Exam
1. Question:
A reddish blue, irregularly shaped, solid and spongy mass of blood vessels
that may be present at birth and enlarge during the first 10 to 15 months is
characteristic of a:
cavernous hemangioma. Correct
strawberry mark.
telangiectasia.
port-wine stain.
Explanation:
A cavernous hemangioma appears as a reddish blue, irregularly shaped,
solid and spongy mass of blood vessels. It may be present at birth, may
enlarge during the first 10 to 15 months, and will not involute spontaneously.
A port-wine stain is a large, flat, macular dark red or purplish patch covering
the scalp or face, frequently along the distribution of cranial nerve V and
intensifies with crying, exertion, or exposure to heat or cold. A strawberry
mark is a type of hemangioma that has a raised bright red area with well-
defined borders about 2 to 3 cm in diameter. It does not blanch with
pressure. Telangiectasia are caused by vascular dilation and are
permanently dilated blood vessels that are visible on the skin surface.
2. Question:
A chancre is defined as a:
group of small scattered vesicles.
painless ulceration. Correct
papule of many shapes.
non-tender penile indurated nodule.
Explanation:
A chancre is defined as a painless ulceration formed during the primary
stages of syphilis. A group of scattered small vesicles is associated with
,genital herpes. Papules appearing in many shapes that can be raised, flat, or
cauliflower-like are characteristic of genital warts (condylomata acuminata).
Non-tender indurated nodules are associated with carcinoma of the penis.
3. Question:
Transverse depressions of the nail plates, usually bilateral, resulting from
temporary disruption of proximal nail growth from systemic illness is termed:
Terry's nails.
Beau's lines. Correct
Mees' lines.
pitting nails.
Explanation:
Beau's lines are deep grooved lines that run from side to side on
the fingernail. They appear as transverse depressions of the nail plates,
usually bilateral, resulting from temporary disruption of proximal nail growth
from systemic illness, such as severe illness, cold stress in the presence of
Reynaud's disease, and trauma. With Terry's nails, the nail plate turns white
with a ground-glass appearance, a distal band of reddish brown, and
obliteration of the lunula. Mees' lines present as curving transverse white
bands that cross the nail parallel to the lunula. They arise from the disrupted
matrix of the proximal nail, vary in width, and move distally as the nail grows
out. These lines are seen in arsenic poisoning, heart failure, Hodgkin’s
disease, chemotherapy, carbon monoxide poisoning, and leprosy. Pitting
nails present as punctate depressions of the nail plate caused by defective
layering of the superficial nail plate by the proximal nail matrix. They may be
associated with psoriasis, but also seen in Reiter’s syndrome, sarcoidosis,
alopecia areata, and localized atopic or chemical dermatitis.
4. Question:
,A child has a maculopapular, blotchy rash and on examination of his mouth,
red eruptions with white centers on the buccal mucosa are visualized. These
eruptions are called:
rubella spots.
aphthous ulcers.
Pastia's spots.
Koplik spots. Correct
Explanation:
Koplik spots are seen with measles. They are small, white spots (often on a
reddened background) that occur on the inside of the cheeks early in the
course of red measles, rubeola. Pastia's spots are pink or red lines that are
formed of confluent petechiae found in skin creases and are seen in patients
who have scarlet fever. Aphthous ulcers are recurrent small, round, or ovoid
ulcers with circumscribed margins, erythematous haloes, and yellow or gray
floors occurring in the mouth.
5. Question:
When examining the external genitalia of a female patient, excoriations and
itchy, small, red maculopapulares were noted. This lesions may be
suggestive of:
genital herpes.
pediculosis pubis. Correct
Chlamydia trachomatis.
genital warts.
Explanation:
Excoriations or itchy, small, red maculopapular suggest pediculosis pubis
(lice or “crabs”). These symptoms are not consistent with those of genital
herpes or, warts, or Chlamydia trachomatis.
6. Question:
, A 75-year-old man presents with several brown, raised, slightly greasy
peeling, velvety appearing lesions on the trunk. These lesions would be
classified as:
lichenification.
seborrheic keratoses. Correct
Kaposi's sarcoma.
actinic keratoses.
Explanation:
Seborrheic keratoses are common, benign, yellowish to brown, raised lesions
that feel slightly greasy and appear velvety and warty. They usually appear
on trunk and face of the elderly. Actinic keratoses are superficial, flattened
papules covered by a dry scale and can appear pink, gray, or tan in color.
They appear on sun exposed skin of older fair-skinned persons.
Lichenification is thickening and roughening of the skin with increased
visibility of normal skin furrows. It can be seen in patients with atopic
dermatitis.
7. Question:
When assessing the skin, it is noted to be thickened, taut, and shiny in
appearance. This could be associated with:
hypothyroidism.
hyperthyroidism.
psoriasis.
scleroderma. Correct
Explanation:
Scleroderma appears as skin that is thickened, taut, and shiny in
appearance. Psoriasis presents as silvery, scaly papules or plaques, mainly
on the extensor surfaces of the skin. In patients who have hyperthyroidism,
the skin has a velvety appearance and is usually warm to touch. Skin that