PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
History & Physical/Dermatology
A patient presents with a rash, characterized by red macules and edematous
papules with a clearing center. This best describes which of the following?
Answers
A. erythema marginatum
B. erythema multiforme
C. varicella
D. impetigo - correct answers✅✅Explanations
(u) A. Erythema marginatum is associated with rheumatic fever and is
characterized by macular to maculopapular lesions. A clearing center is not
found in the rash.
(c) B. Target lesions, also termed iris lesions, are characteristic of erythema
multiforme. The rash may be recurrent but typically resolves over 3-6 weeks.
(u) C. The rash of varicella typically has maculopapules, vesicles, and scabs
in various stages of development. A clearing center is not found in the rash.
(u) D. The lesions of impetigo are pustules that form a honey-colored crust
after rupturing.
History & Physical/Dermatology
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. - correct answers✅✅Explanations
(u) A. See C for explanation.
(u) B. See C for explanation.
,PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
(c) C. The most common site of involvement of seborrheic dermatitis is the
scalp. Other common sites include the eyebrows, eyelids, nasolabial fold, and
ears.
(u) D. See C for explanation.
Diagnostic Studies/Dermatology
A 26 year-old male complains 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 include which of the following
tests?
A. KOH prep
B. Gram stain
C. Skin scraping microscopy
D. Tzanck prep - correct answers✅✅Explanations
(u) A. A KOH prep would be used to examine for evidence of a fungal
infection.
(u) B. A Gram stain would be used for a bacterial infection and would be
inappropriate in this situation.
(c) 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.
(u) D. A Tzanck prep would be used to examine for giant multinucleated cells
characteristic of a herpes infection.
Diagnostic Studies/Dermatology
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
,PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
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 - correct answers✅✅Explanations
(u) A. Although the skin lesion may resemble a fungal infection, a fungal
dermatophyte would not present with systemic symptoms.
(u) B. Culturing of <i>Borrelia burgdorferi</i> from clinical specimens, with
the exception of skin biopsies at the site of the lesion, have resulted in low
yields.
(u) C. RAST testing is utilized in evaluation of allergies and is not indicated in
this situation.
(c) 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.
Diagnosis/Dermatology
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 lesion located under the distal nail bed. It is
mixed dark brown and black in color, with irregular borders. The most likely
diagnosis is
Answers
A. lentigo.
B. trauma.
C. melanoma.
D. nevus. - correct answers✅✅Explanations
(u) A. Lentigos are typically uniform in color with well-demarcated borders.
, PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
(u) B. If the lesion was from trauma, it should have resolved well before one
year.
(c) 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 insure the diagnosis.
(u) D. A nevus usually has regular, well-demarcated borders.
Diagnosis/Dermatology
A mother brings in her 2 year-old child stating that the child has had a 3-day
history 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 presentation is most consistent with early
Answers
A. rubeola.
B. rubella.
C. varicella.
D. streptococcal pharyngitis - correct answers✅✅Explanations
(c) 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 typical erythematous, maculopapular rash and are
pathognomonic for rubeola.
(u) B. See A for explanation.
(u) C. See A for explanation.
(u) D. See A for explanation.
Health Maintenance/Dermatology
A person with atopic dermatitis should be advised to
Answ A+ Guide (Latest update)
History & Physical/Dermatology
A patient presents with a rash, characterized by red macules and edematous
papules with a clearing center. This best describes which of the following?
Answers
A. erythema marginatum
B. erythema multiforme
C. varicella
D. impetigo - correct answers✅✅Explanations
(u) A. Erythema marginatum is associated with rheumatic fever and is
characterized by macular to maculopapular lesions. A clearing center is not
found in the rash.
(c) B. Target lesions, also termed iris lesions, are characteristic of erythema
multiforme. The rash may be recurrent but typically resolves over 3-6 weeks.
(u) C. The rash of varicella typically has maculopapules, vesicles, and scabs
in various stages of development. A clearing center is not found in the rash.
(u) D. The lesions of impetigo are pustules that form a honey-colored crust
after rupturing.
History & Physical/Dermatology
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. - correct answers✅✅Explanations
(u) A. See C for explanation.
(u) B. See C for explanation.
,PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
(c) C. The most common site of involvement of seborrheic dermatitis is the
scalp. Other common sites include the eyebrows, eyelids, nasolabial fold, and
ears.
(u) D. See C for explanation.
Diagnostic Studies/Dermatology
A 26 year-old male complains 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 include which of the following
tests?
A. KOH prep
B. Gram stain
C. Skin scraping microscopy
D. Tzanck prep - correct answers✅✅Explanations
(u) A. A KOH prep would be used to examine for evidence of a fungal
infection.
(u) B. A Gram stain would be used for a bacterial infection and would be
inappropriate in this situation.
(c) 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.
(u) D. A Tzanck prep would be used to examine for giant multinucleated cells
characteristic of a herpes infection.
Diagnostic Studies/Dermatology
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
,PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
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 - correct answers✅✅Explanations
(u) A. Although the skin lesion may resemble a fungal infection, a fungal
dermatophyte would not present with systemic symptoms.
(u) B. Culturing of <i>Borrelia burgdorferi</i> from clinical specimens, with
the exception of skin biopsies at the site of the lesion, have resulted in low
yields.
(u) C. RAST testing is utilized in evaluation of allergies and is not indicated in
this situation.
(c) 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.
Diagnosis/Dermatology
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 lesion located under the distal nail bed. It is
mixed dark brown and black in color, with irregular borders. The most likely
diagnosis is
Answers
A. lentigo.
B. trauma.
C. melanoma.
D. nevus. - correct answers✅✅Explanations
(u) A. Lentigos are typically uniform in color with well-demarcated borders.
, PANCE Prep Derm + Practice Qs and
Answ A+ Guide (Latest update)
(u) B. If the lesion was from trauma, it should have resolved well before one
year.
(c) 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 insure the diagnosis.
(u) D. A nevus usually has regular, well-demarcated borders.
Diagnosis/Dermatology
A mother brings in her 2 year-old child stating that the child has had a 3-day
history 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 presentation is most consistent with early
Answers
A. rubeola.
B. rubella.
C. varicella.
D. streptococcal pharyngitis - correct answers✅✅Explanations
(c) 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 typical erythematous, maculopapular rash and are
pathognomonic for rubeola.
(u) B. See A for explanation.
(u) C. See A for explanation.
(u) D. See A for explanation.
Health Maintenance/Dermatology
A person with atopic dermatitis should be advised to
