CME for Family Physicians

Dermatology

1. A 4 years old girl presents with fever,

runny nose, cough and skin rash. The (A) Measles
rash is vesicular, has erythematous base (B) Rubella
and is distributed mostly on trunk and (C) Chicken pox
face. (D) Drug eruption
(E) Infectious mononucleosis
What is the most likely diagnosis?
How will you treat her?
(A) Measles
(B) Rubella (A) Symptomatic treatment and
(C) Chicken pox education to mother
(D) Herpes simplex (B) A d m i t f o r 2 4 h o u r s f o r
(E) Infectious mononucleosis observation
(C) Admit in isolation ward for 7-10
Case same as above. Days
How will you make this diagnosis in a (D) Oral Acycloris for 1 week
family practice? (E) None of the Above

(A) History & physical exam 4. A 21 years old man presents with painful
(B) A typical lymphocyte on vesicular eruption on the right side of
peripheral film chest since 2 days. On examination there
(C) Microscopy of vericle fluid are vesicles in the line of 6th and 7th ribs
(D) Serology on the right side.
(E) All of the Above
What is the most likely diagnosis?
How will you treat her?
(A) Coxsackie virus infection
(A) Acyclovir tablets (B) Pemphigus vulgaris
(B) Topical acyclovir (C) Chicken pox
(C) Symptomatic treatment only (D) Herpes simplex
(D) Symptomatic treatment and (E) Herpes Zoster
evidence
(E) Of both till vesicles are crusted 5. Case same as above.
(F) All of the above
How would you manage this patient?
2. A 5 years old girl presents with history of
fever of 104o F, cough, runny nose, red (A) Diclofenac
eyes. There is diffuse maculopapular rash (B) Aviclovir 800 mg 5 times a day
on face, neck, trunk and limbs. The rash (C) Cloxacillin capsules
started from the face and extended to (D) A and B
extremities. The child looks ill. (E) All of the above

What is the most likely diagnosis? 6. Case same as above. The patient comes
after two days and tells you that the pain
(A) Measles is unbearable and disturbs his sleep.
(B) Rubella
(C) Chicken pox What would you like to add to his
(D) Drug eruption prescription?
(E) Infectious mononucleosis
(A) Amitriptyline
3. A 5 years old girl presents with history of (B) Carbamezapine
mild fever, cough, and runny nose. There (C) Gabapentine
is diffuse maculopapular rash on face, (D) B+C
neck and trunk. The child is active (E) None of the above
otherwise. There are bilateral occipital
lymph nodes present. 7. A 12 years old girl presents with small
lumps on her hands since 4 weeks. On
What is the most likely diagnosis? examination there are 12 discrete,

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 CME for Family Physicians
Dermatology

rounded, rough on top, non tender, lesions

on the dorsum of her hands. 12. A 54 years businessman presents with a 6
cm x 5 cm swelling on the upper back
What is the most likely diagnosis? since 3 days. The swelling is tender,
warm, erythematous and is discharging
(A) Verruca vulgaris pus from three small openings.
(B) Keratoachanthoma
(C) Melanomas What is the most likely diagnosis?
(D) Lipomas
(E) Fibromas (A) Cellulitis
(B) Carbuncle
8. Case same as above. (C) Furuncle
(D) Gangrene
How would treat this girl? (E) Infected cyst

(A) Diathermy 13. Which other disease will you consider in

(B) Liquid nitrogen case 12
(C) Dry carbon dioxide
(D) Electric cautry (A) Vulgarin pemphigus
(E) Any of the above (B) Cold abscess
(C) Hypothyroidism
9. A 5 years old boy presents with (D) Diabetes
generalized pruritus pustules on his (E) Pots disease
hands, fingers, wrists and feet since 6
days. There are multiple papular lesions 14. Case same as 12
on the affected sites with excoriations and
yellowish pus scattered along the lesions. How would you manage this case as a
His elder brother also has the same family physician?
problem.
(A) Oral Cloxacillin
What is the most likely diagnosis? (B) IV Cloxacillin
(C) IV Cloxacillin and debridement of
(A) Impetigo wound
(B) Icthyosis (D) IV Cloxacillin + IV Gentamycin +
(C) Carbuncle Metronidazole
(D) Infected eczema (E) IV Cloxacillin + IV Gentamycin +
(E) Infected scabies Metronidazole and debridement
of wound
10. Case same as above. 15. A 6 y e a r s o l d g i r l f r o m a p o o r
socioeconomic background presents with
What treatment would you like to give multiple small rashes on the lower legs
initially. since 4 days. There are discrete 0.5 cm
ulcerating lesions, with central pus and
(A) Cloxacillin crust on top, and raised margins. The skin
(B) Chlorpheneramine around the lesion is hyperemic.
(C) Benzyl benzoate
(D) All of the above What is the most likely diagnosis?
(E) A and B
(A) Impetigo
11. Which one is the most common cause of (B) Icthyma
persistent itching after “appropriate” (C) Basal cell carcinoma
treatment of scabies? (D) Leshminiasis
(E) Leprosy
(A) Persistent infection
(B) Inappropriate application 16. A 1 y e a r o l d g i r l f r o m a p o o r
(C) Presence of eggs in the burrows socioeconomic background present with
(D) Resistant organisms few small lesion on face and forearm .The
(E) None of the above lesion are red, well defined with thin

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 CME for Family Physicians
Dermatology

honey colored erusts. What is the most

likely diagnosis? 20. How will you treat her

(A) Impetigo (A) Ampicillin

(B) Icthyma (B) Amoxicillin
(C) Chicken pox (C) Co-amoxiclave
(D) Hand foot and mouth disease (D) Cloxacillin
(E) Erysepalas (E) C&D
(F) Any of the following
17. A 1 7 y e a r s o l d b o y f r o m a l o w
socioeconomic background presents with 21. A 37 years old laborer presents to your
a 4 cm patch since 2 months which is clinic with painful rash on the hands,
hypo pigmented and painless. There is no abdomen, legs, lips, inside nose and
history of contact with chemicals. There is mouth after taking some medicines from a
no other similar lesion on the body. pharmacy. He looks sick & lethargic

Which single clinical sign would you illicit How would you manage this patient?
in your clinic in order to differentiate
between serious causes and non serious (A) Topical steroids
causes of this skin lesion? (B) Systemic steroids at home
(C) Systemic antibiotics at home
(A) Skin scrapings (D) IV line, IV fluids and referral
(B) Use magnifying glass (E) Topical steroids + topical
(C) Auspitz sign antibiotics
(D) Check sensation
(E) Palpate the lesion carefully 22. Case same as above.

18. A 34 years old woman presents with a 4 What would be the management of this
cm plaque on her left cheek since 1 patient in hospital?
month. She also has cough, weakness,
joint pains and swellings, bruises, mouth (A) IV fluids and electrolyte
ulcers and sensitivity to sun light. The monitoring
lesion is round, mildly raised, (B) IV steroids
erythematous, with minimal scaling and is (C) IV Ranitidine
non tender. (D) Sterile dressing
(E) All of the above
What is the most likely diagnosis?
23. A 13 years old boy has come to your clinic
(A) Leprosy because of lethargy and darkening of his
(B) Sarcoidosis skin. Her mother has already shown to a
(C) Discoid lupus erythematosus dermatologist who reassured her and
(D) Tuberculosis gave no treatment. The mother tells you
(E) Fixed drug eruption that her son was very fair in childhood.

19. A woman has come to your clinic with pain What is the most likely cause of this
and redness of the of the legs after condition in this case?
waxing. On examination there are discrete
yellow pustules at the bases of hair with (A) Hemochromatosis
surrounding erythema. The skin in (B) Addison’s disease
between the hair is normal. (C) Hypothyroidism
(D) Melanomatosis
What is the most likely diagnosis? (E) Genetic color changes

(A) Folliculitis 24. A thirty five-year-

(B) Furunculosis old man has
(C) Contact dermatitis d e v e l o p e d
(D) Erythema multiformi asymptomatic
(E) None of the above smooth areas of

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 CME for Family Physicians
Dermatology

hair loss in the beard area. • Treatment is disappointing. The Acanthosis

may remit with successful treatment of
What is the diagnosis? underlying disease

27. A 17-year-old netball

player twisted her ankle,
(A) Alopecia areata which was strapped. This
(B) Tinea impressive itchy rash was
(C) Leprosy found when the strapping
(D) Vitiligo was removed a week
(E) None of the above later.

25. Case same as above. What is the diagnosis?

What is the most appropriate treatment in (A) Contact dermatitis

a family medicine clinic? (B) Atopic dermatitis
(C) Allergic dermatitis
(A) No treatment is usually (D) Streptococcal infection
necessary. Full remission is (E) Stapholoccal infection
achieved spontaneously in 80%.
(B) Intralesional steroid injections. 28. Case same as above.
(C) Topical steroid
(D) Topical antifungal How would you manage this patient in out
(E) Minoxidil spray patient setting?

26. This lady weights 90 kg. (A) Oral steroids

She requests help for (B) Antihistamine
darkening the color of her (C) topical steroid
neck. There are hyper (D) All of the above
pigmented velvety plaques (E) B and C
and skin tags.
29. A 42 years patient
What is this condition? presented with a
swollen, painful and
(A) Addisons disease red lower leg. She
(B) Achanthosis nigricans was systemically
(C) Candidal infection unwell and had
(D) Sun burn experienced rigors
(E) Psoriasis during the night.
There is tender
Acanthosis nigricans i n g u i n a l
• Acanthosis nigricans is due to insulin lymphadenopathy.
resistance.
• With what conditions is it associated? What is the diagnosis?
• Commonest is obesity.
• Endocrine associations include (A) Deep vein thrombosis
• Diabetes mellitus, (B) Cellulitis
• Hypothyroidism, and (C) Necrotozing fasciitis
• Polycystic ovaries. (D) Elephantiasis
• Paraneoplastic associations include (E) Thromboembolism femoral artery
adenocarcinoma of the stomach, and
malignancies of small and large bowel, 30. Case same as above.
ovaries, lung, breast and prostate.
• Drug-induced Acanthosis has occurred How would you manage this patient apart
with nicotinic acid, estrogens and from prescribing antibiotics?
corticosteroids.
(A) Rest
(B) Elevation of the affected part
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 CME for Family Physicians
Dermatology

(C) Hot compresses (D) Erythrasma

(D) All of the above (E) Erythema nodosum
(E) A and B
34. The patient is a man of 68 who has had
this pustular eruption on both feet for
31. A 25-year-old woman presents with a twenty-four years.
twelve-month history of a generalized
itchy rash. A What is the diagnosis?
light scratch
resulted in the (A) Tinea pedis
appearance (B) Lichen simplex
shown. chronicus
(C) Syphilis
What is the (D) Palmoplantar pustulosis
diagnosis? (E) Pyoderma gangrenosim

(A) A dermopathy 35. A twenty-year-

(B) Sytematic lupus erythematosis old male
(C) Dermographisun presents with an
(D) Agraphisthesia asymptomatic
(E) Hypersensitivity reaction rash on his
trunk and
32. A 25 years old patient is concerned by proximal limbs.
dark marks present in the axillae and He tells you the
groins. largest patch
was the first one and preceded the others
by about a week. Individual oval plaques
have a collarate of scale as illustrated,
and are distributed in a fir tree pattern.

What is the diagnosis?

What is this
condition? (A) Atopic dermatitis
(B) Pityriaisis rosea
(A) Aconthosis nigricans (C) Pityriasis versicolor
(B) Addisons disease (D) Lichen Planus
(C) Erythrasma (E) Exfoliative dermatitis
(D) Tinea corporis
(E) Atopic dermatitis 36. A 57 years old
farmer presents
33. A nineteen-year-old with disfigured
student presents nails since 6
with tender months as
erythematous shown in the
nodules on her figure. Rest of
shins, which have the skin is
been present for normal
several weeks. She
has mild arthralgia What is the most likely diagnosis based
affecting both on simple observation of lesion?
ankles and general
malaise. (A) Onychomycosis
(B) Nail psoriasis
What is the name of this cutaneous sign? (C) Chronic eczema
(D) Age related atrophy
(A) Psoriasis (E) A and B
(B) Cellutitis
(C) Acanthosis
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Dermatology

37. A 12 years old boy has come to your clinic

with recurrent Candida infection of the
anorectal area. 40. Case same as above. What would you
advise apart from general measures and
What would be the most appropriate next Topical antifungal agents:
step in this case?
(A) Terbinafine 250 mg / day for 14
(A) Oral Nystatin stat dose days
(B) Oral Ketoconazole for 4-6 weeks (B) Itraconazole 200 mg BD for 7
(C) Terbinafine for 2 weeks days or 200 mg OD for 2 weeks
(D) Grisofulvin for 6-8 weeks (C) Fluconazole 150 mg OD for 4-6
(E) Continues topical Nystatin for weeks
next 3 months (D) Any of the above

38. A few days after a skiing trip, a student

presents with 41. A 42-year old woman presents with a
a painful widespread patchy rash on her upper
blistered area back and chest. She considers it
on the upper unsightly, but denies any symptoms. She
lip. She is has numerous, slightly scaly hypo
feeling unwell pigmented patches on her trunk and
and has mild proximal upper limbs
regional
(A) Pityriasis alba
lymphadenopathy. She reports she has (B) Pityriasis rosea
had a similar problem in the same site on (C) Pityriasis Versicolor
two or three previous occasions over the (D) Lichen planus
last year or so. (E) None of the above

What is the likely diagnosis? 42. T h i s m a n i s

. embarrassed about
(A) Angular stomatis his nose.
(B) Herpes zoster
(C) Herpes simplex What is the most
(D) Candidal infection likely diagnosis?
(E) Atopic dermatitis
(A) Pityriasis
39. A 55-year old male rosa
complains that his (B) Keratosis pilasis
foot lesion is not (C) Kerion
responding to an (D) Rosacea
over-the-counter (E) Pustular Acne
foot powder. Can
you help? 43. The main pathophysiology of rosacea is:

What is the most (A) Obstruction of sweat glands

likely diagnosis? (B) Sebaceous hyperplasia
(C) Infection
(D) Hyperkeratosis
(E) Soft tissue edema

(A) B a s a l 44. What is the most appropriate systemic

treatment for rosacea?
cercircinoma
(B) Cellulitis (A) Amoxicillin
(C) Tinea pedis (B) Erythromyocin
(D) Candida intertrgo (C) Doxycycline
(E) Shoe trauma (D) Ciprofloxacin Metronidanzole

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 CME for Family Physicians
Dermatology

45. What is the most effective topical 50. A 25 year old man presents with a 6
treatment for Rosacea. months history of well-defined oval
macules that are pink / tan in color on his
(A) Erythormycin trunk, upper arms and neck.
(B) Clindamycin
(C) Metronidazole (A) Pityriasis rosea
(D) Hydrogen peroxide (B) Xerosis
(C) Melasma
(D) Tinea versicolor
46. A 19 year old student (E) Lichen planus
complains of itchy
raised lesions on his 51. In a patient with no known drug allergies,
wrists. He has a lacy the treatment of choice for erysipelas is:
white pattern inside his
mouth. (A) Topical mupirocin
(B) Intravenous vancomycin
(A) Pityriasis rosea (C) Intramuscular foscarnet sodium
(B) Melasma (D) Oral penicillin v
(C) Lichen planus
(D) Keratosis pilaris 52. The potassium hydroxide (K+OH–) test is
(E) Tinea versicolor used to diagnose which of the following
categories of skin conditions?
47. A 16 year old girl presents with rough skin
on her upper arms. On (A) Viral infection
close examination this (B) Bacterial infection
is seen to consist of tiny (C) Fungal infection
papules in a grid-like (D) Rickettsial infection
distribution.
53. Which of the following diseases can affect
(A) Xerosis the skin, nails, and joints?
(B) Granuloma annulare
(C) Furunculosis (A) Erythema nodosum
(D) Lichen simplex (B) Psoriasis
(E) Keratosis pilaris (C) Pityriasis rosea
(D) Lichen planus
48. A 32 year old man presents with a 2 year
history of recurrent painful nodules and 54. The treatment of choice for perioral
abscesses in his axillae. dermatitis is:

(A) Granuloma annulare (A) Antibiotic

(B) Furunculosis (B) Steroid
(C) Keratosis pilaris (C) Antifungal
(D) Hydradenitis suppurativa (D) Antiviral
(E) Kerion
55. The condition manifesting as velvety,
hyperpigmented, papillomatous lesions of
49. An 11 year old Afro- the neck, axillae and groin, associated
Caribbean has a boggy, with insulin resistance, is known as:
pustular, in-durated plaque
on his scalp. (A) Verruca vulgaris
(B) Acanthosis nigricans
(A) Xerosis (C) Hidradenitis suppurativa
(B) G r a n u l o m a (D) Seborrheic keratoses
annulare
(C) Alopecia areata 56. A patient reporting hair loss is found to
(D) Furunculosis have a round, well-circumscribed 3-cm
(E) Kerion
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 CME for Family Physicians
Dermatology

area of hair loss on the parietal scalp (A) Isotretinoin

area. The most likely diagnosis is: (B) Benzoyl peroxide
(C) Tetracycline
(A) Anagen effluvium (D) Metronidazole
(B) Androgenetic alopecia
(C) Alopecia areata 62. A 65-year-old patient presents with a 4-
(D) Traumatic alopecia week history of dark red pruritic urticarial
plaques on the flexor surfaces. The
57. Focal loss of epidermis is most closely plaques begin developing tense bullae on
associated with the surface. This clinical presentation is
most suggestive of
(A) Macule
(B) Papule (A) Bullous pemphigoid
(C) Lichenification (B) Bullous impetigo
(D) Plaque (C) Pemphigus vulgaris
(E) Erosion (D) Dermatitis herpetiformis

58. Using the "rule of nines" to calculate body 63. A T z a n c k s m e a r d e m o n s t r a t i n g

surface area, what would the percentage multinucleated giant cells indicates which
of burned area be in an adult patient with of the following conditions?
second-degree burns involving the entire
right arm, the anterior chest and (A) Scabies
abdomen, and the entire right leg? (B) Tinea versicolor
(C) Impetigo
(A) 27 (D) Herpes simplex
(B) 36
(C) 45 64. The pathognomonic skin finding in
(D) 52 hidradenitis suppurativa is

59. A patient being treated for acne reports (A) Lichenification

symptoms of headaches and blurred (B) Ulceration
vision (Pseudotumor cerebri). Which of (C) Double comedones
the following agents is most likely (D) Atrophy
responsible?
65. A 20-year-old male patient presents with a
(A) Minocycline 2-month history of pruritic, scaling,
(B) Erythromycin erythematous plaques on the proximal
(C) Trimethoprim-sulfamethoxazole inner thighs. The plaques have sharply
(D) Retinoids also cause advancing serpiginous margins without
(E) Doxycycline satellite lesions. The most likely diagnosis
is
60. Which etiologic agent is associated with
erysipelas? (A) Psoriasis
(B) Urticaria
(A) Group A Streptococcus spp. (C) Pityriasis rosea
(B) Borrelia burgdorferi (D) Tinea cruris
(C) Pityrosporum orbiculare
(D) Treponema pallidum 66. Erythema with scale-forming yellowish
(E) Propionibacterium acnes plaques on the eyebrows, nasolabial
folds, glabella, and presternal area best
61. Miss Sara is a college student and has describes
been coming to you for treatment of acne.
Your intial therapy is not showing (A) Bacterial folliculitis
significiant results. You want to inhibit (B) Allergic contact dermatitis
scbaceous gland function and (C) Rosacea
keratinization. Which drug will you (D) Seborrheic dermatitis
prescribe her?

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Dermatology

67. An acute eruption of violaceous, pruritic, (D) Blastomycosis

polygonal, shiny, flat-topped papules (E) Histoplasmosis
involving the flexor surfaces is suggestive
of which of the following? 72. A 36-year-old woman who is losing
handfuls of hair three months after
(A) Lichen planus sustaining serious injuries in a motor
(B) pityriasis rosea vehicle crash most likely has which one of
(C) Psoriasis the following conditions?
(D) seborrheic dermatitis
(A) Androgenetic alopecia
68. The most common causative organism in (B) Telogen effluvium
folliculitis is: (C) Alopecia areata
(D) Traction alopecia
(A) Pityrosporum ovale
(B) Pseudomonas aeruginosa 73. Which one of the following medications
(C) Staphylococcus aureus approved by the U.S. food and drug
(D) Propionibacterium acnes administration for the treatment of
androgenetic alopecia is currently
69. A patient known to have allergic rhinitis available over the counter?
and asthma presents with chronic pruritic
inflammatory lesions of the flexor (A) Minoxidil topical solution
surfaces, wrists, and dorsal areas of the (B) Finasteride
feet. The lesions are excoriated, (C) Spironolactone
lichenified, and crusted patches and (D) Tretinoin
plaques. The most likely diagnosis is
74. Which one of the following is the
(A) Nummular eczema treatment of choice in an adult with patchy
(B) Psoriasis alopecia areata affecting approximately
(C) Seborrheic dermatitis 40 percent of the scalp?
(D) Atopic dermatitis
(A) Await spontaneous resolution
70. A 32 year old man presents to your office. (B) Oral corticosteroids
Approximately 5 days ago he was (C) Topical corticosteroids.
cleaning out his dark, undisturbed attic. (D) Inralesional corticosteroid
The following day he notices an injections
erythematous lesion with a clear center on
his arm. The lesion has necrosed in the 75. Which one of the following statements
center, giving rise to a crater-like eschar about hidradenitis suppurativa is correct?
lesion. The most likely diagnosis is
(A) Scarring, fistulous tracks help to
(A) Lyme disease exclude the diagnosis.
(B) Spider bite (B) The disease is limited to the
(C) Psittacosis axillary and perianal regions.
(D) Herpes zoster (C) The condition generally is
(E) Scorpion sting painless.
(D) Hidradenitis nodules tend to be
71. A 40 year old florist presents to your office sterile.
complaining of a nontender nodule that (E) If perianal lesions appear, they
formed on his hand, then enlarged, and should be biopsied.
finally ulcerated. In the days that followed,
the patient developed similar nodules in 76. An obese woman who has had several
the area of the axillary lymphatics. episodes of hidradenitis suppurativa asks
Otherwise he has had no other symptoms. what she can do to prevent new lesions
The most likely diagnosis is from developing. Which one of the
following actions would be effective?
(A) Cat-scratch fever
(B) Sporotrichosis (A) Weight loss.
(C) Tuberculosis (B) Use of deodorants.
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 CME for Family Physicians
Dermatology

(C) Axillary depilatory treatment. (B) Women of childbearing potential

(D) Avoidance of contact with other who are not adequately
affected persons. protected against pregnancy
(C) Allergy to topical tretinoin
77. Mr Hamid is a 22 years old laborer and (D) All of the above
has a pain and swelling around the nail of (E) None of the above
right index finger since 3 days. On
examination the nail bed is swallen, red, 82. A 2-month-old infant is brought to your
tender and warm Which one of the office by his mother. He developed dry
following is the most common infecting skin rash on both cheeks approximately 1
organism in this case of week ago and worsens after she feeds
him. The father has seasonal allergies. On
(A) Streptococci examination, the child appears healthy.
(B) Pseudomonas species He has an erythematous maculopapular
(C) Herpes simplex virus eruption that covers his cheeks, neck,
(D) Staphylococcus aureus both wrists, and both hands.
(E) Candida species
What is the most likely cause of this
78. Acne is the result of a pathophysiologic infant's skin rash?
process in the pilosebaceous unit that
stems from abnormalities in: (A) Atopic dermatitis
(B) Allergic contact dermatitis
(A) Sebum production (C) Seborrheic dermatitis
(B) Follicular hyperkeratization (D) Infectious eczematoid dermatitis
(C) Proliferation and colonization of (E) None of the above
propionibac terium acnes
(D) R e l e a s e o f i n f l a m m a t o r y 83. Case same as above. What is the
mediators recommended treatment of the skin rash?
(E) All of the above
(A) Skin hydration
79. Which of the following bacteria is (B) Local corticosteroid therapy
associated with the Acne? (C) Systemic antihistamines
(D) Minimizing the use of soap
(A) Staphylococcus (E) All of the above
(B) Streptococus
(C) Propionibacterium acnes 84. What other conditions are associated with
(D) All of the above atopic dermatitis?
(E) None of the above
(A) Asthma
80. Which of the following is (are) essential for (B) Allergic rhinitis
a good skin-care program specifically (C) Wool sensitivity
designed for patients with acne? (D) Keratosis pilaris
(E) All of the above
(A) Oil-free products
(B) Thorough, frequent cleansing of 85. Which statement is TRUE regarding
skin with exfoliants atopic dermatitis?
(C) Manual manipulation of skin
lesions (A) A cotton diaper is preferred over
(D) Use of gels and solutions for dry a disposable diaper in this
skin condition
(E) A p p l y i n g a l l o f t o p i c a l (B) Breastfeeding offers no
medications at bedtime advantage over formula feeding
in this condition
81. What is the absolute contraindication(s) to (C) Sun exposure may be helpful in
the use of oral isotretinoin for the this condition
treatment acne vulgaris? (D) Patients do better in a dry climate
(E) Antihistamines can be curative in
(A) Children younger than age 14 this condition

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Dermatology

86. 1-month-old infant is brought to your office (A) Irritant diaper dermatitis spares
by his mother. She states that the infant the crural folds
has had a diaper rash or the past 2 weeks (B) Candidal diaper rash spares the
that has not cleared up with the use of crural folds
zinc oxide three times a day. On (C) Irritant diaper dermatitis involves
examination, the infant has a mildly the crural folds
erythematous greasy, scaly rash in the (D) None of the above
diaper area. He also has a scaly rash on (E) A, b, and c
the scalp, the ear, the sides of the nose,
and he eyebrows and eyelids. The rest of 91. A 3-year-old comes to your office with
the physical examination is normal. fatigue and irritability and a low-grade
fever that he has had for 3 days. On
What is the most likely diagnosis in this physical examination His temperature is
infant? 38° C. His skin examination shows
scattered small vesicles on an
(A) Atopic dermatitis erythematous base. The rash was seen
(B) Allergic contact dermatitis first on the face and seems to be
(C) Seborrheic dermatitis spreading to the trunk. What is the most
(D) Infectious eczematoid dermatitis. likely diagnosis in this child at this time?
(E) None of the above
(A) Rubella
87. What is the treatment(s) of choice for (B) Adenoviral exanthem
seborrheic dermatitis? (C) Varicella
(D) Mumps
(A) Wet compresses (E) Rubeola
(B) Topical corticosteroids
(C) Topical ketoconazole 92. What is the most outstanding feature of
(D) A and b varicella zoster infection?
(E) All of the above
(A) Constitutional symptoms
88. 8-month-old infant is brought to your office (B) The appearance of a rash at the
by his mother for assessment of a diaper same time as the temperature
rash. On examination, the infant has an falls.
intensely erythematous diaper dermatitis (C) The description of the lesion as a
that has a scalloped border and sharply dew drop on a rose petal
demarcated edge. There are (D) Recurrence of the rash in
numerous"satellite lesions" present on the adulthood
lower abdomen and thighs. What is the (E) Benign nature of this infection
most likely diagnosis in this infant?
93. A 5 year-old into the office with a 3-day
(A) Atopic dermatitis history of fever, nonproductive, cough and
(B) Allergic contact dermatitis coryza and conjunctivitis. This morning a
(C) Seborrheic dermatitis rash appeared on his forehead and
(D) Infectious eczematoid dermatitis behind the ears and appears to be
(E) Candidal diaper dermatitis spreading to his upper arms and chest.
On physical examination you note a fine
89. What is the treatment of choice for the maculopapular rash over the face that
diaper rash candidal? appears to be spreading to the back and
thighs.
(A) A topical corticosteroid What is the most likely diagnosis in this
(B) A topical antibiotic . patient?
(C) A systemic. Antibiotic
(D) A topical antifungal agent (A) Erythema .infectiosum
(E) None of the above (B) Streptococcal infection
(C) Cytomegalovirus
90. What differentiates a candidal diaper rash (D) Measles
from irritant diaper dermatitis? (E) Rubella

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 CME for Family Physicians
Dermatology

(D) Human parvovirus b19

94. What are the hallmark signs and (E) Adenovirus
symptoms of this infection?
99. What are the morphologic features of
(A) Koplik spots Erythema infectiosum?
(B) C o a l e s c i n g e r y t h e m a t o u s
maculopapular rash (A) Circumoral pallor and
(C) Suboccipital and postauricular sandpaperlike appearance of the
lymph node enlargement trunk.
(D) Conjunctivitis (B) Fine pustular appearance and a
(E) All of the above bright red macular-papular rash
with central clearing
95. Which of the following is a relatively (C) Erythematous cheeks with a lacy
common complication of this infection? reticular pattern
(D) Coalesced lesions in various
(A) Encephalitis stages (vesicles, bullae, and
(B) Myocarditis papules)
(C) Pneumonia. (E) None of the above
(D) Thrombocytopenic purpura
(E) Keratoconjunctivitis 100. The mother asks you what she can do
about the slap-cheeked appearance.
96. What treatment recommendations will you People are staring at her as though she
make to the parents of a child with has been abusing her child:
measles?
(A) Tell her to tell them to stop
(A) Amoxicillin staring; it's none of their
(B) Erythromycin business
(C) Symptomatic treatment (B) Tell her to give the child
(D) Vitamin a parecetamol every 4-6 hours
(E) Ribavirin (C) Tell her to wash the face
repeatedly with cold water
97. 4-year-old is brought to the office by his (D) Advise her to keep the child out
mother. The child has had a low-grade of the sun
fever, headache, and a sore throat for the (E) Reassure her that this will
past 1 week. Four days ago he suddenly resolve on its own
developed a bright red rash on his cheeks,
which now over the last 2 days has spread 101. The mother then tells you that she is 4
to the trunk, arms, and legs. months pregnant and asks whether she
On physical examination, the child has should she be worried about anything.
erythema of the checks and a What do you tell her?
maculopapular rash on the trunk
spreading to the extremities. There are no (A) There is no cause for concern;
other significant findings. this is a self-limiting illness
What is the most likely diagnosis in this (B) There is a small chance for fetal
child? demise or congenital defects
(C) Tell her you are too busy and ask
(A) Rubella her why doesn't she just look it
(B) Adenoviral exanthema up on the internet like everyone
(C) Human herpesvirus 6 else
(D) Erythema infectiosum (D) All of the above
(E) Rhinovirus (E) None of the above

98. What is the causative agent of Erythema

infectiosum? 102. Which one of the following treatments for
external genital warts can be applied by
(A) Herpes virus 6 the patient?
(B) Human papillomavirus
(C) Rhinovirus (A) Podofilox
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 CME for Family Physicians
Dermatology
(B) Podophyllin.
(C) Interferon.
(D) Trichloroacetic acid.
103. Which one of the following factors is most
commonly associated with nonallergic
rhinitis?
(A) Viral infection.
(B) Positive skin test.
(C) Positive family history.
(D) Allergen exposure.
104. Which one of the following statements
about impetigo is correct?
(A) It is most common in winter
months.
(B) It can spread rapidly through
schools.
(C) It is not related to poor hygiene.
(D) Bullous impetigo is the most
common form of the infection.
105. Which one of the following statements
about topical antibiotics for treatment of
impetigo is correct?
(A) They are consistently less
effective than oral antibiotics.
(B) They are as effective as oral
antibiotics for localized disease.
(C) They should be used in an
alternating fashion with topical
cleansers.
(D) They have more adverse effects
than oral antibiotics.
106. A 24-year-old pregnant woman presents
with severe itching at 25 weeks' gestation.
Physical examination reveals no jaundice
or skin lesions other than excoriations
from scratching. Her serum bilirubin acid
level is 17.73 mcg per mL (43.40 µmol per
L). Which one of the following therapies is
most appropriate for this patient?
A. Corticosteroids.
B. S-adenosylmethionine.
C. Ursodeoxycholic acid.
D. Cholestyramine
107. A 25 years old woman comes with small
papules on her forearms and dorsum of
hands. These are recurrent, warty round,
with central dermal necrosis with mucin
deposit, because of which their shape
becomes annular. Which one of the
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following statements about localized
granuloma annulare is correct?
(A) Treatment is important to prevent
complications.
(B) It almost always lasts for two or
more years.
(C) The eruption is typically highly
pruritic.
(D) The eruption is self-limited and
usually does not require
treatment.
108. Case same as above.
Which one of the following is a treatment
option for localized granuloma annulare?
(A) Isotretinoin
(B) Dapsone
(C) Infliximab
(D) Intralesional corticosteroid
injections
109. A patient who has sought treatment for an
outbreak of herpes simplex virus (HSV)
infection notes that she has several
round, itchy lesions on her forearms and
palms. Which one of the following
statements is correct?
(A) The lesions should be biopsied.
(B) The lesions are likely to resolve
spontaneously over three to five
weeks.
(C) Occurrence of lesions on the
palms and soles excludes the
diagnosis of erythema
multiforme.
(D) A history of migrating lesions
strongly supports the diagnosis
of erythema multiforme.
110. Which one of the following statements
about treatment of erythema multiforme is
correct?
(A) Topical acyclovir applied to the
HSV lesions prevents eruption of
additional lesions.
(B) Prednisone is the safest and
most effective option in herpes-
associated erythema multiforme.
(C) Oral acyclovir is likely to reduce
the number and duration of
lesions in coexisting HSV
infection.
 CME for Family Physicians
Dermatology

(D) Aggressive treatment with (D) Pyogenic granuloma

sulfonamides prevents (E) Aphthous stomatitis
recurrence.
115. W h i c h o n e o f t h e f o l l o w i n g
111. Which one of the following pregnancy- recommendations about antibiotics for the
specific skin conditions typically worsens prevention of cold symptoms is correct?
after delivery?
(A) Antibiotics are recommended for
(A) Intrahepatic cholestasis of patients with purulent nasal
pregnancy. discharge after three to five
(B) Pemphigoid gestationis. days.
(C) Pruritic folliculitis of pregnancy. (B) Antibiotics are recommended to
(D) Pruritic urticarial papules and prevent pneumonia.
plaques of pregnancy. (C) Antibiotics are not recommended
(E) Impetigo herpetiformis. for patients with a suspected
cold.
112. A patient previously diagnosed with oral (D) Antibiotics are recommended for
lichen planus returns for follow-up. She adults with cold and fever after
complains that the lesion in her mouth has three to five days.
recently become painful. Which one of the
following is the most appropriate treatment 116. A six-year-old boy has a flare-up of atopic
option? dermatitis. On examination, the lesions
seem to be located mostly on the
(A) Topical penciclovir forearms, particularly the hands. Which
(B) Nystatin suspension one of the following statements about
(C) Fluocinolone gel topical steroid treatment for this patient is
(D) Zinc supplements. correct?
(E) Thalidomide
(A) The child will require
113. A 12-year-old boy with a painful sore in his approximately 40 g of a
mouth is brought to the office by his corticosteroid for a 10-day
mother. He has had this occur two times treatment course.
previously, but this is the first office visit (B) Lotion is the application vehicle
for the condition. On examination, a single of choice to optimize skin
small ulcer is noted on his lower labial hydration.
buccal mucosa. It has a whitish (C) Creams are commonly implicated
pseudomembrane overlying it and mild in the development of allergic
surrounding erythema. Which one of the contact dermatitis.
following is the most likely diagnosis? (D) Ointments decrease the potency
of the active ingredient.
(A) Erythema migrans.
(B) Oral candidiasis.
117. At follow-up, the child's skin looks much
(C) Reticular oral lichen planus.
better but he continues to itch, which is
(D) Recurrent aphthous stomatitis.
disrupting his sleep. Which one of the
(E) Erosive oral lichen planus.
following recommendations is most
appropriate to manage these symptoms?
114. At a routine prenatal visit, a 22-year-old
woman is concerned about a growth in her
mouth that bleeds when she brushes her (A) The child should be given
teeth. She does not smoke and denies frequent hot baths.
any oral trauma or pain. Oral examination (B) A lubricating ointment should be
shows a 1-cm, erythematous, lobulated applied to the child's hands
mass on her gingiva. Which one of the before bedtime, and he should
following is the most likely diagnosis? sleep in cotton gloves to promote
hydration.
(A) Fibroma (C) The child should receive oral
(B) Mucocele pimecrolimus (Elidel).
(C) Squamous cell carcinoma
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 CME for Family Physicians
Dermatology

(D) The child should receive a sleep in cotton gloves to promote

desensitization injection. hydration.
(C) The child should receive oral
118. Patients with which one of the following pimecrolimus (Elidel).
conditions are more prone to the (D) The child should receive a
development of seborrheic dermatitis? desensitization injection.

(A) Congestive heart failure.

(B) Parkinson's disease
(C) End-stage renal disease
(D) Multiple myeloma
(E) Hyperthyroidism

119. Which one of the following should be

considered in the treatment of severe
seborrheic dermatitis that is unresponsive
to topical therapy?

(A) Oral antibiotics

(B) Oral antifungal agents
(C) Isotretinoin (Accutane)
(D) Methotrexate
(E) Prednisone.

120. Same case as 116, a six-year-old boy has

a flare-up of atopic dermatitis. On
examination, the lesions seem to be
located mostly on the forearms,
particularly the hands. Which one of the
following statements about topical steroid
treatment for this patient is correct?

(A) The child will require

approximately 40 g of a
corticosteroid for a 10-day
treatment course.
(B) Lotion is the application vehicle
of choice to optimize skin
hydration.
(C) Creams are commonly implicated
in the development of allergic
contact dermatitis.
(D) Ointments decrease the potency
of the active ingredient.

121. Same case as 117, at follow-up, the child's

skin looks much better but he continues to
itch, which is disrupting his sleep. Which
one of the following recommendations is
most appropriate to manage these
symptoms?

(A) The child should be given

frequent hot baths.
(B) A lubricating ointment should be
applied to the child's hands
before bedtime, and he should

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