which of these is true of the pathogenesis of erythema multiforme:

infiltration of epidermis by macrophages and CD8 cells > cytokine release, cell mediated reponse to inciting incident

Which of these statements most likely are true of this lesion?

This is due to Trichophyton rubrum infection, This a Majocchi granuloma

Why is doxycycline preferred over erythromycin when treating P acnes?

Macrolides interfer with p450 system

Which one does not describe Elfornithine MOA

blocks testosterone conversion to DHT

In which patients is treatment used with (extra) caution

Patient with history of MI and familial hypercholesterolemia, Patient with MELD score of 15

severe presentation of tinea capitis with crusting

Which of these is not a cause of the hyperchromatic rim around the nucleus?

mutation of chromatin structure

MOA of a medication that treats both Hansen disease and dermatitis herpetiform

inhibits dihydropteroate synthetase, nucleic acid synthesis inhibitor

Which of these is false about this condition?

exquisitely tender to gentle touch

maintains open K channels in arterial smooth muscle

what is an Id reaction?

autoeczematous reponse which may occur just after starting antifungals

22 yo female c/o painful lesion on lip monthly since age 15. What's the MOA of the drug which may prevent flares?

Monophosphorylated by viral thymidine kinase (TK), triphosphorylated by cellular enzyme to inhibits viral DNA polymerase, Viral DNA polymerase inhibitor, causes DNA chain termination

what is true about the pathogenesis of psoriasis

T cells differentiate and secrete TNF alpha and IL-17

which of these may play a role in the development of seborrheic dermatitis?

Malassezia species, Pityrosporum ovale, colon cancer

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Mod 1 part 2

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Answers

1
which of these is true of the pathogenesis of erythema multiforme:
infiltration of epidermis by macrophages and CD8 cells > cytokine release
infiltration of epidermis by neutrophils and NK cells > epithelial death
humoral response to inciting incident
cell mediated reponse to inciting incident
2
Which of these statements most likely are true of this lesion?
This is acne conglobata
This is due to Trichophyton rubrum infection
This is acne fulminans
This a Majocchi granuloma
3
Name the rosacea
phymatous
often coexists with seborrheic dermatitis
papulopustular
Erythematotelangiectatic
4
Which of these antibiotics may be used to treat acne vulgaris?
macrolides
tetracyclines
vancomycin
penicillins
5
Dermophytes consume
desmoglein 1
collagen
healthy microbiome
keratin
6
Which of these mutations is not associated with squamous cell carcinoma?
P16
PTCH1
Ras
P53
7
Why is doxycycline preferred over erythromycin when treating P acnes?
Macrolides interfer with p450 system
Doxycycline is reserved for severe cystic acne
erythromycin is teratogenic
erythromycin causes phototoxicity
8
Which one does not describe Elfornithine MOA
inhibits hair follicle division
ornithine decarboxylase
blocks testosterone conversion to DHT
inhibits polyamine synthesis
9
Bacterial toxins resposible for the development of impetigo cleave which protein?
desmoglein 1
Occludin
desmoglein 3
Claudin
10
Spiranolactone MOA
ornithine decarboxylase
inhibits polyamine synthesis
inhibits hair follicle division
blocks testosterone conversion to DHT
11
Bullous pemphigoid is due to autoantibodies against
desmoglein 1
BP 180
desmoglein 3
BP 230
12
Cause of these lesions?
Ecthyma 2nd to Strep
Squamous cell carcinoma
Eschar 2nd to Bacillus anthracis
Ecthyma gangrenosum 2nd to embolic phenomenon
13
In which patients is treatment used with (extra) caution
Patient with history of MI and familial hypercholesterolemia
13 year old child with pruritis and flaking from scalp
Patient on dialysis
Patient with MELD score of 15
14
Which of these drugs have the same MOA?
Erythromycin
Clindamycin
Doxycycline
Dapsone
15
Pathogenesis of SJS is not mediated by
Fas pathway for apoptosis
Th1 cells
Th2 cells
Th17 cells
16
This is called
erythema nigricans
erythema nodosum
erythema migrans
erythema multiforme
17
Steven Johnson Syndrome is associated with certain
HLB allotypes
HLC allotypes
HLA allotypes
18
what is favus?
fungal infection caused by Histoplasma duboisii
focal, ulcerated papules and plaques of fungal eitiology
severe presentation of tinea capitis with crusting
acute inflammatory process due to fungal infection
19
What is this most likely?
Keratoacanthoma
Bowen disease
melanoma
basal cell carcinoma
20
CNAQ/GNA11 is associated with melanoma in which location?
subungal
palms
choroid
back
21
What form of tinea capitis is this
ectothrix
endothirix
22
Which of these mutations is not associated with basal cell carcinoma?
P53
PTCH1
Ras
BRAF
23
Which of these is a common (1/3) cause of pediatric arterial ischemic stroke?
hemophilia
VZV
renal failure
aneurysm
24
Which of these is not a cause of the hyperchromatic rim around the nucleus?
molding of the nucleus
migration of the chromatin to the edge of the nucleus
mutation of chromatin structure
multinucleation
25
Which of these is not anti-inflammatory
salicyclic acid
azelaic acid
benzoyl peroxide
hydrocortisone
26
Fibrin and neutrophils accumulate at the tips of dermal papillae forming small microabscesses in which condition?
bullous pemphigoid
Dermatitis herpetiformis
Psoriasis
secondary syphillis
27
Which drug is a TNF-alpha receptor decoy?
Ixekizumab
adalimumab
infliximab
Etanercept
28
Dermatitis herpatiform is associated with:
disseminated HSV
celiac disease
AIDS
IBD
29
Which of these is elevated in this condition, which is preceded by a herald patch?
CD4 T cells
B cell activity
NK cells
Langerhan cells
30
Which drug is a monoclonal ab againt membrane bound TNF-alpha (induces apoptosis in cells involved in inflammation)
Ixekizumab
adalimumab
infliximab
Etanercept
31
MOA of a medication that treats both Hansen disease and dermatitis herpetiform
inhibits dihydropteroate synthetase
inhibition of dihydrofolate reductase
nucleic acid synthesis inhibitor
32
HSV may associated with cyclic eruptions of
erythema nodosum
erythema multiforme
erythema herpatiform
granuloma annulare
33
Which of these is false about this condition?
primarily affects menopausal women and adolescents
primary vasculitis affecting the vessels supplying the subcutis
causes granulomatous inflammtion and necrosis.
exquisitely tender to gentle touch
34
Cowdry type A bodies are seen in
CMV
polio
HSV
rabies
35
28 yo presents w/ hypopcalcemia lesions following withdrawal of steroids. Name the psoriasis
Plaque
Erythrodermic
Guttate
Pustular
36
What is this immunofluorescence pattern consist with?
Pemphigus vulgaris
bullous pemphigoid
linear IgA bullous dermatoses
dermtitis herpetiform
37
Minoxodil MOA:
maintains open K channels in arterial smooth muscle
ornithine decarboxylase
inhibits polyamine synthesis
blocks testosterone conversion to DHT
38
How long should patients wait to become pregnant after stopping Acitretin?
1 year
Just after discontinuing, she can become pregnant
3 years
4 months
39
what is an Id reaction?
autoeczematous reponse which may occur just after starting antifungals
a type of eosinophilic pustular folliculitis
contact dermatitis often seen in association with musical instruments
a rare benign granulomatous skin disease of unknown cause
40
These are the bilateral 1st toes of the patient. What is the most likely dx?
subungal hematoma
Onychomycosis
Nail psoriasis
Subungal melanoma
41
22 yo female c/o painful lesion on lip monthly since age 15. What's the MOA of the drug which may prevent flares?
Monophosphorylated by viral thymidine kinase (TK)
triphosphorylated by cellular enzyme to inhibits viral DNA polymerase
Viral DNA polymerase inhibitor
causes DNA chain termination
42
What kind of chemotherapy is not used for management of melanoma
Topical 5-fluorouracil
pegylated IFN-α
BRAF inhibitor
adjuvant anti-PD-1 therapies
43
When is this most commonly seen?
Spring
Winter
Summer
Fall
44
Which of these is not helpful in visualization of dermatophyte hyphae?
H&E
Wood's lamp
KOH prep
PAS stain
45
Name the rosacea
phymatous
often coexists with seborrheic dermatitis
papulopustular
Erythematotelangiectatic
46
Ixekizumab is a monoclonal ab against
IL-5
IL-1
IL-2
IL-17
47
Gorlin syndrome is
sudden appearance, multiple seborrheic keratosis associated with malignancy
squamous cell carcinoma in situ
aggressive progression of SCS
basal cell nevus syndrome
48
Metronidazole is not used to treat
Leprosy
Trichomonas vaginalis
C difficile
encephalopathy
49
what is true about the pathogenesis of psoriasis
T cells differentiate and secrete TNF alpha and IL-17
decreased proliferation of keratinocytes
results in varicosities in distal extremities
Proliferation of Th2 cells
50
28 year old patient. Name the psoriasis
Guttate
Erythrodermic
Pustular
Plaque
51
which of these may play a role in the development of seborrheic dermatitis?
Malassezia species
corticosteroids
Pityrosporum ovale
colon cancer
52
What causes Tinea incognito?
long term use of antibiotics
fulminant candidiasis
use of topical steroids
withdrawal of steroid treatment
53
Pt c/o chronic pain in eye & blurry vision, bulbous and intermittently red nose. Most likely dx?
conjunctivitis
sicca syndrome
hayfever
Ocular rosacea
54
What should be included on the differential in this patient with Wickham striae?
HCV
lichen simplex
HBV
lichen planus
55
Which of these is not used in the diagnosis of candida?
KOH
Silver
H&E
PAS
56
Swish and swallow; swish and spit. How does it kill candidiasis?
Binds ergosterol, makes holes in the cell wall
same as terbinafine
Interferes with fungal microtubule function and disrupts mitosis
same as amphotericin B
57
What is this?
Atopic dermatitis
Flexural psoriasis
58
Risk factors for development of seborrheic dermatitis
HIV
female gender
Parkinsons
adolescence
59
Necrotizing variants of cellulitis is most often due to
Staph aureus
Mycobacterium leprae
Group A beta hemolytic strep
Pseudomonas
60
whta kind of hypersensitivities are bullous disorders?
type 3
type 4
type 1
type 2
61
Which protein does IgA attack in dermatitis herpatiform?
desmoglein
gliadin
BP230
BP180
62
Name the rosacea
often coexists with seborrheic dermatitis
phymatous
papulopustular
Erythematotelangiectatic
63
MOA of drug used in combination with an aminoglycoside and bacitracin for topical antibiotic treatment
Bind to 50S ribosomal subunit
Bind to 30S ribosomal subunit
nucleic acid synthesis inhibitor
Destabilized outer membrane of the bacteria and disrupts membrane integrity
64
28 yo presents with lesions following a strep infection. Name the psoriasis
Pustular
Guttate
Plaque
Erythrodermic
65
Before starting TNF-alpha inhibitor, which screening should be done?
bone density
echocardiogram
colonoscopy
TB screen
66
Lichen planus:
Wickham striae
polygonal, purple, planar, pruritic papules
irregular thickening of stratum basale
degeneration of the stratum granulosum
67
What is dermatitis herpatiform not associated with?
bullous pemphigoid
non-Hodgkin's lymphoma
lyme disease
other autoimmune conditions
68
What is MOA of the most common cause of pseudomembranous colitis
Binds to PBPs and inhibits cell wall synthesis
Binds to 30S subunit of bacterial ribosomes to inhibit protein synthesis
Binds to 50S subunit of bacterial ribosomes to inhibit protein synthesis
Binds to the D-ala-D-ala terminus of nascent peptidoglycan pentapeptide
69
Cutaneous T cell lymphoma (CTCL) is treated by -(drug)- which acts by -(MOA)
Bexarotene; selectively activates retinoids X receptors > tumor apoptosis
Vorinostat; binds retinoid receptors to inhibit proliferation of tumor cell
Bexarotene; histone deacetylase inhibitor >cell cycle arrest
Alitretinoin; binds retinoid receptors > tumor apoptosis
70
Imiquimod:
Binds to toll-like receptor 7
Neurotoxin
Stimulates the innate immune system.
stimulates production of interferon–α, interleukins & TNF-α to fight virus
71
What's the pathogenesis of this cutaneous noninfectious granulomatous disease?
thought to be delayed hypersensitivity reaction.
Th1 reaction in which interferon-gamma stimulates macrophages
spirochetes slowly migrate outward from the initial location of the bite
increased neutrophilic chemotaxis
72
What is this?
molluscum contangiosum
tinea barbae
folliculitis
basal cell carcinoma
73
How does tinea appear by microscopy
spagetti and meatballs
giant cells and granulomas
segmented hyphae
slings of pseudohyphae
74
Pt has been residing in homeless shelters for the past several months. What are the MOA's of possible treatments?
Opens sodium channel and disrupt the functionof neurons
Causes hyperpolarization by interfering w/ glutamate-Cl channels
Organophosphate pesticide. Anticholinesterase
Neurotoxin. Blocks GABAA receptors.
75
Neurologic diseases potentiate
Rosacea
Acne
Alopecia
Vitiligo
76
Mutations in KIT is associated with which kind of tumor?
melanoma
squamous cell carcinoma
basal cell carcinoma
Merkel cell carcinoma
77
Which of these is a potential complication of HSV 1
encephalitis
Ramsay-Hunt syndrome
Alzheimer's
post herpetic neuralgia
78
Pt w/ IBD and ankylosing spondylitis presents with prodrome and erythematous lesions on legs. What's the most likely dx
Erythema induratum
Dermatitis herpetiformis
Erythema nodosum
Bullous pemphigoid
79
Tzank smear is used to detect
CMV
HSV 1
HPV
VZV
80
Which patients are most at risk of developing drug induced lupus erythematous?
slow metabolizers of N-acetyltransferase 2 (NAT2)
ultrarapid metabolizer of CYP2C19
Patient with cardiac arrhythmia on procainamide
patient with history of MI using 81 mg of aspirin daily
81
Which of these etiologies typically presents on hands and feet?
pityriasis rosea
VZV
secondary syphillis
HSV
82
Adrenarche is associated with:
DEHS increase
horny teenagers
decreased bone density
diploplia
83
what is kerion?
severe presentation of tinea capitis with crusting
fungal infection caused by Histoplasma duboisii
acute inflammatory process due to fungal infection
focal, ulcerated papules and plaques of fungal eitiology
84
Tinea corporis gladiatorum is most commonly due to
Trichophyton rubrum
Epidermophyton floccosum
Trichophyton tonsurans
Microsporum canis
85
What form of tinea capitis is this
endothirix
ectothrix
86
Psoriasis is associated with increase risk of
Alzheimers disease
osteomyelitis
acoustic neuroma
metabolic syndrome
87
Furuncles are deeper than carbuncles
False
True
88
Which of these mutations is not associated with melanoma?
BRAF
NRAS
MAPK pathway
PTCH1
89
exfoliative toxin of S aureus which results in impetigo cleaves which protein?
elastin
desmoglein 3
desmoglein 1
collagen
90
Pityriasis versicolor is cause by -- which looks like -- by microscopy
Malassezia dermatis; bilobed
Malassazia furfur; spaghetti and meatballs
Pityrosporum ovale; safety pin shaped
Cutibacterium acnes; bunch of grapes
91
How does candida appear by microscopy
spagetti and meatballs
giant cells and granulomas
segmented hyphae
slings of pseudohyphae
92
Pt on furosemide, atorvastatin, naproxen, and amoxicillin develops bullouos pemphigoid. Which drug didn't cause it?
naproxen
furosemide
amoxicillin
atorvastatin
93
28 yo presents with lesions after stopping corticosteroids. Name the psoriasis
Erythrodermic
Pustular
Guttate
Plaque
94
Which of these drugs inhibits amino acid incorporation and inhibits the 30s subunit?
Clindamycin
Doxycycline
Erythromycin
Dapsone
95
Morphology of the bacteria causing these lesions:
G + cocci
G - rods
G - cocci
G + rods
96
Pt w/ long history of anabolic steroid use presents with onychomycosis. What is the MOA of the preferred treatment?
interferes with fungal microtubule function and disrupts mitosis
selective inhibition of squalene epoxidase
block ergosterol synthesis by inhibiting 14-α-demethylase
inhibits fungal ergosterol synthesis
97
A 24 yo female swimmer became pregnant despite taking OCPs. She recently was treated for rash (pic); MOA of the drug?
Interferes with fungal microtubule function and disrupts mitosis
Azoles block ergosterol synthesis by inhibiting 14-α-demethylase
Inhibits dihydropteroate synthetase
Binds ergosterol, makes holes in the cell wall
98
Chronic scratching can cause:
lichen simplex chronicus
pruritus
keloid
seborrheic dermatitis
99
Which drug binds to TLR7 and stimulates mononuclear cells to produce interferon-alpha, IL and TNF-alpha?
Imiquimod
etanercept
Ixekizumab
infliximab
100
which of these is not used for treatment of HSV
Pyrithione
Fostemsavir
Famciclovir
Analgesics

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