Download Neet PG Skin MCQs Question Bank
2.Amelanocyticnaevussurroundedbyadepigmentedhaloiscalled: a)Sutton'snevus b)Meyerson'snaevus c)Cockadenaevus d)Nevusanaemicus CorrectAnswer-ASutton'snevus/halo'snevus:ahaloofdepigmentationappearsaroundapreexistingmelanocyticnaevus.Meyerson'snaevusisusedtodescribeamelanocyticnaevusthathasdevelopedanassociatedinflammatoryreaction,whichlookslikeeczema. Ref:Rook'stextbookofdermatology,8theditionPg54.20.
3.Whichofthefollowingisthemostcommonformofmalignantmelanoma? a)Nodular b)Superficialspreading c)Acrallentiginous d)Mucosal CorrectAnswer-BThecommonesttypeofmelanomaisthesuperficialspreadingmelanoma(SSM).Themelanomaprogressthrough3phases:insitu,radialgrowth,verticalgrowth.NB:Aprimarymelanomawithnorecognizableadjacentinsituorradialgrowthphaseisnodularmelanoma.Melanomawithsimilarprevalenceinallethnicgroups-acrallentiginousRef:Rook'stextbookofdermatology,Edition-8,Page-54.45.
4.LinesofBlaschkorepresent: a)Linesalonglymphatics b)Linesalongbloodvessels c)Linesalongnerves d)Linesofdevelopment CorrectAnswer-DThelinesofBlaschkoaredefinedbyapatterndeterminedbynevoidrepresentingnonrandomlinesonthehumanskinormucosa.BlaschkolinesorthelinesofBlaschkoarethoughttorepresentpathwaysofepidermalcellmigrationandproliferationduringthedevelopmentofthefetus.LinesofBlaschkorepresentnon-randomdevelopmentallinesoftheskinfundamentallydifferingfromthesystemofdermatomes.Theyfollowa'V'shapeovertheback,'S'shapedwhorlsoverthechest,stomach,andsides,andwaryshapesonthehead.Thelinesarebelivedtotracethemigrationofembryonicepidermalcells.Thestripesareatypeofgeneticmosaicism.Theselinescharacteristicallydonotfollowtheunderlyingnervous,Vascular,muscularorlymplaticstructuresintheskin.LinesofBlaschkoarenotordinarilyvisibk,butarerecognizedinseveralcutaneousdisordersthatfollowthesearallelstreaks. Ref:Syndromes:Rapidrecognitionandperioperativeimplications,byBrunoBisonnette,Page400;Neurocutaneousdisorders:PhakomatosisandHamartoneoplasticSyndromes,byMartinoRuggieri,Page364.
5.Allarefeaturesofatopicdermatitis,except: a)Dennie-Morganfold b)Hertoghe'ssign c)Darier'sSign d)Hyperlinearityofpalms CorrectAnswer-CItisseeninurticariapigmentosa.
6.Allofthefollowingaretrueaboutincontinentiapigmenti,except: a)Ocularinvolvementisseeninalmost100%casesandis typicallyunilateral b)Avascularityofperipheralretina c)Primaryskinabnormality d)X-linkeddominant CorrectAnswer-AOcularinvolvementisseeninabout20-35percentofthecasesofincontinentiapigmentibutnotin100percentcasesasmentionedintheoption.IncontinentiapigmentiisaX-linked dominantprimaryskindiseasethatleadstoavascularityoftheretina.Ref:Rook'sTextbookofDermatology7thEdition,Pages39.20-3.22;TheRetinalAtlasByLawrenceA.Yannuzzi,Page38
7.Pemphigusvulgarisischaracterizedbyall,except: a)PositiveNikolsky'ssign b)Oralerosions c)Subepidermalbulla d)Tzancksmearshowingacantholyticcells CorrectAnswer-CPemphigusvulgarisisanintraepidermalblisteringdisease.
8.Whichofthefollowingistheagentofchoiceforcryosurgery? a)Nitrousoxide b)CO2snow c)Liquidnitrogenspray d)Freons CorrectAnswer-CThishasatemperatureof-196c(spray/probe)&theonlycryogenadvocatedformalignantskinlesions.Ref:Textbookofdermatosurgery&cosmetology,satishSsavant,E-2,P-117.
9.Treatmentofnodulocysticacneis a)Erythromycin b)Tertacycline c)Isoretinonine(Retinoicacid) d)Steroids CorrectAnswer-CCi.e.Isoretinonine
10.Anagenphaseofthehairindicates: a)Thephaseofactivityandgrowth b)Thephaseoftransition c)Thephaseofresting d)Thephaseofdegeneration CorrectAnswer-AAi.e.Thephaseofactivity&growth
11.AfterhepatitisBvaccinationchildwith allergicfamilyhistoryandpruritisinvolvingface&convexitiesdevelopednumerousumblicatedvesicles;whichbecamepustular&haemorhagic&crusted.After2dayschilddevelopedhighfeverandlymphadenopathy.Thediagnosisis a)Secondaryinfectedatopicdermatitis b)Molluscumcontagiosum c)Eczemaherpaticum d)Eczemavaccinatum CorrectAnswer-CC.i.e.Eczemaherpaticurrtx*EczemaherpeticumorKaposi'svaricelliformeruptionresultsfromwidespread(usually)primaryHSV-1(herpessimplexl)infectioninskindamagedbyatopicdermatitis(eczema)Q.*Patientswithatopiceczemamaydevelopsevereorofacialherpessimplexvirus(HSV)infectionQ(eczemaherpaticum),whichmayrapidlyinvolveextensiveareasofskin&occasionallydisseminatetovisceralorgans.Systemicacyclovirorvalacicloviristreatmentofchoice.*Inatopicdermatitispatients,smallpoxvaccinationorevenexposuretovaccinatedindividual,maycauseseverewidespreaderruption(k/aeczemavaccinatum)thatresemblestoeczema
herpaticum.*Kaposisvaricelliformeruptionsmanifesteitheras-eczemaherpeticumoreczemavaccinatum. Causative Disease Virus HSV-1(Herpes Eczema simplexhonimis herpeticum virus)QEczema Vacciniavirus vaccinatum dueto inadvertentvaccinationofsmallpoxwithlivevirusvaccine Milker's Paravaccinia/ node Pseudocowpox
12.A40yearoldmalereportedwithrecurrent episodesoforalulcers,largeareasofdenudedskinandflacidvesiculo-bullouseruptions.Whichisthemostimportantbed-sideinvestigationhelpfulinestablishingthediagnosis- a)Gramstainingoftheblisterfluid b)Cultureandsensitivity c)Skinbiopsyandimmunoflurescence d)Tzancksmearfromthefloorofbulla CorrectAnswer-DAns.D.i.e.Tzancksmearfromthefloorofbulla
13.TrueaboutpemphigusvulgarisA/E: a)Subepidermal b)Autoimmunedisease c)Tzancksmearshowsacanthoylticcells d)Antibodyareformedagainstdesmogleins CorrectAnswer-AAi.e.Subepidermal
14.Agirlabouttomarryhascomedonalacne. Drugtotreatsuchacaseis:March2013 a)Topicalantibiotic b)Benzoylperoxide c)Retinoids d)Estrogen CorrectAnswer-CAns.Ci.e.RetinoidsRetinoidsaremainlycomedolyticAcneComedonesarecharacteristicof:AcnevulgarisComedonesare:*Smallcysts,*formedinhairfollicles,*duetoblockageofthefollicularorifice*bytheretentionofsebumandkeratinousmaterialAcenvulgarisiscausedby:ObstructionofpilosebaceousductNodulocysticacne(NA)TreatmentofNA:Isotretinonin(syntheticretinoicacid)
15.Koebnerphenomenonseenin? a)Psoriasis b)Lichenplanus c)Warts d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,Alltheabove
16.Heliotopresignisseenin? a)Dermatomyositis b)Scleroderma c)Photodermatitis d)Vitiligo CorrectAnswer-AAns.is'a'i.e.,DermatomyositisCutaneoussignsofdermatomyositsGottron'spapules:-lilacorviolaceouspapulesonknuckle,dorsaofhands.Gottron'ssign:-Violaceouserythemawithedemaovershoulder,arms,forearms.Heliotropesign:-Violaceouserythemawithedemaovereyelids,periorbitalregion.Poikiloderma:-Atrophyofskin,hypopigmentaion,dilatedbloodvesselsovertrunk.Mechanichand:-Symmetrichyperkeratosisalongulnaraspectofthumbandradialaspectoffingers.ShawlSign:-Violaceouserythemaextendingfromdorsolateralaspectofhands,forearms,andarmstoshoulder&neck.Calcinosiscutis:-Calciumdepositsinskin(inJuvenilevariant).Miscellaneoussigns:-Photosensitivity,vasculitis,panniculitis,Nail-foldtelangiectasia. Extracutaneousinvolvement 1. Proximalmyositis2. Cardiomyopathy3. Raynaud'sphenomenon4. Arthralgia
17.Patientpresentswithdischargeper urethrumandmicroscopyshowspresenceofintracytoplasmicgramnegativecocci;whatisthemostprobablediagnosis? a)Gonorrhea b)Donovanosis c)Bacterialvaginosis d)Syphilis CorrectAnswer-AAns.is'a'i.e.,GonorrheaPresenceofpusdischargeperurethruminmaleswithpresenceofintracytoplasmicgramnegativecocciarepointerstothepresenceofN.gonorrheainfection.GONOCOCCALINFECTIONN.Gonorrhoeaeisanintracytoplasmicgramnegativecoccus.N.gonorrhoeaeisexclusivelyahumanpathogenalthoughchimpanzeeshavebeeninfectedartificially.Itisneverfoundasanormalcommensalalthoughaproportionofthoseinfected,particularlywomen,mayremainasymptomatic.Acuteurethritisismostcommonmanifestation.Purulentdischargeperurethraisthemostcommonmanifestation.Theprocessmayextend,alongtheurethra,toprostate,seminalvesicle,epididymis.
18.Christmastreeappearanceinskinisseen in? a)Pityriasisrosea b)Pityriasisrubrapilaris c)Psoriasis d)Vitiligo CorrectAnswer-AAns.is'a'i.e.,PityriasisroseaPityriasisrosaceaP.roseaisacommonscalydisorder,occuringusuallyinchildrenandyoungadults(10-35years).Characterizedbyround/ovalpinkbrownpatcheswithasuperficial,centrifugalscale,distributedovertrunkinaChristmastreepattern.Thediseaseisthoughttobeviraldisease,isselflimiting,andsubsidesin6-12weeks.Theexactetiologyisnotknown,butitisconsideredtobeaviraldisease;HumanHerpesvirus6(HHV6)andHumanHerpesvirus7(HHV7)mayplayarole.ClinicalmanifestationsofP.roseaThediseasestartswithanupperrespiratoryprodromeoramildflu.After1-2weeks,Annularerythmatousplaqueappearsontrunkthatisreferredtoasmotherpatchorheraldpatch.Overthenext1-2weeks,freshpatchappearalloverthetrunk,inaChristmastreeconfigurationorFirtreeConfigration.Thelesionsarepinkishinwhiteskin,hencethenamerosea.However,onthedarkIndianskinthelesionsareskincolouredorbrown.Themostcharacteristicclueforthediagnosisisthepresenceofa
finescaleattheedgeofthelesionreferrredtoascentrifugalscaleorcollarettescalesorcigarettepaperscales.Lesionssubsidewithhyperpigmentation.Trunkisinvolvedpredominantly,Sometimes(in20%ofpatients)lesionsoccurpredominantlyonextremitiesandneck(inversepattern).
19.Pomphyloxaffects? a)Palms&soles b)Groin c)Scalp d)Trunk CorrectAnswer-AAnsis'a'i.e.,Palms&solesPOMPHOLYXAnattackofpompholyxischaracterizedbythesuddenonsetofcropsofclearvesicles,whichappear'sago-like'.Itchingmaybesevere,precedingtheeruptionofvesicles.Theattacksubsidesspontaneouslyin2-3weeks.Inmildcases,onlythesidesofthefingersmaybeaffected,butinatypicalcasethevesiclesdevelopsymmetricallyonthepalmsand/orsoles
20.Erythrasmaiscausedby? a)Comybacterium b)Staphylococcus c)Streptococcus d)HerpesVirus CorrectAnswer-AAns.is'a'i.e.,CornybacteriumErythrasmaisaskindiseasethatcausesbrown,scalyskinpatches.ItiscausedbytheGram-positivebacteriumCorynebacteriumminutissimum.Itisprevalentamongdiabeticsandtheobese,andinwarmclimates;itisworsenedbywearingocclusiveclothing.
21.HPVcauses? a)Condylomalata b)Condylomaacuminata c)Bubo d)Chancre CorrectAnswer-BAns.is'b'i.e.,Condylomaacuminata
22.Drugofchoiceforgenitalwartsis? a)Acyclovir b)Podophyllin c)Minocyclin d)Interferonalpha CorrectAnswer-BAns.is'b'i.e.,Podophyllin
23.Depigmentingagentofchoiceinin treatmentofdermatologicaldisordersis a)Hydroquinone b)Zinc c)Kojicacid d)Azelaicacid CorrectAnswer-AAns.is'a'i.e.,HydroquinoneSkindepigmentingagentsinclinicaluseareHydroquinone-mosteffectiveandwidelyusedKojicacidKojicdipalmitateAzelaicacid
24.Nailpittingisseenwith? a)Paronychia b)Ectodermaldysplasia c)Alopeciaareate d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,Alltheabove
25.Vitiligoisassociatedwiththefollowing except a)Addison'sdisease b)Mensyndrome c)Perniciousanemia d)Crohnsdisease CorrectAnswer-DAns.is'd'i.e.,CrohnsdiseaseVitiligoisassociatedwiththefollowingautoimmunediseases:-AlopeciaareataDiabetesmellitusHyperthyroidismHypothyroidismPerniciousanemiaAddisondiseaseMultipleendocrinopathysyndrome
26.Trueabouterythematoxicumneonatorum is? a)Itispresentin3-5%ofthenewborns b)Itismostlypresentatbirth c)Itiscalledthefleabittenrashofnewborn d)Topicalantibioticsisthetreatmentofchoice CorrectAnswer-CAns.is'c'i.e.,ItiscalledthefleabittenrashofnewbornErythemaToxicumNeonatorumItistheharmless,erythematous,shortlivederuptionsofthenewborn.Itispresentin30-50%ofthenewbornsItisconsideredapartofnormaltransitionfromthewaterywombtothedryexternalenvironment.Itappearsmostofteninthefirst2daysoflifeandisrarelypresentatbirthItconsistsofwidespreaderythematousmaculesmostpresentinthetrunkandtheproximalpartsoftheextremities.Hurwitzcalleditthefleabittenrashofnewborn.Noactivetherapyisneededforthetreatment.
27.Whatisthethemostprobablediagnosis ofachildwhopresentswithwhiteumbilicatedlesionsonface? a)Molluscumcontagiosum b)Herpessimplexinfection c)Erythematoxicumneonatorum d)Humanpappilomavirusinfection CorrectAnswer-AAns.is'a'i.e.,MolluscumcontagiosumPearlywhiteumblicatedpapuleonfaceinchildrenismostcommonlyseeninMolluscumcontagiosum.MolluscumcontagiosumItisacommonviralinfectioninchildren.Itiscausedbypoxvirus,i.e.,Molluscumcontagiosumvirus.Itischaracterizedbymultiplepearlywhite,dome-shapedpapuleswhichareumbilicatedcentrally.Onusingahandlens,manyofthepapuleshasamosaicappearance.Epidermalcellscontaineosinophilicintracytoplasmicinclusionbodies(MolluscumorHenderso-Patersonbodies).Autoinoculationcangiverisetolesionsarrangedlinearlyalonglineoftrauma---->pseudoismorphic(pseudokoebner's)phenomenon.M.C.mayinvolveanypartofthebodyInchildrenfaceisinvolvedmostcommonly.AnogenitalmolluscumcontagiosumisaSTD.TreatementCurretage,electrocautery,cryotherapyaresimpleandeffectivemethods.Imiquimed,arecentlyintroducedimmunostimulant,ishelpfulinpatientswithmultiplelesionsandinsmallchildren.
28.Haascheibencellsinepidermisare responsiblefor? a)Touch b)Temperature c)Pressure d)Proprioception CorrectAnswer-AAns.is'a'i.e.,Touch
29.Applejellynodduleisseenin? a)Lupusvulgaris b)Cutaneousanaphylaxus c)Erythroderma d)Erysepals CorrectAnswer-AAns.is'a'i.e.,LupusvulgarisLupusvulgarisLupusvulgarisisachronicandprogressiveformofcutaneoustuberculosisthatoccursintuberculinsensitivepatients.Itisthemostcommontypeofcutaneoustuberculosisandhasmostvariablepresentation.Seeninchildrenandyoungadults,thoughnoageisexempted.Occursonexposedarealikeface(nose,eyelid,pinna);andsometimesonbuttock,trunk.Lesionsareusuallysolitaryandcharacterizedby:- 1. Reddishbrown(erythematous).2. Annularinshape.3. Indurated.4. Slowlyincreasesinsize(graduallyprogressive).5. Healingwithtissuepaperlikescarringatcentre(mostcommon)or edge. 6. Peripheralcrusting.7. Blanchingwithglassslide(diascopy)willrevealgreygreenfoci--> Applejellynodules. 8. Match-sticktestpositive-->Applejellynodulehasnoresistanceto pressurebyasharpmatch-stick.Reappearanceofnewnoduleswithinpreviouslyatrophicorscarredlesionsischaracteristic.Cartilage(Ear,nose)intheaffectedareais
progressivelydestroyed(Lupusvorax);boneisusuallyspared.Buccal,nasalandconjuctivalmucosamaybeinvolvedprimarilyorbyextension.Treatmentisantituberculardrugs(ATT).
30.Flaccidbullaewithmucosalinvolvement andintraepidermalacantholysisarecharacteristicof? a)Pemphygusvulgaris b)Pemphigusfoliaceous c)Psoriasis d)Vitiligo CorrectAnswer-AAns.is'a'i.e.,PemphygusvulgarisAmongthegivenoptions,twoarevesicullabullousdisorders:- 1. Pemphigusvulgaris2. Pemphigusfoliaceous Bothofthesecauseflaccidbullaewithintraepidermalblisters.but,mucosalinvolvementiscommoninpemphigusvulgaris(notinPfoliaceous).
31.IgAdepositionindermoepidermal junctionskinseenin? a)Dermatitisherpetiformis b)Bullouspemphigoid c)LinearIgAdisease d)Epidermolysisbullosa CorrectAnswer-CAns.is'c'i.e.,LinearIgAdisease
32.Notafeatureofscabiesis? a)Serpentineburrow b)Severeitching c)Webspaceaffection d)Genitaliaarenotaffected CorrectAnswer-DAns.is'd'i.e.,Genitaliaarenotaffected
33.Trueaboutthelesionsoflichenplanus? a)Polygonalviolaceouspaple b)Affectskinandmucousmembranes c)Arepruritic d)Alltheabove CorrectAnswer-DAns.is'd'i.e.,Alltheabove
34.AntigendefectinPemphigusVulgaris- a)Desmoglein-1 b)Desmoglein-3 c)Desmocollin-3 d)Desmocollin-2 CorrectAnswer-BAns.is'b'i.e.,Desmoglein-3
35.Coloroftuberoussclerosislesionson woodlampexamination? a)Brightgreen b)Milkywhite c)Goldenyellow d)Bluewhite CorrectAnswer-DAns.is'd'i.e.,BluewhiteWoodlampThisisasourceofultravioletlight(320-400nm)fromwhichvirtuallyallvisiblerayshavebeenexcludedbyaWood's(nickeloxide)filter.Primarilyemits360nm.UVlight,whenabsorbedbycertainsubstances,fluorescencesindarkandcolorproduced,isusefulindiagnosisofthecertainconditions Condition Fluorescencecolour Tineacapitis Brightyellowgreen Erythrasma Coralredorpink Vitiligo Milkywhite Albinism Bluewhite Leprosy Bluewhite Tuberoussclerosis Bluewhite Pseudomonasinfection GreenishwhitePorphyria Pink/orange Tineavesicolor Goldenyellow
36.Alopeciaareataisa/an? a)Autoimmunedisorder b)Allergicdisorder c)Anaphylacticdisorder d)Bacterialinfection CorrectAnswer-AAns.is'a'i.e.,Autoimmunedisorder
37.Whitfield'sointmentconsistsof? a)3%salicylicacid+6%benzoicacid b)3%benzoicacid+6%salicylicacid c)2%salicylicacid+4%benzoicacid d)2%benzoicacid+4%salicylicacid CorrectAnswer-AAns.is'a'i.e.,3%salicylicacid+6%benzoicacidWhitfield'sOintmentWhitfield'sointmentissalicylicacidandbenzoicacidinasuitablebase,suchaslanolinorvaseline.Theoriginalointmentcontains3%salicylicacidand6%benzoicacid,butotherratiosarealsoused.Itisusedforthetreatmentoffungalinfections,suchasathlete'sfoot.Itseffectivenessisunclear.Itcanhaveaslightburningeffectthatgoesawayafterafewminutes.ItisnamedforArthurWhitfield(1868-1947),aBritishdermatologist
38.Sphagettiandmeatballappearanceis seenin? a)Pityriasisrosacae b)Tineacapitis c)Tineacarporis d)Tineaversicolor CorrectAnswer-DAns.is'd'i.e.,TineaversicoloPitvriasisversicolor(tineaversicolor)Tineaversicolorisamisnomerasitisnotcausedbyadermatophyte;itiscausedbyanondermatophyticfunguscalledPityrosporumovale(malaseziafurfur).Usuallyaffectsyoungadults.ClinicalfeaturesTherearemultiplescalyhypopigmented(morecommon)orhyperpigmentedmacules.Scalingisfufuraciousorricepowderlike.Maculesstartaroundthehairfolliclesandtheymergewitheachothertoformlargeareas.Affectstrunkandshoulders(mainlychestandback).Theremaybelooseningofscaleswithfingernails-coupledonleorstrokeofnail.Lesionsarerecurrentinnature.Diagnosis 1. Examinationofscalesin10%KOHshowsshorthyphaeandround spores(sphagettiandmeatballappearance).Wood'slampshowsapplegreenfluorescence(blue-greenfluorescnce). 2. Skinsurfacebiopsy-acyanoacrylateadhesiveisusedtoseparate thelayerofstratumcorneumonglassslideandthenstainedwithPASreagent.Treatment 1. Systemicagents:-systemicazolesprovideconvenienttherapeutic
option.Drugsusedareketokonazole,fluconazoleoriatroconazole 2. Topicalantifungalsusedare? Azolesclotrimazole,econazole,miconazole,ketoconazoleOthers:-seleniumsulphide,sodiumthiosulphate,whitefield'sointment(3%salicylicacid+6%benzoicacid).
39.Whichofthefollowingcancauseboth cicatricialaswellasnoncicatricalalopecia? a)Alopeciaareata b)Telogeneffluvium c)SLE d)Hypothyroidism CorrectAnswer-CAns.is'c'i.e.,SLE
40.Miliariaarisesfromobstructionof? a)Eccrinesweatglands b)Apocrinesweatglands c)Sebaceousglands d)Ectopicsebaceousglands CorrectAnswer-AAns.is'a'i.e.,EccrinesweatglandsMilliriaOccurasaresultofeitherobliterationordisruptionoftheeccrinesweatduct.Threeforms:- 1. Miliariacrystallina-Clear,thin-walledvesicles,1-2mmindiameter, withoutaninflammatoryareola,areusuallysymptomlessanddevelopincrops,mainlyonthetrunk. 2. Miliariarubra-erythematouspapulesespeciallyinareasoffriction withclothing,andinflexures,produceintenseprickingsensation. 3. Miliariaprofunda-Thisnearlyalwaysfollowsrepeatedattacksof miliariarubra,oComplications:-Secondaryinfectionanddisturbanceofheatregulation
41.Patchyhairlosswithvelvetyskinpoints tothediagnosisof a)Alopeciaaereata b)Trichotelomania c)Hyperthyroidism d)Adenomasebacicum CorrectAnswer-CAns.is'c'i.e.,HyperthyroidismHairlossincombinationwithvelvetyskinisseeninpatientswithexcessofthyroidhormoneproduction;thusthemostprobableanswerishyperthyroidism
42.Blackpiedraiscausedby? a)Piedraiahortae b)Trichosporonasahi c)Trichosporonovoides d)Trichosporoninkin CorrectAnswer-AAns.is'a'i.e.,PiedraiahortaePiedraisanasymptomaticsuperficialfungalinfectionofthehairshaftalsoknownastrichomycosisnodu-laris.BlackpiedraiscausedbyPiedraiahortae,whereaswhitepiedraiscausedbypathogenicspeciesoftheTrichosporongenus,namelyTrichosporonasahii,Trichosporonovoides,Trichosporoninkin,Trichosporonmucoides,Trichosporonasteroides,andTrichosporoncutaneum.
43.Inscabieswhichskinlayerisaffected? a)Stratumcorneum b)Stratumbasale c)Stratumlucidum d)Stratumgerminatum CorrectAnswer-AAns.is'a'i.e.,StratumcorneumAftercopulation,themalemitediesandthefemalemiteburrowsintothesuperficialskinlayer(stratumcornuem)attherateof2mm/day.Femalemitelayseggswhichhatchintolarva,whichmouldsandmatureintoadultmites.Themitethenburrowsintostratumcorneum.Theseburrowisvisibleclinicallyasanirregulargray-brownline.Burrowisapathognomicsignforscabies.
44.Groovesignofgreenbaltisseenin? a)LGV b)Donovanosis c)Chancroid d)GenitalHerpes CorrectAnswer-AAns.is'a'i.e.,LGVGroovesignofGreenblatt'ispathognomonicofLGVwheninguinallymphnodesareenlarged,theyareseparatedbyPoupart'sligment,producingagroove.
45.Mutationinwhichcollagenispresentin epidermolysisbullosa? a)II b)IV c)V d)VII CorrectAnswer-DAns.is'd'i.e.,VIIMolecularpathologyofEBNormalbasementmembraneisbetweenepidermalbasallayeranddermis.Thisbasementmembrane(basallamina)isattachedtobasalcellshemidesmosomeswiththehelpofkeratincontainingintermediatefilamentsandisattachedtodermis(dermalpapillarylayer)withthehelpoftypeVIIcollegencontainingfibrils.Anydefectinthisanchoringcomplexleadstoseparationofskin;thesiteofseparationdependsonthetypeofdefect 1. EBsimplex-->Mutationingenecodingforkeratin5&14(major keratinofBMZ)andseparationwillbeepidermal. 2. EBjunctional-->MutationinLantinina-3(LAMa-3),LAM[I-3,LAM 7-2genes.Aslamininispartofbasementmembranetheseparationwillbeatdermo-epidermaljunction(DEJ). 3. EBdystrophicans-->MutationincollagenVII-Algene.Ascollagen VIIcontainingfibrilsjoinBMtodermalpapilla,separationwillbeinthedermis.Anyoftheabovedefectresultsindefectivecohesivenesswhichleadstovulnerabilitytotraumaandblistersformation.Asthediseaseisinherited,Familyhistorymaybepositive.
46.Onychomycosisismostcommonly causedby? a)a)Trichophytonrubrum b)Trichophytonmentagrophytes c)Epidermatophytonfloccosum d)a)Candida CorrectAnswer-AAns.is'a'i.e.,TrichophytonrubrumTineaUnguium(Onychomycosis)Tineaunguiumisdermatophyticinfectionoffingersandtoenails.MostcommoncausativespeciesisT-rubrum.Toenailsaremorecommonlyinvolved.T.Unguiummaybeoftwotypes:? 1. Distalsubungalonychomycosis:-Thisismostcommontypeof fungalinfectionofnail(90%).Itstartsatthedistaledgeofthenailplateandslowlygrowsinwardstoinvolveentirenailplate. 2. ProximalSubungalonychomycosis:-Startsatthebaseofnailand slowlyinvolvestheentirenailplate.
47.RASTtestisusedindiagnosisof a)Allergicdermatitis b)Seborrhoeicdematitis c)Mycosisfungoides d)Squamouscellcarcinoma CorrectAnswer-AAns.is'a'i.e.,AllergicdermatitisRAST:RadioallergosorbentassayItisthemethodusedtomeasuretotalaswellasspecificIgEagainstaparticularallergenoracomplex.DiagnostictestsinallergiccontactdermatitisDiagnosticTests(ifindicated)PatchtestingPhotopatchtestingTestsforimmediatehypersensitivityRadioallergosorbentassaytest(RAST)Openandsemiopenpatchtests(readat10and45minutes)PricktestScratch-chambertestRepeatopenapplication"use"testPotassiumhydroxideexaminationtofungi,glassfibersFungal,bacterial,andviralsmearsandculturesSkinbiopsiesDimethylglyoximetestfordetectingnickel,othertests(detectionofchromatesandformaldehyde)Chemicalanalysis
48.Characteristicofchroniceczema? a)Erythema b)Induration c)Lichenification d)Edema CorrectAnswer-CAns.is'c'i.e.,Lichenification Phase Clinicalfeatures Histology (stage) Spongiosis VesiclesaErythema Acute (intracellular EdemaoCrusts edema) Erythmatous,hyperpigmented Subacute Parakeratosis plaqueScales&Crusts Thickeningof Chronic Lichenification stratummalpighi
49.Sexworkerwithdischargingulcer,gram negativediplococci&growthonmodifiedThayermartinmedia.Diagnosis? a)N.gonococci b)Syphilis c)LGV d)Chaneroid CorrectAnswer-AAns.is'a'i.e.,N.gonococciInformationinthisquestionare? 1. Gramnegativediplococci.2. GrowthonmodifiedThayer-martinmedia. oNeisseriagonorrhoeaeisagramnegativediplococciandThayer-martinmediumistheselectivemediumforgonococci.LabdiagnosisofgonorrheaUrethraldischargeisthemostimportantspecimen.Transportmedia 1. LaItprocessingistooccurwithin6hrs--->StuartmediumorAmies medium. 2. Ifprocessingistooccur>6hrs-->JEMBECorGono-Pak system(mediawithself-containedCO2-generatingsystem).Cluturemedia 1. Inacutecases-->ChocolateagarorMuller-Hintonagar.2. Inchroniccases--->Selectivemedium-Thayermartinmedium. Normallythediagnosisofgonorrhoeaismadebyisolatingtheorganisminculture.Itmaynotbepossibletoobtaingonococciinculturefromsome
chroniccasesorfrompatientswithmetastaticlesionssuchasarthritis.Serologicaltestmaybeofvalueinsuchinstances.Inserologicaltestsantibodiestogonococcalpili,LPSandoutermembraneproteinsaredetected.oVarioustestsare? 1. Complementfixationtext2. Precipitation3. Passiveagglutination4. lmmunofluorescence5. Radioimmunoassay6. Enzyme-linked7. immunosorbentassay(ELISA) However,noserologicaltesthasbeenfoundusefulforroutinediagnosticprocedure.Immunobloting
50.Differenceinacnerosacea&acne vulgaris- a)Pustule b)Erythema c)Papule d)Absenceofcomedone CorrectAnswer-DAns.is'd'i.e.,Absenceofcomedone
51.Frequencyofwoodslampis? a)365nm b)400nm c)320nm d)200nm CorrectAnswer-AAns.is`a'i.e.,360nmWood'slampWood'slamphasanultravioletlightlamp(365nm)withafiltercontainingnickleoxideandbariumsilicate.TheUVlight,whenabsorbedbycertainsubstances,fluorescencesindarkandthecoloroffluorescenceisusefulindiagnosisofthecondition. ConditionFluorescentcoloursTineacapitisBrightyellowgreenErythrasmaCoralredorpinkVitiligoMilkywhiteAlbinismBluewhiteLeprosy BluewhiteTuberoussclerosisBluewhitePseudomonasinfection
GreenishwhitePorphyriaPinklorangeTineaversicolorGoldenyellow
52.Lovibondprofilesignisseenin? a)Koilonychia b)Platynochia c)Clubbing d)Onycholysis CorrectAnswer-CAns.is'c'i.e.,ClubbingClinicalindicatorsofclubbingareLovibondprofilesignandcurth'smodifiedprofilesign".Lovibondangleistheanglelocatedatthejunctionbetweenthenailplateandproximalnailfold.Itisnormallylessthan160?.Inclubbing,theangleexceeds180?(Lovibondprofilesign).
53.Whichhormoneisresponsibleforacne? a)Estrogen b)Thyroid c)Testosterone d)Gonadotropins CorrectAnswer-CAns.is'c'i.e.,TestosteronePredisposingfactorsforAcnevulgarisGeneticfactorsHormones-4Androgens,glucocorticoids.Psychologicalstressanddepression.EnvironmentalfactorsHightemperature&humidity.Cosmetics-3Containinglenolin,petroleum,vegetableoils.Infection-->Propionibacterium,Pityrosporum,Staph.epidermidis.Mensturalcycle-4Premensturalaggravation.Hyperkeratosisofpilosebaceousostia.DrugsAntepileptics(Carbamazepine,phenytoin,phenobarbitone),antitubercular(INH,rifampin,ethionamide),antidepressants,cyclosporine,VitaminB12.Coughsyrupscontaininghalogens(Iodides,bromides).
54.Hanifin&Rajkeisthediagnosticcriteria for a)Atopicdermatitis b)Contactdermatitis c)Urticaria d)Erythroderma CorrectAnswer-AAns.is'a'i.e.,AtopicdermatitisHanifinandRajkacriteriaisfordiagnosisofatopicdermatitis. Diagnosticcriteria(HanifinandRajka) Basedmainlyonclinicalexperience Majorcriteria 1. Familyhistoryofatopy2. Chronicity3. Pruritus4. Typicalmorphologyanddistribution Minorcriteria 1. Dryskin2. Chelitis3. Elevatededge4. Dennie'sline/denniemorganfold(infraorbitalfold)5. Whitedermographism6. Peripheraleosinophillia7. Immediate(typei)hypersensivity8. Facialpallor,orbitaldarkening9. Foodintolerance 10. Conjunctivitis(recurrent),keratoconus,cataract11. Pityriasisalba
12. Handdermatitis13. Recurrentinfections Atleast3majoror2majorplus2minorcriteriaarenecessaryfordiagnosis
55.Treatmentofchoiceofscabiesin pregnancy? a)Ivermectin b)Garna-benzenhexachloride c)Permethrin d)Garna-benzenhexachloride CorrectAnswer-CAns.is'c'i.e.,Permethrin'Premethrinisthedrugofchoiceforinfantsaswellaspregnantandnursingwomen'.--EvidencebaseddermatologyAlternativesarebenzyl-benzoateandcrotamitone.Gammabenzenhexachlorideandivermectinarenotrecommended.
56.Mostcommonmetalincontactallergic dermatitisis? a)Gold b)Silver c)Aluminium d)Nickel CorrectAnswer-DAns.is'd'i.e.,NickelContactdermatitisContactdermatitisislocalizedrashorirritationofskincausedbycontactwithaforeignsubstance.Contactdermatitisisalocalizeddisease,i.e.,lesionoccursatthesiteofcontact.However,insevercases,thelesionsmayextendoutsidethecontactareaoritmaybecomegeneralized(referredtoasideruption).Contactdermatitisismainlyoftwotypes:?A.IrritantcontactdermatitisDuetodirectirritantactionofthemateriale.g.Solvents,Alkalis,Detergents.Mostcommonsitesarehands&forearms.B.AllergiccontactdermatisItisduetodelayedhypersensitivity(typeIVhypersensitivity)toaparticularantigeninasensitizedindividual.Themostcommonallergenscausingallergiccontactdermatitisarepollenandmetals:? 1. Parthenium(Congressgrass)2. Nickel
57.Skinscrapping&KOHmountingisdone for? a)Leprosy b)Varicella c)Fungus d)HSV CorrectAnswer-CAns.is'c'i.e.,FungusLaboratorydiagnosisoffungalinfectionLaboratorydiagnosisoffungalinfectiondependson:? 1. l.Recognitionofthepathogenintissuemicroscopy:-Tissue specimens,suchasskinscraping,aregenerallyexaminedaswetmountsaftertreatmentwith10%KOH.KOH(alkali)digestscellsandothertissuematerials,enablingthefunguselementstobeseenclearly.Periodicacidschiff(PAS)andmethanaminesilveraretwomostcommonlyusedstainsforthedemonstrationoffungalelementsintissuesections. 2. Culture:-Culturemediausedmostcommoninmycologyis Sabauraud'sglucoseagar. 3. Serology:-ELISAcomplementfixationtest,Immunodiffusion.4. PCR:-DetectionoffungalDNAisclinicalmaterial.
58.LinesofBlaschko'sarerelatedto? a)Keratinocytes b)Bloodvessels c)Nerves d)Bones CorrectAnswer-AAns.is'a'i.e.,KeratinocytesBlaschko'slinescorrespondtothepathwaysfollowedbykeratinocytesmigratingfromneuralcrestduringembryogenesis.ThelinesfollowaV-shapeoverspine,anS-shapeonabdomen,invertedU-shapefrombreastareatoupperarmandperpendiculardownthefrontandbackofthelowerextrimities.AnumberofinflammatoryconditionscanfollowBlaschko'slines- 1. Lichenstriatus2. Linearlichenplanus.3. Inflammatorylinearverrucousepidermalnaevus(ILVEN).4. Blaschkodermatitis(Blaschtitis).5. Incontinentiapigmenti.6. Goltzsyndrome.7. Linearmorphoea.8. Segmentalvitiligo.9. Focaldermalhypoplasia. 10. CHILDsyndrome.11. HypomelanosisofIto.12. Linearcutaneouslupuserythematosus
59.Treatmentofgraunolmainguinaleis? a)Tetracycline b)Azithromycin c)Clarithromycin d)Streptomycin CorrectAnswer-BAns.is'b'i.e.,AzithromycinGranulomainguinaleorGranulomavenerumorDonovanosisCausedbyCalymmatobecteriuntgranulomatis,agramnegativeintracellularbacteria.IPis1-4weeks.Beginsasoneormoresubcutaneousnodulesthaterodethroughskintoproduceulcer.Ulcerhasfollowingcharacterstics. 1. Painless2. Bleedingwithredgranulationtissue3. Indurated SubcutaneousgranulomasofinguinalregioninDonovenosislooklikeenlargedlymphnodesbutthesearenotenlargedlymphnodes.Therefore,theseareknownasPseudobubos.Sitesofthelesionsaregenitalia(90%),inguinal(10%),andanalregions.Complicationsarepseudoelephentiasis,phimosis,paraphymosis.DiagnosisPreferredmethodisdemonstrationoftypicalintracellularDonavanBodieswithinlargemononuclearcellsvisualisedinsmearpreparedfromlesionorbiopsyspecimen.Itshowssafetypinappearance.TreatmentAzithromycinistheDOC.Alternativesaredoxycycline(2ndchoice)andchloremphenicol.
Streptomycin,onceused,isnotusednow.
60.Thefollowingdrugiseffectivein treatmentofptyriasisversicolor? a)Ketoconazole b)Metronidazole c)Griseofulvin d)Chloroquine CorrectAnswer-AAns.is'a'i.e.,KetoconazolePityriasisversicolor(Tineaversicolor)Tineaversicolorisamisnomerasitisnotcausedbydermatophyte;Pityriasisversicolorismoreappropriateterm.ItiscausedbyanondermatophytefunguscalledPityrosporumovale(Malaseziafurfur).Itusuallyaffectsyoungadults.ClinicalfeaturesTherearemultiplesmallscalyhypopigmentedmacules(maculesmaybehyperpigmentedalso).Scalingisfurfuraceousorricepowderlike.Maculesstartaroundthehairfolliclesandthenmergewitheachothertoformlargeareas.Affectstrunkandshoulders(mainlychestandback).Theremaybelooseningofscaleswithfingernails-4Coupledonleorstrokeofnail.Lesionsarerecurrentinnature(mayreappearaftertreatment).DiagnosisofP.versicolorExaminationofscalesin10%KOHshowsshorthyphaeandroundspores(Sphagettiandmeatballappearance).Wood'slampshowsapplegreenfluorescence(blue-greenfluorescence).Skinsurfacebiopsy--)Acyanoacrylateadhesive(crazyglue)isusedtoremovethelayerofstratumcorneumonglassslideandthenstainedwithPASreagent.
TreatmentofP.versicolor 1. Systemicagents:-Systemicazolesprovideaconvenient therapeuticoption.Drugsusedareketoconazole,Fluconazoleorintraconazole. 2. Topicalantifungals:-Topicalantifungalsusedare:- i.Azoles-->Clotrimazole,econazole,Miconazole,Ketoconazole.ii.Others-->SeleniumSulfide,Sodiumthiosulphate,whield'sointment(3%salicylicacid+6%Benzoicacid).
61.Keivmsskintestisusedfordiagnosisof a)Sarcoidosis b)Wegenersgranulomatosis c)Gravesdisease d)None CorrectAnswer-AAns.is'a'i.e.,SarcoidosisKveimtest(Nickerson-kveimorKveim-Siltzbachtest)wasaskintestusedtodetectsarcoidosis.Itisnotusedknow.
62.Drugofchoicefortreatingchylmydiawith gonorrheais? a)Ciprofloxacin b)Norfloxacin c)Nalidixicacid d)Doxycycline CorrectAnswer-DAns.is'd'i.e.,Doxycycline
63.Singledosetreatmentforgonorrhea? a)Azithromycin b)Tetracyline c)Ceftriaxone d)Erythromycin CorrectAnswer-CAns.is'c'i.e.,CeftriaxoneForuncomplicatedgonococcalinfection,singledoseofIMceftriaxoneisthedrugofchoice.Itisgivenalongwithazithromycin(singledose)ordoxycyline(BDfor7days)tocoverchlamydialinfection
64.Erythroderma%ofskininvolvedis? a)>90% b)<30% c)30-60% d)60-70% CorrectAnswer-AAns.is'a'i.e.,>90%Erythroderma(generalizedexfoliativedermatitis)Erythrodermaisthetermusedwhenthemajorityoftheskiniserythmatousredcolorandusuallyassociatedwithcrusts,theremaybeassociatederosions,pustules,sheddingofnailsorhair."Exfoliativedermatitis(erythroderma)referstoascalingerythematousdermatitisinvolving90%ormoreofthecutaneoussurface".Exfoliativedermatitisischaracterizedby:- 1. Erythema2. Scaling Thisoftenobscurestheprimarylesions,Forexampleinpsoriasistehcharacteristiclesioniserythmatousplaquewithsilveryscale,onextensors.Whenerythermaoccursasacomplication,mostofthecutaneoussurfaceisinvolvedbyerythmawhichobscurestheprimarylesionsofpsoriasis.CausesofErythroderma(exfoliativedermatitis)1.SkindisordersPsoriasisDermatitis/Eczema(atopic,stasis,contact,seborrheic)Pityriasisrubrapilaris
Lichenplanus2.Systemicdiseases-->CutaneousT-celllymphoma3.Drugs-->Gold,Allopurinol,Phenytoin,penicillin,Sulfonamides.4.Idiopathic(secondarytosolidtumorsoflung,liver,prostate,thyroid,colon).Treatmentoferythroderma(exfoliativedermatitis)Topicalcorticosteroidsaretheprimarycategoryofmedicationusedtotreatexfoliativedermatitis.Asedativeantihistaminicmaybeausefuladjunctforpruriticpatients.Systemicantibioticsmaybeusedifinfectionissuspected.Systemiccorticosteroidsmaybeusefulinseverediseaseforremissioninduction,butnotformaintenance.Systemiccorticosteroidsshouldnotbeusedinpsoriasis(psoriaticerythroderma);Acitretinormethotrexatearepreferred.
65.Drugcausingfixeddrugeruption? a)Sulfonamide b)Erythromycin c)Aminoglycoside d)None CorrectAnswer-AAns.is`a'i.e.,SulfonamideDrugscausingfixeddrugeruptionParacetamol(Phenacetin)SulfonamidesNSAIDsAspirinBarbituratesDapsoneTetracyclinesPhenylbutazone
66.Pathergytestisusedfor? a)Reither'ssyndrome b)Bechet'ssyndrome c)Lichenplanus d)Atopicdermatitis CorrectAnswer-BAns.is'b'i.e.,Bechet'ssyndromeCriteriafordiagnosisofBechet'sdiseaseRecurrentoralulcerforatleast3timesin12months.Plusanytwoofthefollowings:? 1. Recurrentgenitalulcer.2. Eyeinflammationwithlossofvision.3. Charactersticskinlesion(erythemanodosum).4. Positivepathergytest(skinpricktest).
67.Tzanksmearinvaricella-zostershows? a)Acantholysis b)Spongiosis c)MultinucleatedGiantcell d)Necroticcell CorrectAnswer-CAns.is'c'i.e.,MultinucleatedGiantcell
68.Deadlayerofepidermis? a)Stratumbasale b)Straumspinosum c)Stratumcorneum d)Stratumgranulosum CorrectAnswer-CAns.is'c'i.e.,StratumcorneumStratumbasale,stratumspinosumandstratumgranulosum,togetherformthelivinglayerandconstitutethesiteofsynthesisofkeratin(Keratinismostlysynthesizedinstratumspinosum).Stratumcorneumisthedeadlayer.Layersofepidermis(Fromdeeptosuperficial)Inpalm&sole(5layers).Elsewhere(4layers)StratumbasaleStratumbasaleStratumspinosumStratumspinosumStratumgranulosumiv)StratumlucidumStratumgranulosumStratumcorneumStratumcorneum
69.Whichofthefollowingcausenon- cicatracialalopecia? a)Teniacapitis b)SLE c)Alopeciaareata d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,Alloftheabove
70.Nailpittingiscausedbyallexcept? a)Lichenplanus b)Hyperthyroidism c)Fungalinfection d)PityriasisRosacea CorrectAnswer-DAns.is'd'i.e.,PityriasisRosacea
71.Apregnantladycomeswithitchyhand lesionsasshown.Herhusbandalsogetsit.Thebesttreatmentthatcanbegivenis? a)Permathrin b)Ivermectin c)GBH d)Benzylbenzoate CorrectAnswer-AAns.is'a'i.e.,PermathrinPermethrin5%creamisconsideredthedrugofchoicefortreatingscabiesinpatients,includingpregnantwomen.Otherscabicidesconsideredsafeforuseduringpregnancyaresulfur5-10%inpetrolatumandcrotamiton10%.Sulfuriseffectiveandithasagoodsafetyprofile;however,sulfurpreparationscanstainclothingandtheyareodorous.Crotamiton10%creamisnotabsorbedpercutaneouslyandisconsideredsafeinpregnancyalthoughitisnoteffectiveasothertherapies
72.Spongiosisinvolves? a)Stratumbasal b)Stratumcarneum c)Stratumgranulosum d)Stratumspinosum CorrectAnswer-DAns.is'd'i.e.,StratumspinosumSeparationofkeratinocytesduetolossofintracellularbridges-->AcantholysisIntracellularedemaofkeratinocytes--->BallooningStratumbasaleAcantholyticcellsofpemphigusvulgarisarederivedfromstratumbasal.BasalcelldegenerationoccursinLichenplanus.StratumspinosumIntercellular(inbetweenthecells)edema-->SpongiosisThickening-->Acanthosis Stratumgranulosum ThickeningHypergranulosis Stratumcorneum --> Retentionofnucleiwithincells Parakeratosis --> Thickening Hyperkeratosis Stratumcorneumisinvolvedin --> Micromunro abscess,Dermatophytes
Dermatophytes
73.Raindroppigmentationiscausedby? a)Clofazimine b)Dapsone c)Minocycline d)Arsenic CorrectAnswer-DAns.is'd'i.e.,Arsenic
74.manwithpainindefecation,no gastrointestinalsymptoms,clusteredulcersextendingintoanalcanal.Diagnosis- a)CMV b)Gonorrhea c)Herpesgenitalis d)HIV CorrectAnswer-CAns.is'c'i.e.,HerpesgenitalisHerpesgenitalisisasexuallytransmitteddisease,characterizedbyappearanceofmultiplepainfulvesiclesinclusteresingenitalareawhichlateronmayulcerate.Thesesmallulcersmaycombinetoformalargeulcer.FirstattackofthisininfectionmaybeassociatedwithflulikesymptomsbutGITsymptomsareusuallyabsent.Gonorrheaischaracterizedbyacuteanteriorarthritisassociatedwiththickyellowurethraldischarge.Perianalulcerationisnotafeatureofgonorrhea.AlthoughHIVcanbeconsideredinthedifferentialdiagnosisofPerianalulcers,butisusuallyassociatedwithGITsymptoms.PerianalulcerationisnotafeatureofCMVinfection.
75.Acanthosisnigricansisseenin? a)Diabetes b)GITcancer c)Hypothyroidism d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,AlloftheaboveAcanthosisnigricansAcanthosisnigricansisabrowntoblack,velvetyhyperpigmentationoftheskin.Itisusuallyfoundinbodyfolds,suchasposterior&lateralfoldsofneck,axilla,groin,umblicus,forehead.Ittypicallyoccursinindividualsyoungerthan40yearsofage.Histopathologicallypapillomatosisischaracteristicallyseen;however,thereisnohypermelanosisandthereisonlymildacanthosis,ifpresent.Itisassociatedwith 1. Obesity(mostcommon)2. Endocrinopathies-->Hypothyroidism,hyperthyroidism,insuline resistancediabetes,Cushing'sdisease,PCOD,Bloomsyndrome. 3. Internalmalignancy-->Gastricadenocarcinoma
76.CircleofHebraisinvolvedin? a)Pediculosiscorpora b)Pityriasisversicolar c)Scabies d)Leprosy CorrectAnswer-CAns.is'c'i.e.,ScabiesScabiesScabiesiniscausedbymitesofthefamilySarcoptidae,whichincludesSarcoptesscabiei,thescabiesmite.Usuallyaffectschildrenbutcanoccuratanyage.Morecommoninlowsocioeconomicstrataasovercrowdingandpoorhygienefacilitatethespread.Themostimpmeanofspreadisdirectcontactwiththeinfectedindividual.Scabiesiswatersheddiseasewhichoccursdietoinadequateuseofwaterandimproperhygiene.Clinicalfeatures:? 1. Severeitchingisthemostprominentclinicalfeatureabdhas followingcharactersticsWorseatnightGenerelisedAffectingseveralfamilymembers2.Bodyareasmostcommonlyinvolvedarewebspacesoffingers,wrists,elbow,axillaandgroinarea,areasknownascircleofHebra.3.Burrowisserpentine(S.shaped),threadlikegreybrownlinewhichrepresentstheintraepidermaltunnelcreatedbymovingfemalemiteinstratumcorneum.Burrowispathognomicsignofscabies.Burrowsareverydifficulttodemonstrateininfants.4.Paulesandpapulovesiculareruptionsduetohypersensitivitytomite
mite5.Pustulescanoccurduetoseceondaryinfection6.Excoriationandscratchmarks7.Historyofinvolvementoffamilymembers
77.Drugcausingexanthema? a)Atropine b)Phenytoin c)Sulfonamide d)Alloftheabove CorrectAnswer-DAns.is'd'i.e.,Alloftheabove
78.A15cmhyperpigmentedmaculeonan adolosentmaleundergoeschangessuchascoarceness,growthofhair&acne.Diagnosisis? a)Melanocyticnevus b)Beckernevus c)Sebaceousnevus d)Sebaceousnevus CorrectAnswer-BAns.is'b'i.e.,BeckernevusBeckerNevusUsuallystartsinadolescenceasanirregularsmoothhyperpigmentedmacule.Usuallyinvolvesshoulder,anteriorchestandscapularregion,althoughanypartofthemaybeinvolved.Slowlygrowsinsizeofapalmwileacquiringthickdarkhair.Oftenlesionresemblingacnevulgarisindifferentstagesmayappearonsurface.Notreatmentisrequired.
79.AllareseeninBehchetssyndromeexcept a)Genitalulcers b)Genitalulcers c)Oralulcers d)Pyodermagangrenosum CorrectAnswer-DAns.is'd'i.e.,Pyodermagangrenosum
80.Ulceronecroticnoduleisseenin? a)Lucioleprosy b)Lucioleprosy c)Indeterminateleprosy d)Histoidleprosy CorrectAnswer-AAns.is'a'i.e.,LucioleprosyLuciophenomenonItisfoundinlucioleprosywithtype2leprareaction.Itisprevalentinmexico.Characterizedbypainfultenderredpatchesparticularlyonextremitieswhichlateronbecomenecroticandfinallydevelopintobrownblackeschar.Ulcersaremorepersistentonlegs.Tuberculoidandindeterminateleprosyarecharacterizedbyhyperpigmentedmaculewithimpairmentofsensations.Inhistoidleprosy,classicalfeatureiserythematousshinyredsubcutaneousorcutaneousnodules,espovertheextensoraspectofextremities,back,buttocks&face.Ulcerationisunusual.
81.Scalpandfaceareinvolvedin? a)Adultscabies b)Nodularscabies c)Infantilescabies d)None CorrectAnswer-CAns.is'c'i.e.,Infantilescabies Type Feature oInfantile Scalp,face,palmsandsolesareinvolved scabieso Crustedhyperkeratoticlesionsonface,palms, Norwegian soles,nails.Itchingisnotprominent.Mitesarescabies foundinthousand,mostsevereformofscabies Crusted Extensivecrusts scabiesNodular Extensivecrusts scabiesGenital Extensivecrusts scabiesAnimal Historyofcontactwithcatordog.Atypical scabies presentation
82.Nervesarenotinvolvedin? a)Tuberculoidleprosy b)Lepromatousleprosy c)Indeterminateleprosy d)Borderlinetuberculoidleprosy CorrectAnswer-CAns.is'c'i.e.,Indeterminateleprosy
83.Grattagetestisusedfor- a)Tineacapitis b)Lichenplanus c)Pemphigusvulgaris d)Psoriasis CorrectAnswer-DAns.is'd'i.e.,PsoriasisBedsidetestsforpsoriasisTwobedsidetestscanbedonetoconfirmtheclinicaldiagnosisofpsoriasis:-i.GrattagetestScrapingthelesionwithaglassslidecausesaccentuationofthesilveryscales.ii.Auspitz'sSignScrapingthelesionwithglassslidecausesaccentuationossliveryscales(asinGrattagetest).Ifscrapingiscontinuedfurther,aglisteningwhiteadherentmembrane(Burlkey'smembrane)appears.OnremovingBurlkey'smembranepunctate(finepinpoint)bleedingbecomevisible,whichisreferredtoasAuspitz'ssign.
84.Treatmentofchoiceforlichenplanus? a)Topicalcorticosteroids b)Systemiccorticosteroids c)Antihistaminics d)Acitretin CorrectAnswer-AAns.is'a'i.e.,TopicalcorticosteroidsTreatmentofLichenplanusThefirstlinetreatmentoflichenplanusaretopicalcorticosteroids.Secondchoicewouldbesystemiccorticosteroidsforsymptomcontrolandpossiblymorerapidresolution.Oralantihistaminicsaregivenforpruritic.PUVAcanbeusedforextensivelesions.Acitretincanbeusedformucosallesions.
85.Keratodermicsandlesisafeatureof? a)Pityriasisrosacea b)Lichenplanus c)Psoriasis d)Pityriasisrubrapilaris CorrectAnswer-DAns.is`d'i.e.,PityriasisrubrapilarisPityriasisrubrapilarisItisachronicpapulosquamousdisorderofunknownetiologycharacterizedby:? 1. Scaling(PityriasismeansscalingSkindisorder)2. Erythmatousplaque(Rubra)3. Follicularpapules(Pilaris) Hencethenamepityriasisrubrapilaris.Twopeaksofageareseen:? 1. 5-10yearsinjuveniletype2. 40-60yearsinadulttype ClinicalpresentationCharacteristiclesionsareerythmatous(orangetopink),follicular,scalyplaques.Acharacteristicfeatureofplaquesisthepresenceofdistinctislandsofnormalskin.SitesofpredilectionTrunk-->Lesionsonthetrunkevolveincraniocaudal(Cephalocaudal)direction.Typically,follicularlesionsareseenonthedorsumofhandsonknuckles-->Nutmegpapules.Associatedfeatures 1. Diffuseerythemaandscalingofface.2. Orangishthickeningofpalmsandsoles(Keratodermicsandals).3. Nails-->Distalyellowbrowndiscolorationandnailplatethickening.
ComplicationsErythrodermaTreatmentLocalizedlesions-->Topicalcorticosteroids+Keratolytics(Salicylicacid,urea)Erythroderma-4VitaminA,Acitretin(Retinoids),oralmethotrexate
86.Schamberg'spurpuraareseenon? a)Face b)Feet c)Chest d)Arms CorrectAnswer-BAns.is'b'i.e.,FeetSchamberg'spurpuraMostcommonfromofpigmentedpurpuradermatosis(PPD).Puncatepurpuramaculesdeveloponlowerextrimities,particularlyaroundankles&pretibialregion.Mostlyasymptomatic
87.Nikolsky'ssignisseenin? a)Pemphigus b)Herpeszoster c)Bullousimpetigo d)Alloftheabove CorrectAnswer-DAns.is`d'i.e.,AlloftheaboveNiko!sky'ssignisseenin?PemphigusToxicepidermalnecrolysisBullousimpetigoStevenjonsonsyndromeStaphylococcusscaldedskinsyndromeHSV&VZVinfectionEpidermolysisbullosaMalignancy(leukemia)MycosisfungoidesBullouslichenplanus
88.Erythemamultiformeismostcommonly causedby? a)Herpessimplex b)Idiopathic c)TB d)Drugs CorrectAnswer-BAns.is'b'i.e.,IdiopathicIdiopathicerythemamultiformeisthemostcommoncauseofEM.HerpessimplexisthemostimportantinfectiouscauseofEM.CausesofErythemamultiformeIdiopathic--)MostcommoncauseViral-->HSV(mostimportant)HBV,Mumps,AdenovirusBacteriaStreptococci,tuberculosisFungal-->Coccidioidomycosis,Histoplasmosis.Drugs--->Antibiotics(Sulphonamide),Phenytoin,NSAIDS.Autoimmunedisease-->SLE,thyroiditis,RAOthers-->Sarcoidosis,Pregnancy,Malignancy.
89.Eyebrowsdon'tgrowbeyondcertain lengthastheyhaveashort? a)Anagenphase b)Telogenphase c)Telogenphase d)Exogenphase CorrectAnswer-AAns.is'a'i.e.,AnagenphaseHairgrowsincyclesofvariousphases.Anagenisgrowthphase.Catagenisinvolutingorregressionphase.Telogenisrestingphase.Exogenissheddingphase.Normally90%ofthefolliclesareinanagenphase,10-14%areinTelogenand1-2%areincatagen.Thecyclesdurationisvariableforthedifferentpartsofthebody.Foreyebrows,thecycleisfinishedin3-4monthswhileforscalpittakes3-4yearstofinish.Thisisthereasonwhyeyebrowshavemuchshorterlengthlimitascomparedtoscalphair.
90.Notacutaneousporphyria? a)Erythropoeiticporphyria b)Hereditarycoproporphyria c)Congenitalerythropoeiticporphyria d)Sideroblasticanemia CorrectAnswer-BAns.is'b'i.e.,HereditarycoproporphyriaPorphyriasPorphyriasareheterogenousgroupofdisorderscharacterizedbydefectivemetabolismofporphyrins.PorphyrinsareimportantintermediatesinbiosynthesisofhemefromglycineandsuccinylCoA.Eachstepiscontrolledbyspecificenzyme.So,prophyriasareduetoinheritedoracquireddeficiencyofenzymesinhemebio-syntheticpathways(alsocalledporphyriaspathway).Theymanifestwitheitherneurologicalcomplicationsorskinproblems(orrarelyboth).Basedonthesiteofoverproductionandaccumulationofporphyrins,porphyriasarebroadlyclassifiedas:?A.Acute(hepaticprophyria) 1. Acuteintermettantporphyria2. 5-ALAdehydratasedeficiency3. HereditaryCoproporphyria4. Variegateporphyria5. Porphyriacutaneatarda B.Cutaneous(erythropoeitic)porphyria 1. Erythropeiticprotoporphyria2. Congenitalerythropoeiticporphyria3. X-linkedsideroblasticAnemia Theacute(hepatic)porphyriasprimarilyaffectnervoussystem
resultinginabdominalpain,vomiting,acuteneuropathy,seizures,muscleweakenss,psychiatric/mentalsymptoms(i.e.,Hallucination,depression,anxiety,paronoia);andautonomicnervousdisturbanceslikehypertension,tachycardia,constipation,arrhythmias,sweating.Thecutaneous(erythropoietic)porphyriasprimarilyaffectskincausingphotosensitivity(photodermatitis)blisters,itching,maculopapularrash.Thereisnoabdominalpain.Therearesomevariationinabovepresentation. 1. Followingtwotypesofhepatic(acute)porphyriasalsoaffectskin:- Hereditarycoproporphyriaandvarigatedporphyria.Thereforethesetwohavebothneuropsychiatricaswellasskinmanifestations. 2. Porphyriacutaneatarda(ahepaticporphyria)doesnothave neuropsychiatricsymptom,ratherithasonlyskinmanifestation. 3. X-linkedsideroblasticanemia(anerythropoieticporphyria)has neitherneuropsychiatricnorskinsymptoms.
91.Potatonoseisseenin? a)Acnevulgaris b)Rhinosporoidosis c)Acnerosacea d)Lupusvulgaris CorrectAnswer-CAns.is'c'i.e.,AcnerosaceaAcnerosaceaAcnerosacea,commonlycalledrosacea,isachronicnon-curableskindiseasewithperiodicupsanddown.Itoccursinmiddleage(30-50years).Itismorecommoninfemales,butismoresevereinmales.Rosaceaisacentrofacialdisease,i.e.,itinvolvesthecentralfaceCheeks,Chin,Forehead,Nose,makingtypicalcruciatepatternofinvolvement.Periorbital&perioralareasarespared.Clinicalfeaturesareintermittantflushingfollowedbymorepermanenterythmaandtelangiectasia.Onthisback-ground,erythmatouspapules,papulopustulesandrarelynodulesdevelop.Lesionsmaybeexacerbatedbylight(photosensitive)andspicyfoods.Complicationsare:? 1. Rhinophyma:-Rhinophymaislarge,bulbous,ruddyappearanceof nosecausedbygranulomatousinfiltrationofskin.Itisslowlyprogressiveconditionduetohypertrophyofsebaceousglandonthetipofnose.ItisalsoknownasPotatonose. 2. Ophthalmologic:-Blephritis,Conjuctivits,Keratitis,.
3. Lymphedema:-Infra-orbitalandonforehead.
92.Bullousimpetigoiscausedby? a)Streptococcus b)Staphylococcus c)Staphylococcus d)Y.Pestis CorrectAnswer-BAns.is'b'i.e.,StaphylococcusImpetigoImpetigoisahighlycontagious,Gram-positivebacterialinfectionofsuperficiallayerofepidermis.ImpetigooccursinTwoforms:?1.Non-bullousimpetigo(Impetigocontagiosa)Itisthemostcommonbacterialinfectionofchildren(occursmainlyinchildrenincontrasttoBullousimpetigowhichoccursininfants).ItiscausedbybothstaphylococcusaureusandhemolyticgroupAstreptococcus(Str.pyogens),thoughitismostlycausedbystaphaureus.Mostcommonlyoccursonface,i.e.,aroundnose&mouth;andexposedparts,i.e.,arms,legs.Presentserythematousmacule/papulewhichchangesintovesiclewhichsoonruptureswithformationofcrusting.Crusthascharacteristicfeatures:- 1. Honey-yellowcolourinstreptococcalimpetigo.2. Waxyinstaphylococcalimpetigo. Lesionhealwithoutscarring.Mucousmembraneinvolvementisrare.Lymphadenopathyiscommon2.BullousimpetigoItiscausedbystaphylococcusaureusmostoftenphagetype71.Itusuallyoccursininfantsandmanifestsasvesiclethatdevelopintobullaandlaterapustulewithoutanysurroundingerythema.Itmainlyoccursonface.Mucousmembranemaybeinvolved(incontrastto
impetigocontigiosa).Lymphadenopathyisrare.
93.Matchsticktestispositivein? a)Rhinophyma b)Rhinosporiodosis c)Lupusvulgaris d)P.versicolor CorrectAnswer-CAns.is'c'i.e.,LupusvulgarisLupusvulgarisLupusvulgarisisachronicandprogressiveformofcutaneoustuberculosisthatoccursintuberculinsensitivepatients.Itisthemostcommontypeofcutaneoustuberculosisandhasmostvariablepresentation.Seeninchildrenandyoungadults,thoughnoageisexempted.Occursonexposedarealikeface(nose,eyelid,pinna);andsometimesonbuttock,trunk.Lesionsareusuallysolitaryandcharacterizedby:- 1. Reddishbrown(erythematous2. Annularinshape3. Indurated4. Slowlyincreasesinsize(graduallyprogressive).5. Healingwithtissuepaperlikescarringatcentre(mostcommon)or edge. 6. Peripheralcrusting7. Blanchingwithglassslide(diascopy)willrevealgreygreenfoci Applejellynodules. 8. Match-sticktestpositive--->Applejellynodulehasnoresistanceto pressurebyasharpmatch-stick.Reappearanceofnewnoduleswithinpreviouslyatrophicorscarredlesionsischaracteristic.Cartilage(Ear,nose)intheaffectedareais
progressivelydestroyed(Lupusvorax);boneisusuallyspared.Buccal,nasalandconjuctivalmucosamaybeinvolvedprimarilyorbyextension.Treatmentisantituberculardrugs(ATT).
94.Onback,bigblackpatchdiagnosisis? a)Seborrheicmelanosis b)Beckernevus c)Lichenplanuspigmentosus d)Pityriasisversicolor CorrectAnswer-BAns.is`b'i.e.,BeckernevusBeckerNevusUsuallystartsinadolescenceasanirregularsmoothhyperpigmentedmacule.Usuallyinvolvesshoulder,anteriorchestandscapularregion,althoughanypartofthemaybeinvolved.owlygrowsinsizeofapalmwileacquiringthickdarkhair.Oftenlesionresemblingacnevulgarisindifferentstagesmayappearonsurface.Notreatmentisrequired.SeborrheicmelanosisBrownishblackpigmentationtypicallydistributrdoverseborrheaareas(forehead&beard,retroauricularfolds,neck,upperpartofchest,interscapularareas)accompaniedbyerythemaanditching.LichenplanuspigmentosusHyperpigmenteddarkbrownorslategreymaculesdistributedmainlyoverexposedareasandflexures.PityriasisversicolorDarkbrowntoblackoverlappingconfluentpatcheswithsatellitelesions,mainlyoveruppertrunkandextendingtoupperarms,neckandabdomen.
95.Whichofthefollowingultra-violet radiationcausemostskindisorder? a)UV-A b)UV-B c)UV-C d)None CorrectAnswer-BAns.is`b'i.e.,UV-BUltravioletradiation(UVR)UVRiselectromagneticradiationwithwavelength(200-400nm)shorterthanvisiblelight,butlongerthanxrays.TherearethreesegmentsofUVR.1.UV-C/ShortwaveUV-radiation(200-290nm)Itismostdangerousasithasseriouseffectsontheskin.But,Itisnotmedicallyimportantasitisabsorbedbyozonelayerandhencedoesnotreachthesurfaceofearthinmeasurableamounts.2.UV-B/mediumwaveUV-radiation(290-320nm)MedicallymostimportantUVRasitcausesmostofthedermatoses,e.g.,sunburn,tanning,photoaging.Itisabsorbedinepidermis.ItisusedinphototherapyasnarrowbandUV-B(NBUVB)whichhaswavelengthof311nm.3.UV-A/LongwaveUV-radiation(320-400nm)Itisabsorbedindermis.Itisfurtherdividedinto:? 1. UVA-2--->320-340nm2. UVA-1--->340-400NM Wood'slampusesUVA-1(365NM).UVAisalsousedinphotochemotherapy(PUVA).
96.Dermatophyesaffect? a)Keratin b)Dermisofskin c)Stratumbasal d)Stratumbasal CorrectAnswer-AAns.is'a'i.e.,KeratinDermatophytesarekeratinophillicfungi,livingonlyonthesuperficialdeadkeratin.Thatiswhytheyinfectskin,hairandnail.Inskintheyinfectmostsuperficiallayeroftheepidermisi.e.stratumcorneum.Theydonotpenetratelivingtissues.Dermatophytescauseavarietyofclinicalconditions,collectivelyknownasdermatophytosis,tineaorringworm.Dermatophyteshavebeenclassifiedinto3genera:-trichophyton,microsporum,epidermophyton. 1. Trichophytonaffects;-skin,hair,nails2. Microsporumaffects;-skin,hair(nailsarenotaffected)3. Epidermophytonaffects:-skin,nails(hairarenotaffected) Deepfungalinfections(eg:-maycetoma,chromoblastomycosis,pheohyphomycosis,sporotrichosis,lobomycosis,rhinosporidiosis)involvesubcutaneoustissue.Dermatophytosisisitchyandscaly
97.Treatmentofdermatitisherpetiformis? a)Glutenfreediet b)Dapsone c)Sulfonamide d)Alloftheabove CorrectAnswer-AAns.is'a'i.e.,GlutenfreedietTineacapitisshowsgreenishfluorescence.Erythrasmagivesacoralpinkhue.Pseudomonasinfectiongivesayellowish-greencolour
98.Brownmacularpigmentationinmalararea inapregnantfemaleisdueto? a)Acnerosacea b)Cholasma c)Acanthosisnigricans d)Urticaricpigmentosa CorrectAnswer-BAns.is`b'i.e.,CholasmaChloasma(Melasma)Melasma(Chlosma)isthemostcommoncauseforfacialpigmentationinIndianpatients.ThereisBrownmacularpigmentationonthemolarareaofface,foreheadandsometimeschin.Itusuallyaffectsyoungandmiddleagedwomen.Whenmelasmaresultsfrompregnancyitisreferredaschloasma.Twomajoretiologicalfactorsare:- 1. Hormonal(estrogen)-->Appearsinpregnancyorinpersonon OCPs. 2. Sunexposure--->EspeciallyUVB. FortreatmentCombinationoftopicalhydroquinone(2-4%),retinoicacidandatopicalcorticosteroids.Otherdrugsare-->Glycolicacid(4-10%),Azelicacid,topicalvitaminC.
99.15mm/cmhyperpigmentedlesionon shoulderenlargingandhairoverit? a)Melanocyticnevus b)Beckernevus c)Sebaceousnevus d)Comedonevus CorrectAnswer-BAns.is'b'i.e.,BeckernevusBeckerNevusUsuallystartsinadolescenceasanirregularsmoothhyperpigmentedmacule.Usuallyinvolvesshoulder,anteriorchestandscapularregion,althoughanypartofthemaybeinvolved.Slowlygrowsinsizeofapalmwileacquiringthickdarkhair.Oftenlesionresemblingacnevulgarisindifferentstagesmayappearonsurface.Notreatmentisrequired.
100.Allaretrueaboutskinexcept: a)Bothdermis&ectodermarederivedfromectoderm b)Skinaccountsfortotalof15%ofbodyweight c)Mostofthecellsinskinarekeratinocytesderivedfrom ectoderm d)Dermisismadeupoftype1andtype3collagenin3:2ratio CorrectAnswer-AAns:A.Bothdermis&ectodermarederivedfromectoderm.Truefact:Dermisderivedfrommesodermandepidermisfromectoderm.
101.Identifytheconditionintheimage? a)Leukoderma b)Piebaldism c)Vitiligo d)DLE CorrectAnswer-AAns:A.LeukodermaLeukodermaisaskindiseasethatcauseslossofskinpigmentation(melanin)thatleadstoskinwhitening.Thewhitepatchesontheskinaretermedasleukoderma.Whentheconditiongetssevere,thespotscoveralmostallpartsofthebodyincludingscalp,faceandthegenitals.
102.Acantholysisis/arenotseenin: a)Lichenplanus b)Bullouspemphigoid c)Dermatitisherpetiformis d)Hailey-Haileydisease e)Pemphigusvulgaris CorrectAnswer-A:B:CAns.(A)Lichenplanus(B)Bullouspemphigoid(C)DermatitisherpetiformisAcantholysis:Separationofepidermalcellsfromeachother.AcantholyticdisordersincludesPemphigusfamily(includingparaneoplasticpemphigus),eosinophilicspongiosis,Darier'sdisease,Hailey-Hailey'sdisease(Familialbenignchronicpemphigus)andtransientacantholyticdermatosis(Grouer'sdisease),aswellasspecifichistologicalpatternssuchasfocalacantholyticdyskeratosisandepidermolytichyperkeratosis.
103.Whichofthefollowingepidermallayeris deadlayer? a)Stratumbasale b)Stratumspinosum c)Stratumcorneum d)Stratumgranulosum CorrectAnswer-CAns.C.StratumcorneumStratumcorneum(Hornylayer):Thisisthemostsuperficiallayerofepidermisandskin.Cellsarefullykeratinizedandendupasanucleatedeadcells.Therefore,stratumcorneumisdeadlayer.Stratumcorneumislasttodevelop4Thereforeinprematurenewbornitisabsent.
104.Langerhanscellareseeninwhichlayer ofskin? a)Stratumbasal b)Stratumcarneum c)Stratumgranulosum d)Stratumspinosum CorrectAnswer-DAns.D.Stratumspinosum[RefVenkataram151/ep.2]LangerhanscellsThesecellsarefoundinstratumspinosumandfunctionasepidermalmacrophages(Antigenpresentingcells).Thesecellscontaincharacteristictennisracquetshapedgranules(Birbeckgranules).
105.Increaseinthethicknessoftheprickle celllayeroftheepidermisiscalled? a)Spongiosis b)Acanthosis c)Hypergranulosis d)Hyperkeratosis CorrectAnswer-BAns.B.Acanthosis[RefRook's7th/ep.7.36]ImportantterminologyrelatedtoepidermallayersSeparationofkeratinocytesduetolossofintracellularbridges-AcantholysisIntracellularedemaofkeratinocytesBallooning
106.Substancecommoninskinandhairis? a)Keratin b)Laminin c)Nectin d)Vimentin CorrectAnswer-AAns.A.Keratin[Ref:IADVL3rd/ep.12]Keratinisafamilyoffibrousstructuralproteins.Keratinistheproteinthatprotectsepithelialcellsfromdamageorstress.Keratinisthekeycomponentofourskin,hairandnails.Itsproteinbuildingblockshaveaminoacidchains,coiled,cross-linkedandclassifiedaseitherhardorsoft.
107.Whichofthefollowingisamelanising agent? a)Methoxsalen b)Dapsone c)Minocycline d)Kojicacid CorrectAnswer-AAns.A.Methoxsalen[RefInternet&IADVL3'/ep.756]Melanizingagentsaredrugsthatincreasesensitivitytosolarradiationandpromotere-pigmentationofde-pigmentedareasofskin.Melanizingagentssensitizetheskintosunlight.Asaresult,erythema,inflammationandpigmentationoccurs.
108.Fordycespotsinvolve? a)Penis b)Tongue c)Fingers d)Nails CorrectAnswer-AAns.A.Penis[RefIADVL3"1/ep.1779]Fordycespots(FordycegranulesorFordycedisease):Fordyce'sspotrepresentsectopicsebaceousglandsonlips(mostcommonsite)andoralmucosa.Theymayalsoappearonvulvaandpenis,wheretheyarecalledTyson'sgland,i.e.,ectopicsebaceousglandatpenis(prepuce)andvulvaiscalledtyson'sgland.Theseglandshavehistopathologysimilartonormalsebaceousglands,despitetheirectopiclocation.
109.Mostcommonetiologyoferythema multiformeis? a)Idiopathic b)Drugs c)HSV d)TB CorrectAnswer-AAns.A.Idiopathic[Ref:NeenaKhannaYalep.61,63]ErythemamultiformeMostofthecasesoferythemamultiformeareidiopathic,butamongstthecausativeagentsHerpessimplexvirusisthemostimportantcause.Erythemamultiformeisanacute,oftenselflimitederutptioncharacterizedbyadistinctiveclinicaleruption,thehallmarkofwhichistheTargetlesion(IrislesionorBulle'seyelesion).
110.Hypopigmentedmaculesarefoundin? a)Addison'sdisease b)Porphyria c)Cutaneousmastocytosis d)Tuberoussclerosis CorrectAnswer-DAns.D.Tuberoussclerosis[RefRook's7th/ep.17.37-17,39.58-39.59;Behl10thiep.154]Causesoflocalizedhypopigmentation(Macule/Patch):PrimaryCutaneousdisorders:VitiligoPityriasisversicolorPityriasisalbaPostinflammatoryNevusdepigmentosus(achromicus)NevusanemicusPiebaldismChemicalleukodermaIdiopathicguttateHypomelanosisSystemicdiseases:SclerodermaTuberoussclerosisSarcoidosisCutaneousT-celllymphomaLeprosy(tuberculoid&Indeterminate)OnchocerciasisHypomelanosisofItoIncontinetiapigmenti(StageIV)
Vogt-Koyangi-Haradadisease
111.Whichofthefollowingdiseaseisclosely relatedtoenetropathy? a)LinearIgAdisease b)Pemphigusfoliaceous c)Dermatitisherpetiformis d)Erythemamultiforme CorrectAnswer-CAns.C.Dermatitisherpetiformis[Ref:Behl10m/ep.293]DermatitisherpetiformisisadiseaseoftheskincausedbythedepositionofIgAinpapillarydermisandalongtheepidermalbasementmembranezone(Dermoepidermaljunction).Almostallpatientsofdermatitisherpetiformishaveanassociatedglutensensitiveenteropathy.
112.ResidualHypopigmentationfollowinga drugreaction,isbestknownas? a)Vitiligo b)Chemicalleukoderma c)Postinflammatoryhypomelanosis d)Piebaldism CorrectAnswer-CAns.C.Postinflammatoryhypomelanosis[RefIADVL3"1/ep.747-748]Amonggivenoptions,postinflammatoryhypomelanosisisthebestanswer.understandletushavealookatthedefinitionfewimportantterms.Vitiligoisalsoanacquiredconditionwithlossofpigmentationbutmostcasesareidiopathic.Itismainlyconsideredtobeanautoimmunecondition.Precipitatedbyhormonalchanges,acuteemotionaltraumaorstressoranyconditionleadingtoimmuneimbalance.So,anyhypomelanosisresultingafterinflammationisknownaspostinflammatoryhypomelanosis(includingleucoderma).Sometimesboththetermsareusedsynonymously.Whereastheterm'chemicalleucoderma'isusedonlywhenthererepeatedexposure(contact)tosomespecificchemical.Thereforeamonggivenoptions,postinflammatoryhypomelanosisisthebestanswerasdrugreactionisaninflammatoryconditionleadingtoresidualhypopigmentation.
113.Mostcommonpatternofonychomycosis is? a)Distalandlateralsubungual b)Proximalsubungual c)Whitesuperficial d)Totaldystrophic CorrectAnswer-AAns.A.Distalandlateralsubungual[RefIADVL3fli/ep.266]Distalandlateralsubungual:DSOisthemostcommonform(90%)ofonychomycosis.CharacterizedbyinvasionofthenailbedandundersideofthenailplatebeginningatthehyponychiumandmigratesproximallythroughtheunderlyingnailmatrixDSOisusuallycausedbythedermatophyteT.rubrum.Infectionofthetoenailsbeingmuchmorecommonthaninfectionofthefingernails
114.Whichofthefollowingisnotafeatureof dermatomyositis? a)'V'sign b)Holstersign c)Pokiloderma d)Groovesign CorrectAnswer-DAns.D.Groovesign[Ref:Rooks7th/ep.127-38;IADVL3'/ep.1236]Groovesign(adepressionalongthecourseofaveinorbetweenmusclegroups)isseenindeepmorphea.Cutaneoussignsoddermatomyositis 1. Gottron'spapules:lilacorviolaceouspapulesonknucklesand dorsaofhands 2. Gottron'ssign:violaceouserythemawithedemaovershoulders, armsandforearms 3. Heliotropesign:violaceouserythemawithedemaovereyelids, periorbitalregion 4. Poikiloderma:atrophyofskin,hypopigmentation,dialaltedblood vesselsovertrunk 5. Mechanichand:symmetricalhyperkeratosisonulnaraspectof thumbandradialaspectoffingers 6. Shawlsign:violaceouserythemaextendingfromdorsolateral aspectofhands,forearmsandarmstoshouldersandneck. 7. 'V'sign:violaceouserythemainaVshapeddistributionover anteriorneckandchest. 8. Holstersign:b/1symmetrical,patchymacularviolaceouserythema displayibgareticuloidorlevidoidarrayoverthelateralaspectof
upperthighandhips. 9. Calcinosiscutis:calciumdepositsinskin(injuvenilevariant) 10. Miscellaneoussigns:Photosensitivity,vasculitis,panniculitis,Nail- foldtelangiectasia
115.Notafeatureofcandidalintertrigois? a)Obesityisariskfactor b)C.albicansisthemostcommoncausativespecies c)Centralscaling d)Satellitelesions CorrectAnswer-CAns.C.Centralscaling[RefNeenaKhanna's4th/ep.294]CandidalintertrigoInfectionofskinfoldsiscalledcandidalintertrigo.Itischaracterizedbyreddened(erythematous)plaques,withsatellitepustules(peripheralpustules).Theremaybefinescalesatperiphery.Overtheregionscoveredwiththickstratumcorneum,i.e.,toewebsandFingerwebs,thelesionappearasmoist,whitecoloredplaques.Virtuallyanybodyfoldmaybeaffected.Groins,axillae,submammaryfoldsinfemales,toes&fingerwebsarecommonsitesofaffection.Lesionspersistingforalongtimeleadtothedevelopmentofsuperficialpainfulerosionsthattakealongerperiodtoheal.Thisiscalled"erythemaoflacquer.
116.Nevussimplexcommonlypresentsat? a)Face b)Trunk c)Legs d)Hand CorrectAnswer-AAns.A.Face[RefIADVL3rdiep.201]Nevussimplex(Nevusflammeusnuchae/storkbite/Salmonpatch)Itisacongenitalcapillarymalformationpresentsin30percentofnewbornbabies.Astorkbiteisduetodilationofbloodvesselsandmaybecomedarkerwhenthechildcriesorstrains.Theyaremostcommonontheforehead,eyelids,upperlip,betweentheeyebrows,andthebackoftheneck,thesemarksfadeastheinfantgrows.
117.Scalingisnotfeatureofwhichofthe following? a)Tinea b)Lichenplanus c)Herpeszoster d)Reiter'sdisease CorrectAnswer-CAns.C.Herpeszoster[RefBeh110th/ep.254-268;NeenaKhanna3"Yep.37]Inherpesthereiscrustingbutnoscaling.Papulo-squamousdisordershavefollowingtwocharacteristics:-Papule(solidelevatedskinlesion<1cms)orplaques(solidelevatedlesion>1cm).ii)Scales(visibleexfoliationoftheskinwhichrepresntsvisiblesheddingofskin)."Papulosquamousdisordersmanifestpapulessurmountedbyscales".
118.A40yearsoldmalepatientpresentswith multipleerythematousannularlesionswithperipheralscalesarrangedpredominantlyontrunk.Treatmentofchoiceis? a)Topicalsteroids b)Systemicsteroids c)SystemicAzathioprine d)Topicalantifungal CorrectAnswer-AAns.A.Topicalsteroids[Ref:Beh110`Vep.263]PityriasisrubrapilarisClinicalpresentationofthepatientinquestionsuggeststhediagnosisofPRPforwhichtreatmentofchoiceistopicalsteroidsandsalicylicacid.TreatmentLocalizedlesions-Topicalcorticosteroids+Keratolytics(Salicylicacid,urea)Erythroderma-VitaminA,Acitretin(Retinoids),oralmethotrexate.
119.Woronoff'sringisafeatureof? a)Psoriasis b)Lichenplanus c)Pityriasisrosea d)Pemphigus CorrectAnswer-AAns.A.Psoriasis[RefRooks7"Vep.35.1-35.63]ClinicalfeaturesofPsoriasis(psoriasisvulgaris)Psoriasisoccursatallages,mostpatientsareyoungormiddleagedadults.Thetypicallesionisnummularroundplaquewhichhasfollowingcharacteristicfeatures:WelldefinedProfuse,silverywhite,powderyscales(Candledropscales)-Loselyadherentandeasilydrops.Brightrederythmatousbase.PlaqueisoftensurroundedbyahypopigmentedhaloRingofWoronoff.
120.Trueabouterythematoxicumis? a)Commoninpre-termbaby b)Lesionscontainmanylymphocytes c)Canbelifethreateningcondition d)Occursmainlyinneonatalperiod CorrectAnswer-DAns.D.Occursmainlyinneonatalperiod[RefIADVL.3rdlep.163]*Erythematoxicumneonatorum(ETN/babyacne/toxicerythemaofthenewborn)-Itisabenign,asymptomaticskinconditionthatischaracterizedbysmall,erythematouspapules,vesicles,and,occasionally,pustules.-Thelesionsareusuallysurroundedbyadistinctivediffuse,blotchy,erythematoushalo-Itismorecommoninbabiesbornatfullterm(between37and40weeksofgestation)comparedwithprematurebabies.-Onlyoccursduringtheneonatalperiod,usuallybetweenday2-5afterbirthandtypicallyresolveswithinfirsttwoweeksoflife.-Thefluidfromerythematoxicumlesionswillshowmanyeosinophils
121.Mostimportantfactorincausationof Ingrowntoenailis? a)Fungalinfection b)Illfittingshoes c)Geneticpredisposition d)Nutritionaldeficiency CorrectAnswer-BAns.B.IllfittingshoesIll-fittingshoes:Ingrowntoenail(unguisincarnates/onychocryptosis)Itisacommonpainfulconditioninwhichthenailgrowssothatitcutsintooneorbothsidesoftheparonychiumornailbed.Whileingrownnailscanoccurinthenailsofboththehandsandthefeet,theyoccurmostcommonlywiththetoenails.Presentswithpain,tenderness,rednessandswellingalongoneorbothsidesoftheaffectednail.
122.Whichofthefollowingistrueabout xerodermapigmentosa? a)Autosomaldominant b)Goodlongtermprognosis c)Purinedimmers d)DNArepairdefect CorrectAnswer-DAns.D.DNArepairdefect[RefRook's4thiep.78.12]XerodermapigmentosaMoleculardefect:ExposuretoUVraysdamagesDNAduetoproductionofconvalentlinkagesbetweenadjacentpyrimidines(pyrimidinedimmers).NormallythedamagedDNAisrepairedbyexcisionandrepair.InxerodermapigmentosatherepairofUVdamagedDNAisdefective.Itisanautosomalrecessivedisorder.
123.Whichofthefollowingisnotafeatureof lichenplanus? a)Pterygium b)Spontaneoushealing c)Scarringalopecia d)Notpremalignant CorrectAnswer-DAns.D.Notpremalignant[RefBehl/ep.265;Rooks7th/ep.5.13]Veryrarelychroniculcerativelesionsmaydevelopmalignantchanges,i.e.,squamouscellcarcinoma.Clinicalfeaturesoflichenplanus.
124.Mostcommonmetalresponsiblefor contactdermatitisis? a)Gold b)Silver c)Nickel d)Mercury CorrectAnswer-CAns.C.Nickel[RefAndrew'sdiseasesofskinE-bookp99&IADVL3rd/ep.559]Contactdermatitisismainlyoftwotypes:A.IrritantcontactdermatitisDuetodirectirritantactionofthemateriale.g.Solvents,Alkalis,Detergents.Mostcommonsitesarehands&forearms.B.AllergiccontactdermatitisItisduetodelayedhypersensitivity(typeIVhypersensitivity)toaparticularantigeninasensitizedindividual.Themostcommonallergenscausingallergiccontactdermatitisarepollenandmetals: 1. Parthenium(Congressgrass)2. Nickel
125.Whichofthefollowingisnottruefor scabies? a)Wristiscommonsiteinchildren b)Burrowsareintradermallesions c)Papulesandpustulesareduetohypersensitivitytomite d)Itchinggeneralized CorrectAnswer-BAns.B.Burrowsareintradermallesions[RefBehl10th/ep.179]Burrowistheserpentine(S-shaped),threadlikegray-brownlinewhichrepresenttheintraepidermaltunnelcreatedbythemovingfemalemiteinstratumcorneum.BurrowisPathognomicofscabies.Burrowsaredifficulttodemonstrateininfant.Clinicalfeaturesofscabies1.Severeitchingisthemostprominentsymptom,andhasfollowingcharacteristicfeatures:WorseatnightGeneralizedAffectingseveralfamilymembers2.InScabies,severeitchingtypicallyworsenatnight,mostnotablyalongthewebspacesoffingers,wrists,elbows,axillaeandgroinarea-AreasknowascircleofHebra.3.Papulesandpapulovesiclesduetohypersensitivitytomite.4.Pustulescanoccurduetosecondaryinfection.5.Excoriationandscratchmarks.6.Historyofinvolvementoffamilymember
126.Treatmentofchoicefororalcandidiasis is? a)Terbinafin b)Nystatin c)Griesofulvin d)Seleniumsulphide CorrectAnswer-BAns.B.Nystatin[RefIADVL3rdlep283]TreatmentofcutaneouscandidiasisTopical(TOCforuncomplicatedcases):-nystatinsuspension,clotrimazoletroches,gentionviolet,chlorhexidine,ketoocnazole,amphotericingel.Systemic(reinfection,unresponsive&chroniccases):-oralfluconazole,itraconazoleorketoconazoleareneeded.
127.Scabiesiscausedby? a)Mite b)Tic c)Virus d)Fungus CorrectAnswer-AAns.A.Mite[RefBehl10thiep.179]ScabiesisanintenslypruriticskininfestationcausedbySarcoptesscabiei,anacarus(mite).Scabiesusuallyaffectschildrenbutcanoccuratanyage.Morecommoninlowsocioeconomicstrataasovercrowdingandpoorhygienefacilitatetransmission.Themostimportantmeansoftransmissionisviadirectcontactwithaninfectedindividual.Scabesisawaterwasheddiseasewhichoccursduetoinadequateuseofwaterorimproperhygiene.
128.Volcanosignisseenin? a)Leprosy b)Leishmaniasis c)Lupusvulgaris d)DLE CorrectAnswer-BAns.B.Leishmaniasis[RefIndianDermatolOnlineJ.2012Sep-Dec;3(3):159-165.doi:10.4103/2229-5178.101810]Volcanosign:DescriptivetermforthemorphologicfeatureofOldWorldcutaneousleishmaniasis.Thelesionstartsasasmallnontenderpapule,whichenlargesinsizeandulceratesinthecentre.Theborderofthecrustedulceroftenhasanerythematousrimandiscalledas"Volcanosign".
129.Seleniumsulphideisusedinthe treatmentof? a)Scabies b)T.versicolor c)T.cruris d)Cutaneousleishmaniasis CorrectAnswer-BAns.B.T.versicolor[RefHarrison17th/ep.318]Seleniumsulphide(2.5%)indetergentbaseisappliedalloverbodybelowneck(sparingthegenitalia),leftovernightandwashedofnextmorning.Twotothreeapplicationsappliedonceortwiceaweekusuallyclearstheinfection.TreatmentofP.versicolor 1. Systemicagents:-azolessuchasketoconazole,fluconazoleor itraconazole. 2. Topicalagents:3. Azoles-clotrimazole,econazole,miconazole,ketoconazole.4. Others-seleniumsulfide(2.5%),sodiumthiosulphate(20%), whitfield'sointment(3%Salicylicacid+6%Benzoicacid),zincpyrithione(1%),tolnaftate,ciclopiroxolamine.
130.Firstgenerationtopicalretinoidis? a)Retinoicacid b)Adapalene c)Tazarotene d)Acitretin CorrectAnswer-AAns.A.Retinoicacid[RefComprehensivedermatologicaldrugtherapyp.254&internet]RetinoidsTheretinoidscompriseaclassofchemicalcompoundsthatarevitamersofvitaminAorarechemicallyrelatedtoit.Retinoidshavefounduseinmedicinewheretheyregulateepithelialcellgrowth.Retinoidshavemanyimportantfunctionsthroughoutthebodyincludingrolesinvision,regulationofcellproliferationanddifferentiation,growthofbonetissue,immunefunction,andactivationoftumorsuppressorgenes.
131.Mostcommontypeofcutaneous mastocytosisis? a)Solitarymastocytoma b)Urticariapigmentosa c)Telangiectasiamaculariseruptivaperstans d)Diffuseerythrodermic CorrectAnswer-BAns.B.Urticariapigmentosa[RefIADVLtextbookofdermatology3rdep.146Urticariapigmentosa:(Generalizederuptionofcutaneousmastocytosis(childhoodtype).Itisthemostcommonformofcutaneousmastocytosis.Urticariapigmentosaismostcommoninchildren.Itcanalsooccurinadults.Itisafamilialcutaneousdisordercharacterisedbygeneraliseddistributionofredbrownmacules.Eachlesionrepresentsacollectionofmastcellsinthedermiswithhyperpigmentationofoverlyingepidermis.Themostcharacteristicfeaturesisthattheselesionsurticateonscratching.
132.Treatmentforimpetigoincludesall except? a)Topicalmupirocin b)Systemicerythromycin c)Topicalgentamycin d)Systemiccephalosporins CorrectAnswer-CAns.C.Topicalgentamycin[RefIADVL3rd/ep.235]*"Topicaluseofgentamycinshouldbeavoidedasgentamycinresistancecandevelopanditcanbetransferredbetweendifferentspeciesandstrainsofstaphylococcus."Treatmentofimpetigo*Impetigocontagiosum-Localized4Topicalantibioticslikefusidicacidormupirocin-Extensive-Systemicantibiotics(erythromycingrouptocoverstaphylococcusandstreptococcus).-Ifresponseispoor,oxacillin-Clavulanicacidorcephalexincanbetried.BullousImpetigo*LocalizedTopicalfusidicacidormupirocin*Extensive4Systemicantistaphylococcalantibiotics(flucloxacillin,amoxicillin-clavulanicacid,methicillinorerythromycin)
133.FalseaboutLanger'slinesis? a)Remainconstantthroughoutlifetimeofaperson b)Correspondtothecollagenfibersindermis c)Incisionalongtheselinesproducesbetterscar d)Skinalongtheselinesisleastflexible CorrectAnswer-AAns.A.Remainconstantthroughoutlifetimeofaperson[Ref:IADVLtextbookofdermatology3rdlep.175&Internet]Langer'slinesAlsocalledcleavagelines,isatermusedtodefinethedirectionwithinthehumanskinalongwhichtheskinhastheleastflexibility.Theselinescorrespondtothealignmentofcollagenfiberswithinthedermis.Usually,asurgicalcutiscarriedoutinthedirectionoflanger'slines,andincisionsmadeparalleltolanger'slinesgenerallyhealbetterandproducelessscarring.DirectionalchangesofLanger'slineshavebeenknowntooccurwithinthecourseofaperson'slifetime.Sometimestheexactdirectionoftheselinesareunknown,becauseinsomeregionsofthebodytherearedifferencesbetweendifferentindividuals.
134.Jockitchiscausedby? a)Epidermophytonfloccosum b)Candidaalbicans c)Trichophytontonsurans d)Malasseziafurfur CorrectAnswer-AAns.A.Epidermophytonfloccosum[RefNeenaKhanna3rd/ep.242-244]Tineacruris(Jockitch):ItisalsoknownasDhobi'sitch.Tineacrusisisdermatophyticinfectionofthegroinandadjacentskin.Theclassicalappearanceoftineacrurisisred(erythematous)scalylesionwithclearcentre.Marginsarewelldefinedwithraisedborders.Itchingisveryprominent.Themostcommonsitesofinvolvementaregenitalareaandmedialaspectofupperthigh(Mostcommonsiteofdermatophytosisinmales).Tcrurisusuallyaffectyoungadultmale.InIndiatrichophytonrubrumisthemostcommoncauseandinwesterncountriesepidermophytonfloccosumisthemostcommoncause.
135.Resorcinolisusedinthetreatmentof? a)Lichenplanus b)Acne c)Vitiligo d)Scabies CorrectAnswer-BAns.B.Acne[RefContactandoccupationaldermatologyp.195]Resorcinolisincludedinmanyantisepticandkeratolytictopicalmedications.Usesincludepsoriasis,hidradenitissuppurativa,eczema,acne,seborrhea,corns,calluses,warts,andotherskindisorders.
136.Multiplepsoriaticlesionsonhands. Treatmentofchoiceis? a)NBUVB b)Systemicmethotrexate c)Topicalsteroidsandsalicylicacid d)Systemicsteroids CorrectAnswer-CAns.C.Topicalsteroidsandsalicylicacid[RefNeenaKhanna3rdlep.46]Preferredtreatmentforlocalizedpsoriasisistopicalcoaltarorshortcontact,dithroanol.Alternativeistopicalsteroids+Salicylicacid.
137.Hertoghe'ssignisseenin? a)Atopicdermatitis b)CutaneousTB c)Lichenplanus d)Psoriasis CorrectAnswer-AAns.A.Atopicdermatitis[RefIndianDermatolOnlineJ.2012Sep-Dec;3(3):159-165.doi:10.4103/2229-5178.101810]TheSignofHertogheorQueenAnne'ssignisathinningorlossoftheouterthirdoftheeyebrows(superciliarymadarosis).Itisaclassicalsignofhypothyroidismoratopicdermatitis.Itcanalsobeseeninleprosy,myxedema,follicularmucinosis,trichotillomania,ectodermaldysplasia,discoidlupuserythematosus,alopeciaareata,syphilis,ulerythemaophryogenes,systemicsclerosisandHIVinfection.
138.Treatmentofchoiceforerytherodermic psoriasisis? a)Prednisolone b)Hydroxyurea c)Acitretin d)Ciclosporin CorrectAnswer-CAns.C.Acitretin[Ref:NeenaKhanna3rdlep.46]MethotrexateistheDOCforErythrodermicpsoriasis.Acitretinisanalternative.
139.Preferredconcentrationofminoxidilfor femaleandrogeneticalopeciais? a)2% b)5% c)8% d)10% CorrectAnswer-AAns.A.2%[RefIADVL3'/ep.891]Infemaleandrogenicalopeciaresultsaresimilarwith2%and5%minoxidilbutsideeffectsaremorewith5%solution.Whereasinmales5%ismoreefficacious.Thereforeinafemalepatient2%minoxidilispreferredwhereasinmales5%solutionisthepreferredchoice.
140.Normalepidermalturnovertimeis? a)1week b)2weeks c)3weeks d)4weeks CorrectAnswer-CAns.C.3weeks[Ref:NeenaKhanna3rdlep.297;Roxburgh's7th/ep.62]TreatmentofscabiesinchildrenTopicalpermethrin(5%cream)isasafeandeffectivescabicideinchildren.Itisrecommendedasafirst-linetherapyforpatientsolderthan2monthsofage.Becausetherearetheoreticalconcernsregardingpercutaneousabsorptionofpermethrinininfantsyoungerthan2monthsofage,guidelinesrecommend7%sulfurpreparationinsteadofpermethrin.
141.Alopeciauniversalisis? a)Lossofallthescalphair b)Lossofallbodyhair c)Losshairatthescalpmargin d)Malepatternhairloss CorrectAnswer-BAns.B.Lossofallbodyhair[RefFitzpatrick]Inalopeciaaerata,whenthereistotallossofscalphairitiscalledAlopeciatotalis.WhenthereislossoftotalbodyhairitisreferredasAlopeciauniversalis.Alopeciaalongthescalpmarginiscalledophiasis.Aninverseophiasispattern(sisaphio)iswhenitsparesoccipitalregionandaffectsrestofthescalp.
142.Treatmentofchoiceforscabiesinan infant<6monthsis? a)BHC b)Ivermactin c)Permathrin d)Crotomiton CorrectAnswer-DAns.D.Crotomiton[Ref:NeenaKhanna3rdlep.297]Ivermectinistheonlyoraldrug,availableforscabiestreatment.
143.Aknowncaseofdiabetesdevelops annularorangeskinlesions,whichdisappearafterbiopsy.Thisphenomenonisknownas? a)Koebner'sphenomenon b)ReverseKoebner'sphenomenon c)AsboeHensonsign d)Isotopicphenomenon CorrectAnswer-BAns.B.ReverseKoebner'sphenomenon[Refhttps://www.researchgate.net/publication/268343496_Proposed_classification_for_koebner_wolfisotopic_renbok_koebner_nonreaction_isotopic_nonreaction_other_relatedphenomen]Annularorangeskinlesionsinadiabeticindicatetowardsgranulomaannulare.Therehavebeenfewreportsofdisappearanceoflesionsafterbiopsyingranulomaannulare.ThisphenomenonisknownasreverseKoebner'sphenomenon.
144.Oraltreatmentofchoiceforscabiesis? a)Albendazole b)Itraconazole c)Sulphur d)Ivermactin CorrectAnswer-DAns.D.Ivermactin[RefBehl10th/ep.406;NeenaKhanna3rd/ep.50,51]Pityriasisrosea:P.roseaisselflimitingdisease,subsideswith6-12weeks.P.roseaisacommonscalydisorder,occuringusuallyinchildrenandyoungadults(10-35years).Characterizedbyround/ovalpinkbrownpatcheswithasuperficial,centrifugalscale,distributedovertrunkinaChristmastreepattern.Theexactetiologyisnotknown,butitisconsideredtobeaviraldisease;HumanHerpesvirus6(HHV6)andHumanHerpesvirus7(HHV7)mayplayarole.
145.Pityriasisroseaclearswithin? a)1-2weeks b)2-4weeks c)4-8weeks d)6-12weeks CorrectAnswer-BAns.B.2-4weeks[RefBehl10th/ep.406;NeenaKhanna3rd/ep.50,51]Pityriasisrosea:P.roseaisselflimitingdisease,subsideswith6-12weeks.P.roseaisacommonscalydisorder,occuringusuallyinchildrenandyoungadults(10-35years).Characterizedbyround/ovalpinkbrownpatcheswithasuperficial,centrifugalscale,distributedovertrunkinaChristmastreepattern.Theexactetiologyisnotknown,butitisconsideredtobeaviraldisease;HumanHerpesvirus6(HHV6)andHumanHerpesvirus7(HHV7)mayplayarole.ClinicalmanifestationsofP.rosea:Thediseasestartswithanupperrespiratoryprodromeoramildflu.After1-2weeks,annularerythematousplaqueappearsontrunkthatisreferredtoasmotherpatchorheraldpatch.Overthenext1-2weeks,freshpatchappearalloverthetrunk,inaChristmastreeconfigurationorFirtreeConfiguration.
146.Periungualdesquamation,whichisa characteristicfeatureofKawasakisyndrome,occursat? a)1st-2ndweek b)2nd-3rdweek c)3rd-4thweek d)4th_5thweek CorrectAnswer-BAns.B.2nd-3rdweekPeriungualdesequamationinkawasakidiseasestartsbetween10-18days.
147.TrueaboutKeratinocyteis? a)Ectodermderivedcell b)Presentonlyinbasallayer c)Matureinbasallayer d)Differentiateinbasallayer CorrectAnswer-AAns.A.EctodermderivedcellTheprincipalcellsofepidermisarekeratinocytes.Keratinfilamentisthehallmarkofkeratinocytes.Keratinocyteshasfollowingfeatures: 1. Proliferate(divide)inbasallayer2. DifferentiationoccursinstratumsPinosumandstratumgranulosum.3. Completelymatureanddieinstratumcorneum. So,keratinocytesarepresentinallfourlayersofepidermis,Keratinocytesarederivedfromectoderm.
148. Odlandbodiesareseeninwhichlayerof epidermis? a)Basalcelllayer b)Pricklecelllayer c)Stratumgranulosum d)Stratumcorneum CorrectAnswer-CAns.C.StratumgranulosumOdlandbodiesaremembranecoatedgranulesinstratumgranulosum,whichcontainlipidswhichisresponsibleforbarrierfunctionofthislayer.Thislayeralsocontainsdiamondshapedkeratohyalinegranules,whicharethecharacteristicfeaturesofthislayer.Thesekeratohyalinegranulescontainfilaggrinproteinwhichisresponsibleforaggregationofkeratinfilaments.
149.Whichofthefollowingdrugcanleadto pemphigus? a)Penicillamine b)Isoniazid c)Carbamazepine d)Furosemide CorrectAnswer-AAns.A.PenicillamineDrugscausingpemphigus-PenicillaminePenicillinsandCefalosporinsCaptopril,Iodine,LithiumPhenophthelin,PropanololRifampicinePhenytoin,Phenylbutazone,Salicylates,Piroxicam,Sulphonamides
150.Inwhichofthefollowingphototherapyis usefulintreatment? a)Psoriasis b)Tineacorporis c)Pemphigus d)PMLE CorrectAnswer-AAns.A.PsoriasislndicationsforPUVAandUVB 1. Establishedmajorindications:-Psoriasis,atopicdermatitis,vitiligo, mycosisfungoides,Polymorphiclighteruption,pompholyx. 2. Lessfrequentlytreated(lessevidenceofeffectiveness):-Pityriasis rosea,morphea,chronicurticaria,Pityriasislichenoidchronica,Alopeciatotalis&Universalis,Lichenplanus,Pityriasisrubrapilaris,Granulomaannulare,Generalizedpruritis,Nacrobiosislipoidics.
151.Allaretrueaboutactiniclichenplanus except? a)Associatedwithseverepruritus b)Autoimmuneetiology c)Voilaceousbrownpapules d)Usuallyaffectsexposedareasofbody CorrectAnswer-AAns.A.AssociatedwithseverepruritusActinicLichenPlanus(lichenplanussubtropicus/tropicus/lichenplanusactinicus)Lichenplanusisanautoimmunedisease.Commoninspringandsummersintropicalcountries.UsuallyaffectschildrenandyoungadultsSunlightisconsideredtobethepredisposingfactorthereforelesionsaremorecommononsunexposedareas(face,dorsumofhand,forearmsandarms,napeoftheneck).Papulesarehyperpigmentedwithvoilaceous-brownwithwell-definedhypopigmentedborder.Pruritrusandscalingareminimal.
152.Acanthosisnigricansischaracterizedby allofthefollowingexcept? a)Commoninobesepeople b)Associatedwiththickskinwithhyperpigmentaion c)Histologicallythereishypermelanosis d)Maybeasignofinternalmalignancy CorrectAnswer-CAns.C.HistologicallythereishypermelanosisAcanthosisnigricansisbrowntoblackdiscolourationwhichusuallyaffectsbodyfoldslikeaxilla,groin,umblicus,forehead.Acanthosisnigricansoccursinindividualsyoungerthan40yearsofage.Itisassociatedwithobesity(mostcommon);endocrinopathylikeinsulinresistanceDM,hypothyroidism,Bloomsynd.,PCOD,andinternalmalignancye.g.gastricadenocarcinoma.Histopathologically,Papillomatosisisthecharacteristicfeaturewhereasthereisnohypermelanosis.n
153.Whichofthefollowingischaracterized byasolitarypainlessulcerongenitalia? a)Herpes b)Softchancre[chancroid] c)Hardchancre d)Traumaticulcer CorrectAnswer-CAns.C.HardChancreCharacteristicsofvariousdifferenttypesofgenitalulcers-Primarysyphilis(hardchancre):-punchedout,painless,non-bleeding(avascular)ulcerwith6rminduration.Donovanosis:-oneormore,painless,bleeding(vascular)ulcerswithinduration.Chancroid(softchancre):-multiple,painful,bleeding(vascular)ulcerswithnoorsoftinduration.LGV:-single,painless,non-bleedingulcer.Herpesgenitalis:-multiplepainful/asymptomaticulcers.
154.Epidermalnevusfollows? a)Blaschko'slines b)Langer'slines c)Vasculature d)Lymphatics CorrectAnswer-AAns.A.Blaschko'slinesBlaschko'slinescorrespondtothepathwaysfollowedbykeratinocytesmigratingfromtheneuralcrestduringembryogenesis.LinesofBlaschkorepresentnon-randomlinesofdevelopmentofskin.EpidermalnevusfollowtheBlaschko'slineTheskinlesionsthatfollowtheBlaschko'slinesare- 1. Pigmenteddisorders:-Nevusachromicus(includingHypomelanosis ofito),Epidermalnevus(Nevussebaceous,Inflammatorylinearverrucousnevus). 2. X-linkedgeneticskinconditions:-Incontinentiapigmenti,CHILD syndrome. 3. Acquiredinflammatoryskinrashes:-Lichenstriatus,Lichenplanus, lupuserythematosus. 4. Chimerism
155.Whichofthefollowingorganismhasa roletoplayinSeborrhicdermatitis? a)Pityrosporumovale b)Canidaalbicans c)Propionibacterium d)Noneoftheabove CorrectAnswer-AAns.A.PityrosporumovaleMalaseziafurfuroritsyeastformPityrosporumovaleplaysanetilogicalroleinSeborrhicdermatitis."
156.Pruritusisafeatureofwhichofthe following? a)Pemphigusfoliaceous b)Pemphigusvulgaris c)BullousPemphigoid d)Alloftheabove CorrectAnswer-CAns.C.BullousPemphigoidDiseasescausingmildornoitching:Psonasis,Pityriasisrosea,SLE,parapsoriasis,Secondarysyphilis,Pemphigus.Diseasescausingmoderateitching:Contactdermatitis,Dryskin,Bullouspemphigoid,Photosensitivity(sunburn).Diseasescausingsevereitching:Lichenplanls,Lichensimplexchronicus,Herpesgestationis,Mastocytosis,Dermatitisherpetiformis,scabies,Prurigonodularis.
157.Goekarmanregimenusedinfor treatmentofpsoriasisis? a)UVBpluscoaltar b)UVBplusanthralin c)Coaltarplusanthralin d)UVBplusmethotrexate CorrectAnswer-AAns.A.UVBpluscoaltarGoekermanregimenwasinventedforthetreatmentofmildtomoderatepsoriasis.Inthistherapyapplicationofcrudecoaltarapplicationfor2-10hoursisfollowedbyexposuretoUVBlight.Treatmentisnowobsolete.SimilarlyUVBplusanthralincombinationisknownasIngramregimen.
158.TrueregardingBowen'sdiseaseis? a)InsituBCC b)Morecommonindarkskinnedpeople c)HSVinfectionplaysarole d)Chronicsundamageplaysarole CorrectAnswer-DAns.D.ChronicsundamageplaysaroleBowen'sDiseaseBowen'sdiseaseisSCCinsitu.Morecommoninfairskinnedpeople.Morecommononsunexposedareassuchashead&neckfollowedbylimbs.Whenarisesonglanspenis,itiscalled"erythroplasiaofQueytat."
159.Amongvarioustypesofpsoriatic arthrirtis,whichvarietyismostcommon? a)Classic b)Oligoarticular c)Rheumatoid d)Spondylitis CorrectAnswer-BAns.B.OligoarticularPsoriaticarthritis(Affects5-1Ochofpsoriaticpatients)Classicorpolyarticulartype(16%):-affectsDIPjointswith"sausageshapeapearance"offingersandtoes.Nailinvolvementiscommon.Monoarticularoroligoarticulartype(70%)mostcommontype,affectslargejointslikeknee.Rheumatoidtype(15%):-RAlikepresentation.Symmetrical.AffectsPIPjointsleadingto"swanneckdeformity."Axialtypeorspondylitis:-associatedwithHLA-B27.
160.
Allofthefollowingsarepartofthetreatmentofscabiesexcept? a)TopicalPermathrin b)Oralivermactin c)Oralantihistamines d)Longtermoralsteroids CorrectAnswer-DAns.D.LongtermoralsteroidsDrugsusedinscabies 1. Topical:Permethrin(drugofchoice),GBH/BHC,benzyl-benzoate, crotamine,malathion. 2. Oral:Ivermectin.3. Forpruritis:Antihistaminics
161.Drugofchoiceforbubosinapregnant femaleis? a)Tetracycline b)Doxycycline c)Ceftriaxone d)Erythromycin CorrectAnswer-DAns.D.ErythromycinBuboesaremostcommonlycausedbyLGV.Doxycycline/tetracyclineisthedrugofchoiceforLGVinanon-pregnantfemale.Inapregnantfemaleandchildrenbelow8years,itshouldbetreatedwitherythromycin.
162.Which'P'isnotafeatureoflichen planus? a)Polygonal b)Polyhedral c)Pruritus d)Plane CorrectAnswer-BAns.B.Polyhedral5characteristic'P'oflichenplanus 1. Pruritic(itching)2. Polygonal3. Purple(violaceous)4. Plane(flattopped)5. Papuleorplaque These5Psarethecharacteristicfeaturesoflichenplanuslesionspresentation.
163.Inlichenplanusallthefollowingsites areaffectedexcept? a)Flexoraspectofupperextrimities b)Oralmucosa c)Nails d)Extensoraspectofupperextrimities CorrectAnswer-DAns.D.ExtensoraspectofupperextrimitiesSitesofinvolvementinlichenplanusFlexorsaspectofupperextremitiesandlegsarethemostcommonsiteinvolved.OralmucosainvolvementmayleadtolacypatternoflesionsNailinvolvementmaycausepterygium(mostcharacteristic),onychorrhexia,nailatrophy,anychia.HairinvolvementcausescaringalopeciaInverselichenplanusaffectsaxillae,groin,infraaxillaryareas.
164.Bull'seyelesionsarefoundin? a)Erythemanodosum b)Erythemagangrenosum c)Erythemamultiforme d)Erythroderma CorrectAnswer-CAns.C.ErythemaMultiformeClinicalfeaturesoferythemamultiformeTypicallesionofEMisaTargetlesion(lrislesionorBulle'seyelesion)whichconsistsofthreeconcentriccomponents:- 1. Centralduskyerythma,surroundedbyvesiclebulla2. Paleedematousring3. Erythematoushalo
165.Notahemorrhagiclesion? a)Petechiae b)Echymosis c)Plaque d)Noneoftheabove CorrectAnswer-CAns.C.PlaquePetechiaearesmallpinpointpurpuricmacularlesionsthatoccurduetoextravasationofredbloodcellsfromcutaneousvesselsintotheskin.Echryosisarelargerbruiselikehemorrhagiclesions.Causeisgenerallynoninflammatory.Plaqueisasolidplateaulikeelevationthatoccupiesalargesurfaceareaincomparisontoitsheightabovethenormalskinandhasadiametermorethan0.5cms.Thereisnohemorrhageinvolvedassuch
166.Maculaeceruleaisseenin? a)Pediculosishominiscorporis b)Pediculosiscapitis c)Scabies d)Lupuserythematosus CorrectAnswer-AAns.A.PediculosishominiscorporisMaculaecerulea:Thisisalatinnameforblue-greymacula.Pathognomicofliceinfestation(PediculosiscorporisandPediculosispthiris)Theyarehemosiderin-stainedpurpuricspotsatthesiteofinsectbite.Enzymesininsectsalivebreaksdownhumanbilirubintobiliverdin,causingthecolorchangeintheskin.
167.Mostcommonsiteforatopicdermatitis- a)Scalp b)Trunk c)Poplitealfossa d)Knees CorrectAnswer-CAns.C.PoplitealfossaSitesofitchingpatchinatopicdermatitisInfant;Face(especiallycheek),extensorsofforearm&legs.Childhood&adult>Flexures(antecubitalrbitalfoxa,Poplitealfossa).
168.Incontinentiapigmentiinvolvesallexept ? a)Skin b)Bones c)Teeth d)Heart CorrectAnswer-DAns.D.HeartIncontinentiapigmenti(alsok/aBloch-Sulzbergersyndrome)isaX-linkeddominantgeneticdisorder.ItinvolvesSkin(100%ofaffectedpeople)Teeth(80-90%ofaffectedpeople)Bones(30-40%ofaffectedpeople)CNSi.e.brain&spinalcord(30-40%ofaffectedpeople)Eyes(25-35%ofaffectedpeople)
169.NottrueaboutSkintag? a)Associatedwithseborrhoeickeratosis b)Pedunculated c)Mostcommonsiteisneckandaxilla d)Premalignant CorrectAnswer-DAns.D.PremalignantSkintags(softwarts;achrochordon)AcommonbenignlesioncomposedofloosefibroustissueandoccurringmainlyontheneckandmajorflexuresasasmallsoftPedunculatedProtrusion.Verycommon,particularlyinwomenatthemenopauseorlater.Theyarefrequentlyfoundtogetherwithseborrhoeickeratoses.Treatment:Cauteryandcryotherapy
170.Spidertelengectaciafalseis? a)Morecommoninmales b)Canbecausedbytrauma c)Lighttherapyfortreatment d)Maybeassociatedwithliverdisease CorrectAnswer-AAns.A.MorecommoninmalesSpidertelangiectasia(arterialspider,spidernevus,nevusaranus)Seenin2/3rdofpregnantfemalesandusuallydisappearsafterdelivery.Estrogenissaidtobeinvolvedinpathogenesis.Whenmultiple,liverdiseaseshouldberuledout.Centralradiatingbodywithradiatingvesselsgivesalookofspider.Lesionusuallyoverupperhalfofthebody.Treatmentbydiathermyandexcision.
171.Whichofthefollowingisuntrue regardingpiebaldism? a)autosomaldominantcondition b)amelanoticskinassociatedwithawhiteforelock c)Islandsofnormalorhypermelanoticskin d)Usuallyimproveswithage CorrectAnswer-DAns.D.UsuallyimproveswithagePiebaldismPiebaldismisarareautosomaldominantconditioncharacterizedbystableareasofvitiligo-likeamelanoticskinassociatedwithawhiteforelock.Presentatbirthandusuallyremainunchangedthroughoutlife.Mostcommonisafrontalmedianorparamedianpatch,associatedwithameshofwhitehair(whiteForelock).Often,whitepatchesoccurontheupperchest,abdomenandlimbs,bilaterallybutnotnecessarilysymmetricallyThehandsandfeet,aswellastheback,remainnormallypigmentedIslandsofnormalorhypermelanoticskinoccurinthewhiteareas,orlessoftenonnormalskin.
172.WhichofthefollowingisnotaNEVUSof melanocyte? a)Mongolianspot b)NevusofIto c)Nevusofota d)Beckernevus CorrectAnswer-DAns.D.BeckernevusBeckernevusisappendagealneviwhereasotherthreearemelanocyitcnevi.Melanocyticneviare:-DysplasticnevusBIuenevusNevusofito&nevusofotaSpitznevusGiantpigmentednevusMongolianspotIntramucosalneyus
173.Ichypurplepapulefollowedby hayperpigmentationonresolution,isseenin? a)Addison'sdisease b)DM c)Hypothyroidism d)Lichenplanus CorrectAnswer-DAns.D.LichenplanusLPischaracterizedbyshiny,violaceous,flat-toppedpolygonalpapuleswhichretaintheskinlines.Whitelines,knownasWickham'sstriae,maytraversethesurfaceofthepapules.Linearlesionsoftenappearalongscratchmarksorinscars(Koebnerphenomenon).Inmostcases,thepapuleseventuallyflattenaftera6monthsto2yrs,oftentobereplacedbyanareaofhyperpigmentation.
174.LossofIntercellularcohesionbetween keratinocytesiscalledas? a)Acanthosis b)Acantholysis c)Keratinolysis d)Spongiosis CorrectAnswer-BAns.B.AcantholysisSeparationofepidermalkeratinocytesduetolossofintercellularbridgeisreferredtoasacantholysis.Acantholysisisseenintheepidermis(especiallyinbasallayer).
175.Tzankcellis? a)Keratinocyte b)Fibrobalst c)Neutrophil d)Lymphocyte CorrectAnswer-AAns.A.KeratinocyteTzankcellsareacanthoylyticcellsi.e.largeroundedkeratinocyteswithsrelativelylargenucleuswithcondensedorhazycytoplasm.
176.Trueaboutlepromatousleprosy? a)Only3cutaneouslesions b)Lepromintesthighlypositive c)Thickenednerveroots d)ENLin>50%cases CorrectAnswer-CAns.C.ThickenednerverootsNerveinvolvementinlepromatousleprosycausesthickeningofnerve.Lepromintestisnegative.Therearemorethan10macules/patches/plaques.
177.Dermatophytosisisnot? a)Scaly b)Itchy c)Superficial d)Subdermal CorrectAnswer-DAns.D.Subdermal
178.Oculoorogenitalulcersareafeatureof? a)Behcetdisease b)lichenplanus c)SLE d)Psoriasis CorrectAnswer-AAns.A.BehcetdiseaseBehcet'sdiseaseisamultisystemdiseasethatisdefinedbythepresenceoforalaphthosiswithatleasttwoofthefollowing:genitalaphthaesynovitis,posterioruveitis,cutaneouspustularvasculitisormeningoencephalitis,intheabsenceofIBDorautoimmuneDiseases.
179.Maximumcumulativedoseofisotretinoin shouldn'texceedforacnetreatment? a)30-60mg/kg b)60-90mg/kg c)90-120mg/kg d)120-150mg/kg CorrectAnswer-DAns.,D.120-150mg/kgIsotretinoinisrecommendedforseverenodulocysticacneandalsoforthepatientswithmilderdiseasewhodon'trespondtoconventionaltreatment.Treatmentregimensusuallybeginat0.5-1.0mg/kg/dayforthedurationofbetween16and20weeks.Cumulativedoseamounttoatotalofatleast12Omg/kg,butthereisnoaddedbenefitwhen150mg/kgisexceeded.
180.Exanthemasubitumiscausedby? a)HHV b)HPV c)HIV d)HCV CorrectAnswer-AAns.A.HHVHHV-6viruscausesroseolainfantum(exanthemsubitum),themostcommonexanthematicfeverinchildrenundertheageof2years,withapeakincidencebetween6and9months.
181.Cutismarmorataoccursduetoexposure to? a)Coldtemperature b)Dust c)Hottemperature d)Humidity CorrectAnswer-AAns.A.ColdtemperatureCutismarmorataisaconditionwhereintheskinhasapinkishbluemottledormarbledappearancewhensubjectedtocoldtemperatures.Itisseenthroughoutinfancyandin50%ofchildren.Rewarmingrestorestheskintonormal.Itiscausedbysuperficialsmallbloodvesselsintheskindilatingandcontractingatthesametime.
182.Whatconstitutesmalpighianlayer? a)Corneumlucidum b)Corneumspinosum c)Spinosumandbasale d)Basalegranulosum CorrectAnswer-CAns.C.SpinosumandbasaleTheMalpighianlayeroftheskinisgenerallydefinedasboththestratumbasaleandstratumspinosumasaunit,althoughitisoccasionallydefinedasthestratumbasalespecifically,orthestratumspinosumspecifically.ItisnamedafterMarcelloMalpighi.
183.AChildisborn,coveredwithathick membranouscoat,whatcouldbethepossiblediagnosis? a)Lamellarichthyosis b)X-linkedichthyosis c)IchthyosisVulgaris d)Ichthyosisacquista CorrectAnswer-AAnswer-a.LamellarichthyosisExplanation-Ichthyosisisoneofthemostcommongenodermatoses.Itischaracterizedbydry(xerotic)scalyskinalloverthebody.Scalesaredull-brown-black.Thebasicdefectisanimpairmentinthebarrierfunctionofskinandinabilitytomaintainmoisture.Collodionbabyisthetermusedtodenotethenewbornbabywithichthyosis;thenewbornbabyisencasedinathick,shinymembranecoatcalledcollodionandisseeninLamellarichthyosisRef-ArvindAroraskin,6thedition,pageno203
This post was last modified on 23 November 2021