McqMate
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% |
Answer» C. The most common cause is drug reaction |
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 |
Answer» A. Itch |
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 |
Answer» A. Punctate rash on neck and truck |
4. |
Erythema Nodosum is an example of |
A. | Panniculitis |
B. | Vasculitis |
C. | Serum sickness |
D. | Erythroderma |
E. | Type 2 hypersensitivity |
Answer» A. Panniculitis |
5. |
Geographic tongue is caused by |
A. | Kawasaki disease |
B. | Syphilis |
C. | Acromegaly |
D. | Pernicious anaemia |
E. | None of the above |
Answer» 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 |
Answer» A. Anaphylaxis |
7. |
Which of the following is associated with a lower incidence of wound infection (given adequately cleaned wounds) |
A. | Steristrips |
B. | Staples |
C. | Histoacryl |
D. | Antibiotics for puncture wounds |
E. | All of the above |
Answer» 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 |
Answer» B. Broad based flap lacerations |
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 |
Answer» D. Capnocytophaga Caniniosus |
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 |
Answer» 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 |
11. |
Which rash is not characteristically found on the hands? |
A. | secondary syphilis |
B. | erythema multiforme |
C. | gonococcus |
D. | meningococcus |
E. | herpes simplex |
Answer» 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 |
Answer» B. Herpes vesicular lesions |
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 |
Answer» 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 |
Answer» D. cimetidine |
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 |
Answer» A. molluscum contagiosum |
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 |
Answer» C. there is no mucosal invovement |
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 |
Answer» A. toxic shock syndrome |
18. |
Which rash is not usually itchy? |
A. | urticaria |
B. | eczema |
C. | scabies |
D. | bites |
E. | scarlet fever |
Answer» 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 |
Answer» B. the rash does not blanche |
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 |
Answer» 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 |
Answer» D. Clotting disorders |
22. |
Which is not associated with erythema nodosum? |
A. | sarcoid |
B. | crohns disease |
C. | leukemia |
D. | salmonella |
E. | hep B |
Answer» E. hep B |
23. |
Which is not associated with pyoderma gangrenosum? |
A. | IBD |
B. | Rheumatoid arthritis |
C. | Leukemia |
D. | salmonella |
E. | myeloma |
Answer» D. salmonella |
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 |
Answer» D. clinically the two can be usually differentiated with a good examination |
25. |
Which is the usual causative organism in toxic shock syndrome? |
A. | staph aureus |
B. | e coli |
C. | pneumococcus |
D. | strep pyogenes |
E. | meningococcus |
Answer» A. staph aureus |
26. |
Which medication does not commonly cause photosensitivity eruptions? |
A. | thiazide diuretics |
B. | spironolactone |
C. | loop diuretics |
D. | amioderone |
E. | sulfonylureas |
Answer» B. spironolactone |
27. |
Which is not true of antiviral medications if given within 72 hours of vesicle formation in herpes zoster? |
A. | it decreases time to healing |
B. | it decreases new lesion formation |
C. | it decreases recurrence |
D. | it possibly decreases pain |
E. | it possibly decreases duration of post herpetic neuralgia |
Answer» C. it decreases recurrence |
28. |
Which is not true of measles? |
A. | Koplicks spots are seen a few days after the onset of rash |
B. | The rash appears a few days after the prodrome, starting at the head and moving downwards |
C. | Unimmunised contacts should be given MMR within 72 hours if over 6 months of age |
D. | If greater than 72 hours immunoglobulin should be given i.m. |
E. | Unimmunised contacts should be excluded from school for 2 weeks |
Answer» A. Koplicks spots are seen a few days after the onset of rash |
29. |
Which is not true of henoch schonlein purpura? |
A. | it is a vasculitis of unknown cause |
B. | purpura are classically on the lower limbs |
C. | abdominal pain and malena are documented |
D. | renal disease is a potentially serious complication |
E. | steroids diminish the likelihood of renal complications |
Answer» E. steroids diminish the likelihood of renal complications |
30. |
How many days it take a wound to reach 100% of its original tensile strength? |
A. | 40 |
B. | 100 |
C. | 150 |
D. | 250 |
E. | 360 |
Answer» C. 150 |
31. |
Which imaging modality is most successful at detecting suspected foreign bodies in wounds? |
A. | normal plain xray |
B. | plain xray ‘soft tissue view’ |
C. | ultrasound |
D. | CT |
E. | Bone scan |
Answer» D. CT |
32. |
Which is the best irrigation fluid for most wounds? |
A. | normal saline |
B. | povodine – iodine |
C. | aquesous chlorhexidine |
D. | chlorhexidine with cetramide |
E. | a combination of A and B |
Answer» A. normal saline |
33. |
Which is the correct regimen for wound irrigation? |
A. | 21 gauge needle, 50 ml syringe |
B. | 21 gauge needle, 20 ml syringe |
C. | 19 gauge needle, 50 ml syringe |
D. | 19 gauge needle, 20 ml syringe |
E. | 1 litre bag with giving set wide open |
Answer» C. 19 gauge needle, 50 ml syringe |
34. |
When antibiotics are given for a wound with a high risk of infection, how should they be given in the ED? |
A. | orally prior to wound manipulation, with discharge prescription |
B. | iv prior to wound manipulation, with discharge prescription |
C. | a prescription to be filled on discharge |
D. | both A and B give the same result |
E. | infiltrated around wound i.m |
Answer» B. iv prior to wound manipulation, with discharge prescription |
35. |
Which wound is most likely to produce tetanus? |
A. | Intraoral laceration |
B. | scalp laceration with underlying skull fracture |
C. | crush injury to distal phalynx |
D. | frostbite |
E. | puncture wounds |
Answer» E. puncture wounds |
36. |
Which suture should be used for wounds at risk of infection? |
A. | monofilament, natural |
B. | monafilament, synthetic |
C. | multifilament, natural |
D. | multifilament, synthetic |
E. | catgut |
Answer» B. monafilament, synthetic |
37. |
Which is false regarding staples? |
A. | they have a higher rate of infection than sutures |
B. | they are cheaper than sutures |
C. | they are quicker to insert than sutures |
D. | they are more painful to remove than sutures |
E. | they do not provide as accurate a finish as sutures |
Answer» A. they have a higher rate of infection than sutures |
38. |
At which distance should two point discrimination be possible? |
A. | 2mm |
B. | 5mm |
C. | 7.5mm |
D. | 10mm |
E. | 15mm |
Answer» B. 5mm |
39. |
Which is not readily seen on Xray? |
A. | all glass greater than 2mm |
B. | gravel |
C. | teeth |
D. | fish bone |
E. | steak bone |
Answer» D. fish bone |
40. |
Human bites to what area have the highest rate of infection? |
A. | face |
B. | arm |
C. | shin |
D. | back |
E. | hand |
Answer» E. hand |
41. |
Regarding bites which is false? |
A. | all hand bites (animal and human) should be managed by delayed primary closure or secondary intention |
B. | primary wound closure to the head and neck is acceptable after appropriate wound irrigation |
C. | wounds less than1-2 cm have a lower rate of infection and can be safely treated with primary closure |
D. | infection with pasturella multicodia is specific to cat bites |
E. | infection with capnocytophaga caninorsus is secific to dog bites |
Answer» C. wounds less than1-2 cm have a lower rate of infection and can be safely treated with primary closure |
42. |
Which antibiotic regimen is recommended in antibiotic guidelines for bites with a high risk of infection? |
A. | augmentin duo forte |
B. | penicillin |
C. | ampicillin |
D. | cephalexin |
E. | metronidazole plus penicillin |
Answer» A. augmentin duo forte |
43. |
Which wound does not require antibiotic prohylaxis upon discharge (assuming seen within 3 hours and appropriate wound care applied)? |
A. | intraoral |
B. | complicated dog bites |
C. | complicated human bites |
D. | all cat bites |
E. | axillary |
Answer» E. axillary |
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