EX 15 1

Ex 15 1

1-Dermoscopically, a globular pattern with hyphae-like structures is characteristic for:

a. Recurrent melanocytic nevus
b. Dermal nevus
c. Halo nevus
d. Atypical melanocytic nevus
e. Medium – sized congenital nevus Fig. p6 page 1882 Bolognia

2- One of the following is not correct about Flegel’ disease:

a. Papular lesions are most commonly observed on the dorsal aspect of the feet and
distal arms and legs
b. Most lesions are symptomatic asymptomatic
c. Patient occasionally complain of pruritus
d. The dis has been reportedly associated with DM and hyperthyroidism
e. Treatment by PUVA with calcipotriol
Nb: Flegel’s disease, Harlequin ichthyosis: ↓ lamellar granules (LG)

3- One of the following systemic Treatment of morphea has level 1 of evidence:

a. Penicillin level 3
b. Vit D analogues topical is level 3, systemic is level 1
c. Methotrexate level 2
d. Corticosteroids topical is level 3 , systemic is level 3
e. Cyclosporine level 3
( NB systemic vit D has no efficacy = 0 and has level 1 evidence ,
but topical vit D is moderately effective = + and level 3 evidence )table 44.2 Bolognia

4- One of the following is non- acute porphyria:

a. Acute intermittent porphyria
b. Variegate porphyria
c. Hereditary coproporphyria
d. PCT
e. ALA-D deficiency porphyria

1
 EX 15 1

5- One of the following is not correct about cockayne syndrome (cs):

a. Photosensitivity with pigmentary changes
b. Loss of adipose tissue
c. Hypogonadism
d. Classification of basal ganglia
e. CS type III, late onset normal growth and development
A (without pigmentary changes ) bolognia table 87-4
AR disorder due to defective transcription-coupled NER(nucleotide excision repair)
= inability to resume RNA synthesis after UVR exposure (differs from XP, which has
defective global genomic NER)
Cutaneous manifestations: photosensitivity, with telangiectatic erythema; unlike XP,
has NO ↑risk of skin cancer and LACKS pigmentary changes
COCKAYNE – 8 letters (ERCC8), Cachectic dwarfism, Ocular (salt/pepper RP),
Cataracts, Avoid sun, Ears (‘mickey mouse’)

6- Bacilli in skin lesion are not detected in the following type of leprosy:
a. Lepromatous leprosy
b. Borderline Lepromatous leprosy
c. Mid - Borderline leprosy
d. Borderline tuberculoid leprosy
e. Tuberculoid leprosy

7- One of the following is not clinical presentation of talc foreign body reaction:
a. Sarcoide- like papules
b. Furuncles Bolognia table 94-3
c. Thickening and erythema of an old scar
d. Umbilical stumps

2
 EX 15 1

8- One of the following is not correct about plane xanthoma and xanthelasma:
a. Younger patients with xanthelasma are haven’t an underlying lipid disorder
b. Intertriginous plane xanthoma may occur in the antecubital fossae or the web
spaces of the finger
c. Xanthoma striatum palmare are almost dg for dysbetalipoproteinemia
d. Plane xanthoma of cholestasis may occur as a complication of atresia or primary
biliary cirrhosis
e. Plane xanthoma can occur in anormolipemic patient, where they may signal the
presence of an underlying monoclonal gammapathy

Younger patients with xanthelasma, or those with a strong family history of

hyperlipidemia and xanthelasma, are more likely to have an underlying lipid disorder
and should be appropriately screened. Bolognia

9- One of the following is not correct about post – steroid panniculitis.:

a. onset 1 – 40 days after cessation of high- dose systemic cortico steroid therapy
b. firm red plague on chest, arms, trunk are observed
c. the associated systemic finding are leukemia, cerebral edema and nephrotic synd
d. histology is a mixed lobular- septal panniculitis Table 100.8 Bolognia
e. patient characteristics is a children 1 – 14 y old
Lobular panniculitis with lymphocytes, macrophages, multinucleated giant cells;
needle-shaped clefts in lipocytes and giant cells.

10- One of the following markers is( – ) in blood vessels :

a. Laminin
b. Collagen type XVIII
c. CD34
d. VEGFR-2
e. VEGFR-3 table 102.3 Bolognia

11- One of the following is a major diagnostic criteria for For Nevoid basal cell
carcinoma
A. macrocephaly
B. congenital malformation
C. bilateral ovarian fibroma
D. three or more palmer or planter pits table 108.5 Bolognia
E. medulloblastoma

3
 EX 15 1

12- Which of the following is non – stratified squamous epithelium cyst?

A. Hidrocystoma table 110.1 Bolognia
B. Epidermoid cyst.
C. Vellus hair cyst.
D. Steatocystoma
E. Dermoid cyst.

13- One of the following is incorrect about poroma:

a. Usually present as solitary papules, plaques or nodules

b. When sessile vascular plaques surrounded by thin indented moats appear on the
palms and soles, an astute dermatologist can strongly suspect the dg
c. The scalp is a rare site for poroma
d. Occasionally, a poroma will be pigmented
e. Rarely, multiple poromas will develop in a widespread distribution known as
poromatosis

14- One of the following antiviral drugs does not have effect on CMV:
a. GANCICLOVIR
b. FOSCARNET
c. FAMCICLOVIR
d. CIDOFOVIR
e. ACYCLOVIR

15- One of the following is not correct about Golimumab :

a. It is fully human recombinant IgG1 monoclonal antibody

b. It is approved for the treatment of psoriatic arthritis
c. It is contraindicated to be administred with methotrexate
d. It has specificity for human TNF -alpha
e. It is supplied in a 50 mg prefilled syringe or autoinjector that is administred s/c
monthly

4
 EX 15 1

16- The least effect of UVB for photodamage is?

a. Sunburn
b. Photosensitivity Table 132.5 Bolognia
c. photoaging
d. SCC
e. Photoimmune suppression

17- Which of the following type of laser does not have water as target chromophor?
a. Diode
b. Holmium YAG
c. Erbium YAG
d. CO2
e. Pulsed dye hemoglobins table 136.4 Bolognia

18- Which of the following muscles is not innervated by the temporal branch of facial
nerve:
a. Frontalis muscle
b. Corrugator supercilii Muscle
c. Orbicularis oculim (upper portion )
d. Orbicularis oculim (lower portion ) by zygomatic branch. Table 142.1 bolognia
e. Auricular muscle ( anterior and superior portion)

19- Which of the following absorbable suture has poor ease of handling
a. Surgical gut
b. Polyglycolic acid
c. Polyglactin 910
d. Poliglecaprone 25
e. Glycomer 631

( NB there is 3 types of surgical gut , plain and fast-absorbing which are fair
handling; and chromic which is poor ) but all other choices good handling. Bolognia
table 144.1

5
 EX 15 1

20- Which of the following is not correct about Lymphogranuloma venereum:

a. It caused by chlamydia trachomatis serevars L 1 – 3
b. The bubo is firm and painless it is painful
c. Urethra- genito- perianal syndrome
d. Pelvic inflammatory disease
e. Rectal strictures and stenosis
NB Gamma-Favre body Intracytoplasmic basophilic inclusions within
endothelial cells in Lymphogranuloma venereum
Ttt for 3 weeks: Azithromycin 1g q week or Erythromycin qid or Levo 500 mg qd
or Doxycycline 100mg bid

21- One of the following is inflammatory disorder that can flare immune
reconstitution inflammatory syndrome (IRS):
A. Eosinophilic folliculitis. table 78-5 Bolognia
B. Dermatophytes.
C. Cytomegalovirus.
D. Varicella- zoster virus.
E. Demodex.
all are infectious cause except A which is inflammatory

22- The epidermis is a dynamic tissue in which cells are in constant motion. The
kinetics of this motion is characterized by:
A. Direction and speed are synchronous.
B. Keratinocytes pass each other but not melanocytes.
C. Movement is unidirectional.
D. Stability for direction and flow is provided by the basal membrane comples.
E. Lateral motion is slower than forward.
Not present in Bolognia , Fitzpatrick or Rook

23- Itching in atopic dermatitis is characterized by:

A. Histamine is a key factor.
B. Partly produced by proteolytic enzymes. Table 12.4 Bolognia
C. Causes atrophy.
D. Its basis is unknown
E. Occurs mainly during the night.

6
 EX 15 1

24- A 26 year old male presents with erythematous and scaly place bilaterally in
groins area. Which of the following diagnosis should not be considered in the
differential diagnosis:
A. Erythrasrma.
B. Candidiasis.
C. Dermatophytes infection.
D. Lichen planus.
E. Psoriasis.

25- In parapsoriasis:
A. Large and small plaques present as infiltrated plaques.
B. The small plaque variant appear to exist in continuum with patch stage of mycosis
fungoides.
C. Lesions in both variants are chronic and favor sun exposed skin.
D. Pathology consists of superficial mostly CD4+ infiltrate
E. Best treatment is systemic corticosteroids.

They are patches rather than plaques; spps has no risk of MF; sun protected;
topical ttt

26- The development of lichen planus is mediated through immune mechanisms

.Which of the following statements is true regarding this:
A. the majority of lymphocytes in the infiltrate is CD4+. CD3+ not CD4
B. IG g is constantly found in the basement membrane.
C. progression of the disease is led by CD4+
D. CD8+ lymphocyte with TCR gamma-beta is responsible for apoptosis

E. the basement membrane antigen involved is fibronectin.

27- which of the following is true about angioedema?

A. The allergic type is observed within 24-72 h after exposure to allergen

B. The pseudoallergic type is IgE mediated
C. ACE inhibitor induced type is mediated
D. Nonallergic type is histamin mediated
E. Acquired angioedema has increased function of C1- INH

7
 EX 15 1

28- DIF of DH reveals :

A. Linear band of IgG along the BMZ
B. Linear band of IgA along the BMZ
C. GranuLar deposits of IgG in the dermal papillae
D. GranuLar deposits of IgA in the dermal papillae
E. GranuLar and Linear band along BMZ

29- Propionbacterium acne is :

A. An aerobic organism
B. Located in hair follicule and does not diffuse through it
C. Activates TLR
D. Incapable of producing inflammatory mediators directly
E. Its density in hair follicule is inversely related to serum level of testosterone

30- Which of the following is true about lichen sclerosis atrophicans:

A. Unknown to occur in children
B. Extragenital lesions are seen more frequently than genital lesions
C. The disease is benign
D. Antibodies to extracellular matrix proteins have been detected in the disease.
resemble Q 53/89 in Board vitals, rheumatology
E. Topical steroids are not helpful

31 Which of the following is associated with Darrier’ disease?

A. Clear cell acanthoma
B. Acrokeratosis verruciform of Hopff
C. Syringocystadenoma papilliform
D. Fibrofolliculoma
E. Sebaceous adenoma

32 Thining , longitudinal ridges and distal splitting are nail changes that are typically
found in :
a. pso
b. onychomycosis
c. 20 nail dystrophy
d. Chronic eczema
e. LP page 192

8
 EX 15 1

33- A 38 year old woman presented with loss of subcutaneous fat in The face and
torso in a progressive way. Which of these laboratory Tests would you like to check
first :
A. CBC
B. Protein electrophoresis
C. Urine analysis
D. Serum lipids
E. Serum lipase
I think the diagnosis is Acquired partial lipodystrophy (but clinical pictures in the
question is little )

Alikhan : Acquired partial lipodystrophy (Barraquer-Simons syndrome)

Sporadic vs AD LMNB2 ; Linked to infections and autoimmune diseases
F≫M
Loss of fat on face (cadaveric facies), upper extremities, trunk (spreads in
cephalocaudal direction, sparing lower extremities. ↑fat in hips, legs, gluteal region
acanthosis nigricans, hirsutism. starts in childhood/adolescence

↑Triglycerides and DM2/ insulin resistance may occur but metabolic syndrome less
common than other disorders
may be preceded by infection and/or a/w AICTD (SLE, DM)
Menstrual issues
Membranoproliferative glomerulonephritis (several years after lipodystrophy, 1/5
pts)
↓C3 and ↑C3 nephritic factor (polyclonal IgG; binds C3) → activates alternative
complement pathway → adipocyte death and ↑ N. meningitides infections

34 Kasabach- Meritt syndrome is :

A. Infantile hemangioma
B. Rapidly involuting hemangioma
C. Kaposiform Hemangioendothelioma
D. Non-involuting congenital Hemangioma
E. Cherry angioma

35- A young man developed an asymptomatic slow growing skin colored nodule on
his sole. The histology showed sharply circumscribed tumor of cuboidal epittelial
cells whith compact eosinpophilic cytoplasma containing vacuoles. What is the
diagnostic :
A. Nodular BCC
B. SCC
C. Hydradenoma
D. Poroma
E. Seborrheic keratosis

9
 EX 15 1

36- Which of the following is most commonly implicated in the production of AGEP
?
A. Beta blockers
B. Tetracyclines
C. NSAID
D. Lithium
E. Gold

According to Bolognia page 343. There is no answer; or choice A is beta lactam or ca

channel blockers instead of beta blockers.
Most common drugs: β-lactam (PCNs and cephalosporins) and macrolide
antibiotics > CCBs (diltiazem most common) and antimalarials

37- Woods lamp filter is made of:

A. Tin and chromium oxide
B. Nickel hydride and barium silicate
C. Nickel oxide and barium carbonate
D. Nickel oxide and barium silicate after search
E. Silicon dioxide

38- The eye is involved in leprosy in different ways. Which of these is the
commonest:
A. Insensitive cornea
B. bleeding cornea
C. conjunctivitis
D. iritis
E. optic neuritis
Ocular manifestations such as lagophthalmos (inability to completely close the eyes)
and corneal and conjunctival anesthesia due to involvement of branches of the facial
and trigeminal nerves, respectively, are sometimes present in severe cases. Bolognia

39- Cutaneous larva migrans is characterized by:

A. The infected human is a dead end host.
B. Cutaneous lesions are mildly or non pruritic. Intense pruritus
C. The commonest site afflicted is the face. Lower extremities and buttocks
D. The folliculitis form lasts 6 – 8 months
E. The 1st line treatment is a 3 days course of albendazole

10
 EX 15 1

40- Which of the following is not a histological feature of Polymorphic Light

Eruption :
A. Epidermal spongiosis
B. Perivascular lymphocytic infiltrate
C. Scattered eosinophils and neutrophils
D. Normal papillary dermis Bolognia 1469
E. Sometimes it is difficult to distinguish from cutaneous Lupus Erythematous.
(Significant papillary dermal edema occurs commonly) Bolognia 1469

41- Raindrops on a dusty road appearance is seen in a toxicity to:

A. Antimony
B. Beryllium
C. Arsenic Table 88.11
D. Bismuth
E. Chromium
Hyperpigmentation of axillae, groin, nipples, palms, soles and pressure points, with
superimposed guttate hypopigmentation (“raindrops on a dusty road”). Table 88.11

42- Which of the following is the most single characteristic finding in child abuse:
A. bruises
B. blunt trauma
C. pinch marks
D. buckles
E. loop marks Bolognia page 1522

43- Which of the following is not associated with Elastosis Perforans Serpiginosa ?
A. Down syndrome
B. Ectodermal Dysplasia
C. Marfan syndrome
D. Osteogenesis imperfecta
E. Pseudoxanthoma elasticum
MADD PORES: Marfan’s, Acrogeria, Down syndrome, D-Penicillamine,
Pseudoxanthoma elasticum, Osteogenesis imperfecta, Rothmund-Thomson,
Ehlers Danlos, Scleroderma

11
 EX 15 1

44- Which of the following about hypertrophic scar is not true:?

A. always preceded by injury
B. there is prominent erythema
C. does not contain myofibroblasts Table 98.2
D. no spontaneous healing
E. good response to treatment
C is the best choice but d may be right. (because spontaneous healing is Sometimes,
gradual )

45- Which of the following is not true about pseudoxanthoma elasticum :

A. Autosomic Recessive disease
B. Mutation in ABCC6 gene
C. Present at birth during childhood or 2nd/3rd decade of life
D. Lateral neck is usually affected first
E. Angioid streaks are suggestive of diagnostic

Fragmented purple elastic fibers in dermis (VVG+ and Von Kossa+)

↑risk of first trimester miscarriage
Morbidity and mortality 2° to GI hemorrhage, cerebral hemorrhage,
atherosclerotic disease, and myocardial infarction

Agioid streaks also seen in Paget’s disease of bone, sickle cell anemia, thalassemia,
EDS, lead poisoning, and age-related degeneration

46- Which of the following is a predominantly septal panniculitis ?

A. Erythema induratum
B. Pancreatic panniculitis
C. Sclerema neonatorum
D. Lipodystrophic panniculitis
E. Alpha -1 antitrypsin deficiency table 100.1
septal panniculitis
• Erythema nodosum , Erythema nodosum migrans (subacute nodular migratory
panniculitis)
• Panniculitis of morphea/scleroderma
• Alpha1-antitrypsin deficiency panniculitis.

12
 EX 15 1

47- The most helpful investigative tool in the diagnosis of lymphatic malformations is

A. Ultrasonography Table 104.3

B. Biopsy
C. CT scan
D. Lymphography
E. Arteriography

48- Collection of endothelial cells, pericytes and formation of vascular lumen,

histologically favors the diagnosis of:
A. Nevus flammus
B. Cystic hygroma
C. Hemangioma Fig. 103.23
D. Port-wine stain
E. lymphangioma

49- In which of the following antibiotic, the site of action is DNA gyrase :
A. Vancomycin
B. Clindamycin
C. Sulfonamides
D. Quinolones Table 127.7
E. Trimethoprim

50- Which of the following antifyngal is FDA category D in pregnancy:

A. Terbinafine. B
B. Variconazole. D Table 127.17 Bolognia
C. Amphotricin B. B
D. Flucytocin C
E. Caspofungin acetate. C

Nb : most of anti-fungal are c , only terbinafine and Amphotericin b are B , and

voriconazole is D

13
 EX 15 1

51- Imiquimod is not used in :

A. lentigo maligna
B. AK
C. HSV
D. Exra-mammary Paget
E. keloids

52- IV IG is not used in :

A. Kawasaki disease
B. Erythrodermic psoriasis table 128.11
C. Pemphigus Vulgaris
D. Dermatomyositis
E. Necrotizing fasciitis

53- Regarding cryotherapy which of the following statement is NOT TRUE:

A. The freezing time is shorter for benign lesions than malignant.
B. 10 seconds with open spray technique will cure 80% of actinic keratosis.
C. The freeze time is the same for both cryoprob or spray technique
D. 2-3 nm lateral spread is sufficient for successful treatment of warts.
E. Keloids can be treated with open spray technique alone or in combination with
intralesional steroids.
Nb:( freeze time in cryoprobe is 2 to 3 times longer than spray technique )

54- Concerning treatment of malignancy with cryotherapy, One of the following is

not true:
A. The entire tumor is generally frozen in one session
B. The recommended temperature is -50 to -60 at the base Of The tumor
C. It is not advised for treatment Of The tumor on the nose
D. Cure rate for BCC is over 90%
E. Freezing time is approximately 45 sec for a 1 cm lesion
C not a
((The entire tumor is generally frozen in one session using a double freeze–thaw
cycle))
((Cryosurgery is advantageous for tumors on the ears and nose because cartilage is
relatively resistant to freezing damage and the architecture of the structure is
preserved )) Page 2286 bolognia 2012

14
 EX 15 1

55- By dermatoscopy, melanin located at the papillary dermis appear as:

A. Black
B. White
C. Brown
D. Slate blue
E. Red – black

Upper epidermis (stratum corneum, stratum spinosum) - Black

Dermoepidermal junction - Light-to-dark brown
Papillary dermis - Slate blue
Reticular dermis - Steel blue

56- Superantigen T – cell interaction lead to activation of :

A. 5 – 30% of entire circulatory T – cell population
B. O.o1% of entire circulatory T – cell population
C. 50% of entire circulatory T – cell population
D. 75% of entire circulatory T – cell population
E. Almost the entire circulatory T – cell population

Anti-CD3 and Anti-CD28 Antibodies (CD28-SuperMAB) have also shown to be

highly potent superantigens (and can activate up to 100% of T cells)
Superantigens are able to bypass many elements of the normal immune response.
They are not processed by antigen presenting cells. Instead, they bind directly to the
MHCII complex and interact with T cells in a relatively non-specific fashion.
Whereas conventional antigens require recognition in all 5 elements of the T-cell
receptor (V-alpha, J-alpha, V-beta, D-beta, J-beta), superantigens are recognized by
V-beta alone.

57- The most common secondary proliferation in nevus sebaceous is :

A. Trichoblastoma
B. Syringocystadenoma papilliformis
C. Sebaceous adenoma
D. Trichilemmoma
E. BCC
Secondary adnexal neoplasms arising within nevus sebaceus: trichoblastoma (#1) >
SPAP > trichilemmoma, poroma, TAA, and BCC.
TAA= Tubular apocrine adenoma SPAP= Syringocystadenoma papilliferum

15
 EX 15 1

58 - IN purpura fulminans:
A. Prognosis is good in neonatal type ( it is fatal unless treated )
B. Patients with sepsis and DIC correlate with severe protein S deficiency
( there is antibody against protein s ( = no deficiency)
C. Acquired type is most famously associated with meningococcal infection
D. Post infection type is characterized by antibody production which interfere with
protein C function ( against protein s not c )
E. protein S concentrate is the treatment of choice( there is no commercial protein s )

59- Histologic profile of cantharidin blisters produced by blister beetle is similar to

that seen in:
A. PV
B. BP
C. HAILEY- HAILEY Disease
D. Darier disease Bolognia page 1439
E. Sub-corneal pustular drematosis
Cantharidin
• Blistering agent (comes from blister beetle/Spanish fly, Lytta vesicatoria)
• MoA: disrupts desmosomes → intraepidermal acantholysis → bullae
• Applied in office under occlusion for warts/molluscum; washed off at home 4 hours
later
• SEs: pain from blister and ring wart formation
Pathology of blister beetle from Bolognia page 1439
The blisters demonstrate acantholysis in suprabasal keratinocytes. Disruption of cell
outlines and cellular necrosis may be noted. The profile of adhesion molecule loss in
cantharidin blisters is similar to that seen in Darier disease.

60- One of the following is not increased in acne :

A. Substance P
B. 5- Lipooxygenase
C. Linoleic acid Table 35.4
D. Monounsaturated fatty acid
E. Corticotropin releasing hormone

16
 EX 15 1

61- Infra patellar hypertrichosis is a cutaneous manifestation of:

A. Spinal dysraphism
B. Becker’s nevus
C. Juvenile dermatomyositis Bolognia 1119
D. PCT
E. Coffin- siris syndrome
Localized hypertrichosis in hereditary and acquired systemic diseases
There are multiple genodermatoses characterized by the presence of localized
hypertrichosis as a major or secondary diagnostic feature (see Table 70.2)5,6. For
example,
hypertrichosis within sun-exposed areas is one of the signs of the porphyrias – in
particular, porphyria cutanea tarda (Fig. 70.5) and congenital erythropoietic
porphyria7.
Likewise, the low frontal hairline and synophrys (confluent eyebrows) in the
Cornelia de Lange syndrome are important diagnostic features of that entity8.

Localized hypertrichosis may also be observed in acquired systemic diseases, such as

infrapatellar hypertrichosis in juvenile dermatomyositis or hypertrichosis overlying
pretibial myxedema, indurated plaques of Rosai–Dorfman disease, and areas affected
by reflex sympathetic dystrophy. Bolognia 1119

62- The mode of inheritance in which both parents are not affected is :
A. AR
B. AD
C. X- linked recessive
D. X – linked dominant
E. A semidominant

63- Streaks and whorls of hyperkeratosis following Blashko ‘s lines describes:

A. Erythrokeratoderma variabilis
B. KID syndrome
C. CHILD syndrome
D. Chanarin – dorfman syndrome
E. Conradi- huerman – happle syndrome Table 57.3

17
 EX 15 1

Conradi– Hünermann–Happle syndrome X-linked dominant

Rare onset at Birth
Primary cutaneous features At birth, ichthyosiform erythroderma with feathery,
adherent scale along Blaschko’s lines; later, follicular atrophoderma along Blaschko’s
lines

Associated features : Unilateral cataracts; chondrodysplasia punctata (during

infancy); asymmetric Skeletal abnormalities; patchy scarring alopecia

Diagnosis : Clinical; epiphyseal stippling on X-rays during infancy; accumulation of

plasma 8(9) cholesterol; molecular testing

64- One of the following is more common in streptococcal rather than staphylococcal
toxic shock syndrome :
A. Localized extremity pain
B. Diffuse macular erythema
C. Soft tissue infection
D. Mortality
E. Positive blood culture
The question is wrong , it seems to be one of the following is not common
So the answer is b

65- The least site to expect scabies mites on is the:

A. Wrists and hands.
B. Elbows. Page 1423 Bolognia
C. Axilla.
D. Genitalia.
E. Buttocks.

66- The earliest manifestation of chronic granulomatous disease is:

A. Oral ulcers resembling aphthous stomatitis.
B. Cutaneous granulomas.
C. Large poorly healing cutaneous ulcers.
D. Infection of the skin around ears and nose. Page 910 Bolognia
E. Seborrheic dermatitis and scalp folliculitis.

18
 EX 15 1

67- The most prevalent ophthalmologic finding in pseudoxanthoma elasticum?

A. Optic drusen
B. Angioid streaks
C. Owl’s eye
D. Macular degeneration
E. Peau d’orange color change of retinal epithelium

Mottling of the retinal pigment epithelium (referred to as “peau d’orange” changes)

(Fig. 97.7B) is actually the most prevalent ophthalmologic finding in PXE and may
precede the development of angioid streaks. Less commonly, macular degeneration,
optic drusen and “owl’s eyes” (paired hyperpigmented spots) may be detecte

68- The most typical presentation of microvasular occlusion syndrome:

A. Macular purpura.
B. Macular ecchymosis.
C. Livedo reticularis.
D. Inflammatory retiform purpura.
E. Non inflammatory retiform purpura. Page 357

69- The type of cutaneous T –cell lymphoma that has the worst prognosis is :
A. Primary cutaneous anaplastic large cell lymphoma. Favorable.
B. Sub-cutaneous panniculitis like T –cell lymphoma. favorable
C. Primary cutaneous CD4+small/medium pleomorphic T- cell lymphoma.
solitary lesion have an excellent prognosis.
D. Pagetoid reticulosis. In contrast to classic MF, extracutaneous dissemination

E. Primary cutaneous gamma/ delta T- cell lymphoma. rapidly fatal disease.

70- The highest risk of mother to child transmission of untreated syphilis occur if the
mother infected :
A. During the 1st seven months of pregnancy. Table 82.6
B. 1 year before pregnancy
C. During the 8th or 9th month of pregnancy
D. 3-6 weeks before labor
E. 2 year before pregnancy

19
 EX 15 1

71- Which of the following is affected by loss – of function mutations within fillagrin
gene?
A. Lamina lucida
B. Lamina densa
C. Hemidesmosome
D. Keratohyaline granule
E. Membrane coating granule

72- In vogt – koyanagi – harada syndrome there is what :

A. Poliosis Table 66.4
B. Hypertrichosis
C. Café au lait macules
D. Palmar hyperkeratosis
E. Peroccular hyperpigmentation

73- Where androgen receptors are predominantly expressed?

A. Isthmus.
B. Dermal papilla.
C. Startumbasale.
D. Papillary dermis.
E. Periglandulare dermis.

74- What is the prognosis of atopic eruption of pregnancy:

A. Flare after delivery
B. Premature delivery
C. Intrauterine fetal death
D. Good even in severe cases
E. Post- delivery haemorrhage

20
 EX 15 1

75- which is a neutrophilic dermatosis?

A. Erythema ab igne
B. Granuloma multiform
C. Pyoderma gangrenosum
D. Pyoderma faciale
E. Acute haemorrhagic oedema of childhood

76- The hallopeau type of pemphigus vegetans differs from Neumann type by what?
A. Vegetating erosions
B. More benign course
C. Intercellar IgG and C3
D. Involvment of oral mucosa
E. Antibodies 30 KDa PV antigen

77- In a female patient presenting with acne which of the following indicates to the testing for
hyperandrogenism ? :
A. Premenstrual flare
B. Submarine comedones
C. Pitted scars in the checks
D. Location of lesions in the trunk
E. Sudden onset of severe lesion

78- Which of the following results from inherited anomalies in genes encoding
connexins?
A. Diminished sweating
B. Nail- patella syndrome
C. NF-1
D. PPK
E. EBS ( Dwoling- Meara )

21
 EX 15 1

79- Glycine is a major component of a structure that is detected in Which of the

following?
A. Cutis laxa
B. Dercum ‘s disease
C. Asteatotic eczema
D. Penile fibromatosis
E. Ehler- danlos syndrome type I
Dominant-negative effects leading to EDS are caused by mutations in different
collagen genes, including those encoding α-chains of type I (COL1A1, COL1A2), type
III (COL3A1) and type V (COL5A1, COL5A2) collagensCharacteristically, these
types of genetic lesions are splice site mutations resulting in an in-frame deletion of a
single exon, or missense mutations resulting in a glycine substitution in the
collagenous domain

80- Which disease is transmitted by affected males to their daugters but not to their
sons?
A. Phenylketonuria AR
B. Incontinentia pigmenti XLD
C. Acrodermatitis enteropathica AR
D. Anhidrotic ED XLR
E. Hereditary haemorrhagic telangiectasia AD

• A characteristic of X-linked inheritance is that fathers cannot pass X-linked traits to

their sons (no male-to-male transmission).
• XLD When a female is affected, each pregnancy will have a one in two (50%) chance
for the offspring to inherit the disease allele. When a male is affected, all his
daughters will be affected, but none of his sons will be affected.
• XLR: Affected males transmit the disease allele to all of their daughters, who are then
carriers, but to none of their sons.

81- What causes thinning of the nail plate?

A. Old age
B. Acitretin Table 71.8
C. Tetracycline Onycholysis/photo-onycholysis
D. Darrier’s disease
E. Onychomatricoma

22
 EX 15 1

82- Spores resulting from fragmentation of hyphae into separate cells are what:

A. Microconidia Small asexual spores

B. Macroconidia Large leaf or club-shaped asexual spores
C. Blastospores Conidia formed by budding
D. Arthroconidia Barrel-shaped spores released by fragmentation of
hypha (C. immitis)
E. Sporangiospores Spores that are produced in a sac, example: Zygomycetes

83- What refers to anetoderma ?

A. Yellow thick wrinkled skin with elastotic degeneration
B. Cigarette paper – like scars and thin weakly polarized collagen
C. Circumscribed areas of slack skin with loss of elastis tissue
D. Streaks of atrophy. Telangiectasia and with adipose tissue beneath the epidermis
E. Streaks of atrophy. Telangiectasia and s/c fat immediately beneath the epidermis

84- What is mixed type of panniculitis?

A. Neutrophilic panniculitis
B. Lupus profundus. may be right according to table 100-1 Bolognia
C. Relapsing febrile nodular Panniculitis
D. Idiopathic nodular Panniculitis
E. Pancreatic panniculitis this is the best correct answer

85- In Which of the following pseudo darier sign is positive?

A. Linear connective tissue naevus
B. Congenital Smooth muscle hamartoma
C. Malignant peripheral nerve sheath tumor
D. Naevus lipomatous cut superficialis
E. Porokeratosisi eccrine ostial and dermal duct naevus

23
 EX 15 1

86- UVB light is most effective in the treatment of pruritus associated with?
A. Hypothyroidism
B. Pharmacologic pruritus
C. Chronic renal failure
D. Diabetes mellitus
E. Lymphoma

87- Combining tetracycline and isotretinoine for the treatment of thr severe acne
should be avoided because of Which of the following ?
A. Multiple exuberant bone growth
B. Intracranial hypertension
C. Severe chilostomatitis
D. Nasal bleeding
E. Myalgia and arthralgia

88- Giemsa stain from a genital lesion shows shoal of fish (school of fish)
arrangement. What is the clinical presentation?
A. Pubic excoriations.
B. Painful ulcer
C. Purulent urethral discharge.
D. Multiple itchy penile papules.
E. Crural erythematous scaly plaques with expanding borders.

89- What refer to Cheiroarthropathy?

A. Pachydermodactyly
B. Diabetic thickcskin
C. Restrictive dermopathy
D. Vinyl chloride induced scleroderma
E. Nephrogenic systemic sclerosis

Diabetic cheiroarthropathy : Symmetric, painless loss of joint mobility, and stiffness

of the small joints of the hand with sclceroderma-like skin thickening of the dorsal
aspects of the hands and feet; “prayer sign” 30%–50% of chronic DMII patients;
correlates w/microvascular disease

24
 EX 15 1

90- A patient develops polyarteritis nodosa and orchitits. What is the likely etiology?
A. Hepatitis B
B. HIV.
C. Mumps.
D. EBV.
E. HPV.

91- A 4-month-old infant has a skin-colored, non-tender, nodule on the bridge of the
nose. The lesion intermittently swells and becomes darker upon crying. What is the
next most appropriate step?
A. Treatment with systemic steroids.
B. Biopsy.
C. Surgical excision.
D. Magnetic resonance imaging
E. Observation.

92- Which of the following is associated with Piebaldism?

A. Myocardial infarction.
B. Blindness.
C. Hirschsprung’s disease
D. Basal cell carcinoma.
E. Multiple myeloma.
Nb Hirschsprung’s = Shah–Waardenburg syndrome (WS4)

93- In patients with Dermatomyositis, Anti-Jo1 is associated with what?

A. Renal involvement.
B. Pulmonary involvement
C. Cardiac involvement.
D. Shawl sign.
E. None of the above.

25
 EX 15 1

94- A 17 year-old white male with past history significant for acne vulgaris presents
with a 6 month history of swelling of the forehead, nasal root, and eyelids. The
symptoms have not responded to oral antibiotics. The most likely diagnosis is:
A. Solid facial edema.
B. Erysipelas.
C. Myxedema.
D. B-Cell lymphoma.
E. Angiosarcoma.

95- Patients with Darier’s disease have an increased incidence of which of the
following?

A. Kaposi’s varicelliform eruption.

B. Kaposi’s sarcoma.
C. Squamous cell carcinoma.
D. Basal cell carcinomas.
E. Malignant melanoma.

96- A patient presents with complaints of an urticaial- like rash periodically

associated with lower extremity bone pain and fever. The urticarial is not pruritic and
you suspect a dg of Schnitzler synd. Which of the following lab tests would support
this dg?
A. Serum ferritin
B. Complement level
C. Serum and urine protein electrophoresis Board vitals, rheumatology 9/89
D. RF
E. ANA

97- Which of the following CHEMICAL peels requires either rinsing off with water
or neutralization with 5% sodium bicarbonate after 2-4 mn to end its action ?

A. Glycolic acid
B. salicylic acid
C. trichloroacetic acid
D. lactic acid
E. jessner’s solution

26
 EX 15 1

98- Biopsy of suspected discoid lupus would show inflammation around Which
portion of the hair follicule ?

A. Hair bulb
B. Infundibulum
C. Isthmus Board vitals 70/136
D. Bulge
E. Matrix

Isthmus for DLE to remember ( s for lupus )

infundibulum for LPP ( in fun dibulum …. L P P ) both are 3 phrases
bulb for alopecia areata ( b with a )

99- A patient presents with reccurent otitis media and atopic dermatitis , What
syndrome may the child have?

A. Chronic granulomatous disease

B. Wiskott-aldrich syndrome page 922
C. Severe combined immunodeficiency
D. Job syndrome
E. Familial chronic muccocutaneous candidiasis

100- Which of the following cutaneous feature of relapsing polychondritis is

indicative of an associated myelodysplastic syndrome ?
A. Aphtous ulcers
B. Cutaneous small vessel vasculitis
C. Livedo reticulris
D. A + B Board vitals, Rheumatology 5/89
E. All of the above

27
 EX 15 1

101- Which of the following diagnosis tools cannot be used to follow and monitor
muscle inflammation in Dermatomyositis?
A. EMG
B. CT- SCAN
C. MRI
D. Ultrasound
E. Serum level of muscle enzymes

102- A patient presents with complaints of dry eyes and mouth giving her mucosa a
gritty feeling. She has a family history of SLE . Which of the following
AUTOANTIBODIES is most specific for this diagnosis ?
A. SS-A
B. SS-B
C. Alpha-fodrin
D. dsDNA
E. None of the above
Because the pt has a hx of SLE ALpha fodrin will have most specific for sjogren
syndrome
Alpha-fodrin 70% An actin-binding protein found at the periphery of chromaffin cells
that may be involved in secretion
More specific for SjS than anti-Ro aAb; also seen in SLE
Most specefic for sjs but not sensetiv

103- Microcystic adnexal carcinoma is most likely to occur on the?

A. Scalp
B. Neck
C. Back
D. Lips
E. Legs

28
 EX 15 1

104- A mutation in the gene on chromosome 17 that encodes the protein

neurofibromin increases the risk of Which malignancy ?

A. Prolactinoma
B. Mucosal neuroma
C. Acute lymphocytic leukemia
D. Juvenile myelomonocytic leukemia
E. Progressive multifocal leukoencephalopathy

105- What is the lag time between radiation exposure and development of non
melanoma SCC ?:
A. 1 YEAR
B. 5 YEAR
C. 10 YEAR
D. 20 YEAR page 1775
E. 40 YEAR

106- High ratio of maternal urinary estrogen precursors in a male fetus suggests the
diagnosis of ?
A. Refsum’s dis
B. Sjogren-larsson synd
C. X – linked ichtyosis
D. CHILD Syndrome
E. Neutral lipid storage disease

107- Which of the following is NOT correct about clinical features of immune
deficiency caused by HIV - 2:

A. 5 – 8 folds less transmissibility

B. More vertical transmission
C. Longer period of latency
D. Slower rate of CD4+ cell count decline and clinical progression
E. The outcome among HIV - 2 infected patients may be slightly better

29
 EX 15 1

108- What is The 2 most common neoplasm in Gorlin syndrome:

A. Medulloblastoma
B. Meningioma
C. Melanoma
D. Renal cell carcinoma
E. SCC

109- Which of the following is NOT CORRECT about special stains in dermatology:
A. Crystal violet stains amyloid metachromatically purple with blue background
B. Fite – faraco Stains mycobacterium leprae blue red not blue
C. Orcien Stains muscle and nerve yellow
D. Sudan black Stains lipids black
E. Colloidal iron stains acid mucopolysaccharides blue

110- Which of the following is affected by loss – of function mutations within

fillagrin gene?

A. Lamina lucida
B. Lamina densa
C. Hemidesmosome
D. Keratohyaline granule ‫السؤال مكرر في نفس االمتحان‬
E. Membrane coating granule

111- The cellular source of antibacterial peptide Dermcidin is:

A. Keratinocytes.
B. Airway epithelia.
C. Granulocytes.
D. Intestinal tract.
E. Sweat glands.

30
 EX 15 1

112- The most frequently observed dermatologic manifestations of acute hepatitis C

is:
A. Lichen planus. C particularly erosive oral disease
B. Polyarteritis nodosa. classic – B, cutaneous – C)
C. Leukocytoclastic vasculitis B,C
D. Necrolytic acral erythema. C
E. Porphyria cutanea tarda C>B

113- Movement of basal cells in basal layer is facilitated by :

A. Crowding of cells resulting from mitosis

B. Made possible by degradation of Anchoring filaments
C. Associated with downgrading of integrin alpha 6 beta 4
D. Mediated through cytokinens arriving from basement membrane
E. Controlled by growth factors

Such committed cells detach from the basement membrane and move suprabasally, a
process that is mediated by the inactivation of integrins, extracellular matrix
receptors that anchor basal cells to the basement membrane.Bolognia

114- Which of the following is needed by tyrosinase to function?

A. Zinc.
B. Iron.
C. Selenium.
D. Magnesium.
E. Copper

115- Which of the following toll-like receptor is involved in recognizing

lipopolysaccharide?
A. TLR2.
B. TLR3.
C. TLR4.
D. TLR5.
E. TLR7.

31
 EX 15 1

116- Staphylococcal scalded skin syndrome (SSSS) is associated with which of the
following?
A. Desmocollin 1.
B. Desmocollin 3.
C. Desmoglein 1
D. Desmoglein 3.
E. None of the above.

117- Early cornification can be observed within the hair canal at approximately:
A. 12 weeks estimated gestational age (EGA).
B. 18 weeks EGA.
C. 15 weeks EGA.
D. 22 weeks EGA.
E. 8 weeks EGA.

Early cornification can be observed within the hair canal at approximately 15 weeks’
EGA,
but it does not commence in the interfollicular epidermis until 22–24 weeks’ EGA,
occurring first in the skin on the head, palms and soles

118- which of the following is not a component of the epidermal differentiation

complex:

A. loricrin
B. involucrin
C. s – 100 calcium-binding proteins
D. small proline- rich peptides
E. transglutaminase

119- Pharmacologic pruritus of idiopathic pathomechanism is seen with:

A. Gold salts
B. Beta- blockers.
C. 8- methoxypsoralen.
D. Tramadol.
E. Chloropromazine.
Sebostasis/xerosis
Phototoxicity
Neurologic (or histamine release)
Cholestasis

Idiopathic : Chloroquine, clonidine, gold salts, lithium. Table 6.8 Bolognia

32
 EX 15 1

120- Which of the following drugs causes cholestasis:

A. Morphine. Neurologic (or histamine release)
B. Retinoids. Sebostasis/xerosis
C. Erythromycin estolate.
D. Chlorquine. Idiopathic
E. Isoniazide Hepatotoxicity

Cholestasis : Chlorpromazine, erythromycin estolate, estrogens (including oral

contraceptives), captopril, sulfonamides. Table 6.8 Bolognia

33