Dermatology and Wounds solved MCQs

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1. All of the following statements about erythroderma are true EXCEPT

a. There is > 90% body surface involvement

B. It is more common in males

c. The most common cause is drug reaction

d. High output cardiac failure is a recognised sequelae

e. Splenomegaly is associated in about 15%

2. The feature you would NOT expect to find in a case of erythema multiforme after cefaclor use is

a. Itch

B. Target lesions

c. No cross sensitivity with cefotaxime

d. Complete resolution in 2-3 weeks, without sequelae

e. Arthralgia

3. Which of the following features is consistent with scarlet fever

a. Punctate rash on neck and truck

B. Perioral erythema

c. Geographic tongue

d. Resolution without desquamation

e. Only occurs in association with streptococcal pharyngitis

4. Erythema Nodosum is an example of

a. Panniculitis

B. Vasculitis

c. Serum sickness

d. Erythroderma

e. Type 2 hypersensitivity

5. Geographic tongue is caused by

a. Kawasaki disease

B. Syphilis

c. Acromegaly

d. Pernicious anaemia

e. None of the above

6. The toxic reaction you would least expect with bupivocaive is

a. Anaphylaxis

B. Sense of impending doom

c. Fitting

d. Arrythmia

e. Depressed level of consciousness

7. Which of the following is associated with a lower incidence of wound infection (given adequately cleanedwounds)

a. Steristrips

B. Staples

c. Histoacryl

d. Antibiotics for puncture wounds

e. All of the above

8. Which of the following is not associated with poor wound healing

a. Lower limb lacerations in the elderly

B. Broad based flap lacerations

c. Long flap lacerations

d. Haematoma beneath a flap laceration

e. All of the above are associated with poor wound healing

9. If a patient presents with DIC after dog bite the likely organism would be

a. Pseudomonas Aeruginosa

B. Staphylococcus Aureus

c. Streptococcus Viridans

d. Capnocytophaga Caniniosus

e. Pasturella Multocida

10. A backpacker returns from Thailand claiming to have been bitten by a dog in Bangkok the week before. There is a healing wound with scab on the right forearm ulnar aspect of the extensor surface. She cannot remember her vaccination status. Which statement is most correct

a. You should give 250U TIG, 0.5mL of ADT, commence oral antibiotic and refer back to the GP for further care – complete ADT vaccinations

B. There is a strong risk that cellulitis due to pasturella multocida will develop in the next week

c. ADT is contraindicated if she is either haemophilliac or pregnant

d. You should give 250U TIG, 0.5mL of ADT 3 x in the next 3 months, 20U/kg RIG once and 0.1mL HDCV 5 times in the next month

e. Her risk of contracting rabies would not be reduced if she had cleaned the initial wound thoroughly straight after the injury occurred

11. Which rash is not characteristically found on the hands?

a. secondary syphilis

B. erythema multiforme

c. gonococcus

d. meningococcus

e. herpes simplex

12. In what dermatological condition is a Tsanck smear used to aid diagnosis?

a. Skin lesions of meningococcus

B. Herpes vesicular lesions

c. Secondary syphilis

d. Urticaria

e. EBV

13. Which is not true of erythema multiforme?

a. less than 30% of the skin must be blistered to make this diagnosis

B. classically there are target lesions, especially on the periphery

c. there tends to be associated fever and arthralgia

d. it settles within 7-10 days if left untreated

e. steroids orally quicken the recovery

14. Which drug is not likely to cause toxic epidermal necrolysis?

a. penicillin

B. trimethoprim

c. carbamazepine

d. cimetidine

e. piroxicam

15. Which is not a possible cause of a blistered patient?

a. molluscum contagiosum

B. hand, foot and mouth disease

c. eczema herpeticum

d. allergic contact dermatitis

e. bites

16. Which is NOT TRUE of staphylococcal scalded skin syndrome?

a. it is most commonly seen in infants

B. it is toxin mediatied

c. there is no mucosal invovement

d. it tends to be less severe than toxic epidermal necrolysis

e. the focus for infection may be non cutaneous

17. Which infectious erythema is purely caused by toxin alone and not from the infectious process as well?

a. toxic shock syndrome

B. scarlet fever

c. streptococcal toxic shock syndrome

d. staphylococcal scalded skin syndrome

e. all of the above

18. Which rash is not usually itchy?

a. urticaria

B. eczema

c. scabies

d. bites

e. scarlet fever

19. Which is not true of scarlet fever?

a. the erythema appears very early after the prodrome begins

B. the rash does not blanche

c. there is circumoral pallor

d. there is often pharyngotonsillitis

e. there is a strawberry tongue

20. Which is not one of the five criteria other then fever required to make the diagnosis of Kawasakis disease?

a. cervical LN

B. peripheral changes. Eg erythema and oedema

c. bilateral non purulent conjunctivitis

d. polymorphous rash

e. pustular tonsillitis

21. Which dose not tend to produce palpable purpura?

a. meningococcus

B. vasculitis

c. SLE, rheumatoid arthritis

d. Clotting disorders

e. Henoch schonlein purpura

22. Which is not associated with erythema nodosum?

a. sarcoid

B. crohns disease

c. leukemia

d. salmonella

e. hep B

23. Which is not associated with pyoderma gangrenosum?

a. IBD

B. Rheumatoid arthritis

c. Leukemia

d. salmonella

e. myeloma

24. Which is NOT TRUE of pemphigus and pemphigoid?

a. the prognosis of pemphigoid is better

B. pemphigous lesions are intra dermal where as the lesions in pemphigoid are subdermal

c. mucosa is more often involved in pemhigous

d. clinically the two can be usually differentiated with a good examination

e. they are both autoimmune disorders

25. Which is the usual causative organism in toxic shock syndrome?

a. staph aureus

B. e coli

c. pneumococcus

d. strep pyogenes

e. meningococcus

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