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Quiz on Common Dermatological Problems , created by MPusey on 29/12/2014.

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Common Dermatological Problems

Question 1 of 75

1

What is atopic eczema?

Select one of the following:

  • An inflammatory process affecting the skin

  • Loss of melanocytes from the stratum basale

  • Thinning of the epidermis

Explanation

Question 2 of 75

1

Atopic eczema is not the most common form of eczema.

Select one of the following:

  • True
  • False

Explanation

Question 3 of 75

1

What percentage of the population does eczema affect?

Select one of the following:

  • 5%

  • 15%

  • 35%

  • 60%

Explanation

Question 4 of 75

1

What is the most common age of onset of atopic eczema?

Select one of the following:

  • Childhood

  • Middle age

  • Aged 60+

Explanation

Question 5 of 75

1

What conditions are often associated with atopic eczema?

Select one of the following:

  • Hayfever

  • Asthma

  • IBS

  • Meningitis

Explanation

Question 6 of 75

1

Histologically, which layer of skin thickens in the chronic stage of eczema?

Select one of the following:

  • Epidermis

  • Dermis

  • Subcutis

Explanation

Question 7 of 75

1

In which stage of eczema is the skin likely to be weepy?

Select one of the following:

  • Acute

  • Chronic

Explanation

Question 8 of 75

1

The vesicles that are present during the acute stage of atopic eczema are found....

Select one of the following:

  • intraepidermally

  • intradermally

  • between the epidermis and dermis

Explanation

Question 9 of 75

1

Where does infantile atopic eczema usually first present?

Select one of the following:

  • Cheeks

  • Nappy area

  • Flexures (e.g. crook of elbow)

  • Extensor surfaces (e.g. back of elbow)

Explanation

Question 10 of 75

1

What area of the body does infantile atopic eczema usually spare?

Select one of the following:

  • Face

  • Nappy area

  • Hands and feet

  • Torso

Explanation

Question 11 of 75

1

Where does eczema tend to localize to in school-age children?

Select one of the following:

  • Flexures

  • Extensor surfaces

  • Hand and feet

  • Between the digits

Explanation

Question 12 of 75

1

What is lichenification?

Select one of the following:

  • Thick, leathery skin due to extensive scratching or rubbing of the area

  • Thin, papery skin due to the skin drying out

  • Thickening of the skin due to the skin drying out

  • Skin that has lost its pigment due to excess scratching or rubbing

Explanation

Question 13 of 75

1

Which of the following are common triggers for atopic eczema?

Select one or more of the following:

  • Cleaning products

  • Dust mites

  • Animal fur

  • Pollens

  • Salt water

Explanation

Question 14 of 75

1

What can be used to break the itch-scratch cycle commonly seen in eczema?

Select one or more of the following:

  • Mittens or gloves

  • Steroids

  • Antihistamines

  • Oral antibiotics

Explanation

Question 15 of 75

1

How times a day are emollients usually prescribed for a person with eczema?

Select one or more of the following:

  • Once a day

  • Twice a day

  • Three times a day

  • As required

Explanation

Question 16 of 75

1

How can using soap substitutes help in the treatment of eczema?

Select one or more of the following:

  • Reduce irritation

  • Moisturize the skin

  • Prevent bacteria from entering the affected areas

Explanation

Question 17 of 75

1

How should steroids be used in the treatment of eczema?

Select one or more of the following:

  • Intermittently to control flare ups, but not on more the 7 days in a month

  • Constantly

  • As required, but not for more than a month at a time

Explanation

Question 18 of 75

1

What treatments can a dermatologist offer for eczema that a GP cannot?

Select one or more of the following:

  • Topical steroids

  • Systemic treatments

  • UV light therapy

  • Calcineurin inhibitors

  • Oral antibiotics

Explanation

Question 19 of 75

1

What are calcineurin inhibitors?

Select one of the following:

  • Immunomodulating drugs that block calcineurin receptors

  • Immunomodulating drugs that prevent the production of calcineurin

  • Immunomodulating drugs that decrease the effects of calcineurin by binding to it and changing its shape

Explanation

Question 20 of 75

1

What does calcineurin do?

Select one of the following:

  • Activates inflammation within the skin

  • Causes immune cells within the skin to proliferate

  • Aggravates the skin causing inflammation

Explanation

Question 21 of 75

1

Steroids can cause stretch marks or striae on the skin.

Select one of the following:

  • True
  • False

Explanation

Question 22 of 75

1

What is the most common bacterial infection that accompanies eczema?

Select one of the following:

  • Staphylococcal infection

  • E. Coli infection

  • Streptococcal infection

Explanation

Question 23 of 75

1

What is the most common viral co-infection that accompanies eczema?

Select one of the following:

  • Herpes infection

  • Rhotavirus infection

  • Coronovirus infection

Explanation

Question 24 of 75

1

When is hyper- or hypo- pigmentation most likely to occur in eczema?

Select one of the following:

  • Following treatment with steroids

  • After an acute phase

  • After scarring has healed

Explanation

Question 25 of 75

1

Eczema does not cause scarring. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 26 of 75

1

Where does psoriasis most often occur on the body?

Select one of the following:

  • Flexor surfaces

  • Extensor surfaces

  • Torso

  • Extremities

Explanation

Question 27 of 75

1

Which of these descriptions most accurately describes psoriasis?

Select one of the following:

  • Well-defined, inflamed plaques which appear white and scaly

  • Poor-defined, inflamed plaques which appear white and scaly

  • Well-defined, inflamed plaques which appear golden and crusty

  • Poorly-defined, inflamed plaques which appear golden and crusty

Explanation

Question 28 of 75

1

What percentage of the population is affected by psoriasis?

Select one of the following:

  • 0.1-0.5%

  • 1-2%

  • 5-7%

  • 10-15%

Explanation

Question 29 of 75

1

What is the peak age of onset for psoriasis?

Select one of the following:

  • 15 years old

  • 28 years old

  • 40 years old

  • 67 years old

Explanation

Question 30 of 75

1

Psoriasis only affects women. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 31 of 75

1

Psoriasis usually affects extensor surfaces, but where else can it commonly affect?

Select one or more of the following:

  • Sacrum

  • Scalp

  • Ears

  • Palms of the hands and soles of the feet

  • Cheeks

  • Lips

  • Axillary region

Explanation

Question 32 of 75

1

The distribution of psoriasis is usually symmetrical. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 33 of 75

1

Histologically, what occurs in psoriasis?

Select one or more of the following:

  • Disordered maturation of keratinocytes

  • Increased epidermal transit time of keratinocytes

  • Thickening of the epidermis

  • Hyperplasia of keratinocytes in the stratum corneum

  • Benign proliferation of Langerhan cells within the epidermis

Explanation

Question 34 of 75

1

How does coal tar help to treat psoriasis?

Select one or more of the following:

  • Slows the growth of keratinocytes

  • Restores the skins appearance

  • Reduces the irritation of the skin

  • Thins the epidermis

  • Slows hair growth

Explanation

Question 35 of 75

1

Why is coal tar not well tolerated?

Select one or more of the following:

  • It can make the skin red and itchy

  • It can stain clothes, bedding and light-coloured hair

  • It causes hair loss

  • Not very much improvement is seen after short-term use

Explanation

Question 36 of 75

1

How is salicylic acid useful in treating psoriasis?

Select one of the following:

  • It softens the plaques and helps lift them off the skin to reveal normal skin underneath

  • It reduces blood pressure which helps to prevent psoriasis flare-ups

  • It moisturizes the skin

Explanation

Question 37 of 75

1

What is the mechanism of action of vitamin D analogues used in the treatment of psoriasis?

Select one of the following:

  • Reduces proliferation of keratinocytes and stimulates epidermal cell differentiation

  • Reduces proliferation of melanocytes and stimulated epidermal cell differentiation

  • Increases proliferation of keratinocytes and stimulates epidermal cell differentiation

  • Reduces proliferation of keratinocytes and reduces epidermal cell differentiation

Explanation

Question 38 of 75

1

What treatments can dermatologists offer for psoriasis that GPs cannot?

Select one or more of the following:

  • Topical steroids

  • UV phototherapy

  • Systemic medications

  • Monoclonal antibodies

  • Emollients

  • Coal tar

Explanation

Question 39 of 75

1

Which wavelength of UV light is used in UV phototherapy?

Select one of the following:

  • UV A

  • UV B

  • UV C

Explanation

Question 40 of 75

1

Why are oral retinoids given before a course of UV phototherapy?

Select one of the following:

  • To enhance the effects of the UV phototherapy

  • To sedate the patient

  • To ensure the patient does not experience and nausea or vomiting

  • To reduce the risk of DNA damage to skin cells

Explanation

Question 41 of 75

1

What is the course of treatment for UV phototherapy?

Select one of the following:

  • 2-3 times per week for 3-4 months

  • As required

  • 6 times per week for a month

  • Once per week for one year

Explanation

Question 42 of 75

1

What is the cause of acne vulgaris?

Select one of the following:

  • Over-activity of pilo-sebaceous glands

  • Over-activity of apocrine sweat glands

  • Over-activity of eccrine sweat glands

  • Under-activity of pilo-sebaceous glands

Explanation

Question 43 of 75

1

What causes the over stimulation of the sebaceous glands?

Select one of the following:

  • Hormonal stimulation

  • Diet

  • Sympathetic nervous stimulation

  • Parasympathetic nervous stimulation

Explanation

Question 44 of 75

1

How does the over stimulation of the sebaceous glands then lead to acne?

Select one of the following:

  • The hair follicles become "plugged" with secretions

  • Inflammation occurs within the hair follicles

  • Hair growth is too fast due to increased sebum leading to the follicle becoming blocked

Explanation

Question 45 of 75

1

Where on the body is acne most common?

Select one or more of the following:

  • Face

  • Upper chest and back

  • Hands

  • Scalp

Explanation

Question 46 of 75

1

Why is acne most common on the face, upper chest and upper back?

Select one of the following:

  • Because the highest population of sebaceous glands is found here

  • Because these areas are often exposed

  • Because these areas are most often touched with dirty hands

Explanation

Question 47 of 75

1

How many grades of severity are there for acne vulgaris?

Select one of the following:

  • 3

  • 4

  • 6

  • 7

Explanation

Question 48 of 75

1

What do topical retinoids do?

Select one of the following:

  • Dry skin out

  • Moisturize the skin

  • Prevent stimulation of sebaceous glands

  • Reduce the viscosity of sebum

Explanation

Question 49 of 75

1

How should systemic retinoids not be given to?

Select one of the following:

  • Pregnant women

  • Anyone under the age of 12

  • Anyone taking oral antibiotics

Explanation

Question 50 of 75

1

How is the oral contraceptive pill useful in treating acne?

Select one of the following:

  • It controls the hormones to prevent over stimulation

  • It makes sebum less viscous preventing "plugging" of the hair follicles

  • It makes hair follicles larger so that they become "plugged" less easily

  • It is used in women and girls to give a placebo effect

Explanation

Question 51 of 75

1

Both oral and topical antibiotics can be used to treat acne vulgaris. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 52 of 75

1

What type of infection is impetigo?

Select one of the following:

  • Bacterial

  • Viral

  • Fungal

Explanation

Question 53 of 75

1

Which bacteria are most commonly responsible for impetigo?

Select one or more of the following:

  • Staphylococcus aureus

  • Staphylococcus pyogenes

  • E. coli

  • All Streptococcal bacteria

Explanation

Question 54 of 75

1

What feature is very characteristic of impetigo?

Select one of the following:

  • Golden-yellow crust

  • Severe inflammation

  • Purple-ish flecks within the rash

Explanation

Question 55 of 75

1

What two treatments are most commonly used to treat impetigo?

Select one or more of the following:

  • Fucidin cream

  • Oral flucloxadin

  • Topical penicillin

  • Emollients

  • Methotrexate

  • Topical dexamethasone

Explanation

Question 56 of 75

1

What virus usually causes viral warts?

Select one or more of the following:

  • Human papilloma virus

  • Rhotar virus

  • Astrovirus

  • Herpes simplex virus type I

Explanation

Question 57 of 75

1

How are viral warts most commonly transmitted?

Select one of the following:

  • In water

  • By sharing clothes or bedding

  • By touching the wart and then touching areas of damaged skin

Explanation

Question 58 of 75

1

Viral warts are often self-resolving. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 59 of 75

1

Which of the following is not a treatment for viral warts?

Select one of the following:

  • Duct taping and filing down

  • Salicylic acid

  • Cryotherapy

  • Topical antibiotics

Explanation

Question 60 of 75

1

Tinea and roundworm are different skin conditions. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 61 of 75

1

What is tinea caused by?

Select one of the following:

  • A bacteria

  • A virus

  • A fungus

Explanation

Question 62 of 75

1

What is the usually given as treatment for tinea?

Select one of the following:

  • Topical anti-fungals

  • Topical antibiotics

  • Emollients

  • Topical corticosteroids

Explanation

Question 63 of 75

1

Systemic treatment is never used for tinea infection. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 64 of 75

1

What causes actinic keratosis?

Select one of the following:

  • Sun exposure

  • Benign proliferation of melanocytes

  • Hormonal over-stimulation

  • Wear and tear of the skin over time

Explanation

Question 65 of 75

1

In what age group is actinic keratosis most common?

Select one of the following:

  • Over sixties

  • Forties to fifties

  • Teenagers

  • Infants

Explanation

Question 66 of 75

1

Why must actinic keratosis be closely observed?

Select one of the following:

  • Because it can develop into skin cancer

  • Because as it increases in size it can become very painful

  • Because if a person has more than three lesions they may have liver cirrhosis

Explanation

Question 67 of 75

1

What skin cancer is actinic keratosis most likely to develop into?

Select one of the following:

  • Melanoma

  • Squamous cell carcinoma

  • Basal cell carcinoma

Explanation

Question 68 of 75

1

What treatments are there for actinic keratosis?

Select one or more of the following:

  • Cryptherapy

  • Emollients

  • Topical corticosteroids

  • Systemic retinoids

  • Oral antibiotics

Explanation

Question 69 of 75

1

Which type of skin cancer is considered to be the least serious?

Select one of the following:

  • Basal cell carcinoma

  • Squamous cell carcinoma

  • Melanoma

Explanation

Question 70 of 75

1

Where on the body does basal cell carcinoma most commonly present?

Select one of the following:

  • Head and neck

  • Hands and arms

  • Torso

  • Any sun exposed area

Explanation

Question 71 of 75

1

What is the appearance of a basal cell carcinoma lesion?

Select one of the following:

  • Shiny, translucent nodule

  • Dark, asymmetrical lesion

  • Inflamed, crater-shaped lesion

Explanation

Question 72 of 75

1

Why is basal cell carcinoma not referred under the two week wait rule?

Select one of the following:

  • Because it very rarely metastasizes

  • Because nothing can be done to remove this cancer

  • Because too many people get this type of cancer for the NHS to deal with

Explanation

Question 73 of 75

1

Squamous cell carcinoma only arises from actinic keratosis. True or false?

Select one of the following:

  • True
  • False

Explanation

Question 74 of 75

1

What is squamous cell carcinoma caused by?

Select one of the following:

  • Cumulative sun-exposure

  • Over stimulation by hormones

  • Smoking

  • Some recreational drugs

Explanation

Question 75 of 75

1

What features of a skin lesion would make it suspicious?

Select one of the following:

  • One solid colour only

  • Asymmetry

  • Clear borders

  • Diameter bigger than 6mm

  • Additional features, e.g. itching or bleeding

Explanation

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