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Derm - Exam Master Final Exam Practice | Correct Q&A Review Guide With Rationales (100% Score)

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Derm - Exam Master Final Exam Practice | Correct Q&A Review Guide With Rationales (100% Score)

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Derm - Exam Master Final Exam Practice |
Correct Q&A Review Guide With
Rationales (100% Score)




Case
A 20-year-old Caucasian woman presents to the hospital with a 2-
month history of itchiness of her scalp. On examination you note
greasy yellowish scales on her scalp and eyebrows.


Question
What is the most likely diagnosis?
A) Hand eczema
B) Seborrheic dermatitis
C) Atopic dermatitis
D) Nummular dermatitis
E) Pompholyx - ✔ANASWER✔-Correct answer:
Seborrheic dermatitis

,Explanation
This patient most probably has seborrheic dermatitis. Itis
characterized by greasy scales over the scalp. It may also be
visible along the hairline, on the eyebrows, in the external
auditory canals, in the nasolabial folds, and over the sternum.
There may be some pruritus.


Hand eczema is characterized by erythema, dryness, cracking, and
edema of the skin of the hands. It is a chronic condition, which is
aggravated by frequent immersion of hands in water and
detergents.


Atopic dermatitis is characterized by chronic pruritic lesions
marked by exacerbations and remissions. There is a personal or
family history of asthma, allergic rhinitis, food allergies, or eczema.
In the acute phase, they may present with erythematous patches,
weeping, and crusted plaques. In the chronic phase, they present
with hyperpigmented lichenified lesions. It commonly affects the
face, neck, wrists, antecubital, and popliteal fossae.


Nummular dermatitis is characterized by chronic coin-shaped,
crusted lesions, which are usually pruritic. They commonly appear
on the trunk and extensor surfaces of the extremities, especially
the pretibial areas.

,Pompholyx is characterized by scaling and deep-seated vesicles
on the palms, fingers, and soles, which are pruritic. There may also
be erythema and scaling.


Case
A 7-year-old boy presents with a 3-day history of intense pruritus
on his wrists, fingers, and antecubital fossae. It began on his
fingers and has moved proximally. According to his mother, they
are raised red eruptions and some have scabbed over. She states
he has never had this before and it is keeping him up at night. He
recently started at a new school.




Question
What procedure would be most helpful in confirming your
diagnosis?
A) Skin scraping with immersion oil
B) Woods lamp inspection
C) Skin scraping with KOH
D) Punch biopsy
E) Skin culture and gram stain - ✔ANASWER✔-Correct answer:

, Skin scraping with immersion oil


Explanation
Skin scraping with immersion oil is the confirmatory test for
scabies, which is the most likely diagnosis.


Wood lamp inspection consists of shining ultraviolet light on the
skin, looking for fluorescence indicative of such diseases as
erythrasma, fungal infections, and sclerosis. Skin scraping with
KOH is helpful in diagnosing fungal infections of the skin. Punch
biopsies are more invasive, and they are used for deeper skin
lesions. Skin culture and Gram stain are not helpful in the
diagnosis of scabies; they are used for suspected bacterial or
fungal infections.


Question
A 23-year-old man presents with unbearable itching in his genital
area. The itching increases in intensity at night. He admits to
several recent sexual encounters with different people in the past
month. Skin exam reveals multiple excoriated papules and
burrows with surrounding inflammation. What is the most likely
diagnosis?
A) Tinea cruris
B) Pediculosis pubis

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