sore on the skin or mucous membrane that results from the loss of the surface tissue. ii) Ecchymosis does not involve tissue loss but rather bleeding into the skin. e) larger bleeding into a skin > 1cm 79.) Wheal lesion is visible in - A wheal is a raised, red, and often itchy area of skin that appears suddenly, typically as a result of an allergic reaction. - Wheals are commonly associated with acute urticaria (hives), where they appear due to the release of histamines and other inflammatory mediators in response to allergens. - Wheals are typically transient, appearing and disappearing within a few hours. a) acute urticaria b) shingles i) Shingles (herpes zoster) causes a vesicular rash that typically follows a dermatomal distribution and does not present with wheals. The lesions in shingles are blisters. c) vasculitis i) Vasculitis involves inflammation of blood vessels, often leading to purpura (small purple spots), ulcers, or nodules rather than wheals. ii) Vasculitis lesions are typically persistent. d) pemphigus i) Pemphigus is an autoimmune blistering disorder that causes bullae and erosions rather than wheals. ii) It is characterized by fluid-filled blisters that result from the destruction of skin cells but does not present with transient wheals. e) a,c 80.) What is seborrhoea? a) occlusion of sebaceous glands terminals b) increased sebum production due to its drying on the (...) c) transitional short-term increase of sebum by neuroti(...) d) increased function of sebaceous glands by therapeu(...) e) increased production of pathologically changed seb(...) 81.) A bulla may be the primary lesion of all of the following ??? a) molluscum contagiosum b) IgA linear dermatosis c) drug eruption d) impetigo e) erythema multiforme 82.) Thin to thick fibrous tissue that replaces normal skin following a) eschara i) refers to a hard, dry scab or crust that forms on the skin following a burn or other wound. ii) An eschar is a temporary protective layer that may form during wound healing, but it does not replace skin as a scar does. iii) Eschar eventually falls off as the wound heals, whereas a scar is a permanent tissue replacement. b) plaque i) a plaque is a raised, flat-topped lesion on the skin that is larger than a papule (typically over 1 cm). Plaques are often seen in conditions like psoriasis. c) scar i) A scar is a thickened fibrous tissue that forms as a result of the healing process after the skin has been damaged by injury, surgery, or other trauma. ii) During the healing process, collagen fibers are produced to repair the skin, resulting in a scar that replaces the normal skin tissue with a denser, fibrous structure. iii) Scars are a common result of wound healing and are thicker than normal skin. d) tumor i) A tumor refers to any abnormal growth of tissue, which can be benign or malignant. ii) Tumors do not replace normal skin following injury; rather, they represent an abnormal mass of cells that can arise from various tissues in the body. iii) They are distinct from scars, which are the result of normal wound healing. e) papule i) A papule is a small, raised, solid bump on the skin, typically less than 1 cm in diameter. ii) Papules are a primary lesion and do not involve the replacement of normal skin tissue with fibrous tissue. iii) They may result from localized inflammation or infection but are not related to the wound healing process that leads to scarring. 83.) Which location is typical for discoid lupus erythematosus? - Discoid lupus erythematosus (DLE) is a chronic skin condition characterized by discoid-shaped lesions that are typically red, inflamed, and scaly. - The lesions are most commonly found in areas that are exposed to the sun a) seborrhoeic i) Seborrhoeic areas (such as the scalp, face, and chest) are often associated with seborrhoeic dermatitis or psoriasis, not specifically DLE. ii) While DLE can affect the scalp, it is not typically described as being localized to seborrhoeic areas. b) embolic i) Embolic refers to an event where an embolus (a clot or other blockage) travels through the bloodstream. ii) This is unrelated to the localization of DLE lesions. c) unilateral i) While DLE can sometimes present on one side of the body, it does not have a strong predilection for being unilateral. ii) Lesions are more commonly found symmetrically in sun-exposed areas. d) sun-exposed e) intertriginous i) Intertriginous areas (skin folds, like underarms, groin, or under breasts) are more commonly affected by conditions like intertrigo or fungal infections. ii) DLE is not typically localized to these areas. 84.) Mark the secondary lesion a) ulcer b) wheal c) vesicle d) nodule e) blister 85.) Which of the following are related to vascular spot? a) lentigo i) Lentigines (singular: lentigo) are pigmented spots (brown or black) caused by an increase in melanocytes or melanin. ii) They are not vascular spots but are pigmented lesions. b) chloasma i) Chloasma (also known as melasma) refers to dark, pigmented patches on the skin, often caused by hormonal changes, such as during pregnancy or due to oral contraceptive use. c) teleangiectasia i) Teleangiectasias are small, dilated blood vessels visible on the skin, often presenting as red or purple lines or spots. They are directly related to vascular changes, and therefore are classified as vascular spots. ii) Common causes include sun exposure, rosacea, and certain systemic conditions. d) vitiligo i) Vitiligo is a skin condition characterized by depigmented spots, where melanocytes are destroyed, leading to white patches on the skin. ii) It is not a vascular spot but a pigmentation disorder. e) freckles i) Freckles (ephelides) are small, brown spots that appear due to an increase in melanin, typically in response to sun exposure. 86.) Which of the following expresses primary lesion? a) pyoderma grangrenosum i) This condition involves ulceration of the skin, often in response to underlying systemic diseases (such as inflammatory bowel disease). b) striae distense i) These are secondary lesions that occur due to skin stretching (such as in pregnancy, rapid weight gain, or corticosteroid use). c) chancre i) A chancre is a primary lesion seen in syphilis caused by Treponema pallidum. It typically appears as a painless, firm ulcer with a clean base, usually at the site of infection (often genital, anal, or oral). ii) Since it appears as a direct result of syphilis infection, it is considered a primary lesion. d) lichen ruber planus i) Lichen planus presents with papules or plaques as primary lesions, but it is a chronic inflammatory condition that typically affects skin, mucous membranes, and nails. e) morphoea i) Morphoea (localized scleroderma) involves plaques of thickened skin due to fibrosis and is a secondary manifestation of an immune-mediated process. The initial lesions are indurated plaques, which represent secondary skin changes. 87.) Clinical feature of lyme borreliosis is - nochmal gucken a) erythema centrifugum b) lymphadenosis cutis benigna c) dermatitis acuta atrophicans d) pityriasis rosea e) pityriasis versicolor 88.) Which symptoms does not occur in ery(...)? a) sharply defined erythema with edema b) shiver c) fever d) painfulness to touch e) pruritus 89.) In which age group herpes simplex virus primoinfection usually occurs? a) 6-10 years b) up to 12 months c) 11-15 years d) 15-20 years e) 1-5 years 90.) Mark the false statement about scabies a) The symptoms of scabies are intense itching, especially at night i) This is true. Intense itching that worsens at night is a hallmark symptom of scabies, caused by the body’s allergic reaction to the mites, their eggs, and waste. b) is contagious and can be spread quickly through close physical contact in family i) This is correct. ii) Scabies is easily spread through prolonged skin-to-skin contact and can spread quickly within families or groups in close contact. c) rash usually spreads across the whole body, apart from the heads i) This is generally true for adults, as the rash commonly spares the head. ii) However, in young children or infants, the rash can also involve the head and neck. d) scabies is non-contagious inflammatory skin condition e) the female mite burrows just beneath your skin and makes a tunnel where it deposits i) The female scabies mite creates tiny burrows just under the skin’s surface to lay eggs, which triggers the immune response that causes itching and rash. 91.) Onychomycosis is a) ringworm of scalp i) Ringworm of the scalp is called tinea capitis, a fungal infection specifically affecting the scalp and hair follicles. b) ringworm of the face i) Ringworm of the face is known as tinea faciei, which affects the skin of the face but does not involve the nails. c) ringworm of the feet i) Ringworm of the feet is called tinea pedis (athlete’s foot). It affects the skin of the feet, typically between the toes, but not the nails directly. d) ringworm of the groin i) Ringworm of the groin is called tinea cruris (jock itch), affecting the skin of the groin area. e) none of the above 92.) Mark the correct statement about the tuberculosis cutis luposa ??? a) course is short and heals ad integrum b) serious complication may be development of malignancy melanoma c) is most infected stage of tuberculosis 93.) What is relevant for the diagnosis of scabies? - Each of the listed factors—positive family history, night itching, and distribution of lesions—is relevant for diagnosing scabies and can help confirm the presence of a scabies infestation. a) positive family history i) Scabies is highly contagious and often spreads within households. A positive family history of similar symptoms (such as itching and rash) can be a strong indicator of scabies. b) night itching i) Itching that worsens at night is a classic symptom of scabies. ii) The itching is caused by the immune response to the mites, their eggs, and their waste products in the skin, which becomes more noticeable during the quiet hours of the night. c) distribution of lesions i) The typical distribution of scabies lesions includes areas such as the webs of the fingers, wrists, elbows, waistline, and genital region. ii) Recognizing this characteristic distribution can help distinguish scabies from other skin conditions. d) all of the above e) none of the above 94.) Which of the following factor is predisposing factor in the development of candidiasis a) cytostatics i) Cytostatic drugs (used in chemotherapy) suppress the immune system, which can reduce the body’s ability to fight off fungal infections, including Candida. b) diabetes mellitus i) High blood sugar levels in diabetes provide an ideal environment for Candida growth, especially in warm, moist areas like skin folds, the mouth, and the genital region. c) treatment with broad-spectrum antibiotics i) Broad-spectrum antibiotics kill a wide range of bacteria, including beneficial bacteria that help control Candidapopulations. ii) When these bacteria are reduced, Candida can overgrow, leading to candidiasis. d) long lasting treatment with corticosteroids i) Corticosteroids suppress the immune system and can disrupt local immune responses, which can promote Candidainfections, particularly in the mouth (oral thrush) or other mucous membranes. e) all of the above 95.) Warts can be treated by all of the following except a) cryotherapy i) Cryotherapy, which involves freezing the wart with liquid nitrogen, is a common and effective treatment for warts. ii) It destroys wart tissue and stimulates the local immune response to fight the virus. b) intralesional steroids i) Intralesional steroids are not typically used to treat warts. ii) Steroids are anti-inflammatory medications and are commonly used to reduce inflammation in skin conditions like eczema or psoriasis, but they do not address the viral cause of warts (human papillomavirus). iii) steroids could potentially suppress the local immune response and may even worsen or prolong the wart by reducing the body’s natural defense against the virus. c) Keratolytics i) Keratolytics, such as salicylic acid, are used to peel away layers of the wart. ii) This gradual removal helps to break down the wart and exposes it to the immune system, aiding in its elimination. d) laser i) Laser therapy, especially pulsed-dye lasers, can be used to target and destroy wart tissue by heating and killing the blood vessels feeding the wart. e) electrocautery i) Electrocautery uses heat generated by electric current to burn and destroy wart tissue. ii) This method is also commonly used in wart removal. 96.) Clinical feature of lyme borreliosis is a) erythema annulare i) referring to erythema annulare ii) While erythema migrans, a red circular or "bull's-eye" rash, is the hallmark early skin sign of Lyme borreliosis, erythema annulare is not a clinical feature specific to Lyme disease. i

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