AAD All Modules Study Guide (with Pictures) | Latest, Complete Solutions

AAD All Modules Study Guide (with Pictures) | Latest, Complete Solutions Which of the following is an indication for a total body skin exam? a. New patient with acne on her forehead b. New patient with a sister who has melanoma c. New patient with a mole on his chin that he's had since childhood without change d. New patient with a paternal aunt with a history of melanoma e. New patient with a wart on her right index finger Your patient's brother was recently diagnosed with melanoma. She asks about risks for melanoma. Which of the following is true? a. Consistent use of SPF 30 sunscreen has been shown to decrease melanoma incidence b. Daily sunscreen with SPF 70 or higher is recommended for all skin types c. Getting a base tan from indoor tanning reduces your risk of melanoma d. Most melanomas occur in families with a genetic mutation in CDKN2A or BRCA2 e. Performing skin exams at home does not improve melanoma outcomes Based on the morphologic features of the photo, what is the MOST likely diagnosis? a. Asteatotic dermatitis b. Bilateral cellulitis c. Necrotizing fasciitis d. Vasculitis e. Stasis dermatitis In addition to treatment of the patient with permethrin, which of the following would you recommend to a patient diagnosed with new onset scabies infestation? a. No one else in the family needs to be treated as this is not contagious. b. The groin is generally spared in scabies infestation. c. The itching should subside within 1-2 days after treatment with permethrin. d. Items that cannot be washed should be placed in a sealed bag for at least 72 hours. A 68 year-old Vietnam veteran comes to your clinic for evaluation of high blood pressure and high cholesterol. He asks you in passing about some dryness and mild itching on both his feet for several years that has not improved with 1% hydrocortisone cream and moisturizers. What is the next step in diagnosis? a. Patch testing for allergic contact dermatitis b. Potassium hydroxide exam in clinic c. Punch biopsy to rule out squamous cell carcinoma in situ or mycosis fungoides d. Serum protein electrophoresis to search for immunosuppression e. Titers for agent orange exposure Which of the following is true regarding respecting patient modesty during skin exams? a. Adult diapers in wheelchair/ bed-bound patients should stay on to preserve modesty b. Chaperones should only be offered if the patient appears litigious c. Doctors should ask permission before moving the gown to examine the next body part d. Medical providers should not touch their patient's skin during full body exam e. Patients should just lift up their clothing to show you spots they are worried about Which of the following treatments would you recommend for this patient (see photo)? a. Apply hydrogen peroxide b. Compression wraps c. Oral antibiotics d. Oral antifungal e. Topical antibiotic ointment A 26-year-old male presents with two years of white spots on his neck, upper chest, and back, that are more noticeable in the spring and summer months and get better in winter (see photo). You perform a KOH exam in the office is shown. What treatment would you recommend? a. Desonide cream b. Pimecrolimus cream c. Oral prednisone d. Selenium sulfide lotion e. Ultraviolet light therapy A 22-year-old male college student presents with a two-week history of total body pruritus. On examination there are numerous excoriated papules on the abdomen, buttocks, glans penis, and scrotum (see photo). Which of the following is most likely to confirm the diagnosis in this patient? a. Bacterial culture b. Skin biopsy c. Skin scraping d. Viral culture e. KOH preparation A 63-year-old patient presents with a lesion on his toe that has doubled in size in the past year. It is non-tender and does not bleed, but his wife says it's getting bigger and darker on one side. The macule is 7mm in diameter (see photos). Which of the following is the best next step? a. Liquid nitrogen cryotherapy b. Reassurance and observation c. Refer to dermatology for biopsy d. Refer to orthopedics for toe amputation e. Topical imiquimod cream A 10-year-old girl presents with scalp pruritus for several weeks. Nits are visible on her hair. Which of the following treatment recommendations would you recommend? a. 1% permethrin lotion, apply to clean, dry hair for 10 minutes, re-treat in 4 weeks* b. 1% permethrin lotion, apply to wet hair for 10 minutes, re-treat in 4 weeks c. 1% permethrin lotion, apply to clean, dry hair for 10 minutes, re-treat in 1 week d. 1% permethrin lotion, apply to wet hair for 10 minutes, re-treat in 1 week Which of the following patients needs to be seen in dermatology every year? a. A 42 year old woman with about 15 normal nevi; no personal or family history of skin cancer b. A 35 year old man with a history of melanoma in situ 3 years ago c. A 32 year old woman with a history of three dysplastic nevi that were excised d. A 27 year old man with 3 dysplastic nevi; no personal or family history of skin cancer e. A 48 year old woman with a grandfather who had melanoma in his 70s Mrs. H. is a 30-year-old female who presents with several months of worsening pruritic dry scaly skin between the toes and over the lateral aspects of the foot (see photos). More recently she developed blisters on the plantar aspect of the foot beneath the toes. She does not report any new shoes or lotions to the feet. Which diagnosis is MOST likely? a. Contact dermatitis b. Dyshidrotic eczema c. Friction blisters d. Psoriasis e. Tinea pedis Mr. Lewis is a 67-year-old man who presents to your primary care clinic with a lesion on his right foot (see photo). Which of the following abnormal findings would you expect on the physical exam? a. Hypertension b. Lower extremity edema c. Decreased dorsalis pedis pulses d. Decreased sensation to microfilament testing Which of the following is true regarding the order in which you perform a skin exam? a. Start with the head and then move to the face, neck, chest, abdomen, arms, etc. b. Try to use a different order each time you examine the skin c. You may use any order you want, but it's better to do it in the same order each time d. You must have the patient start sitting up, then have them stand e. You must lay the patient down, then have them flip over What is the best way to examine the skin of a 5-year old? a. Ask the parent to leave the room so they child doesn't feel self-conscious b. Avoid asking any direct questions to the child c. Have the parent sit across the room from the child d. Eliminate all play things from the room so there are no distractions e. Perform the exam with the child sitting on their parent's lap A 65-year-old man with a history of hypertension and hyperlipidemia presents with an ulcerated lesion on his right lateral leg for several weeks (see photo). He occasionally has cramping in his calf when walking. His dorsalis pedis and posterior tibial pulses are not palpable. The ulceration cannot be undermined, and his ankle-brachial index is 0.6 (normal is > 0.8). What is the most likely diagnosis? a. Arterial ulcer b. Diabetic ulcer c. Pressure ulcer d. Squamous cell carcinoma e. Venous ulcer The following is seen under the microscope. What are the findings? a. Budding yeast forms, no hyphae b. Mites, eggs, and scybala c. Multinucleated giant cells d. Negative preparation e. Septate branching hyphae The bite reaction from a brown recluse spider is generally referred to as which of the following? a. Flag sign (red, white, and blue) b. Breakfast, lunch and dinner sign c. Erythema migrans d. Erythema marginatum Which of the following factors is of most prognostic value in determining survival rates in patients with primary cutaneous malignant melanomas? a. Age of patient b. Duration from onset to diagnosis c. Fitzpatrick skin type of patient d. Tumor diameter e. Tumor thickness A 50-year-old obese woman presents to clinic with skin-colored lesions on her neck. Based on the image, which of the following is the most likely diagnosis? a. Acrochordons b. Basal cell carcinoma c. Dermatofibromas d. Seborrheic keratoses e. Warts A 41-year-old male experiences a painful, solitary bulla at the same location on his glans penis intermittently after episodes of constipation. He takes a laxative each time he experiences constipation. Which of the following drug reactions is the most likely diagnosis? a. Drug-induced hypersensitivity syndrome b. Exanthematous drug eruption c. Fixed drug eruption d. Stevens-Johnson Syndrome e. Vasculitis What is the best way to improve your skills with performing the skin exam? a. Limit the skin exam to only the part(s) of the body the patient chooses to show you b. Listen to the heart or lungs through the patient's shirt or gown instead of removing it c. Only perform full body skin exams on patients who ask for one d. Perform full skin exams on as many patients as possible during training This 54-year-old man presents with several years of erythema and greasy scale on his central face, including the glabella, eyebrows, and nasolabial folds (see photo). The most appropriate next step is: a. Avoidance of spicy foods, alcohol, or hot liquids b. Clobetasol cream twice daily c. Ketoconazole cream twice daily d. Moisturizers 2-3 times daily e. Topical retinoid cream A 63 year-old obese woman who has suffered from chronic leg swelling for several years. Her legs get intermittently red and swollen. When this happens she applies a combination of lanolin and Neosporin. One week ago, she did this and her legs got very inflamed and developed blisters, oozing and severe pruritus. The most likely diagnosis is: a. Allergic contact dermatitis b. Bullous Impetigo c. Cellulitis d. Erysipelas e. Irritant contact dermatitis What is the BEST morphological description for these primary lesions? (lesions measure less than 0.5cm) Macules A 52 year-old male thin smoker who frequently gets leg cramps when walking. Recently he started to get a sore over his anterior shin. Your evaluation and treatment would most likely include: a. ABI >0.9, recommend leg elevation b. ABI <0.7, recommend leg compression c. ABI >0.8, recommend light exercise d. ABI <0.6, recommend smoking cessation e. ABI >1.0, recommend wound-vac A 28 year-old mother of two developed a minimally pruritic rash on her wrist over the past 2 months. She used clotrimazole cream daily for 2 weeks without resolution. She was prescribed topical triamcinolone which decreased the redness and itching but did not resolve the rash after using it for 3 weeks. KOH exam was floridly positive. What is the next appropriate treatment? a. Naftifine cream or gel twice daily for 4 weeks b. Nystatin cream or ointment twice daily for 6 weeks c. Oral ketoconazole 400 mg daily for 5 days d. Oral terbinafine 250 mg for 14 days e. Selenium sulfide shampoo for 2 weeks then 2-3 times a week A 60-year-old female presents with a pruritic lesion on her back that is getting darker (see photo). The most likely diagnosis is a: a. Dermatofibroma b. Flat wart c. Melanoma d. Seborrheic keratosis e. Squamous cell carcinoma A 54-year-old man developed a diffuse red papular eruption three weeks after starting allopurinol for elevated uric acid. Skin lesions became confluent and were associated with anasarca, recurrent high fevers, arthralgias, myalgias, decreased urine output, and proteinuria. Laboratory studies revealed a leukocytosis with dramatic eosinophilia, and elevated liver enzymes. Based on the history and clinical findings, which of the following drug reactions do you suspect? a. Drug-Induced Hypersensitivity Syndrome b. Fixed Drug Eruption c. Stevens-Johnson Syndrome d. Toxic epidermal necrolysis e. Vasculitis The difference between a vesicle and a bulla is: a. Diameter of the lesion b. Extension into the dermis c. Location on the body d. Presence of pus vs. clear serous fluid e. Thickness (height) of the lesion Which of the following terms is used to describe the initial lesion of pityriasis rosea? a. Christmas patch b. Guttate plaque c. Herald patch d. Nummular patch e. Nummular plaque A 52 year-old healthy male complains of ten years of thickening of the great toenails with a crusty debris, and he's worried it's spreading to other toes. Which of the following do you recommend first? a. Ciclopirox nail lacquer twice daily for 6 months b. Empirically begin oral fluconazole 150 mg weekly for 6 months c. Empirically begin oral ketoconazole 400 mg daily for 3 months d. Empirically begin oral terbinafine 250 mg daily for 3 months e. Perform fungal culture or KOH to confirm diagnosis A 32-year-old male presents with an asymptomatic papule on his thigh that he noted following an inflamed hair follicle (see photo). It dimples on either side when squeezed. What is the most likely diagnosis? a. Benign melanocytic nevus b. Dermatofibroma c. Epidermal inclusion cyst d. Keloid e. Seborrheic keratosis A 32-year-old woman presents to the emergency room with a rash covering 25% of her body surface area (see photo), which began 2 weeks after starting TMP/SMX for a urinary tract infection. In addition to her skin findings, she has oral and conjunctival erosions. Based on the history and photo, what is the most likely diagnosis? a. Disseminated herpes zoster b. Drug-induced hypersensitivity syndrome c. Fixed drug eruption d. Sepsis e. SJS/TEN Mr. Thompson is a 40-year-old male who presented to the emergency room with a diffuse pruritic rash that began on his trunk and spread peripherally. The rash started 10 days after he began taking ampicillin for "food poisoning." There are no mucosal lesions or systemic symptoms. Based on the history and photo, what is the most likely diagnosis? a. Disseminated zoster b. Drug-induced hypersensitivity syndrome c. Exanthematous drug eruption d. Fixed drug eruption e. Stevens Johnson Syndrome A 42-year-old African American woman presents with brown papules located around her eyes and on the malar cheeks. Several of her aunts were similarly affected at the same age. She would like them removed. Which of the following treatments is most likely to cause hypopigmentation? a. Liquid nitrogen b. Low voltage hyfrecation c. Keratolytic moisturizer d. Snip excision For a patient with seborrheic dermatitis of the scalp, what advice would you give with regard to using anti-dandruff shampoos? a. Allow them to sit on the scalp overnight then rinse out in the morning b. Avoid using any topical steroids on the scalp if you are using antidandruff shampoos c. Leave them in for at least 10 minutes before rinsing out d. They should be applied to a dry scalp e. You should avoid conditioner after using them In counseling a patient with pityriasis rosea, on average, how long should you tell them their rash will last? a. 5 hours b. 5 days c. 5 weeks d. 5 months e. 5 years