Ex 15 2

Ex 15 2

1 Dermoscopically, a lattice-like pattern is characteristic for:

a. Recurrent melanocytic nevus

b. Pigmented spindle cell nevus
c. Melanocytic nevus of acral skin Fig. P4 page 1881
d. Atypical melanocytic nevus
e. Medium – sized congenital nevus

2- Which of the following metals does not cause irritant contact dermatitis

a. Iron
b. Lead
c. Lithium
d. Nickel
e. Magnesium

3- one of the following is not skin disorder in acquired cutis laxa :

a. SLE Table 97.7
b. Drug eruption due to penicillin
c. EM
d. DH
e. Lupus panniculitis

4- one of the following is minor diagnostic criteria for PHACE syndrome:

a. Anomalies of major cerebral arteries
b. Persistant embryonic arteries table 103.4
c. Posterior fossa anomalies
d. Aortic arch Anomalies
e. Optic nerve hypoplasia

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5 The very rare type of pigmented purpuric dermatosis is :

a. Shamberg’ disease
b. Granulomatous pigmented purpura table 22.9
c. purpura Annularis telangiectodes of majocchi
d. Lichen aureus
e. linear pigmented purpura

B ( very rare ) , A ( Shamberg) is the commonest , the others are rare

6- new born skin involvement observed in the following dermatosis of pregnancy:

a. polymorphic eruption of pregnancy

b. intrahepatic cholestasis of pregnancy
c. Atopic eruption of pregnancy
d. prurigo of pregnancy
e. pemphigoid gestationis table 27.2

7- 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 1286
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

8- one of the following is not correct about Langerhans cell histiocytosis ( LCH ) :

a. LCH is a clonal proliferative disorder

b. LCH cells are S 100 and CD1a positive
c. Intracytoplasmic Birbeck granules are seen
d. Osteolytic bone lesions are common
e. DM is common Diabetes insipidus not DM page 1529

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9- one of the following is not correct about HIV/ ART ASSOCIATED lipodystrophy
synd.:
a. 2months- 2y after initiation combination antiretroviral therapy
b. Decreased fat on face & extremities
c. Decreased fat on Central & dorsocervical ( lipohypertrophy not lipoatrophy )
d. Systemic complication is cardiovascular disease
e. Increased level of TG and LDL , DECREASED LEVEL OF HDL

10- ONE of the following Systemic disease DOES NOT cause flushing :
a. carcinoid synd
b. medullary carcinoma of the thyroid
c. POEMS synd
d. Fabry’ s disease table 106-2 Bolognia
e. Prostaglandin-secreting renal cell carcinoma

11- Which of the following is not high risk factor for recurrence of non-melanoma
skin cancer ?
a. Perineural involvement is positive
b. Degree of differentiation is well differentiated Table 108.7 and paragraph below
c. Micronodular subtype of BCC
d. Desmoplastic SCC only is positive
e. Depth is IV , V of=or > 4mm

12- The typical laser pulse duration for terminal hair follicule is:
a. 3 – 100 ms Table 136.2
b. 0,4 – 20 ms
c. 0,1s
d. 10 – 100 ns
e. 10 ns

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13- One of the following is incorrect about maximum recommended EMLA

application in children:
a. Age < 3 months maximum total dose of cream is 1 g
b. Age < 3 months maximum Area 20cm2 table 143-4 Bolognia
c. Age 3- 12 months maximum total dose of cream is 2g
d. 1- 6 years maximum Area 100 cm2
e. 7- 12 years maximum total dose of cream is 20 g

Lidocaine Fastest onset of action (<1 min) Anesthetic of choice in pregnant women

Mepivacaine Slowest onset of action; Risk of fetal bradycardia(slow & bradycardia)

Prilocaine Risk of methemoglobinemia (↑risk with G6PD deficiency and in children
<1 y) Component of topical EMLA

Bupivicaine Longest duration of action, when combined with epinephrine (up to 8

hours) Most common use: added to lidocaine for big Mohs cases to provide long-
lasting anesthesia Highest risk of cardiac toxicity! Risk of fetal bradycardia

Ropivicaine Longest duration of action in absence of epinephrine (up to 6 hours)

14- One of the following is not clinical feature of meningeal neurosyphilis:

a. meningovascular
b. cerebrovascular
c. Acute syphilitic meningitis
d. Tabes dorsalis table 82.5
e. spinalform

15- one of the following is not cutaneous reactions due to opium :

a. bullous eruption
b. FDE
c. Vasculopathy with retiform purpura. table 89-5 ( only cocaine can induce )
d. SJS
e. Urticaria

( table 89-5 Bolognia ) remember ( obacm ‫) ترتيب بولونيا‬

opiate can induce all reactions except Vasculopathy with retiform purpura
barbiturate induce all reactions except Vasculopathy with retiform purpura & AGEP
Amphetamines can induce morbilliform eruption, FDE, SVV, urticaria
cocaine can induce all reactions except morbilliform eruption, FDE and TEN
cocaine is the only drug not cause morbilliform eruption
cocaine is the only drug that can cause Vasculopathy with retiform purpura
marijuana can induce only morbilliform eruption, urticaria ,AGEP
all can induce urticaria

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16- Which of these cells has the ability to express H4 receptor participating in the
modulation of itch?
a. The keratinocyte
b. Langerhans cell
c. Merckel cell
d. Mast cell page 101
e. Lymphocyte
NB:eosinophils, mast cells, dendritic cells, monocytes, CD8+ T cells can express H4
receptor

17- Which of the following is an important sweat component?

a. Lactate. Page 539
b. Uroconic acid.
c. Phosphates.
d. Pyrovates.
e. Citric acid

18- Earliest Histological change in lichen planus is: ‫اظن السؤال خطأ‬
a. Colloid bodies.
b. Basal cell degeneration.
c. Band like lymphocytic infiltrate.
d. Saw toothing of rete ridged.
e. Acanthosis

19- A young girl was seen in the clinic suffering from a recurrent disease in the form
of recurrent crops of erythematous papules that develop vesicles, crusts, pustules and
erosions. Spontaneous regression takes place within a matter of weeks. What is this
condition?
a. Chicken pox.
b. Atopic dermatitis.
c. Pityriaisis licenoides variloformis.
d. Lymphatoid paulosis.
e. Papular syphilled.

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20- Sphingosine is thought to play a role in the regulation of basal cells division. It is
produced by:
a. Basal cells.
b. Fibroblasts.
c. Spinous and granular cells. ?????????
d. The corneal layer.
e. Merkel cells.

21- For a patient suffering from chronic spontaneous urticarial not responding to
sedating antihistamine the treatment should be :
A. Higher doses of sedating antihistamines ??????????
B. 1 generation non sedating antihistamines
C. sedating antihistamines And antibiotics
D. sedating antihistamines And methotrexate
E. 2 generation non sedating antihistamines

A ; need more informations , look to table 18-19 Bolognia

22- Which of these molecule is not involved in the immune process in bullous
pemphigoid?
A. bullous pemphigoid Antigene type 2
B. metalloproteases page 476
C. eotaxin page 477
D. Alpha 4 beta 6 integrin in cicatricial pemphigoid
E. plectin

23- The following feature are characteristic for drug induced subacute LE :
A. ANNULAR papulo-squamous rash as SCLE
B. Exanthematous rash with some blisters
C. Fever
D. Arthralgia
E. Lymphadenopathy

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24- a middle aged man presented with chronic painful bullae and ulceration of the
foot often with cicatricial sequlae. his nails were dystrophic, some of them lost
altogether. He had erosions and ulcers on the buccal mucosa, alveolar epithelium and
sulci. What is the diagnosis ?
A. PV
B. Paraneoplastic pemphigus
C. Ulcerative tinea
D. Ulcerative LP page 192
E. Severe dishydrotic dermatitis

25- The treatment of PPK has a multiple approach. Which of these treatments is most
effective ?
A. Regular chiropody
B. Topical keratolytics
C. iontaphoresis
D. botox injections
E. Acitritin

26- Which of these mucosal ulceration is associated with circulating antibodies ?

A. Aphtous ulcer major
B. Candidiasis
C. Ulcerative LP
D. Behcet dis.
E. EBA IgG autoantibodies against NC1 domain of type VII collagen

27- A middle aged woman presented with chronic erythematous subcutaneous

nodules, some ulcerating others already scarred on the posterior aspect of both legs.
The histology showed lobular panniculitis with vasculitis and epithelioid
multinucleated giant cells. what is the most likely diagnosis?
A. EN
B. Cutaneous Polyarteritis nodosa
C. Sclerosing panniculitis
D. Erythema induratum
E. Erythema Elevatum diutinum

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28- An 84 old woman with a 6 months history of asymptomatic rapidly increasing

brown macules in her legs developed 2 months later a red nodule with central
ulceration on her right shoulder. Blood tests were normal and skin biobsy showed
atrophic epidermis, lymphocytic infiltration at the dermo- epidermal junction with
epidermotropism and anaplastic cells in the basal layer. Immunohistochemistry was
positive for CD3+. CD8+, CD30+ , CD4 - .what is the diagnostic?
A. MF
B. Sezary synd
C. CD30+ LYMPHOPROLIFERATION
D. Primary aggressive CD8+ T cell lymphoma
E. pagetoid T cell lymphoma

29- dapsone topical gel has proven to be effective in inflammatory acne because it:
A. exerts an antibacterial effect
B. reduces the oiliness of the face
C. has a strong comedonlytic effect
D. inhibits leukocytes traffic
E. changes the PH of the skin

The mechanism of action of topical dapsone in the treatment of acne vulgaris may
result from a combination of both antiinflammatory and antimicrobial effects. In vitro,
dapsone has some antibacterial activity against Propionibacteriumacnes.
This is in consistency with earlier findings that dapsone therapy does not induce
inhibition of LTB4-induced chemotaxis in the skin of patients with acne [Prendiville
et al., unpublished data]
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3927068/

30- UVR interacts with the skin in the following manner :

A. 50% is diffusely reflected
B. Radiation above 300nm are removed within the epidermis
C. DNA is the most important chromophore
D. Collagen bundles patialy absorb UV
E. Cell photoproducts are completely repaired by vit E

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31- Bacillary angiomatosis though a cutaneous disease may involve internal organs.
which is most often involved ?
A. lungs
B. brain
C. liver page 1210
D. kidneys
E. peripheral nerves

32- Peripheral nerve changes in leprosy are :

a. Symmetrical nerve enlargement
A. Nerves trunk palsies without overt clinical manifestation ( silent palsy )
B. Stocking – gloves pattern of loss of sensation due to proliferation of c fibres.
F. Anhydrosis of palms and soles due to parasympathetic nerve involvement
G. Cranial nerves are never involved
( a : asymmetric not symmetric ; c due to loss ( not proliferation ) of c fibers; d due to
sympathetic involvement not parasympathetic involvement ; e creanial nerves are
involved )

33- The common age of giant cell histiocytoma is :

A. 0 – 2 y
B. 3 – 7 y
C. Any age
D. Adult
E. Elderly

34- The associated condition of acrocyanosis is :

A. Malignancy
B. Erythromalcia
C. Cryoprotiens table 88-8 Bolognia
D. Trauma
E. Blood dyscrasia
NB it is associated with Erythromelalgia not erythromalcia

35- Periorbital region is the most common site involved in :

A. Necrobiotic xanthogranuloma
B. Papular xanthogranuloma
C. Juvenile xanthogranuloma
D. Eiosinophilic granuloma
E. Chediak – higashi syndrome

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36- Which of the following is not true about PLE ?

A. IT is the least common photodermatosis
B. It occurs within hours of sun exposure
C. Most severe in spring
D. Action spectra : UVB. UVA
E. Antimalarial can be used in treatment

37- Cobalt toxicity may leads to :

A. Coagulopathy caused by chromium
B. Diffuse nodular fibrosis table 88.12
C. Burns
D. Lichenoid drug eruption
E. Hepatic failure

38- Pityriasis Rosea – like eruption may be caused by :

A. Lithium
B. Cu
C. Gold
D. Zn
E. Irons salts

39- One of the following is not correct about chediak - Higashi syndrome:
A. AR with LYST gene mutation
B. Giant intracytoplasmic granules
C. Most common skin infection are superficial pyoderma
D. About 15% of patients suffer from hemophagocytic syndrome which leads to death
by 10 year of age around 80 %
E. Photophobia and nystagmus , but normal visual acuity

40- Which of the following is false about chondrodermatitis nodularis helicis :

A. Age below 40 year older than 50
B. Unilateral tender nodule
C. Actinic damage is a predisposing factor
D. Mostly on upper helical rim
E. Acanthosis, parakeratosis and hypergranulosis.

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41- In reactive perforating collagenosis, Which of the following is not true:

A. It begins during childhood

B. Keratotic papule develop after superficial trauma
C. Koebernization is commonly seen
D. Lower extremities are common sites involved in arms and hands.page 1600
E. It resolves spontaneously in 6-8 weeks

42- Needle- shaped clefts in lipocytes, Histologically favors the dg of :

A. Pancreatic panniculitis
B. Traumatic panniculitis
C. Nodular vasculitis
D. Poststeroidal panniculitis
E. Lupus panniculitis
Needle-shaped cleft in:
Within adipocytes (radiating pattern):
SQ fat necrosis of newborn, sclerema neonatorum, and poststeroid panniculitis

Within dermis: NXG (> NLD), plane xanthoma, and eruptive xanthoma

Within arterioles: cholesterol embolism (fibrin thrombus surrounds cholesterol)

43- which of the following is true about venous leg ulcer ?

A. occurs at pressure sites arterial
B. A punched out ulcer neuropathic
C. Leg and ankle odema may be seen table 105.1
D. Shiny atrophic skin arterial
E. Peripheral neuropathy neuropathic

44- The most common inherited disorder associated with BCC IS:
A. Bazex syndrome
B. Li-fraumeni syndrome
C. Nev seb
D. Gorlin syndrome
E. Keratoacanthoma

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45- Which of the following retinoids is used to treat Kaposi sarcoma :

A. Tazarotene .
B. Adapalene
C. Bexarotine.
D. Acitretin
E. Alitretinoin

46- Which one of the following is not true regarding risk factors of arterial Ulcers?
A. Peripheral neuropathy
B. Smoking
C. Hyperlipidemia
D. Male gender
E. Hyperhomocysteinemia

47- Which of the following is not side effects of systemic steroids:

A. Hypokalemic alkalosis.
B. Hypocalcemia.
C. Lymphocytosis
D. Pseudotumour cerebri.
E. Exophthalmus.
Remember ( SE is lymphopenia, esinopenia , but leukocytosis) Table 125.8 Bolognia

48- The quantity of ointment required to treat 3 – 5 year child leg and foot is :
A. 1.5 FTUs
B. 2 FTUs
C. 3 FTUs Fig. 129.2
D. 4 FTUs
E. 5 FTUs

49- Which of the following lasers, the target chromophore is vascular:

A. Argon
B. Erbium YAG
C. Pulsed dye
D. Alexandrite
E. Carbon dioxide

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50- which of the following lasers is not used for treatment of nevi ?
A. Q switched ND :
B. LONG pulsed ruby
C. Q switched Alexandrite
D. KTP table 137-3 Bolognia
E. DIODE

51- The longest peak effect of interferons is seen in :

A. Interferon alpha 2a 72–96 h Table 128.1
B. Interferon alpha N3 3–12 h
C. Interferon Alphacon-1 24–36 h
D. Interferon gamma 1b 4.7
E. Interferon Beta1b 1–8 h

52- Elderly patient with hyperpigmented patch of lentigo maligna on his face, after
simple exicion he require radiotherapy in a does range:
A. 10 – 15 Gy IN 5 fractions
B. 12 – 16 Gy adjuvant therapy
C. 40 -50 Gy in 10 – 20 fractions
D. > 60 Gy in 25 fractions
E. > 100 Gy in 40 fractions

53- Total skin electron beam therapy is used to treat selective patient of :
A. Kaposi sarcoma
B. Merkel cell Carcinoma
C. Malignant melanoma
D. Cutaneous T -cell lymphoma
E. SCC

54- One of the following stains can be used to stain Birbeck granules in Langerhans
cell histiocytosis instead of demonstrating them by electron microscope:
A. S - 100
B. Langerin
C. CD1a
D. CD68
E. ATPase

13
 Ex 15 2

CD207 (langerin): most sensitive IHC stain; specific for Birbeck granules. Alikhan

Birbeck granules: Only seen on electron microscopy; classically appear as

tennis racket structures or rods
Pathognomonic of Langerhans cells and LCH cells
Langerin (CD207) is the major component of Birbeck granules → Langerin
immunostain is the most specific stain (> CD1a) for LCH cells and Langerhans cells

55- One of the following is not a feature of sweat secreted by apocrine glands:
A. sterile
B. odorless
C. dilute page 542
D. PH 5 – 6.5
E. Continuous secretion

56- The classic acute presentation of sarcoidosis is typically seen in:

A. Lofgren’s syndrome.
B. Heerfordt’s syndrome.
C. Miculikz syndrome.
D. Darier – Rossy syndrome.
E. Lupus pernio.

57- Concerning pigmented purpuric dermatoses, women are more affected than men
in:
A. Schamberg’s disease.
B. Purpura annularis telangiectoides of Majocchi.
C. Eczematid like purpura of Dukas and Kapetanakis.
D. Pigmented purpuric lichenoid dermatitis of Gougerot and Blum.
E. Lichen aureus.

58- Waldenstrom hypergamma globulinemic purpura is most frequently associated

with:
A. Rheumatoid arthritis.
B. Lupus erythematosus.
C. Lymphoma.
D. Multiple myeloma.
E. Sjogren’s syndrome. page 363

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59- The most common cause of paraneoplastic pemphigus in children is:

A. Sarcoma.
B. Castleman’s disease.
C. Non Hodgkin’slymphoma.
D. Chronic lymphocytic leukemia.
E. Malignant and benign thymomas
Most commonly a/w non-Hodgkin lymphoma or CLL Other associated
malignancies: Castleman disease (most common association in children), thymoma,
sarcoma

60- One of the following variants of acne is typically not comedonal:

A. Chloracne.
B. Acne mechanica.
C. Neonatal acne.
D. Infantile acne.
E. Acne vulgaris.

61- CREST synd is a manifestation of complement disorder associated with

deficiency of:
A. C1q
B. C2
C. C3
D. C5
E. C7 Table 60.7 Bolognia

62- The mild superficial counterpart of epidermolytic hyperkeratosis is :

A. Ichtyosis hysterix
B. Ichtyosis en confetti
C. Ichtyosis bullosa of Siemens
D. Nonbullous congenital ichtyosiform erythroderma
E. Lamellar ichtyosis

63- “Faun tail “ is a cutaneous finding that can be seen in :

A. Congenital melanocytic nevus
B. Plexiform neurofibroma
C. Becker’s nevus
D. Spinal dysraphism
E. Nevoid hypertrichosis

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64- One of the following is false about Plexiform neurofibroma :

A. Occurring along the course of the nerve
B. Present in 30% of patient with neurofibromatosis -1
C. Mostly congenital
D. Associated with overlying skin atrophy
E. Usually affect trigeminal and upper cervical nerves

65- the most common immunoglobulin deficiency is :

A. X- linked agammaglobulinemia
B. IPEX SYNDROME
C. Common variable immunodeficiency
D. Selective IgA deficiency
E. HYPER IgM SYNDROME
Nb the most common is d but the most frequent is ( c and agammagloulinemia )

66- Insect bite reaction is a result of :

A. Innate immunity
B. humoral immunity
C. humoral and cell mediated immunity
D. cell mediated immunity
E. Innate and humoral immunity

Insect venoms and saliva are complex. Immediate reactions are commonly related to
histamine, serotonin, formic acid or kinins. Delayed reactions are typically
manifestations of the host’s immune response to proteinaceous allergens. Page 1435

67- The major target cell in reckettsial diseases is :

A. Monocyte
B. Neutrophil
C. Endothelial cell
D. Keratinocyte
E. Fibroblast
(reckettsiae are gram negative motile , pleomorphic , obligate intracellular usually
infect endothelial cells )

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68- The composition of nits cement in pediculosis is similar to :

A. Amyloid
B. Keratin
C. Desmogleins
D. Actin filaments
E. ceramides

69- Lupoid leishmaniasis is :

A. a clinical form of new world leishmaniasis ( old world )
B. occurs most frequently with zoonotic type (less frequently not most frequently )
C. clinically And histologically resembles LE ( LV not LE )
D. clinically And histologically resembles LV
E. Has few amastigotes on hematoxylin/ eosin and difficult to find(Giemsa not H&E)

70- The most common cause of foreign body reaction in the skin is :
A. Topical applications ( deodorants and antipruritic )
B. Tattoo inks
C. Surgical procedures
D. Ruptured follicule or cyst Table 94.1 Bolognia
E. Ingrown hair or nail

71- In reactive perforating collagenosis, the material being transepidermally

eliminated is collagen type:
A. I
B. II
C. III
D. IV
E. VII
(RPC) Wide channel (“volcano-like”) w/ perforating basophilic collagen
VS
EPS narrow/thin (thinner pink-red elastic fibers, serpiginous channel)

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72- The Most common cutaneous feature of microscopic polyangitis is :

A. Ulcers
B. Urticarial plaques
C. Splinter hemorrhage
D. Palpaple purpura page 400 (clinical features)
E. Livedo racemose

73- The Most common dose- limiting side effect of thalidomide is :

A. Peripheral motor neuropathy
B. Sedation
C. Peripheral sensory neuropathy
D. Teratogenicity
E. Elevated liver enzymes

74- The best site for obtaining biopsy in women suspected of having gonorrhea is:
A. Urethral meatus
B. Labia minora
C. Vaginal canal
D. Endocervix
E. Urethral discharge

75- Which of the following is a substrate for matrix metalloproteinases?

A. Corneosome.
B. Keratin.
C. Collagen.
D. Cornifin.
E. Filaggrin.

76- Itching migrating in distribution and time and without lesions is most likely
secondary to ?
A. Aging
B. Hepatic disease
C. Renal disease
D. Parasitophobia
E. Internal malignancy
Rx: antipsychotic such as pimozide is classic treatment of choice (be aware of QT
prolongation on EKG

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77- One of the following topical drugs is least likely to cause contact sensitization :
A. Neomycin
B. Silver sulphadiazine
C. Diphenhydramine
D. Dinitrochlorobenzene
E. Diphencyprone

78- Which of the following is feature of rosacea?

A. Scale.
B. Seborrhea.
C. Spongiosis
D. Carpet tack sign.
E. Peaud’orange skin.
( in pathology in Bolognia no spongiosis )
NB : d is for DLE

79- Which of the following results from defected neutral amino acid transport?
A. Tyrosinaemia.
B. Alkaptonuria.
C. Hartnup disease (defective intestinal/renal neutral amino acid transport)
D. Homocysteinuria.
E. Gaucher’s disease.

80- Which is the targeted gene product in epidermolysis bullosa simplex with
muscular dystrophy?
A. Plectin.
B. Plakophilin-1.
C. Desmoplakin.
D. Keratin 5 and 14.
E. Laminin 332
Remember: EBS with pyloric atresia is also with plectin deficiency
JEB with pyloric atresia is associated with alpha 6 beta 4 deficiency

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81- What causes botryomycosis?

A. Aspergillus niger.
B. Onchocerca volvulus.
C. Staphylococcus aureus.
D. Trombiculaa kamushi.
E. Malassezia yamotoensis.

82- Maculae caeruleae occur in Which of the following ?

A. Tungiasis
B. Larva migrans
C. Onchocericoma
D. Pediculosis pubis
E. Cutaneous schistosomiasis

83- Which of the following mycobacteria is is a rapid grower in culture ?

A. M . lepra lepra can't be cultured until now
B. M . fortuitum
C. M . kansasii Kansasii is slow grower facultative photochromogen
D. M . ulcerans Ulcerans is slow grower facultative non photochromogen
E. M . tuberculosis TB is slow grower obligate human
Also table 75.1

84- Which is histiocytosis involving other cells than Langerhans ‘ cells and dermal
dendrocytes ?
A. Dermatofibroma fibrohistiocytic
B. Reticulohistiocytoma non LH non dendrocytes
C. Juvenile xanthogranuloma dermal dendrocytes
D. Benign cephalic histiocytosis dermal dendrocytes
E. Progressive nodular histiocytosis dermal dendrocytes

85- Which is Dercum disease ?

A. Lobular panniculitis
B. Localized lipoatrophy
C. Factitial panniculitis
D. Painful lipomatosis
E. hibernomanswer

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86- In Which of the following disorders antibiotics ( tetracycline and amoxicillin ) are
used ?
A. Follicular atrophoderma
B. elastoderma
C. chronic atrophic acrodermatitis
D. vermiculate atrophoderma
E. atrophoderma of Pasini and Pierini

87- Which of the following drugs causes gingival hypertrophy ?

A. Ciclosporin
B. Tetracycline
C. Hydroxyurea
D. Methotrexate
E. Chloropheniramine

88- Which of the following is a broad spectrum blocker of UVB, UVA and visible
light?
A. Salicylates
B. Cinnamates
C. Ferrous oxide
D. Anthranilates
E. Para-aminobenzoic acid

89- For a patient of chancre and allergy to penicillin, What is the alternative therapy ?
A. Metronidazole 2 g single dose
B. Terbinafine 250 mg x 2 daily for 1 month
C. Tetracycline 500 mg x 4 daily for 1 week
D. Erythromycin 500 mg x 4 daily for 2 weeks
E. Clindamycin 150 mg x 4 daily for 3 days

90- Which of the following is associated with seborrhea ?

A. Scleroderma
B. Pachydermoperiostosis
C. Steatocytoma multiplex
D. Piezogenic pedal papules
E. Pseudoxanthoma elasticum
NB steatocytoma multiplex Small sebaceous lobules are found in or immediately
adjacent to the cyst wall

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91- Which of the following is most associated with Kawasaki’s disease ?

A. Vitiligo
B. Eczema/ atopic dermatitis
C. Psoriasis Board vitals
D. Scleroderma
E. Neurofibromatosis

92- Which of the following hair shaft abnormalities is not associated with increased
fragility?
A. Trichorrhexis invaginata
B. Pili torti
C. Pili Annulati
D. Trichorrhexis nodosa
E. moniltrix

93- Mothers with Herpes gestationis (gestational pemphigoid or pemphigoid

gestationis) are most at risk for?

A. Hypertension.
B. Diabetes.
C. Thyroid disease.
D. Stroke.
E. Myocardial infarction.

94- The principal cause of morbidity and mortality in patients with CREST syndrome
is:
A. Sepsis
B. Myocardial infarction
C. Pulmonary hypertension
D. acute renal failure
E. hepatic failure

22
 Ex 15 2

95- What is the antigenic target of this condition presenting with conjunctival and oral
mucosal lesions?
A. BPAg1
B. BPAg2
C. DESMOGLEIN 1
D. DESMOGLEIN 2
E. DESMOCOLLIN
Desmoglein 1 Striate PPK, pemphigus foliaceous, pemphigus vulgaris
(mucocutaneous), bullous impetigo, staphylococcal scalded skin syndrome (SSSS),
PNP
Desmoglein 3 Pemphigus vulgaris (mucosal-dominant and mucocutaneous), PNP
Desmoglein 4 Monilethrix (autosomal recessive)

Desmocollin 1 Subcorneal pustular dermatosis (type of IgA pemphigus)

96- Which of the following is most likely to be found on physical examination of a patient with
Gronblad-Srandberg syndrome:
A. Splenomegaly
B. Angioid streaks . It is PXE
C. Lymphadenopathy
D. Palpable purpura
E. Scaly plaques on the knees

97- the pathology of Which of the following is characterized by sweat gland necrosis ?
A. lichen striatus
B. miliaria rubra
C. miliaria crystallina
D. fox – Fordyce disease
E. coma bullae board vitals

98- A 36- Y – old female presents with dermatofibroma of her lower leg. Which of
the following immunohistochemical stains is most likely to be positive ?
A. Mucin stain
B. CD34
C. Factor XIIIa
D. S - 100
E. Ber EP4

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 Ex 15 2

99- What is the main purpose of a half- buried horizontal mattress stitch?
A. Hemostasis
B. Wound edge eversion
C. Decreasing the possibility of track marks
D. Eliminating dead space
E. Securing the tip of a triangle shaped flap
Tip stitch: best stitch for flap and M-plasty tips; is a half-buried horizontal mattress
suture

100- A 29 – y – old female known to have DLE, returns to your clinic after failing to
improve on topical and systemis corticosteroid, as well as a 6 month course of
hydroxychloroquine. Which of the following is the next best step in treating this
patient ?
A. Discontinuing hydroxychloroquine and initiating treatment with azathioprine
B. Continuing treatment with hydroxychloroquine While simultaneously initiating
quinacrine
C. Discontinuing hydroxychloroquine and initiating treatment with dapsone
D. Discontinuing hydroxychloroquine and initiating treatment with systemis retinoids
E. Continuing treatment with hydroxychloroquine While simultaneously initiating
thalidomide

101- Systemis – onset juvenile idiopathic arthritis, or still’ disease, is categorized as

an autoinflammatory disease driven by the abnormal production of cytokine IL-1.
Which of the following medication would have the greatest effect on controlling this
disease?
A. Etanercept
B. Rituximab
C. Infliximab
D. Anakinra
E. Adalimumab
Remember important to monitor absolute neutrophil count as neutropenia can
occur
IL-1 inhibitors • Canakinumab, Anakinra, Rilonacept, and Gevokizumab

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 Ex 15 2

102- A patient presents for the first time with a distinctly annular scaly rash on the
back and lateral aspects of arms. She has a positive ANA but dsDNA was negative .
Which of the following lab exams would most likely confirm your dg ?
A. Autoantibodies to ss DNA
B. Autoantibodies to Mi-2
C. Autoantibodies to Ro
D. Autoantibodies to La
E. None of the above exams would be expected to be +

103- Which of the following hair disorder is incorrect?

A. Moniltrex : KRT81 and KRT86
B. TRICHORRHEXIS INVAGINATA : SPINKS 5
C. Pili torti : plaloglobin wooly hair with plakoglobin
D. Wooly hair : desmoplakin
E. None . all of the above are correct

104- One of the following is non– stratified squamous epithelium cyst:

a. Epidermoid cyst
b. Hidrocystoma table 110.1 Bolognia
c. Villous hair cyst
d. Steatocystoma
e. Dermoid cyst

105- Phenolic glycolipid-1 is important in identification of:

A. Mycobacterium Kanasasi.
B. Dermatophytes.
C. Moulds.
D. Mycobacterium Leprae.
E. Box virus. Micro

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 Ex 15 2

106- What is the most common location for a spindle cell lipoma?
A. Leg.
B. Face.
C. Buttock.
D. Groin.
E. Neck. Board vitals

107-1st line treatment are surgery and systemic therapy is treatment of choice when
metastatic site (TNM) of melanoma is in:
A. Brain metastasis.
B. Gastrointestinal metastasis.
C. Skin soft tissue metastasis.
D. Disseminated metastasis.
E. Lung metastasis, single and multiple lesions.

108- The SUBCUTIS:

A. Is absent in eyelids and female genitalia
B. The thickness of the layer is independent of race
C. Up to the 14th week is made of mesenchymal lipobalsts ????? need search
D. Matures into lipolytes by the 20th week
E. Some of the primitive cells mature into macrophage

16–18 weeks: initial fat formation in subcutis. Alikhan

109- Poxviruses replicate in the:

A. Host cell cytoplasm ( the only intracytoplasmic )
B. Host cell nucleus.
C. Host cell mitochondria.
D. Outside the host cell.
E. Inside and outside the host

The family Poxviridae are large, brick- or ovoid-shaped, double-stranded DNA

viruses that are characterized by cytoplasmic replication. Diseases caused by
poxviruses include smallpox, vaccinia, cowpox, monkeypox, tanapox, orf, milker’s
nodules and molluscum contagiosum

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 Ex 15 2

110- Which of these dermatophytes causes Tinea capitis without hair loss?

A. Trichphyton violacium. Black dot

B. Microsporum lanosum.
C. Epidermophyton floccusum. Don’t cause tinea capitis
D. Trichophyton gypsum. ectothrix
E. Trichophyton rubrum. black dot

C ?????? it is wrong because it can't cause tinea capitis

Microsporum Lanosum is not present in Bolognia but by search it can cause tinea
capitis ( I don’t know whether it is associated with hair loss or not ) but I found a
book talking about it and it can cause hair to be broken off close to the base.
Epidermophyton floccosum don’t cause tinea capitis according to Bolognia

The causative pathogens are members of only two genera: Trichophyton and
Microsporum. T. tonsurans is currently the most common cause of tinea capitis in the
US (accounting for ≥90% of cases), with a predilection for individuals of African
descent15, and M. canis is the second most frequent etiology.

111- Regarding telogen:

A. Telogen hairs are radiosensitive.
B. Telogen duration is relatively fixed for a particular body site.
C. The percentage of hairs in telogen is independent of body site.
D. In general, body hair has a lower percentage of hairs in telogen than scalp hair.
E. A and B

112- Which of the following is the most potent anaphylatoxin?

A. C 1
B. C 3a
C. C 3b
D. C 5 a
E. C 5b

113- Imiquimod inceases production of Which cytokine ?

A. IL - 1
B. IL -3
C. IL -5
D. TGF - beta
E. IFN –alpha

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 Ex 15 2

Imiquimod
• Mechanism of action
Stimulates IFN-α ➔ ↓TGF-β (note: ↑TGF-β levels are a/w keloid formation)
IFN-α ➔ ↑collagen breakdown
• Clinical activity
Prevention of keloid recurrence after excision ; Results of studies have been mixed
• Cream is applied nightly for 8 weeks

114- The pathogenesis of bullae formation in impetigo is best described as:

A. Systemic circulation of an exfoliating toxin that targets desmoglein 1
B. Local production of an exfoliating toxin that targets desmoglein 1
C. Auto-immune attack of desmoglein 1 by circulating antibodies
D. Auto-immune attack of desmoglein 3 by circulating antibodies
E. Inherited mutations in intercellar adhesion proteins

115- Neonatal desquamation normally begins how long following birth:

A. Immediately after birth

B. 0 – 12 hours
C. 12 - 24 hours
D. 24 - 36 hours
E. 3 weeks after birth

116- The addition of an H2 antagonist to an H1 for the management of chronic urticaria might :
A. Help itch but not wheal numbers or severity
B. Reduce wheal numbers and severity but not itch
C. Stabilize mast cells
D. Discourage the development of tolerance to the antagonist
E. Lead to better absorption of the H1 antagonist
H2 antihistamines have no effect on histamine-induced pruritus and should not be
used as monotherapy

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 Ex 15 2

117- The drug Which needs sensory nerve action potential(SNAP) amplitude
measurement every 6 months or as indicated is:
A. Dapsone
B. Mycophenolate mofetil
C. Thalidomide
D. Hydroxyurea
E. Tacrolimas

118- What is a collodian preparation ?

A. Semi- solid
B. Oil – in - water
C. Water- in - Oil
D. Hydroalcoholic liquid
E. Cellulose nitrate in organic solvent

119- A full thickness skin graft is placed on a patient’s ear to repair a skin defect. The
patient calls the clinic the next day complaining of discoloration of the graft. Upon
examination, you find the graft to have a dusky blue color without fluctuance. What is
your next step?

A. Tell the patient a hematoma has likely formed and should be decompressed
immediately.
B. Ask the patient if he is smoking cigarettes.
C. Culture the exudates.
D. Reassure patient that this is a normal stage in a graft “taking”, due to vascular
injury tissue from handling
E. Recheck graft in 6 days

120- Which of the following suture techniques is most useful for high tension wound
apposition?
A. Vertical Mattress.
B. Horizontal mattress.
C. Far-far near-near vertical mattress.
D. Near-near far-far horizontal mattress.
E. Far-near near-far vertical mattress board vitals

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