DERMATOLOGY

DERMATOLOGY

[Mu-Wi]
DERMATOLOGY

SECTION A: (ATTEMPT ALL QUESTIONS) 25 MARKS: 1⁄2 EACH

1. You have a patient with KS (Kaposi' sarcoma) who comes to you with a list of drugs
and wants to know which ones are chemotherapy agents used in the treatment of his
condition.
what would be your response?
A. Doxorubicin
B. Methotrexate
C. Imiquimod
D. Vincristine
E. A and D
2. A patient comes to you with a painless red fleshy nodule on her finger, which easily
bleeds with minor trauma, she gives a history of being on a protease inhibitor-based
regimen of ART, what would be your probable diagnosis?
A. Kaposi' sarcoma
B. Pyogenic granuloma
C. Primary syphilis
D. Molluscum contagiosum
3. Actinic keratoses may be treated by
A. Cryotherapy or 5-fluorouracil cream
B. Clobetasol cream
C. Miconazole cream
D. Prednisolone tablets
4. The following drugs are used in the treatment of Chancroid Except:
A. Azithromycin
B. Ceftriaxone
C. Valacyclovir
D. Ciprofloxacin
5. The following is the treatment of acne except
A. Benzoyl peroxide
B. Salicylic acid 0.5% to 2%
C. Retinoids
D. Doxycycline
E. Vincristine.
6. Acne keloidalis nuchae is sometimes called
A. Papillaris capillitia,
B. Folliculitis keloidalis nuchae, C. Keloidal folliculitis
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D. All of the above

E. None of the above
7. The following are some types of vitiligo except:
A. Trichome
B. Segmental C. Generalized D. Macular
E. Focal.
8. An acute eruption of intensely itchy papules or wheals is called?
A. Acne vulgaris
B. Pityriasis Rosea
C. Psoriasis
D. Urticaria
9. Which STI is said to have 'kissing' ulcers?
A. Gonorrhea
B. Chancroid
C. Syphilis
D. Donovanosis
10. In which condition do we find a 'fishy' smell which is worse after coitus?
A. Trichomoniasis
B. Bacterial vaginosis
C. Vaginal candidiasis
D. Gonorrhea
11. Donovanosis is sometimes known as:
A. Lymphogranuloma venereum
B. Granuloma inguinale
C. Chlamydia
D. Herpes simplex
12. The following are seen in secondary syphilis except:
A. chancre
B. Hair loss
C. Muscle aches
D. Fever
B. Bullous psoriasis
C. Guttate psoriasis
D. Erythrodermic psoriasis.
E. Sore throat
13. Trichomoniasis responds well to:
A. Doxycycline
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B. Metronidazole
C. Co-trimoxazole
D. Cephalexin
14. Untreated Gonorrhea may lead to:
A. Increased chance of getting HIV
B. Infertility
C. Neonatal conjunctivitis
D. All of the above
E. None of the above
15. Clues that a mole might be a melanoma are:
A. irregular shape and border
B. changes in size, shape, or color
C. itchiness or bleeding of a lesion
D. all of the above
E. A and B
16. Which dermatological condition do we find Demographism?
A. Atopic dermatitis
B. Urticaria
C. Pityriasis versicolor
D. Pyogenic granuloma
17. The bacteria causing impetigo can become invasive, leading to
A. Cellulitis
B. Lymphangitis
C. Osteomyelitis
D. All of the above
18. Which dermatological condition has Wickham striae?
A. System lupus erythematosus
B. Lichen planus
C. Psoriasis
D. Chickenpox.
19. The following are some types of Psoriasis except
A. Plaque psoriasis

20. How often are normal skin cells replaced?

A. 10 to 30 days
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B. 5 to 15 days
C. 3 to 5 days
D. 10 to 20 days.
21. Tinea unguium is sometimes called?
A. Tinea pedis
B. Tinea cruris
C. Onychomycosis
D. Cryptococosis.
22. Which dermatological condition do we find a 'malar' rash?
A. Lichen planus
B. Vitiligo
C. Lupus erythematosus
D. Albinism.
23. Which of the following conditions do we find keobnerisation?
A. Psoriasis
B. Pityriasis versicolor
C. Lichen planus
D. A and B.
E. A and C.
24. What causes molluscum contangiosum?
A. Pox virus
B. HPV
C. HIV
D. CMV.
25. Which of the following drugs can be used in the treatment of post herpetic neuralgia?
A. Carbamazepine
B. Aceclofenac
C. Dapsone
D. Amitryptline
E. A and D.
26. How do you describe the lesions in vitiligo?
A. Hypopigmented patches
B. Hyperpigmented patches
C. De-pigmented patches
D. Triamcinolone.
D. Hyperpigmented papules.
27. Lymphogranuloma venereum (LGV) is caused by serovars of
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A. Neisseria gonorrhoea
B. Chlamydia trachomatis
C. Treponema pallidum
D. Heamophilus ducreyi
28. SLE stands for
A. Squamous laceration ecchymosis
B. Systemic lupus erythematosus
C. Septic lymphoid edema
D. None of these.
29. All of the following are clinical manifestations of gonorrhea except
A. PID in men
B. Neonatal conjunctivitis
C. Painful micturition
D. Bleeding between menses.
30. Where are the melanocytes located?
A. Dermis
B. Epidermis
C. Hypodermis
D. Endodermis.
31. The following are predisposing factors of impetigo except:
A. Scabies
B. Atopic eczema
C. Vitiligo
D. Skin trauma
32. What are the triggering factors of Psoriasis?
A. emotional stress
B. Streptococcal infections
C. Hydroxychloroquine
D. All of the above
E. B and C.
33. The following are some of the drugs used in the treatment of Psoriasis except:
A. Methotrexate
B. Isotretinoin
C. PUVA
D. Triamcinolone.
34. What leads to flare u
A. Infections
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B. Alcohol
C. Smoking
D. All o
E. N
34. What leads to flare up in Psoriasis?
A. Infections
B. Alcohol
C. Smoking
D. All of the above
E. None of the above.
35. How do we prevent tinea cruris?
A. Wearing the correct fit
B. Avoid sharing personal items
C. Wearing clean clothes
D. Staying away from the sun.
36. What is the best treatment option for tinea unguium?
A. Systemic antifungals
B. Systemic antibiotics
C. Topical antifungals
D. Topical antibiotics.
37. Discoid lupus is sometimes known as:
A. Acute cutaneous lupus
B. Subacute cutaneous Lupus
C. Chronic cutaneous lupus
D. Systemic lupus erythematosus.
38. The following can be used in the treatment of condylomata acuminate except:
A. Imiquimod cream 5%
B. HPV vaccine
C. Podophyllin
D. Silver nitrate pencil
E. Electrocauterization.
39. How does Lichen planus present?
A. Salmon coloured plaques
B. Pruritic, red, oozing lesions
C. Golden coloured crusts
D. Pruritic, purple, papules and plaques.
40. The following is true about herpes zoster except:
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A. The lesions develop into clusters of vesicles on an erythematous base

B. The lesions do not usually cross the body's midline
C. It responds well to treatment with hydroxychloroquine The lesions do not usually cross the
C. It responds well to treatment with D.
D. Less commonly, the lesions can be more widespread and affect 3 or more dermatomes.
41. Can syphilis be transmitted from mother to child during pregnancy?
A. Yes
B. No
C. Only if the mother is HIV positive
D. Only if the mother has tertiary syphilis
42. HSV-1 cannot be contracted from general interactions such as:
A. Eating from the same utensils
B. sharing lip balm
C. Hand shakes
D. Kissing.
43. Molluscum cannot be treated with:
A. Scraping
B. Cryotherapy
C. Topical steroids
D. Cantharidin.
44. Koebner phenomenon is
A. Lesions separated from each other
B. Lesions merging together
C. Lesions restricted to one area of the body
D. Linear eruption arising at a site of trauma
45. Another term for itching is
A. Pruritus
B. Petechiae
C. Keratosis
D. Dermatitis.
46. What type of dermatitis presents with oily scales
A. Chronic dermatitis
B. Contact dermatitis
C. Seborrhoeic dermatitis
D. Atopic dermatitis
47. Epidemic Kaposi sarcoma is associated with
DERMATOLOGY

SECTION B: SCENARIO QUESTIONS (40 MARKS)

ANSWER ANY TWO (2) QUESTIONS FROM THIS
SECTION
1. A 22year old male, presents with some non-itchy lesions on his neck, back, arms and
chest which have lasted for 3 weeks, drug history reveals that he has taken some co-
trimoxazole but he has not seen any improvement. On examination you find some flacky
hypopigmented patches.

A. What would be your likely diagnosis? Based on the information provided, a

likely diagnosis for this patient would be pityriasis versicolor.

B. What investigations would you do?

 For the diagnosis of pityriasis versicolor, investigations such as a potassium

hydroxide preparation of skin scrapings or a Wood lamp examination can be
done. These investigations can help confirm the presence of the characteristic
"spaghetti and meatball" appearance of Malassezia yeast under microscopic
examination or fluorescence under the Wood lamp.

C. How will you treat this young man?

 For the treatment of pityriasis versicolor, I would prescribe a

topical antifungal medication such as ketoconazole cream or lotion.
 Additionally, I would advise the patient to apply the antifungal medication to the
affected areas once or twice daily for a period of 2-4 weeks.
 I would also recommend the patient to avoid excessive sweating and to wear
loose-fitting clothing to help prevent recurrence.

D. What would be your differential diagnosis?

The differential diagnosis for this patient's presentation would include

 nummular eczema,
 tinea corporis,
 psoriasis, and
 pityriasis rose

2. An 8 year old boy has been brought to your clinic, with history of very itchy rash
which is worse at night. Examination reveals thin, irregular burrow tracks, vesicles and
papules with a lot of excoriations on the finger webs, the wrists, and soles of the feet, the
penis, and the buttocks.

A. What is the likely diagnosis?

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 The likely diagnosis in this case is scabies.

B. What investigations would you do?

 In cases like this, investigations may not be necessary as scabies can often be
diagnosed based on the clinical presentation and history.

C. How will you treat him?

 The recommended treatment for scabies in this case would be topical

permethrin cream, applied to the entire body from the neck down and left on for
8-14 hours before washing off.

D. What would be your differential diagnosis?.

 The differential diagnosis in this case would include other causes of pruritic
rashes such as contact dermatitis, eczema, and pediculosis.

3.A 6 year old boy is brought to you with history of partial hair loss, the examination
reveals some degree of inflammation and flaking which resembles dandruff, and some
patches on the scalp.

A. What is your working diagnosis?

Based on the given information, my working diagnosis would be scalp psoriasis.

B. What investigations would you do to confirm your diagnosis?

To confirm the diagnosis of scalp psoriasis, I would consider performing a skin

biopsy or a scraping to examine under a microscope, as well as conducting a
complete physical examination to rule out other possible causes of the symptoms.

C. How will you treat him?

The treatment plan for the 6-year-old boy with scalp psoriasis would depend on the
severity of the condition. For mild to moderate cases, I would recommend the
following treatment options:

 1. Topical corticosteroids: These are commonly used as the first-line treatment

for scalp psoriasis. They help reduce inflammation and relieve itching.
 2. Topical calcipotriene: This synthetic vitamin D analog helps in slowing down
the rapid skin cell growth and reducing inflammation.
 3. Topical coal tar preparations: These can help reduce inflammation and
scaling.
 4. Other topical treatments like salicylic acid, anthralin, or dithranol may
also be considered based on the individual's response and preferences, as well as
the patient's age and overall health.
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D. What would be your differential diagnosis?

The differential diagnosis for the 6-year-old boy with partial hair loss, inflammation,
flaking resembling dandruff, and patches on the scalp would include:

1. Seborrheic dermatitis: This is a common condition that can cause scalp

inflammation and flaking, resembling dandruff.
2. Tinea capitis: This fungal infection can cause patches, inflammation, and scaling
on the scalp.
3. Contact dermatitis: This condition can be triggered by allergens or irritants and
can cause inflammation, itching, and flaking of the scalp.
4. Allergic dermatitis: This allergic reaction can cause inflammation and flaking of
the scalp.
5. Scalp folliculitis: This condition is characterized by inflammation of hair follicles,
which can cause itching, flaking, and patches on the scalp

4. A 19-year-old lady walks into your screening room complaining of an itchy

vulva, and painful micturition. History of having been on Amoxyl as treatment
of a respiratory tract infection a week before, she denies history of sexual
intercourse and claims she is a virgin but worried that she could have gotten an
STI from the toilets or from her roommate as they sometimes share personal
items. Past medical history reveals that she is not diabetic nor HIV positive. On
examination you find a 'curd like' discharge on the vulva.

A. What is your working diagnosis?

Based on the symptoms described, history of recent antibiotic use, and the presence of
"curd-like" discharge on the vulva, a possible working diagnosis for this 19-year-
old lady could be vaginal candidiasis, commonly known as a yeast infection.

B. How will you treat her?

The treatment for vaginal candidiasis typically involves topical antifungal

medication, such as clotrimazole or miconazole, applied directly to the affected area.

C. What would be your differential diagnosis?

The differential diagnosis for this patient could include other causes of vulvar itching
and discomfort, such as a bacterial infection (vaginosis), trichomoniasis, or urinary
tract infection.

D. What health education information would you give her in order to calm her
down?

I would educate the patient that vaginal candidiasis is a common infection and can
occur even without sexual activity. It is not considered a sexually transmitted
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infection and can be caused by factors such as antibiotic use, hormonal changes, or a
weakened immune system.