16-DISEASES OF THE SKIN

1.
The following statements about the skin are true
a The surface area of an adult is approximately 2 M2
b The weight of an adult's skin is approximately 4 kg
c Keratinocytes comprise one-third of epidermal cell numbers
d Langerhans cells synthesise vitamin D in the epidermis
e Sweat is produced by eccrine glands

2.
In the terminology of skin lesions
a papules are solid skin elevations > 20 mm in diameter
b nodules are solid skin masses > 5 mm in diameter
c vesicles are fluid-containing skin elevations > 5 mm in diameter
d petechiae are pinhead-sized macules of blood within the skin
e macules are small raised areas of skin of altered colour

3.
Properties of vehicles for topical skin treatments include
a creams composed of grease to moisturise dry skin
b ointments composed of water, grease and an emulsifier
c pastes composed of grease and an alcohol
d shake lotions composed of water and powder to aid skin cooling
e lotions composed of water or alcohol for use in hairy areas

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4.
Effects of topical corticosterold therapy
include
a dermal atrophy most marked in the face and body folds
b striae in the body folds particularly
c absence of hypothalamo-pituitary-ad renal axis suppression
d decreased hair growth particularly of the beard
e spread of skin infection

5.
Characteristic features of eczema include
a epidermal oedema and intra-epidermal vesicles
b delayed hypersensitivity reaction in seborrhoeic eczema
c increased serum IgA concentration in discoid (nummular) eczema
d eyelid and scrotal oedema in allergic contact eczema
e persistence of childhood atopic eczema into adulthood

6.
Typical sensitising agents in contact eczema include
a aluminiurn
b colophony
c lanolin
d rubber
e ethanol

7.
Typical features of psoriasis include
a well-defined erythematous plaques with adherent silvery scales
b epidermal thickening and nucleated horny layer cells (parakeratosis)
c induction of plaques by local trauma
d an association with HLA CW6
e exacerbation by propranolol and lithium carbonate therapy

8.
The characteristic clinical features of psoriasis include
a sparing of the skin over the head, face and neck
b guttate psoriasis predominantly affecting the elderly
c nail changes with pitting and onycholysis
d oligoarthritis particularly associated with nail changes occurring in 5%
e red non-scaly skin areas in the natal cleft and submammary folds

9.
Appropriate therapeutic schedules in psoriasis include
adithranol cream for facial, genital and flexural plaques
b steroid-antifungal combinations for flexural plaques
c tar-steroid combinations during withdrawal of steroid creams
d short wave UVA exposure from sunbeds
e combined psoralen-UVA photochemotherapy and isotretinoin

10.
The typical features of acne vulgaris
include
a involvement of pilosebaceous glands and their ducts
b distribution over the face and upper torso
c infection with the skin commensal Propronobacteriurn acnes
d increased sebum production containing excess free fatty acids
e open and closed comedones, inflammatory papules, nodules and cysts

11.
Recognised agents inducing acnelform
eruptions include
a chlorinated hydrocarbons
b corticosteroid therapy
c androgenic or oestrogenic steroid therapy
d lithium carbonate therapy
e anticonvulsants

12.
Therapies of proven value in acne
vulgaris include
a oral tetracycline or erythromycin drug therapy
b topical preparations of benzoyl peroxide and retinoic acid
c oral contraceptive pill
d cyproterone acetate
e oral isotretinoin

13.
The characteristic features of rosacea
include
a predominantly affects adolescents
b increased secretion of sebum with comedones
c facial erythema, telangiectasia, pustules and papules
d rhinophyma, conjunctivitis and keratitis
e non-responsive to oral tetracycline therapy

14.
The typical features of lichen planus
include
a involvement of the skin, nails, hair and mucous membranes
b dense subepidermal lymphocytic infiltration on histology
c itchy, purplish, polygonal, shiny skin papules
d hypopigmentation at sites of previous lesions
e complete resolution following topical steroid therapy
 15.
Characteristic features in
Henoch-Schenolein vasculitis include
a palpable purpuric rash particularly over the buttocks
b lymphocytic infiltration of capillary endothelium
c leucocytoclastic vasculitis and endothelial IgA deposition
d polyarthritis and mononeuritis multiplex
e corticosteroid therapy is mandatory

16.
Systemic causes of pruritus include
a oral contraceptives and pregnancy
b hypothyroidism and hyperthyroidism
c lymphoproliferative and myeloproliferative diseases
d iron deficiency anaemia
e opiate and antidepressant drug therapy

17.
Skin diseases associated with marked
pruritus include
a cutaneous vascuftis
b lichen planus
c atopic eczema
d seborrhoeic keratosis
e dermatitis herpetiformis

18.
Skin diseases associated with blistering eruptions include
a erythema multiforme
b dermatitis herpetiformis
c pemphigoid
d pemphigus vulgaris
e guttate psoriasis

19.
Skin diseases associated with HIV infection include
a seborrhoeic dermatitis
b oral candidiasis
c hairy leukoplakia
d drug-induced eruptions
e Kaposi's sarcoma

20.
Skin diseases associated with photosensitivity include
a variegate and hepatic porphyrias
b atopic eczema
c drug reactions to phenothiazine, thiazide and tetracycline
d pyoderma gangrenosum
e pityriasis rosea

21.
The typical features of erythema
multiforme include
a target-like skin lesions of the hands and f eet
b skin eruption lasting 6-12 weeks
c absence of vesiculation or blistering
d involvement of the eyes, genitalia and mouth
e association with underlying systemic malignancy

22.
Recognised causes of erythema
mullfitorme include
a herpes simplex infection
b mycoplasmal pneumonia
c sulphonamide therapy
d systemic lupus erythernatosus
e pregnancy

23.
The typical features of erythema
nodosurn include
a red hot tender nodules over the shins
b lesions disappear over 1-2 weeks
c fever, malaise and polyarthralgia
d oral and genital mucosal ulceration
e predominantly affects the elderly

24.
Recognised causes of erythema
nodosum include
a sarcoidosis
b beta-haemolytic streptococcal infection
c inflammatory bowel disease
d tuberculosis
e contraceptive drug therapy
25.
Cutaneous manifestations of systemic
malignancy include
a generalised pruritus
b acanthosis nigricans
c late-onset dermatomyositis
d generalised hyperpigmentation
e seborrhoeic eczema

26.
Typical features of melanocytic naevi
include
a usually present from birth
b development after the age of 40 years
c junctional naevi are smooth, papillomatous, hairy nodules
d intradermal naevi are circular, brown macules < 10 mm in
diameter
e 30% lifetime risk of malignant transformation

27.
Typical features of malignant melanoma
include
a changing appearance of a preceding melanocytic naevus
b diameter of the lesion > 5 mm
c irregular colour, border and elevation
d personal or family history of melanoma
e painless, expanding, subungual area of pigmentation

28.
The typical features of seborrhoeic
keratosis include
a appearance before the age of 30 years
b discrete irregular lesions in light-exposed skin areas
c yellow-brown, pedunculated lesions on the trunk or face
d lesions exhibit greasy scaling and tiny keratin plugs
e eventual transition to squamous cell carcinoma

29.
The typical features of basal cell
carcinoma include
a predominantly affects the elderly
b metastatic spread to the lungs if untreated
c occurrence in areas exposed to light or Xirradiation
d papule with surface telangiectasia or ulcerated nodule
e unresponsive to radiotherapy

30.
The typical features of squarnous cell
carcinoma include
a occurrence in areas exposed to light or Xirradiation
b arise from malignant transformation of the Langerhans cells
c preceded by leukoplakia on the lips, mouth or genitalia
d metastatic spread to the liver and lungs
e unresponsive to radiotherapy

31.
In disorders of the nail
a koilonychia suggests B12 or folate deficiency
b onycholysis is associated with psoriasis
c leuconychia is a feature of severe liver disease
d splinter haemorrhages usually indicate the presence of
infective endocarditis