[MCQs] The Quizzes about Acute Complaints – Part 11 (20 test)

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1.You are caring for a teen with fairly severe Which of the follow- ing has been shown to play a role in the development of acne?

1. Stress
2. Dirty skin
3. Chocolate
4. Increased greasy foods in the diet
5. Oily hair on the forehead

2. One of your patients is concerned about facial He has both inflammatory and comedonal acne (see picture below), and you would rate it as moderate in severity. Which of the following would be the best approach to treating his acne?

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 5.)

1.   A topical retinoid such as tretinoin (Retin-A)
2. A topical antibiotic such as erythromycin or clindamycin (Em-gel or Cleocin)
3. An oral antibiotic such as cephalexin (Keflex)
4. An oral contraceptive
5. A mid-potency nonfluorinated topical steroid

3. You are treating a 16-year-old girl who is complaining of severe nodu- lar She has tried and failed topical retinoids and oral antibiotics, and you are considering using isotretinoin (Accutane). Which of the following is a significant side effect that warrants discontinuing the medication?

1. Depression
2. Worsening of acne
3. Dry skin
4. Joint aches
5. Pregnancy

4. You are caring for a 34-year-old woman who complains of a chronic “blush” around her cheeks and Her picture is below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 9.)

Which of the following is true of this condition?

1. It has a pathogenesis similar to acne vulgaris
2. About 50% of patients with this condition also have eye involvement
3. Topical corticosteroids are the treatment of choice
4. Oral therapy with tetracyclines should be reserved as a last resort
5. Treatment should be aimed at reducing colonization of Propionibacterium acnes

5. A patient comes to you with concerns about a nodule he has had on the side of his nose for several The nodule is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. NewYork: McGraw-Hill, 2005: 283.)

 What is the most likely diagnosis?

1. Verruca vulgaris
2. Molluscum contagiosum
3. Nodular basal cell carcinoma
4. Squamous cell carcinoma
5. Cutaneous T-cell lymphoma

6. You are caring for a 28-year-old man who presents with a A pic- ture of his rash is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. NewYork: McGraw-Hill, 2005: 59.)

He also has fingernail changes shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 993.)

What is the most commonly prescribed therapeutic agent for his rash?

1. Oral Penicillin
2. Topical erythromycin
3. Topical pimecrolimus (Elidel)
4. Vitamin A
5. Topical corticosteroid

7. You are discussing therapy with a patient who has recently been diag- nosed with psoriasis. He is interested in trying calcipotriene (Dovonex). Which of the following best describes its mechanism of action?

1. It is a fatty-acid based moisturizer
2. It induces epidermal differentiation and inhibits keratinocyte proliferation
3. It binds to retinoic acid receptors in the skin, normalizing the epidermal proliferation
4. It is a topical immunomodulator
5. It is a topical keratolytic

8. You are talking with a 24-year-old man who reports an outbreak of a mildly pruritic The rash initially began with a large pink patch on his chest, to the left of his sternum breast. About a week later, he noted a more generalized eruption. The rash is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 119.

What treatment is indicated?

1. Antihistamines
2. Antibiotics
3. Antivirals
4. Antifungals
5. Cyclosporine

9. You are seeing a young child whose mother brings him in with a rash. It developed on his upper lip underneath his He has had cold symptoms with a runny nose recently. His picture is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 589.)

What is the most likely cause of this rash?

1. Infection with group A beta-hemolytic streptococci
2. Infection with S. aureus
3. Infection with an enterococcus species
4. Infection with H. influenzae
5. Infection with a pseudomonas species

10. After returning from a ski trip in the mountains, your 35-year-old patient complains of a rash for 2 He has multiple eythematous pustules over his legs, arms, and chest. They are not pruritic, and do not seem to be spreading. He denies any new soaps, lotions, foods, or medications. He did spend time in a hot tub on the trip. A picture of his rash is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 982.)

Which of the following is the best treatment option for this patient?

1. Reassurance and follow up if no improvement
2. Topical steroid medication
3. Systemic steroid medication
4. Topical antibiotics with activity against streptococcus and staphylococcus
5. Oral antibiotics with activity against Pseudomonas species

11. You are seeing a 21-year-old man with a skin infection on his It is the first time he has ever had this type of infection. It began with a burn- ing at the site of the infection, then an eruption of vesicles. The rash is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 803.)

Which of the following is true of this infection?

1. This is a primary infection, and future infections are likely to be more severe
2. Based on the picture shown, distinguishing features indicate it to be a HSV-1 infection
3. Fever, malaise, and adenopathy are likely to be present
4. Triggers for this rash include fever, infection, or exposure to ultraviolet light
5. If the lesions are pustular, antibiotics are indicated

12. Your patient is known to have genital She has recently had an increase in outbreaks, and is now complaining of symptoms that occur at least every 2 months. Which of the following would be considered an appropriate therapy?

1. Valacyclovir (Valtrex), 1 g twice a day for 10 days with each outbreak
2. Valcyclovir (Valtrex), 2 g in a single dose at the first sign of skin lesion
3. Valcyclovir (Valtrex), 2 g in a single dose at the first sign of the prodrome
4. Valcyclovir (Valtrex), 1 g weekly
5. Valcyclovir (Valtrex), 1 g daily

13. An otherwise healthy 61-year-old male patient complains of a burn- ing sensation on the posterior chest for 24 hours, and subsequent develop- ment of the rash shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 823.)

Which of the following is true about treatment for this condition?

1. Antiviral therapy is not indicated if the lesions have been present for more than 72 hours
2. Antiviral therapy decreases the overall duration of pain
3. Treatment with corticosteroids will decrease the likelihood of postherpetic neu- ralgia
4. Valacyclovir (Valtrex) is the best antiviral treatment choice for this condition
5. Antiviral resistance is common

14. You are seeing a young girl whose mother brings her in for evalua- She has had 3 days of low-grade fever and runny nose. Today, she awakened with a rash on her cheeks, shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 793.)

What is the likely cause of her symptoms?

1. An enterovirus
2. A parvovirus
3. A parainfluenza virus
4. A varicella virus
5. Cytomegalovirus

15. You are seeing a young man who is complaining of a patch of hair He denies pulling the hair, and complains that his scalp is itchy and flakey. His scalp is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 709.)

Which of the following is the most effective treatment?

1. Selenium sulfide lotion, applied daily for 4–8 weeks
2. Ketoconazole (Nizoral) shampoo applied daily for 4–8 weeks
3. Clotrimazole (Lotrimin) cream, twice daily for 4–8 weeks
4. Griseofulvin tablets, daily for 4–8 weeks
5. Fluconazole (Diflucan) tablets, daily for 4–8 weeks

16. You are caring for a 35-year-old woman who works in a She comes to see you complaining of an itchy rash on her calf. It started as a small pink circular lesion, but is spreading. The rash is shown below:

(Reproduced, with permission, from Wolff K, Johnson RA, Suurmond D. Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, 5th ed. New York: McGraw-Hill, 2005: 701.)

 Which of the following is the likely diagnosis?

1. Pityriasis rosea
2. Psoriasis
3. Tinea corporis
4. Atopic dermatitis
5. Contact dermatiti

17. A 32-year-old mother of two young children presents to your office for evaluation of her left She reports redness of the white part of her eye, with a watery discharge. She reports mild itching and a sensation as if something is in her eye. She denies a history of allergies, and reports no concurrent allergic symptoms. Examination reveals a palpable preauricular lymph node. Fluorescein staining does not reveal corneal dendrites. What should be the treatment of choice in this case?

1. Antiviral eye drops
2. Antibacterial eye drops
3. Corticosteroid eye drops
4. Combination antibiotic/corticosteroid eye drops
5. Supportive car

18. Which of the following causes of a red eye is a medical emergency and requires immediate ophthalmologic referral?

1. Gonococcal  conjunctivitis
2. Chlamydial  conjunctivitis
3. Corneal abrasion
4. Sub-conjunctival hemorrhage
5. Blephariti

19. You are seeing a 26-year-old male patient complaining of a red eye who says, “I think I have pink ” He reports increased redness, tearing, discharge, photophobia, and pain. Which of his reported symptoms would be more suggestive of something other than conjunctivitis?

1. Redness
2. Tearing
3. Discharge
4. Photophobia
5. Pain

20. You are seeing a 20-year-old college student who reports that her eye became pink over the last 24 She is otherwise healthy and takes no medications except oral contraceptives. She reports redness, irritation, tear- ing, discharge, and itching. Which of her symptoms are more specific for an allergic etiology for her condition?

1. Use of oral contraceptives
2. Irritation
3. Tearing
4. Discharge
5. Itching