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Derm - Exam Master Final Exam Practice |
Correct Q&A Review Guide With Rationales
(100% Score)
Case
A 23-year-old woman comes to the office for a gynecologic
examination. This is her first visit, and she has no complaints. She tells
you that she has not had a Pap smear in several years. Her menarche was
at 12 years, and she has had regular cycles since then. She has had
several sexual partners in the past, but has been with her current partner
in a monogamous relationship for 1 year. She reports that she had a
chlamydial infection that was treated several years ago, but she denies a
history of other sexually transmitted diseases. She has never been
pregnant. On physical examination, her cervix appears friable with a
slight area of ulceration. There are several perineal and vaginal lesions,
which appear as small cauliflower-like projections. The results of the
Pap smear, which return in 1 week, show a low-grade squamous
intraepithelial lesion (mild dysplasia, CIN I).
Question
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What factor in this patient's - ✔ANASWER✔-Correct answer:
Condyloma acuminata
Explanation
A Pap smear should be obtained routinely during the pelvic examination
at the initial visit. The Pap smear as a screening test has been extremely
successful for the prevention of cervical cancer. Detection of dysplasia
allows for successful treatment and prevention of cancer.
Risk factors for cervical cancer include:
Early age of first coitus
Multiple sexual partners
Immune suppression
Low socioeconomic status
Lack of Pap smear screening
This patient has more than 1 risk factor at this young age.
Condyloma acuminata are soft, fleshy warts that are caused by the HPV.
Cervical dysplasia and carcinoma in situ are likely caused by types 16,
18, 31, 33, and 34. It is sometimes difficult to differentiate from
squamous cell carcinoma. It is possible to treat these warts with a topical
application if they are small in size. If they are large warts, cryotherapy
may be required.
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Case
A 20-year-old African-American woman presents with itchy rashes on
her hands. She reports that they have been persistent for the past 2 years.
On examination, deep-seated vesicles with scaling on her palms are
noted bilaterally.
Question
What is the most likely diagnosis?
A) Atopic dermatitis
B) Pompholyx
C) Seborrheic dermatitis
D) Hand eczema
E) Nummular dermatitis - ✔ANASWER✔-Correct answer:
Pompholyx
Explanation
This patient most probably has pompholyx. It is characterized by scaling
and deep-seated vesicles on the palms, fingers, and soles; the vesicles
are pruritic. There may also be erythema and scaling.
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.
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In the acute phase, the dermatitis may present with erythematous
patches, weeping, and crusted plaques. In the chronic phase, it presents
Derm - Exam Master Final Exam Practice |
Correct Q&A Review Guide With Rationales
(100% Score)
Case
A 23-year-old woman comes to the office for a gynecologic
examination. This is her first visit, and she has no complaints. She tells
you that she has not had a Pap smear in several years. Her menarche was
at 12 years, and she has had regular cycles since then. She has had
several sexual partners in the past, but has been with her current partner
in a monogamous relationship for 1 year. She reports that she had a
chlamydial infection that was treated several years ago, but she denies a
history of other sexually transmitted diseases. She has never been
pregnant. On physical examination, her cervix appears friable with a
slight area of ulceration. There are several perineal and vaginal lesions,
which appear as small cauliflower-like projections. The results of the
Pap smear, which return in 1 week, show a low-grade squamous
intraepithelial lesion (mild dysplasia, CIN I).
Question
,2 | Page
What factor in this patient's - ✔ANASWER✔-Correct answer:
Condyloma acuminata
Explanation
A Pap smear should be obtained routinely during the pelvic examination
at the initial visit. The Pap smear as a screening test has been extremely
successful for the prevention of cervical cancer. Detection of dysplasia
allows for successful treatment and prevention of cancer.
Risk factors for cervical cancer include:
Early age of first coitus
Multiple sexual partners
Immune suppression
Low socioeconomic status
Lack of Pap smear screening
This patient has more than 1 risk factor at this young age.
Condyloma acuminata are soft, fleshy warts that are caused by the HPV.
Cervical dysplasia and carcinoma in situ are likely caused by types 16,
18, 31, 33, and 34. It is sometimes difficult to differentiate from
squamous cell carcinoma. It is possible to treat these warts with a topical
application if they are small in size. If they are large warts, cryotherapy
may be required.
,3 | Page
Case
A 20-year-old African-American woman presents with itchy rashes on
her hands. She reports that they have been persistent for the past 2 years.
On examination, deep-seated vesicles with scaling on her palms are
noted bilaterally.
Question
What is the most likely diagnosis?
A) Atopic dermatitis
B) Pompholyx
C) Seborrheic dermatitis
D) Hand eczema
E) Nummular dermatitis - ✔ANASWER✔-Correct answer:
Pompholyx
Explanation
This patient most probably has pompholyx. It is characterized by scaling
and deep-seated vesicles on the palms, fingers, and soles; the vesicles
are pruritic. There may also be erythema and scaling.
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.
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In the acute phase, the dermatitis may present with erythematous
patches, weeping, and crusted plaques. In the chronic phase, it presents
