DERMATOLOGY

DERMATOLOGY FINAL EXAM RECALLS (A&B)

USTMED BATCH 2020

12. A 60-year-old obese female, itchy annular crust in her

DERMATOLOOGY FINALS SEC A MARCH 6, 2019 inguinals (tinea cruris). The KOH of the lesion will
show?
1. A 30-year-old with painful swelling. She is taking oral
antibiotics for 3 days. With little improvement with • Long septated
oral clindamycin. What is the best treatment?
13. Patient with recurrent vesicle on the vermillion (herpes
• Continue the oral antibiotic. Do incision and drainage
simplex). How long is the duration?
(furuncle daw yung nasa case)
• 1-2 weeks (untreated)
2. A 90-year-old sought consult because of cauliflower
growths off the scrotum (condyloma). The lesions 14. A 70-year-old with uncontrolled diabetes and chronic
are gradually increasing in size. What is the mode renal failure. Nagkaroon ng painful oral ulcers. More
of transmission? than 40% of the body surface area (so TEN ito). What
is the mortality rate?
• Intercourse (since nasa scrotum na)
• 90%
3. What is the risk factor for the spread of warts?

• Immersion in water
o When you immerse your warts in water, the skin
will absorb the water so the warts will spread
faster

4. A patient with SJS, TEN… measure the percentage of

what?
• Sloughed skin
o Makes the patient very uncomfortable. Also take
note of the percentages (20%, 10%...)
15. To differentiate allergy from irritant?
5. A 3-year-old developed honey colored crust… the spread
of lesions to other sites of impetigo is actually due • Allergic contact to cell-mediated…
to? o From the book: allergen comes into contact with
previous sensitized skin. It is caused by a
• Autoinoculation
specific acquired hypersensitivity of the delayed
type, also known as cell-mediated (Type IV)
6. In a patient with tinea versicolor, what laboratory
hypersensitivity
procedure will show spaghetti and meatball?
• KOH 16. Special features of chronic hydrated area?? (ang labo)
• Modified personal and family history
7. 18-year-old student showed erythematous, patchy
scrapping on the periphery of his left tongue. Three
17. A 15-year-old…sudden onset of tender vesicles (nasa ear
days later smaller lesions are seen following the
daw)
skin lines. It disappears after?
• Not sure of the question kasi ang hina ng boses ni doc,
• 3-8 weeks
pero baka may kinalaman sa Ramsay Hunt Syndrome
which results from the involvement of the facial and
8. 15-year-old complains with multiple coin-shaped blots on
auditory nerves.
the extremities. What is your diagnosis?
• Nummular 18. Differentiate impetigo contagiosum from ecthyma. Which
statement is true?
9. Seborrheic dermatitis is a proliferation of what on your
• In impetigo, the lesions are EROSIONS but in ecthyma the
KOH?
lesions are CRUSTED ULCERS, not erosions
• Pityrosporum Ovale
19. Cytokines play a major role in the pathophysiology of
10. A 40-year-old… upper extremities… (di ko maintindihan atopic dermatitis together with?
sorry)
• T cells

11. If you are suspecting of certain allergy, what will you do 20. Heat hives and psoriasis is due to the pruritic component
to observe this? of the?
• Patch test • Proximal nailfold
o Nail plate (nail pits – psoriatic lesions of the nail
plate)

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21. You plan to give methotrexate to your patient with 35. 20-year-old boy complains regarding … on his inguinals.
psoriasis. What laboratory should be incorporated? How will you confirm the diagnosis?
(Blood folic acid level, CBC & SGPT, CXR, ECG?) • KOH
• CBC and SGPT (do the ancillary and check the side
effects in the liver) 36. Differentiate tinea cruris from candidal intertrigo?
• Candida intertrigo present with satellite lesions while tinea
22. What does the pathology of atopic dermatitis involve? does not
• Barrier failure and progressive inflammation
37. 6-year-old boy… recurrent itchiness becomes ulcers
23. 45-year-old farmer with monthly history of scaling of the (ecthyma)… will yield scars… what complications?
interdigit. What is the topical treatment of choice? • Poststreptococcal infection -> Glomerular nephritis
• Miconazole
o Other choices, miconazole with antibiotic, 38. What lesions will progress to cervical carcinomas?
miconazole with steroids, miconazole with • Condyloma acuminata -warts
antibiotic and steroids (know when to use)
o Tinea pedis – only miconazole 39-42. Site of predilection
• Verruca vulgaris – fingers
24. 70-year-old boy with itchy, round, bald, scaly patch. KOH
shows long septated hyphae (dermatophyte – tinea • Nummular eczema – extensors of the upper and lower
capitis). What will you treat? extremities
• Seborrheic dermatitis – nasolabial
• Oral terbinafine
• Di ko maintindihan yung isa pero parang – shin? (pde
psoriasis)
25. 25-year-old with itchy papules and plaques over both
hands. Started when she worked as a dish washer.
43-46. Match with best treatment
• Irritant (not sure of the question)
• Folliculitis – topical
• Tinea corporis with fungal folliculitis – oral terbinafine
26. 60-year-old female, chronic renal failure with vesicles in
• SJS – systemic steroids
linear fashion (herpes zoster). How will you treat?
• Ophthalmic zoster – oral acyclovir
• Dose adjusted acyclovir according to creatinine clearance
o Adjust the dose if there’s renal problem 47-50.
• Colarette scale – Pityriasis rosea
27. Differentiate psoriasis from seborrheic dermatitis. Which
statement is true? • Silver white scales – Psoriasis
• (inaudible) – T. versicolor (sa book: hypo/hyperpigmented,
• Lesions of psoriasis extend beyond hairline while
coalescing scale
seborrhea does not
• Greasy scales – seborrhea/seborrheic dermatitis
28. Differentiate herpes zoster from herpes simplex.
51. Question about stasis dermatitis
• The lesions are recurrent in simplex but not in zoster.
• Answer: Erythematous/yellowish or light brown
o Recurrent vesicles – herpes simplex
pigmentation of the lower legs especially superior to the
medial malleolus
29. Hair easily break around what condition?
• Tinea capitis 52. 6 months pregnant, pitting edema at the lower
extremities, OB detects no other problem. What
30. Differentiate photoallergic from phototoxic? could be the possible underlying problem to this
• Phototoxic is sunburn type? patient?
• Congenital problem or weakness of the lower extremity
31. A 40-year-old…Close contact… Mode of transmission? vein AND Increase in the … vein pressure (stasis daw to)
• Skin to skin
53. 78-year-old obese consulted because of macerated right
32. Flat worms differ in their configuration because of its inframammary folds. What is your treatment of
tendency to? choice?
• Acutely arise?? (because they are seen in acute trauma • Intertrigo to so Dry and aerate
and minor scratches)
o Basta hindi: autoinoculate, autosensitize, or 54. A one-month old baby … scaling of the scalp… (scaling
follow skin line on erythematous base)
• Seborrheic
33. 20-year-old complains of… cauliflower and… (inaudible)
55. moist, red patches over the inframammary… which of the
34. How long will you treat your patients with tinea capitis? following PE will make you use of topical antifungal
• 2 weeks after clearance agent? (intertrigo daw to)
o Continue until 2 weeks after total clearance • Collarette scaling with few pustules – satellite – candida
intertrigo

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56. 58-year-old cook consulted because of painful red 70. 23-year-old, HIV, progressively dystrophic nail, over the
swollen nail folds… noticed blanching when applied proximal area… Which of the following is the best
with pressure on the distal… of the affected approach?
fingernails. What is the etiologic agent? • Something about sa proximal area because the other
• Staphylococcus – pyogenic paronychia daw to choices are about superficial and distal.

57. 40-year-old dishwasher, painful red swollen nailfolds, 71. A 2-year-old male was referred… fever, colds…(may
slight discharge from pressure. What is the best urticaria yung patient) Which of the following is the
treatment? possible etiology of the disease?
• Oral, Topical antifungal and Protect hands from wet • Ongoing infection
environment – because of the moisture (ALL OF THE
ABOVE) 72. 76-year-old… red patches on the upper lip? (about fixed
drug)
58. male with itchy scalp, painful, pustules… occiput…what • Irregular intake of fixed drug/intermittent take
is the best treatment? (folliculitis)
• Penicillinase-resistant penicillin 73. What is the prognosis of patient with fixed drug?
• The patient may probably continue to have recurrences
59. Furuncle… what is the next course of action? and additional lesions if the drug intake is continued
• Cephalosporin
74. Which of the following is consistent with lepromatous
60. Which is the following is considered … for incision and leprosy?
drainage? • Glove and stocking neuropathy – (lepromatous is glove-
• Upper lip (and nose if given) stock)

61. What is the treatment of choice for fluctuant tenderness 75. Which of the following… usage of contraceptives…
on the left thigh? (Furuncle daw to) • Isotretinoin (can’t be given in childbearing age due to
• Incision and Drainage – because it is fluctuant (but there teratogenicity)
should also be antibiotic)
76. 15-year-old complains of itchy scalp which points to the
62. Which if the following infection may indicate HIV? presence of active head lice… adherent to?
• Proximal (choose the uncommon) • 1 cm from the hair growth
o Active headlice – nearer the blood source
63. 47-year-old female, erythematous patches with silvery
scales (so psoriasis). Which of the following is 77. What is your diagnosis if you see multiple vesicles,
specifically related to psoriasis? papules, over the inguinal area, umbilical, wrist
• Salmon macule • Scabies (basta Circle of Hebra)

64. A 35-year-old dishwasher… which of the following is a 78. You see lice in the pubic area, what is the treatment of
clue that you are dealing with a yeast infection? choice?
• Absence of cuticle • Use asphyxiants

65. A 38-year-old, showed whitish colored brittle nails… 79. Which of the following encourages to investigate the
lifting of her fingernails on the right outer most sexual partners?
edge… after her manicurist removed her nail polish. • If you see crab louse
What is your diagnosis?
• Onychomycosis (caused by T. rubrum) 80. the patient has bluish macule over the lower abdomen.
What will you do to check the disease?
66. You ordered KOH… • Check the seams of clothes (to be checked)
• It affirms the dermatophyte infection is present
81. Which of the following… diagnosis of Hansen’s disease?
67. with chronic steroid intake… with generalized itchiness… (basta ang hinahanap Borderline tuberculoid – BT)
What is the expected finding? (with • Satellite lesions and pseudopods
family/household contact) o Other choice swiss cheese (Borderline – BB),
• Scabies saucer shaped (Tuberculoid – TT), classic
dysmorphic lesion (inverted saucer shape)
68. A 57-year-old, diabetic, onychomycosis of the toenail.
What is the best treatment? (with tinea pedis, 82. pustules over follicular areas of the axilla, what is the
diabetic pa siya) possible organism?
• Topical (something) with oral terbinafine • Staphylococcus aureus [MRSA] (if pustules, S.aureus))

69. BONUS

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83. LL (lepromatous form), pregnant, how does this affect the 95. Hallmark of urticaria?
disease? • Evanescence
• Continue multidrug 96. lepromatous leprosy, complained of easy fatigability,
pale, urticaric… These are adverse effect of?
84. Itchy papule and vesicles on the abdomen… how will you • Dapsone
convince the patient to treat?
• Treat the patient and everybody else because the disease 97. Which if the following… falsely positive? (Malabo yung
has an incubation period tanong)
• Biopsy
85. 45-year-old seaman, maculopapular nodules on the
scrotum, generalized itch, skin problem, (so with 98. 30-year-old with hives, what is the drug that is best?
scabies). The physician gave him medicine
• Antihistamine ONLY
(probably permethrin)…still with lesions… how will
you explain this?
99. Which of the following is the best option… for acne?...
• Hypersensitivity…infestation…steroids -> Still with lesions
• Spironolactone
after treating scabies because of the hypersensitivity ->
start steroids
100. Which of the following is FALSE regarding psoriatic
pains?
86. What should you do before initiating treatment for
Hansen’s disease? • It can be treated effectively with low strength corticosteroid
o Seborrheic can present like psoriasis
• Check for TB – because the dose of Rifampicin is very
o It can have concomitant onychomycosis
small in Hansen’s

87. 23-year-old female, pustules over the neck, diagnosis is DERMATOLOGY FINALS SEC B MAY 15, 2019
acne, what is the best reason for NOT having acne 1. 25-year-old with hyperpigmented plaque, exaggeration of
vulgaris as the diagnosis? skin lines with intractable pruritus
• Absence of comedones • Lichen simplex
o Comedones are present in acne, BUT absent in
Furuncle 2. Laundry women with papules and plaques on dorsum of
feet. Pruritus while wearing rubber slippers
88. 60-year-old, meningitis, high grade fever, … • Allergic contact dermatitis
erythematous papules, redness at the back of the
neck 3. Most common organ system affected by Hansen’s
• Obstruction of the sweat gland • Nervous

89. 15-year-old pricked on the pimple on the left cheek and 4. Slow progressive loss of hair on outer third of eyebrows
became swollen…lymphadenopathy, fever. What is sa Hansen’s
the diagnosis?
• Madarosis
• Cellulitis (bacterial infection)
5. Reddish patch on right forearm, occur at same site
90. 69-year-old diabetic with swollen right foot and lower leg whenever taking celecoxib
of 2 days duration… What is the cause of her
• Fixed drug eruptions
present lesion?
• Drying and scaling of toes? (tinea pedis) 6. Well defined erythematous warm swollen tender plaque 2
o Cellulitis of diabetes patient days duration most common etiology
• GABHS most common etiology kasi erysipelas
91. 20-year-old athlete, edematous, papule, palpable,
circumscribed, painful, advancing border, what is
7. Type of onychomycosis sa tip ng nail
the treatment of choice?
• Distal subungual
• Oral amoxicillin
8. Most probable reason why person with lichen simplex
92. symmetrically on the inguinal area, painful ulcers… What
scratches lesion
is your diagnosis?
• Becomes habit
• HSV-related
9. Yellow areas of subungual hyperkeratosis seen in
93. lesion with punctum, saan hindi nagbibite yung insects?
psoriasis
• genitals
• Oil spots
94. 5-year-old boy, red palpable plaques? What is the drug of
10. 35-year-old male with erythematous with dusky patch,
choice to manage?
accompanied with oral ulcers
• Antihistamine and corticosteroids
• EM minor

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11. Type of urticaria after stroked 26. Etiology of nocturnal pruritus with papules in circle of
• Dermatographism Hebra
12. How long before diagnosing urticaria as chronic • Mites kasi scabies
• 6 weeks
27. Most common cause if EM minor (erythema multiforme)
13. Type of urticaria induced by increasing core body • Herpes
temperature either by exercise or warm bath?
• Cholinergic 28. DOC for treating chronic plaques with lichenification and
excoriations
14. Cell mediated na Hansen’s • High potency steroids
• Low-paucibacillary
29. How to manage fixed drug eruptions
15. Erythematous papules with central punctum sa arm, • Discontinue the drug
grouped into series of linear yata
• Bed bugs so insecticides sa cracks ng beds 30. Best management with elderly diabetic, htn, with
erysipelas and cellulitis with chills, fever, inguinal
16. 11-year-old suddenly developed erythematous pruritic lymphadenopathy
papules on the back, antecubital and popliteal areas • IV antibiotics
after playing basketball for two hours
• Miliaria 31. Why is treatment duration shorter for finger
onychomycosis than toenail onychomycosis?
17. 24-year-old band player presented with few erythematous • Fingernails grow faster than toenails
tender nodules with central suppuration,
accompanied by tender inguinal lymphadenopathy 32. 15-year-old female, pruritic evanescent lesions for the
• Cephalosporins best treatment kasi furuncles past 2 months
• Urticaria kaya mainstain of treatment is antihistamine
18. Tender nodules with 5 confluent heads
• Carbuncles 33. Prominent hairs in arms and legs with erythematous
pustules with comedones
19. 16-years-old presented with erythematous pustules and • Hyperandrogenism kasi PCOS
papules with comedone
• Acne, so skin appendage involved is sebaceous glands 34. Best treatment for multiple papules, pustules, nodules
with comedones
20. Comedones are formed by impaction of keratinous plugs • Oral retinoids basta may nodules ang acne
which part of hair follicles does it affect
• Infundibulum 35. Kindergarten brought to clinic because of pruritic
papules at the back, lesions gradually disappears
21. Farmer presented with few erythematous plaques with with coldness. What is affected?
well defined inner border with outer ill defined with • Miliaria diagnosis so affected is Eccrine gland
pseudopods and hyposthesia
• Borderline borderline (BB), most unstable kasi kaya 36. Ill-defined erythematous swollen patch
nagkakaroon ng pseudopods • Cellulitis

22. Presented with saucer right side up well-defined 37. Well-defined erythematous swollen warm tender swollen
erythematous plaques with hyposthesia patch. What layer is affected?
• Tuberculous dapat pero iba sagot nila. Correction daw to • Dermal lymphatics kasi erysipelas, subcutaneous yung
cellulitis
23. 24-year-old presented with macules distributed
symmetrically with gradually progressive loss of 38. Patients with onychomycosis, what should be monitored
hair in eyebrows, stocking glove neuropathy prior to giving systemic antifungals
spectrum? • Liver function test
• Lepromatous but iba sagot nila. So correction ulit to
39. Which among the ff oral antifungals is given with pulse
24. Best diagnostic test to classify Hansen’s dosing
• Skin biopsy • Itraconazole

25. 24-year-old farmer confirmed to be infected with 40. What’s the most common complication of untreated
M.leprae, What work-up? erysipelas na GABHS
• CBC, Chest X-ray, and liver profile • Acute glomerulonephritis
o Dapsone kasi anemia, X-ray kasi baka may
concomitant PTB, Liver kasi hepatic excretion
mga drugs
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41. First clinical manifestation seen in 90% of Hansen’s 55. What division of 5th CN is involved
• Numbness • Ophthalmic

42. Earliest sensory loss in Hansen’s 56. Multiple grouped vesicles sa right left chest, right forearn,
• Temperature right leg accompanying pain over the lesion. What
is the diagnosis?
43. Borderline lepromatous developed subcutaneous • Disseminated zoster kasi more than 20 vesicles outside
nodules accompanied by fever, myalgia, anorexia. dermatomal area
Did not appear from previous lesion. What
recreational state. 57. IV acyclovir about to be administered. History of poorly
• Lucio’s phenomenon controlled DM. monitor?
• Kidney
44. Which is antifolate
• Methotrexate, mali yung key pero YES tama yung 58. Vesicles noted in perinasal and axillary region with honey
methotrexate. Correction ulit colored crust
• Impetigo
45. What is recommended protocol for treatment of
multibacillary Hansen’s 59. Suspected carrier of staph among family members.
• Dapsone, Rifampicin, Clofamizine for 12 months Treatment?
• Mupirocin once a day for 5 days inside nostrils
46. Family presented with erythematous papules with
excoriations in axilla, periumbilical, interwebs with 60. 5 days prior, grouped hemorrhagic vesicles overlying
pruritus. Treatment? erythematous base over right gluteal areas.
• Permethrin Multinucleated giant cells.
• Herpes simplex kasi di raw painful
47. Family presented with erythematous papules with central
punctum sa scalp with___ firmly attached. 61. Mother of patient complained of grouped vesicles sa
Treatment? ankle of daughter. Accompanied by tingling
• Permethrin kasi pediculosis. Seborrheic dermatitis, di sensation. Tzank: multinucleated giant cells. Recur
attached firmly thrice a year. What will you give?
• Acyclovir
48. Most common mode of transmission of Hansen’s
• Aerosol 62. Eldest sister complaining of multiple nits on exam.
Multiple follicular pustules with yellow crust on
49. Teenager presented with open and closed comedones in scalp and postauricular lymphadenopathy.
forehead and cheeks, topical retinoids. How long for Diagnosis?
efficacy? • Bacterial folliculitis
• 6-8 weeks
63. Sister’s lesions with saucer shaped ulcers. Diagnosis?
50. Juice vendor with chronic proximal nail fold swelling, • Ecthyma
with onychodystrophy
• Candida onychomycosis so DOC is itraconazole 64. Frequently bites nails. Swelling edema tenderness with
pus sa periungual region of right index finger
51. 78-year-old cook complained of skin eruptions for past 3 • Paronychia
days. Generalized papules, bullae, erythematous
papules in trunk and extremities. Ulcers of mucosa 65. Best setup to manage TEN
and penile • Burn unit
• SJS
66. Following condition is indication to prescribe mupirocin?
52. 3-year-old with 4 days duration of flaccid bullae • Pyogenic paronychia yata?
• Bullous impetigo
67. Yellowish scaly patches sa eyelids
53. 75-year-old nun with multiple minute vesicles. Show • Seborrheic dermatitis
multinucleated giant cells. Which will not show?
• Bullous impetigo, other choices mga herpes family 68. Etiology of recurrent condition of greasy scales sa
sternal area
54. Geriatric patient presented with acute vesicular eruptions • Malassezia. Sometimes pwede coexist with seborrheic
underlying a bed of erythema, sa side ng nose, and dermatitis
painful
• Hutchinson’s sign

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69. Eczematous lesions on face and flexural. Upon further 84. Mother informs you that she applied ketoconazole yung
exam, notice several hyperpigmented round oozing may hanging curtain yata ito. Why did it not
plaques. Persistent for 2 weeks improve?
• Nummular eczema • HHV yung etiology

70. Complained of sudden onset of sudden itching and 85. Undergoing phototherapy and methotrexate. Diagnosis?
burning sensation on erythematous and edematous • Psoriasis
patch, vesicles over cheek area after applying
cologne while sunbathing 86. Which exhibits Koebner
• Photoallergic dermatitis • Psoriasis. What else? Nummular and verruca plana

71. Past medical history: 3-month-old of eczematous scaly 87. Patient complains of joint pains with accompanying scaly
patches sa cheeks, extensors, accompanied by lesions extending hairline
itching. IgE mast cells, etc. Diagnosis?
• Psoriasis
• Atopic dermatitis
88. Which is best managed by griseofulvin
72. Pathogen that colonizes 90% lesions with chronic
• Tinea corporis
eczematous lesions with accompanying dennie
morgan folds and hyperlinear palms
89. KOH of skin scraping with long septated hyphae
• Staphylococcus aureus
• Tinea corporis
73. Patient’s mother recalls daughter has dome shaped
90. Culture shows growth of microsporum
umbilicated skin colored papules. Diagnosis?
• Tinea corporis
• Molluscum
91. Kerion associated with
74. Topical steroids mainstay tx for?
• Tinea corporis
• Atopic dermatitis
92. Lesions to be following the bands of rubber slippers
75. Normal saline compresses and aeration provides
resolution to? • Allergic contact dermatitis
• Intertrigo
93. Due ti itchiness, rubs lemon extracts. Causes stingin
sensations. What is the cause?
76. Past medical revealed macerated lesions over inguinal,
intergluteal, inframammary regions. Revealed that • Irritant contact dermatitis
applied vinegar over skin, immediate vesicular
eruptions. Likely developed? 94. Requires prior sensitization
• Irritant contact dermatitis • Allergic contact dermatitis

77. Further exam, erythematous eczematous patch on both 95. 3 years ago, patient has been bleaching her hair. After
ankles, tortous veins dying her hair, complained of scalp itchiness
• Stasis dermatitis • Allergic contact dermatitis

78. Which is genetically inherited 96. Which shows fillagrin mutation

• Atopic dermatitis • Atopic dermatitis

79. Which does not necessitate close contact treatment 97. Patch testing. Insurance is asking why?
• Phototoxic dermatitis • Allergic contact dermatitis

80. Phototherapy narrow band indicated in? 98. Which will benefit proactive use of topical calcineurin
inhibitors?
• Psoriasis
• Atopic dermatitis
81. Inguinal area with patch and satellite papules and
pustules. Diagnosis of choice? 99. Does bleach baths. Which will respond?
• Candida intertrigo so KOH • Atopic dermatitis

82. Numerous scaly patches and plaques following skin lines 100. Bleach baths target?
when extending back. No hyphae, no bleeding. • Staphylococcus aureus
Diagnosis?
• Pityriasis rosea - END -

83. Herald patch

• Pityriasis rosea
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