AL-Bashir Hospital

Dermatology Department

3rd and 4th year residency examinations December 2012.

One answer is required for each questions.

1. Using Oral prednisolone in alternate day dosing will reduce the following side
effects EXCEPT:
A. Hyperglycemia.
B. Osteoporosis.
C. Hypertension.
D. Cutaneous atrophy.
E. Hyperlipidemia.

2. Which of the following types of melanoma arise from dermal melanocytes:

A. Superficial spreading melanoma.
B. Spitz-nevus (Juvienile melanoma).
C. Mucosal melanoma.
D. Melanoma in giant hairy nevu s.
E. Melanoma in nail matrix.

3. The worst prognostic factor in Steven Johnson syndrome is:

A. Low PVC.
B. Low neutrophils.
C. Increased WBC.
D. High ESR.
E. Microalbominemia.

4. Nephrotoxicity and genital ulcers are known as side effects of one of these :
A. Valacyclovir.
B. Gancyclovir.
C. Famcilovir.
D. Foscarnet.
E. Acyclovir.
5. One of the followings is not correct about congental syphilis:
A. Interstitial keratitis is diagnosed by dark field examination of smear from
cornea.
B. The nasal dis change is infectious.
C. Negative cord blood serology doesn’t exclude diagnosis.
D. Cardiovascular involvement is uncommon.
E. Interstitial keratitis occurred in late stage.

6. The main Ultra-structural localization of immunoglobulin deposition in LE is:

A. Within the basal cells.
B. Between basal cells and basal lamina.
C. Between basal lamina and dermis.
D. Within the epidermis
E. Within the basal lamina.

7. Acquired cold urticoria is characterized by all of the following EXCEPT:

A. Presence of itchy weal.
B. Flare up of lesions after cold exposure.
C. Absence of angio-odema.
D. Lesions typically confined to cold exposed skin areas.
E. The lesions usually disappear within 30-60 minutes to several hours if cold
is removed.

8. One of the following is not correct regarding mycophenolate mophetil

(Cellcept):
A. Mycophenolic acid is reactivated by B-GIU- curonidase in the epidermis
B. Selectively inhibit the enzyme inosine monophosphate dehydrogenase.
C. The most common side effect is GI symptoms.
D. It is indicated for both pemphigus vulgaris and psoriasis.
E. Both cyclosporine and tacrolimas are increasing mycophenolic acid level.

9. Complete blood count is NOT required for follow-up monitoring during the first
2 weeks of treatment with:
A. Azathioprine.
B. Cyclophosphamide.
C. Mycophenolate mofetil.
D. Cyclosporine.
E. Methotrexate.
10. Which of the following lasers has the greatest depth of penetration:
A. Pulsed dye (585 nm).
B. Diode (800 nm).
C. Nd: YAG (1064 nm).
D. Erbium: YAG (2940 nm).
E. CO2 (1060 nm).

11. Botulinum toxin type A cleaves with protein in the presynaptic neuron?
A. Acetylcholine.
B. Snap-25.
C. Serotonin.
D. Synaptobrevin (VAMP)
E. Syntaxin.

12. The first drug of choice for neurosyphilis is:

A. Third generation cephalosporine.
B. Procaine penicillin.
C. Crystalline penicillin.
D. Benzathine penicillin.
E. Azithromycin.

13. One of the following is FALSE about herpes gestatioun is:

A. Onset during second trimester.
B. Severe oral involvement.
C. Starts around umbilicus.
D. The antigen is bullous pemphigoid antigen 2 (Bp Ag2).
E. Eosinophilic subepidermal blister.

14. Lidocain toxicity can manifest by all of the followings EXCEPT:

A. Ototoxicity.
B. Nystagmus.
C. Seizure.
D. Slurvred speech.
E. Perioral numbness.

15. A child with multiple cup-shaped crust on scalp, KOH showed air spaces within
hair shaft , the most likely cause is:
A. Microsporum canis.
 B. M. audouini.
C. Trichophyton violaceum.
D. T. schoenleinii.
E. T. tonsorans.

16. Most common site of involvement in cicatricial pemphigoid is:

A. Nasal mucosa.
B. Oral mucosa.
C. Conjunctiva.
D. Genitalia.
E. Body folds.

17. Hemorrhagic cystitis is potential side effect of:

A. Dapsone.
B. Cycophosphamide.
C. Azathioprine.
D. Hydroxyurea.
E. Colchicines.

18. Mutation in P53 gene has been associated with:

A. Sqaumous cell carcinoma.
B. Basal cell carcinoma.
C. Seborrheic keratosis.
D. Melanoma.
E. Syringoma.

19. Granular parakeratosis is seen mostly in:

A. Genitalia of adult male.
B. Scalp of infant.
C. Axilla of adult female.
D. Leg of adult female.
E. Chest of adult male.
20. Cutaneous manifestations of antiphospholipid antibody syndrome include the
followings EXCEP:
A. Livedo reticularis.
B. Ulcers.
C. Purpura.
D. Calcinosis.
 E. Necrosis.
21. One if the followings is not correct about dyskeratosis congenital:
A. Brittle, sparse hair.
B. Nail dystrophy.
C. Oral leukoplakia.
D. Reticulated hyperpigmentation.
E. Fanconi type pancytopenia.

22. One of the followings is not correct about congenital melanocytic nevus:
A. It is melanocytic nevi present at birth.
B. They may or may not have associated with hypertrichosis, and perifollicular
hypo or hyperpigmentation may be seen.
C. Satellite congenital melanocytic nevi often accompany of giant congenital
melanocytic nevi.
D. All sizes of this nevus may be associated with melanoma.
E. Neurocutaneous melanosis associated with small congenital melanocytic
nevi.

23. One of the followings is not correct about scleromyxedema:

A. Absence of monoclonal gammopathy.
B. Absence of thyroid disorder.k
C. Mucin deposition.
D. Generalized popular eruption.
E. Sclerodermoid feature.

24. One of the followings cytokines is not elevated in langerhan cell histocytosis:
A. TNF-.
B. Interferon-.
C. Granulocyte- monocyte colony-stimulating factor (GM-CSF).
D. IL-LO.
E. TNF.

25. One of the following types of B.C.C has high recurrence rate:
A. Micronodular BCC.
B. Fibroepithelioma of pinkus.
C. Nodular BCC.
D. Superficial BCC.
 E. Morpheaform BCC.
26. The followings are predisposing clinical setting for development of S.C.C
EXCEPT:
A. Chronic non-healing wounds.
B. Long standing D.L.E.
C. Eurosive lichen planus.
D. Psoriasis.
E. Linear porokeratosis.

27. One of the followings is cutaneous manifistations of hepatitis C:

A. Livedo reticularis.
B. Small vessel vasculatis.
C. Urticarea.
D. Gianotti-crosti syndrome.
E. Erythema nodosum.

28. The most common cutaneous manifistations of mastocytosis in adults is:

A. Diffuse cutaneous mastocytosis.
B. Mastocytoma.
C. Urticarea pigmentosa.
D. Red, tan macules.
E. Telangioectasia macularis eruptiva perstans.
29. The most frequent neoplasma seen in association with seborrheic keratosis is:
A. S.C.C.
B. B.C.C.
C. Cutaneous melanoma.
D. Keratoacanthoma.
E. S.C.C in situ.

30. The following are specific HIV-associated disorders when CD4⁺ < 500 cells /mm³
EXCEPT:
A. Oropharyngeal condidiasis.
B. Herpes zoster.
C. Seborrheic dermatitis.
D. Eruptive atypical melanocytic nevi and melanoma.
E. Kaposi’s sarcoma.
31. A young male patient On methotrexate therapy, how long you should stop
methotrexate in order to have acheave good conception.
A. 1 year.
B. 3 months.
C. 6 months.
D. 6 weeks.
E. 9 months.

32. Which of the following is not an effect of cyclosporine therapy?

A. Inhibition of microphage inhibition migration.
B. Decrease synthesis and release of IL-1 by Mycrophage.
C. Decrease synthesis and release of IL-2.
D. Inhibition of interferon production
E. Inhibition of suppresor T cells.

33. The best suppressive regiemen for genital herpes by using famciclovir is :
A. 125 mg 2 times daily for 3 months.
B. 250 mg single daily dose for 6 months.
C. 250 mg 2 times daily for 6 months.
D. 250 mg single daily dose for one year.
E. 125 mg single daily dose for one year.

34. Anatomical sites which are contraindicated to be injected by mesotherapy

products include the followings EXCEPT:
A. Anterior neck and mandibular border.
B. Breast.
C. Arrmpits.
D. Perineum.
E. Plams and soles.

35. The emitted wavelength range by diodelaser is:

A. 1064 nm.
B. 800-950 nm.
C. 600-1200 nm.
D. 694 nm.
E. 532 nm-1064 nm.
36. Which of the following drug or drugs should be used as first line treatment of
discoid lupus with regards to its saftly profile?
A. Chloroquine.
B. Dapsone.
C. Hydrocychloroquine.
D. Acitretin.
E. Azathioprine.

37. Which of the following is not an immunological effect of systemic retenoids.

A. Decrease leukotriene production.
B. Decrease hydroxyeicos atetraenoic acid (HETE)
C. Inhibition orunithinede carboxylase enzyme.
D. Decrease immunoglobulines production from B-Cell.
E. Suppress the antibody dependent cellular cytotoxicity.

38. Female patient, diagnosed to have dissiminated gonoccal infection which is the
correct approach?
A. Hospitalization, I.V. fluids, crystline penicillin 2-8 millions I.V. every 4 hours.
B. Hospitalization, I.V. fluids , ceftriaxone I gm I.V. daily for 7 days.
C. 2 gm I.M. spectinomycin as out patient.
D. Hospitalization , I.V. fluids , I.V. ampicilline + cloxacilline 500 mg every 8 hrs
for 7 days.
E. Azathioprine oral 1 mg single dose.

39. Which of the following types of cutaneous lymphomas is considered an

aggressive type?
A. Folliculotropic M.F.
B. CD 30 + lymphoprolifative disorder
C. CD 8 + lymphoprolifative disorder
D. CD 4 + lymphoprolifative disorder.
E. Subcutaneous T-cell lymphoma.

40. Which of the following is not matched correctly about sensory nerve supply of
the face:
A. Right frontal skin-right supraorbital nerve.
B. Right lower lip – right mental nerve.
C. Tip of the nose – both infra orbital nerves.
D. Right side of upper lip- right infra orbital nerve.
 E. Glabella- supratrochlear nerve.

41. Achid with dowrfism, pigmentary degeneration of the retain, deafness and
photosensitive dermatitis most likely has:
A. Cockayne’s syndrome.
B. Bloom’s syndrome.
C. Rothmund- Thompson syndrome.
D. Erythropoietic porphyria.
E. Xeroderma pigmentosum.

42. The swiss cheese appearance seen in biopsy of paraffinomas represents:

A. An allergic reaction.
B. Spaces occupied by oily substances.
C. Numerous macrophages in the dermis.
D. Multiple foci of collagen necrosis.
E. Focal collections of fungel spores.

43. Lesions of bromoderma are most likely showed:

A. PAS positive bromide deposits.
B. Intraepidermal abscesses.
C. Follicular plugging.
D. Leukocytoclastic vasculitis.
E. Lobular panniculitis.

44. A12- year old patient has multiple erythematous to fleash-colored papules of
nails is most likely to show:
A. Nail bed hyperkeratosis.
B. Onycholysis.
C. Periungual fibromas.
D. Thin, nothched nail plates.
E. Triangular lunules.

45. Ehlers- Danlos syndrome type VII characterized by deficiency of which enyme?
A. Lysyl oxidase.
B. Lysyl hydroxylase.
C. Proline decarboxylase.
D. Procollagen peptide.
E. Hydroxyproline reductase.
46. The origin of the repigmentation of melanin in PUVA- treated vitiliginous skin
is:
A. The hair matrix .
B. Huxley’s layer.
C. Henle’s layer.
D. The outer root sheath.
E. The infundibulum.

47. Which of the following metals is most likely to accumulate in the membrance
propria of the ecrine sweat gland:
A. Arseni.
B. Bismuth.
C. Gold.
D. Mercury.
E. Silver.

48. Histologically , pseudolymphoma is most likely to be confused with which of

the following?
A. Cutaneus larva migrans.
B. Dracunculosis.
C. Leishmaniasis.
D. Scabies.
E. Scrofuloderma.

49. The syndrome which presents paronychia, nail dystrophy and erythematous
plaques in the nasal bridge and ears is:
A. Bazex.
B. Sweat’s.
C. Crokhite-conada.
D. Carcinoid.
E. Necrolytic migratory erythema.

50. The following changes in the C.S.F are indicator for activity of neurosymphilis:
A. Low cell count.
B. High total protein.
C. High titre of V.D.R.L test.
D. Reduced level of sugar.
E. Raised level of chloride.