Pance Final Exam Dermatology and HEENT Questions with Explained Answers 2023 UPDATE

Pance Final Exam Dermatology and HEENT Questions with Explained Answers 2023 UPDATEPance Final Exam Dermatology and HEENT Questions with Explained Answers 2023 UPDATE A 34-year-old woman presents to the clinic with complaints of intermittent flushing and blushing that started 3 to 4 weeks ago. Since then, she has noticed several inflammatory papules on the cheeks, nose, and chin. Upon exam, you notice an overall rosy hue to the face and the absence of any comedones. Which of the following would be the best course of topical therapy at this time? A 26-year-old female presents with a whitish coating on her tongue and lips. When you attempt to rub the plaque with a tongue depressor, a small amount of bleeding is noted from the oral mucosa. Her past medical history includes asthma. What diagnostic test would you perform to confirm your diagnosis? Which of the following is the third component of the atopic triad, besides allergic rhinitis and asthma? A 63-year-old male presents with an asymptomaticlesion in his mouth that was discovered by his dentist at a check-up.It is ill marginated with pigment ranging from medium brown to black.Parts of the lesion are raised. What is the next appropriate stepin management? What is the appropriate first line treatment of lyme disease in a non-pregnant adult female with erythema migrans and no other symptoms of lyme disease and no known drug allergies? A two-year-old male presents with a noduleon the side of his index finger. His mother states that he has hadthis nodule on one prior occurrence during infancy, and it resolved onits own. What is the most likely diagnosis? A 12-year-old male presents with hyperkeratoticpapules located on both hands. What is the causative organism? A 12-year-old male presents with hyperkeratoticpapules located on both hands. What is the causative organism? A 60-year-old male presents with complaints of irritation and a white plaque on his tongue. He denies pain. During physical exam you are unable to remove the white plaque from the mucosa with a tongue depressor. What is the most likely diagnosis, represented as follows? A 54 year old male presents with dark thickened skin and soft pedunculated papules around his neck. He states that the lesions are asymptomatic. What disease process are the findings commonly associated with? A 45-year-old male presents with purulent discharge from his right ear for three weeks. He states that despite being treated by his family doctor for an ear infection one month ago, the problem continues to get worse. Upon exam, you note purulent discharge in the ear canal, an erythemic tympanic membrane, and a possible perforation. What are the pathogens most likely to culture positive? A six-month-old male has recurrent diaper rashes, which are not responding to ketoconazole cream or zinc oxide diaper creams. Physical exam shows well demarcated perianal erythema, with scattered red papules on the buttocks. A KOH is negative. What would appropriate management include? You are evaluating an 80-year-old female for the first time. She has a history of mild Alzheimer's disease, for which she takes Aricept. She states that she feels fine but her daughter feels she is depressed and has been complaining of not feeling well. Her daughter admits that the patient has a history of primary hyperparathyroidism. What laboratory results would be most consistent with her diagnosis of hyperparathyroidism? The hallmark of primary hyperparathyroidism is a high serum calcium and high intact PTH. A low intact PTH is consistent with hypoparathyroidism. The urine serum calcium is usually high in primary hyperparathyroidism. Cortisol is related to endocrine conditions A 65-year-old female presents with a red irritation in her right eye. She states that this has been occurring intermittently for about two years. She also states that her eyelids are "droopy," and that she needs plastic surgery. On physical exam you notice a diffusely injected conjunctiva and an outwardly tilted lower eyelid. What is the most likely diagnosis for the abnormal physical finding? A patient presents with epistaxis from the right nares, along with direct pressure to the nares and elevation of the head. Which of the following is an appropriate initial treatment? A 15-year-old obese male presents with annularlyconfigured lesions in a generalized distribution. They are asymptomatic.What can these lesions be associated with? A 25 year old female presents with multiple irregular brown macules on her upper back. They are asymptomatic. She has worked as a lifeguard for the past 7 years. She reports a couple of blistering sunburns and admits to maintaining a "healthy tan". What is the most likely diagnosis? A 12-year-old presents with sharply demarcated depigmented macules on bilateral knees. The parents report that this began about one year ago, after the child fell and skinned his knees. After healing, he was left with these markings. What is the most likely diagnosis? Vitiligo is the most An 8-year-old male with hair loss, pruritus, and posterior cervical lymphadenopathy has a + culture on dermatophyte test medium (DTM). Which of the following is the most appropriate treatment? A patient has a 2-day history of an itchy red left eye and marked tearing. There is no history of injury. On physical exam the conjunctiva appear markedly erythemic. What physical finding would help most in differentiating this as a viral conjunctivitis? A 45-year-old male presents with a history of thick, adherent yellow scaling in his scalp, and red scaling patches with fissuring in post auricular areas bilaterally. Which of the following are other areas of potential involvement? A 6-year-old female presents with small erythematous papules grouped around the mouth. The mother reports that she tried to treat with over-the-counter hydrocortisone 1% cream. The condition has worsened. What is the best step in management of this condition? A 30 year old female complains of a dome shaped slightly erythematous nodule on her right thigh. Upon clinical examination it exhibits the "dimple sign". The patient states the lesion is not changing and is asymptomatic. What is the most likely diagnosis? A 25-year-old female presents with a complaint of dry, cracking hands for two months. She has never had any rashes or similar problems. She does not work outside the home. She is the mother of a 6-month-old healthy female. Over-the- counter lotions have been tried, but they sting with application. What is the next appropriate step? Your patient has symptoms consistent with perennial allergic rhinitis, and after performing a history and physical examination, you elect to perform an IgE-specific serum antibody test for both food and respiratory allergens. The results return and the patient does not have an IgE positive response to a single allergen tested, yet the patient's total serum IgE is elevated dramatically. What would be the most appropriate next step in the diagnosis and treatment of this patient? A 26-year-old female presents with a history of a rash around her neck, off and on for several years. It has been treated with mid potency prescription topical steroids, only to recur again. She reports that during treatment she will discontinue wearing jewelry until the rash resolves. The patient complains of pruritis but no other symptoms. What is the most likely diagnosis? A 4 year old male presents with a fever for 3 days. His highest temperature was 39.4C. His mother brings him to the ED because she noticed this morning that his palms and soles were red. Now, there is blotchy erythema on the trunk with bulbar conjunctivitis and diffuse erythema on the tongue and prominent papillae. CBC shows leukocytosis. What is the appropriate management of this patient? A patient presents complaining of a painful rash on his lips. What is the causative pathogen for the rash shown in the image? A 6-year-old male presents with crusted erythematous lesions on the nose, mouth, and chin. He has a history of atopic dermatitis. Which of the following should be part of an appropriate treatment regimen? A 45-year-old female presents with a sudden onset of vertigo, nausea, and vomiting. Upon physical exam, you note that she is holding on to the rails of the bed, and her pain gets worse when you attempt any movement of her head. Neurologic exam is grossly normal. Which combination of the following medications is indicated to treat the patient's symptoms? All other combinations include A 63-year-old female complains of a 5-day history of a persistent left-sided headache, which she has not experienced before. She also notes a tender swollen area around her left temple, which appeared around the same time. On examination you note tenderness and prominence of the left temporal artery. You order an ESR, which is 75 mm/h. What is your best course of action at this time? Which of the following conditions is a cause for central vertigo? is vertigo due to a disease originating from the central nervous system (CNS). In clinical practice, it often includes lesions of cranial nerve VIII as well. Individuals with vertigo experience hallucinations of motion of their surroundings. An 8-year-old female presents with numerous discrete, skin colored papules with a central umbilication. The lesions are mildly pruritic. What is the most likely diagnosis?