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Q.ld: 2781 ( Previous Ne><t Lab Values Notes Calculator

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An 8-year-old boy is brought to the office due to itchy rashes with blisters over his face for the past 2 days.
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His vital signs are normal, except for a temperature of 37.7C (100F). On examination, you notice macules,
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pustules, vesicles, and honey-colored crusts around his mouth and nose. What is the most likely diagnosis?
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9 r A. Contact dermatitis
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r B.lmpetigo
12 r C. Herpes simplex infection
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14 r D. Erythema multiforme
15 r E. Varicella zoster infection
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17 r F. Erysipelas
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ltem:2of18
Q.ld: 2765 (
!ll f' Mark <:1
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A 28-year-old Caucasian woman comes to the office for a routine skin exam. On exam. you encounter a
7 dark-colored lesion. The patient states that she has had a spot there her whole life. She does state that it has
8 recently "been a little itchy and hurts sometimes." She gives a history of sunburns during childhood, and says
9 that she is very "sun-sensitive." A picture of the mole is shown below.
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1cm I,
Displ•yed with p«mlnlon from OermNet NZ.

Which of the following is the most likely diagnosis?

r A. Keratoacanthoma
r B. Blue nevus
r C. Melanoma
r D. Melanocytic nevus
r E. Lentigo simplex
r F. Seborrheic keratosis
 ~ ~
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Item: 3 of 18
Q.ld: <I<W4 (
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A 3-month-old male is brought to your office with a slowly growing skin lesion on his buttock. Physical
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examination findings are shown on the slide below.

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Which of the following is the most likely diagnosis in this patient?

r A. Strawberry (capillary) hemangioma

r B. Cherry hemangioma
r C. Spider angioma
r D. Cavernous hemangioma
r E. Cystic hygroma
2 ltem:4of18 [ii P Mark <:1 t:>- jf ~ 1.":~

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Q.ld: 4312 ( Previous Ne><t Lab Values Notes Calculator

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A 32-year-old Asian female presents to the office with a mole on her foot that recently became darker. She
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has always had skin that is very sensitive to sunlight. She is unable to tan. and has had several sunburns
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when she did not use sunscreens. Her past medical history is insignificant. Her mother had 'a kind of skin
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cancer.' Physical examination reveals a dark mole with irregular borders on the left foot. Which of the
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following is the strongest risk factor for malignancy in this patient?
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11 r A. Asian race
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r B. Age
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14 r C. Location of the mole
15 r D. Sun sensitivity
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17 r E. Previous sunburns
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r F. Family history
r G. Recently changed mole
2 Item: 5 of 18 I I P' Mark <:1 t:>- jf ~ 1.":~ I

Q.ld: 3876 ( Previous Ne><t Lab Values Notes Calculator

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An 18-year-old male is brought to the ER after he has been found lost in the mountains for three days. He had
gone hiking. became disoriented and lost all sense of direction. He says that he did not have gloves and his
hands and fingers are very painful. On physical examination. it appears that the patient has suffered frostbite
injuries to his extremities. What is the best treatment plan for this patient?
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r A. Rapid rewarming with warm water
13 r B. Rapid rewarming with dry heat
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15 r C. Debridement of blisters and devitalized tissue
16 r D. Rapid infusion of warm fluids
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18 r E. Warming with vasodilator drugs
2 Item: 6 of 18 II P Mark <:) t:>- at ~ r.-:~ I

Q.ld: 4<W9 ( Previous Ne><t Lab Values Notes Calculator

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A 20-month-old male is brought to ER with high fever. confusion and a skin rash suggestive of measles. He
has a history of recurrent respiratory infections over the last 6 months. The patient's family has recently
emigrated from a rural Russian province. Which of the following forms of vitamin supplementation should be
considered in this patient?

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r A. Vitamin A
13 r B. Vitamin K
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r C. Vitamin D
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16 r D. Vitamin E
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r E. Vitamin 812
r F. Vitamin 86
2 Item: 7 of 18 I I P' Mark <:1 t:>- jf ~ 1.":~ I

Q.ld: 2775 ( Previous Ne><t Lab Values Notes Calculator

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A 55-year-old man comes to the office due to a sudden onset of blisters all over his body. He complains of
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pain in the involved areas. He first noticed the lesions in his mouth a few days ago. His pulse is 82/min. blood
pressure is 140/90 mm Hg. respirations are 14/min. and temperature is 36 .BC(98 .4F). On examination. there
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are crops of flaccid bullae over normal-appearing skin. and large erosions at sites where the bullae had
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ruptured. The oral mucosa shows erosions and ulcerations. Slight rubbing of the uninvolved skin causes
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easy separation of the epidermis. Immunofluorescence microscopy shows deposits of lgG intercellularly in
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the epidermis What is the most likely diagnosis?
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13 r A. Bullous pemphigoid
14 r B. Bullous impetigo
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16 r C. Pemphigus vulgaris
17 r D. Erythema multiforme
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r E. Dermatitis herpetiformis
2 ltem:8of18 iJIII P Mark -<l t.> if 9-• ~ I

Q. ld: 2774 ( Previous Next Lab Values Notes Calculator

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6 A 25-year-old woman comes to the physician with a rash on her buttocks. She complains of intense itching

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and a burning sensation over these lesions for the past 10 days. She was diagnosed with celiac disease and
advised to follow a gluten-free diet but has found it difficult. Her vital signs are stable. The lesions are shown
in the image below.

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Which of the following is the drug of choice for her skin condition?
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Which of the following is the drug of choice for her skin condition?

r A. Acyclovir
r B. Corticosteroids
r C. Dapsone
r D. Penicillin
r E. Permethrin cream
2 Item: 9 of 18
Q.ld: 2751 (
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6 A 65-year-old male comes to the office complaining of generalized pruritus and rash for the past 3-4 weeks.
7 Initially he attributed the rash to the summer heat and moist sweat, but it has persisted despite the weather

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cooling down. On physical examination. his pulse is 82/min. blood pressure is 140/80 mm Hg. respirations
are 14/min. and temperature is 36 .8•c (98 .4•F). There are tense bullae overlying both normal and
erythematous skin in the groin and axillae and on the legs. He has no oral blisters or erosions. A
representative skin lesion is shown below.

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Which of the following biopsy findings is most likely in this patient's condition?

r A. lgG and C3 deposits atthe dermal-epidermal junction

r B. lgG deposits between epidermal cells
r C. Dermal edema with leukocyte infiltration
r D. Linear lgA deposits atthe dermal-epidermal junction
r E. Multinucleated giant cells at the base of the skin lesions
2 Item: 10 of 18 :ji P Mark <:J t>- jf ~· 1.":~ I

Q.ld: 4267 [ Previous Ne><t Lab Values Notes Calculator

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6 A 34-year-old woman comes to the emergency department with a rash and pruritus. She had a sore throat
7 for several days and took some prescription medication (amoxicillin) left over from 1 year ago. The itchy rash
8 developed about 20-30 minutes after she took the first pill 4 hours ago. She has no dyspnea, dizziness,

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nausea, diarrhea, or abdominal cramps. She has no prior history of skin rash or allergies. Her temperature is
36. r C (98• F), blood pressure is 124/82 mm Hg, and pulse is 80/min. Oxygen saturation is 98% on room
air. Physical examination shows multiple urticaria and mild excoriations over the upper and lower extremities
and upper body. The tonsils are mildly erythematous but without exudates or swelling. There is no lymph
node enlargement. Lungs are clear on auscultation without wheezes. There is no stridor. Abdominal
examination is unremarkable. Which of the following is the best next step in management of this patient?
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17 r A. Administer intravenous glucocorticoids
18 r B. Administer intramuscular epinephrine
r C. Recommend aspirin with the next dose of amoxicillin
r D. Send for lgM antibodies against Epstein-Barr virus
r E. Treat with antihistamine
2 Item: 11 of18 I I P' Mark <:1 t:>- jf ~ 1.":~ I

Q.ld: 4732 [ Previous Ne><t Lab Values Notes Calculator

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6 A 36-year-old male presents to clinic complaining of a pruritic eruption on his forearms. He denies fever, chills
7 and malaise. Physical examination reveals an erythematous rash with occasional vesicles affecting both
8 forearms. No lymphadenopathy is appreciated. Vesicular fluid grows coagulase-negative staphylococci. His
9 only relevant history is recent work in the woods behind his home chopping and transporting firewood. Which

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of the following is the most likely diagnosis?

r A. Herpes simplex infection

r B.S. aureus cellulitis

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r C. S. epidermidis cellulitis
17 r D. Suppurative hidradenitis
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r E. Contact dermatitis
2 Item: 12 of 18 II P Mark <:) t:>- at ~ r.-:~ I

Q.ld: ~85 [ Previous Ne><t Lab Values Notes Calculator

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6 A 17-year-old man presents with a non-pruritic rash in his periumbilical area. The rash consists of firm, dome-
7 shaped, flesh-colored papules with central umbilication. This patient's rash is most commonly associated
8 with which of the following conditions?
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r A. Selective lgA deficiency
r B. Cellular immunodeficiency
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14 r C. Complement deficiency
15 r D. Impaired phagocytosis
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17 r E. Circulating autoantibodies
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2 Item: 13 of 18 II P Mark -<J t>- if ~· !:':~ I

Q.ld: 8821 [ Previous Ne><t Lab Values Notes Calculator

3
4 A 34-year-old woman comes to the physician for evaluation of skin lesions. For the past year, she has
5 noticed darkening and thickening of the skin over her neck and groin areas. These areas occasionally feel
6 itchy. Her blood pressure is 130/80 mm Hg. Skin examination findings are shown in the image below.
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Similar hyperpigmented, velvety lesions are found on the axilla and groin. This patient's condition is most
likely associated with which of the following?

r A. Addison's disease
r B. Hemochromatosis
r C. Liver malignancy
r D. Pellagra
r F Pnlvr.v~tir. nv~ri;m ~vnrlrnmP. .::1
2 Item: 14 of 18 !il f, Mark -<J t>- jf ~· ~ I

Q.ld: 2764 [ Prev1ous Ne><t Lab Values Notes Calculator

3
4 An 80-year-old woman comes to the physician for evaluation of a lesion on her upper back. She requests
5 removal of the lesion because it is "greasy and unsightly." The lesion has been present "for quite a while" and
6 has gradually darkened. Aside from occasional itching, she has no other symptoms. The lesion is shown in
7 the image below.
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What is the most likely diagnosis?

r A. Acrochordon
r B. Actinic keratosis
r C. Basal cell carcinoma
r D. Melanoma
r F SP.hnrrhP.ir. kP.r~tn~i~
2 Item: 15 of 18 ill P Mark <:::J t:> if ~· I~J'll I

Q.ld: 4S93 [ Previous Next Lab Values Notes Calculator

3
4
A 54-year-old man comes to the physician after 2 days of pain, itching, and rash over the left side of his neck.
5 His medical history is significant for rheumatoid arthritis, and his medications include infliximab. Physical
6 examination shows the findings in the image below.
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Which of the following is the best treatment for the patient's condition?

r A. Fluconazole
r B. Mupirocin
r C. Topical corticosteroids
r D. Topical 5-fluorouracil
r E. Valacyclovir
 2 Item: 16 of 18 :ji P Mark <:J t>- jf ~· 1.":~ I

Q.ld : 4314 [ Previous Ne><t Lab Values Notes Calculator

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A 28-year-old Caucasian woman presents to the primary care physician with complaints of painless blistering
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on the backs of her hands. accompanied by an increased fragility of the surrounding skin. She first noted the
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blisters one week ago. after spending some time gardening outdoors. She denies ever having similar
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symptoms. but suspects that her mother may occasionally have had a similar presentation that eventually
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resolved without treatment. Her past medical history is significant for chronic infection with Hepatitis C virus.
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Current medications include oral contraceptives. which were begun last month. Physical examination reveals
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mild hyperpigmentation of the face. Which of the following is the most likely diagnosis?
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13 r A. Allergic contact dermatitis
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r B. Porphyria cutanea tarda
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r C. Herpes zoster
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r D. Dermatitis herpetiformis
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r E.lmpetigo
 2 Item: 17 of 18 I I P' Mark -<:1 t:>- jf ~ 1.":~ I

Q.ld: 2762 [ Previous Ne><t Lab Values Notes Calculator

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6 A 48-year-old Caucasian female presents to your office due to a small swelling on her left lower eyelid. She
7 has worked outdoors her whole life. This swelling has been present for the past 6 months. Recently. she
8 noticed a loss of eyelashes on her lower eyelid. On examination. there is a small nodular lesion on the lower
9 eyelid margin. It is firm. painless. pearly and indurated. Loss of lashes on the left lower eyelid is confirmed.
10 Which of the following is the most likely diagnosis?
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r A. Squamous cell carcinoma
14 r B. Keratoacanthoma
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r C. Basal cell carcinoma
r D. Squamous papilloma
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r E. Seborrheic keratosis
2 Item: 18 of 18 I I P' Mark <:1 t:>- jf ~ 1.":~ I

Q.ld: 2750 [ Previous Ne><t Lab Values Notes Calculator

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A 23-year-old college student comes to the office due to itching all over her body for the past 10 days. She
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hardly gets to sleep at night because of it. Her roommate has similar complaints. Her vital signs are stable.
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Physical examination reveals vesicles and pustules arranged in short, gray wavy channels on the finger webs,
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heels of palms, and in wrist creases. There are papules over the nipples and areola of her breasts. What is
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the most likely diagnosis?
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11 r A. Insect bites
12 r B. Urticaria
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14 r C. Scabies
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r D. Body lice
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17 r E. Bed bugs