Dermatology PANCE Questions And Answers With Verified Solutions 2023 A patient presents with a rash, characterized by red macules and edematous papules with a clearing center. This best describes which of the following? A erythema marginatum B erythema multiforme C varicella D impetigo ✔✔B Target lesions, also termed iris lesions, are characteristic of erythema multiforme. The rash may be recurrent but typically resolves over 3 -6 weeks. In a patient suspected of having seborrheic dermatitis, the most common site of involvement would be the A upper extremities. B thighs C scalp. D feet. ✔✔C The most common site of involvement of seborrheic dermatitis is the scalp. Other common sites include the eyebrows, eyelids, nasolabial fold, and ears A 26 year -old male compl ains of intense itching, especially at night and after hot showers, for the past 4 days. On physical examination he has a few red papules and areas of excoriation on his volar wrists, between his fingers, and around his waist. Proper diagnosis should inclu de which of the following tests? A KOH prep B Gram stain C Skin scraping microscopy D Tzanck prep ✔✔C The history and exam is consistent with a scabies infection. Scrapings from the burrows should be examined for the presence of mites, eggs, and feces. A 35 year -old female who recently returned from a backpacking trip complains of fatigue, malaise, fever, chills, and arthralgias. Physical examination reveals a 6 cm annular lesion with a red border and a clear center on her mid -back. Which of the following laboratory tests would support your diagnosis? A KOH prep of skin scrapings B Blood cultures C RAST testing D Serologic antibody testing ✔✔D Most people with Lyme Disease will have a positive serologic test after the first few weeks of infection and this would support the diagnosis. A 56 year -old, right hand dominant, carpenter presents to your clinic complaining of a prolonged bruise under his left thumbnail. He states that he first noticed it one year ago. Physical examination reveals a nontender left thumb with a 6 mm macular lesio n located under the distal nail bed. It is mixed dark brown and black in color, with irregular borders. The most likely diagnosis is A lentigo. B trauma. C melanoma. D nevus ✔✔C Acral lentiginous melanoma may occur on the palm, sole, nail bed, or mucus membrane. This lesion is suspicious for a melanoma due to its irregular borders, being variegated in color, and its size. A biopsy is required and will ensure the diagnosis. A mother brings in her 2 year -old child stating that the child has had a 3 -day hist ory of a nonproductive cough, thick copious rhinorrhea, conjunctivitis, and a fever to 103 degrees. Physical examination reveals a well -hydrated child, with numerous 1 -2 mm white papules on both buccal mucosa, normal heart and breath sounds. This presentat ion is most consistent with early A rubeola. B rubella. C varicella. D streptococcal pharyngitis ✔✔A Rubeola (measles) is characterized by cough, coryza, and conjunctivitis, along with a fever as a prodrome. Koplik spots appear prior to the onset of the t ypical erythematous, maculopapular rash and are pathognomonic for rubeola. A person with atopic dermatitis should be advised to A avoid cutaneous irritants. B take hot water baths or showers C use a high potency glucocorticoid on skin after bathing. D beg in a prophylactic antibiotic. ✔✔A Avoidance of cutaneous irritants, such as wool and other rough clothing, is the cornerstone of therapy for atopic dermatitis. An elderly woman presents to your clinic complaining of unilateral facial pain and painful lesions. She also complains of blurred vision in the ipsilateral eye. On examination she has several vesicles on an erythematous base, some of the lesions with crusts. They are distributed in a dermatomal pattern and involve the skin overlying the maxillary region and the tip of her nose. Which of the following is the next most appropriate intervention in the care of this patient? A KOH prep B Culture for bacteria C Referral to an ophthalmologist D Application of corticosteroids ✔✔C Immediate referral to an ophthalmologist is needed when herpes keratitis is suspected, as in this case. A fluorescein stain of the eye might reveal the typical dendritic corneal lesion. A 28 year -old female with diabetes mellitus type 2 sustains a partial thickness burn to her left upper arm and her chest when hot grease spilled on her at home. The burn to her arm is circumferential and the estimated total body surface burned is 18%. She has no allergies. The most appropriate treatment of this patient woul d include A outpatient application of silver sulfadiazine. B debridement of all intact blisters. C IV cefazolin (Ancef, Kefzol). D transfer to a burn center. ✔✔D Reasons for transfer to a burn center include a partial thickness burn covering greater than 10% of total body surface area. In addition, burns in patients with pre -existing medical conditions, such as diabetes, that could complicate their management, prolong recovery, or affect their outcome, is also a reason for transfer to a burn center. Pharm acologic treatment of a cat bite in the person with no allergies consists of which of the following? A Trimethoprim -sulfamethoxazole (Bactrim) B Cephalexin (Keflex) C Ceftriaxone (Rocephin) D Amoxicillin -clavulanate (Augmentin) ✔✔D Amoxicillin -clavulanate (Augmentin) has activity against Pasteurella multocida which is the causative agent in the majority of cat bite infections. Which of the following is considered a risk factor for the development of malignant melanoma? A male gender B inability to tan C Japanese ethnicity D brown -haired individuals ✔✔B Inability to tan and propensity to burn are risk factors for developing malignant melanoma. As a general rule, sutures in the face should be removed in A 2 days B 5 days C 7 days D 10 days ✔✔B
