Dermatology 1-50 MRQ

A 19-year-old university student presents to the clinic with targetoid lesions on his palms and forearms. He has mild fever and a sore throat. There is no mucosal involvement. He reports a similar rash six months ago that resolved spontaneously. He is otherwise healthy and takes no regular medications. The picture is given below.

 

Which of the following are recognised causes or associations of this rash? Select four (4) correct answers.

 

A 28-year-old woman presents with a 3-day history of an evolving rash on her hands and forearms. The lesions are round, have central dusky areas, and resemble targets. She denies new sexual partners, travel, or recent vaccinations. The picture is given below

 

Which of the following are well-established causes or triggers for this rash? Select four (4) correct answers.

 

A 16-year-old male presents with target-like skin lesions on the backs of his hands and feet. He recently recovered from a mild sore throat and cold. He has no mucosal involvement. He takes no medications and is otherwise well. On review of systems, he mentions a recent history of mild cough and malaise. The picture is given below

 

Which of the following are recognised causes or triggers for this? Select four (4) correct answers.

 

A 34-year-old man presents with an acute eruption of round, target-like lesions over his hands and forearms. He has mild malaise but is otherwise stable. The picture is given below.

Which of the following are recognised causes or triggers for erythema multiforme? Select four (4) correct answers.

 

A 23-year-old man presents with target-like lesions on both hands, forearms, and feet. The rash began three days ago. He is otherwise stable and afebrile. He has a history of recurrent cold sores and had an outbreak one week ago. There is no mucosal involvement.

The picture is given below.

Which of the following are appropriate management options for this condition? Select four (4) correct answers.

 

A 31-year-old woman presents with painful, dusky target lesions and erosions involving her lips and oral mucosa. She appears systemically unwell with fever and malaise. She had recently taken lamotrigine for the first time. Examination reveals confluent erythema and blistering on her chest and back. The picture is given below.

 

Which of the following are appropriate components of management in this patient? Select four (4) correct answers.

 

A 17-year-old boy presents with worsening acne on his face, chest, and upper back. He has multiple open and closed comedones, inflammatory papules, and pustules. He is otherwise well, with no systemic symptoms. He recently began working out and has been taking several over-the-counter supplements.

 

Which of the following are recognised causes or contributing factors for this condition? Select four (4) correct answers.

 

A 24-year-old woman presents with persistent acne despite using topical retinoids. Her acne worsens premenstrually. She has a history of irregular periods and hirsutism. Examination reveals inflammatory papules and pustules on her lower cheeks and jawline. The picture is given below.

Which of the following are recognised underlying causes or contributors to this condiition in women? Select four (4) correct answers.

 

A 27-year-old female presents with acne that has worsened over the past six months. She has noticed increased facial hair and irregular menstrual cycles. She is overweight and reports a diet high in processed carbohydrates. Her mother had similar symptoms at a young age.

 

Which of the following are known risk factors for this condition in adult women? Select four (4) correct answers.

 

A 16-year-old boy presents with lesions consisting of inflammatory papules, pustules, and a few nodules on his face and upper back. He has tried over-the-counter face washes with minimal effect. He has no signs of systemic illness. He is emotionally distressed due to peer teasing and has missed school events.

 

Which of the following are appropriate first-line or adjunct management strategies for his condition? Select four (4) correct answers.

 

A 21-year-old woman presents with persistent lesions affecting her cheeks and chin. She reports flare-ups around her menstrual period. She has previously tried topical treatments without much success. Her periods are regular, and she is not planning pregnancy. She requests a long-term solution and is concerned about scarring.

Which of the following are appropriate management options or strategies for her condition? Select four (4) correct answers.

 

A 19-year-old male presents to your clinic with a history of moderate to severe lesions over the past 3 years. He has not been consistent with treatment. On examination, he has several inflamed papules and nodules, along with multiple atrophic and ice-pick scars on his cheeks. He also expresses feeling embarrassed and socially withdrawn.

The picture is given below

 

Which of the following are recognised complications of this condition? Select four (4) correct answers.

 

A 22-year-old woman presents with concern about dark patches on her cheeks and uneven skin texture after her acne lesions healed. She had moderate inflammatory acne a few months ago. She has also become more self-conscious and avoids social gatherings.

 

Which of the following are potential complications following acne vulgaris? Select four (4) correct answers.

 

A 14-year-old girl presents with new-onset comedonal and inflammatory acne on her forehead and chin. Her mother reports she had similar acne at the same age, which resolved by her early twenties. The patient is concerned about whether she will have permanent scarring or if the acne will persist.

 

Which of the following factors are associated with a worse prognosis or persistence of acne into adulthood? Select four (4) correct answers.

A 25-year-old woman presents with persistent mild-to-moderate acne on her lower cheeks and jawline. She reports that her acne began in her teens and has continued into adulthood. She has tried multiple topical therapies with partial benefit. She is emotionally distressed and reports avoiding social gatherings due to her skin.

Which of the following are indicators of poor long-term prognosis in acne? Select four (4) correct answers.

A 32-year-old woman presents with painful, red nodules over her shins. She also reports mild fever and joint stiffness. A throat swab done a week ago for a sore throat showed group A streptococci. On examination, she has tender, erythematous subcutaneous nodules on both legs, without ulceration. Blood tests show elevated inflammatory markers.

 

Which of the following are recognised complications or associated conditions that may arise in patients with this condition ? Select four (4) correct answers.

 

A 45-year-old man presents with bilateral painful nodules on his lower legs that appeared two weeks after starting treatment for tuberculosis. He reports joint pain and low-grade fever. He has no ulcers or discharge. Lab investigations show raised ESR and CRP. The picture is given below.

Which of the following are recognised complications or long-term outcomes associated with erythema nodosum? Select four (4) correct answers.

A 27-year-old woman presents with a first episode of erythema nodosum (EN) affecting both shins. She had a recent sore throat, and throat swab confirms Streptococcus pyogenes. She is otherwise healthy, non-pregnant, and not on any long-term medications. She is concerned about the future course of the condition and whether it will return.

Which of the following are associated with a favourable prognosis in erythema nodosum? Select four (4) correct answers.

A 35-year-old man with known sarcoidosis presents with his third episode of erythema nodosum in the past year. He has intermittent ankle swelling, fatigue, and bilateral hilar lymphadenopathy. He is concerned about long-term outcomes.

 

Which of the following are associated with a worse prognosis in erythema nodosum? Select four (4) correct answers.

A 72-year-old retired farmer presents with a rapidly growing dome-shaped lesion on his forearm. It appeared over the past 3 weeks and now measures 1.5 cm. The lesion has a central keratin plug and is surrounded by a symmetrical base. He spends a lot of time outdoors gardening and has fair skin.

 

Which of the following are recognised risk factors for developing keratoacanthoma? Select four (4) correct answers.

A 65-year-old man presents with a solitary lesion on his cheek that grew rapidly over 4 weeks. The lesion has a central keratin-filled crater and appears well-circumscribed. He has a history of renal transplantation and is on long-term immunosuppressive therapy.

 

Which of the following are established risk factors for the development of keratoacanthoma? Select four (4) correct answers.

A 68-year-old man presents with a rapidly growing, dome-shaped nodule on his left forearm. It developed over six weeks and now measures about 2 cm, with a central keratin plug. He has fair skin and a long history of sun exposure. A clinical diagnosis of keratoacanthoma is made.

 

Which of the following are appropriate management options for this patient? Select four (4) correct answers.

A 70-year-old immunosuppressed woman presents with a 1.8 cm dome-shaped lesion on her cheek that has grown rapidly over one month.. Due to her immunosuppression and facial site, there is concern for possible squamous cell carcinoma.

 

Which of the following are suitable management strategies in this case? Select four (4) correct answers.

A 74-year-old man presents with a rapidly growing lesion on his lower lip. It began as a small nodule and enlarged over 4 weeks. On examination, it has a dome shape with a central keratin plug. A clinical diagnosis of keratoacanthoma is made. The patient declined excision, hoping it would regress on its own.

 

Which of the following are recognised complications or consequences of untreated or poorly managed keratoacanthoma? Select four (4) correct answers.

A 65-year-old immunocompromised male presents with multiple rapidly enlarging nodules on his forearms and face. He has previously had one keratoacanthoma excised. Biopsies confirm new lesions are keratoacanthomas. He reports that some lesions healed with depressed scarring.

 

Which of the following are recognised complications of keratoacanthoma, especially in immunocompromised patients or with multiple lesions? Select four (4) correct answers.

A 69-year-old man presents with a dome-shaped lesion on the dorsal hand that appeared six weeks ago. It has grown rapidly and now measures 2 cm. A biopsy confirms keratoacanthoma. He is otherwise healthy and agrees to complete excision with clear margins.

 

Which of the following features are associated with a good prognosis in keratoacanthoma? Select four (4) correct answers.

A 63-year-old woman undergoing renal transplant follow-up presents with two fast-growing nodules on her temple and forearm. She has a history of long-term immunosuppressive therapy and actinic keratoses. Biopsy of both lesions confirms keratoacanthomas.

 

Which of the following are associated with a poorer prognosis in keratoacanthoma? Select four (4) correct answers.

A 73-year-old woman presents with a slowly enlarging, irregularly pigmented macule on her left cheek. It has developed over the past year and measures around 1.2 cm. She has fair skin, light blue eyes, and a history of living in Australia for most of her life. The picture is given below

 

Which of the following are recognised risk factors for developing this lesion. Select four (4) correct answers.

 

A 76-year-old man presents with a pigmented, irregularly bordered lesion on his temple. He worked as a construction supervisor for over 40 years and rarely used sun protection. The picture is given below

 

Which of the following are considered significant risk factors for developing this condition Select four (4) correct answers.

 

A 78-year-old man presents with a slowly expanding, irregularly pigmented macule on his left cheek that has been enlarging over the past 18 months. The picture is given below. The lesion measures 2.4 cm and is located near the lower eyelid. The patient has no significant medical comorbidities.

 

Which of the following are appropriate management options for lentigo maligna in this patient? Select four (4) correct answers.

A 75-year-old immunosuppressed woman presents with lesion on her face measuring 1.5 cm. Biopsy confirms Lentigo maligna. He is reluctant to undergo surgery due to frailty and is concerned about facial scarring.

 

Which of the following are valid management options or considerations in this case? Select four (4) correct answers.

A 79-year-old man presents with a slowly enlarging, pigmented macule on his nose, present for over 3 years. A biopsy confirms lentigo maligna. Due to his comorbidities and personal concerns about cosmetic outcomes, he delayed treatment. On re-evaluation, the lesion has become more nodular and asymmetric.

 

Which of the following are recognised complications of untreated or poorly managed lentigo maligna? Select four (4) correct answers.

A 74-year-old immunosuppressed woman with renal transplantation history presents with a biopsy-proven lentigo maligna on her right cheek. She has declined surgical treatment and was lost to follow-up for 18 months. She now reports a new central nodule in the same area.

 

Which of the following are potential complications or consequences of delayed or untreated lentigo maligna? Select four (4) correct answers.

A 77-year-old woman presents with a pigmented lesion on her left cheek. The lesion has been slowly enlarging over several years. A biopsy confirms lentigo maligna, and she is referred for surgical excision.

 

Which of the following are associated with a favourable prognosis in lentigo maligna? Select four (4) correct answers.

A 74-year-old immunosuppressed man is diagnosed with lentigo maligna on his right temple. The lesion has been present for over two years and measures 3.5 cm. Excision is planned.

 

Which of the following are associated with a poorer prognosis in lentigo maligna or its invasive counterpart, lentigo maligna melanoma? Select four (4) correct answers.

A 35-year-old woman presents with recurrent episodes of urticaria for the past 3 months. Each episode lasts less than 24 hours and is associated with intense itching. She denies any new medications. The lesions appear without warning and affect different parts of the body. She is otherwise healthy.

 

Which of the following are recognised risk factors or triggers for chronic spontaneous urticaria? Select four (4) correct answers.

A 42-year-old man presents with a 6-week history of episodic wheals and itching. He denies any new foods or medications. The episodes appear unpredictably and resolve within hours. He has a history of allergic rhinitis and mild asthma.

 

Which of the following are recognised risk factors or contributing conditions for chronic urticaria? Select four (4) correct answers.

A 29-year-old woman presents with a 6-week history of recurrent, pruritic wheals that last less than 24 hours and occur almost daily. She denies angioedema, known allergies, or new medications. Her symptoms are interfering with sleep and daily activities. She has no systemic symptoms. Clinical diagnosis of chronic spontaneous urticaria (CSU) is made.

 

Which of the following are appropriate first-line and second-line management options for this condition? Select four (4) correct answers.

A 44-year-old man with known chronic inducible urticaria (specifically pressure and cold urticaria) presents with recurrent symptoms despite standard-dose antihistamines. He is otherwise healthy and not on any new medications. He wants to avoid side effects and control symptoms effectively.

 

Which of the following are valid management strategies in this patient’s case? Select four (4) correct answers.

A 38-year-old woman presents with a 4-month history of chronic urticaria. Her symptoms occur daily and include itchy wheals that resolve within 12–24 hours. Recently, she has developed swelling of the lips and eyelids without rash. She’s feeling anxious and exhausted.

 

Which of the following are recognised complications or consequences of chronic urticaria? Select four (4) correct answers.

A 51-year-old man with cold-induced urticaria presents to the emergency department after swimming in cold water. He developed widespread hives, swelling of the lips, and difficulty breathing. He was treated with intramuscular adrenaline.

 

Which of the following are potential complications of inducible or uncontrolled urticaria? Select four (4) correct answers.

A 32-year-old woman presents with a 3-month history of chronic spontaneous urticaria. She is otherwise healthy, has no signs of angioedema, and is responsive to standard-dose second-generation antihistamines. She asks about the likely course of her condition.

 

Which of the following are associated with a favourable prognosis in chronic urticaria? Select four (4) correct answers.

A 55-year-old man has had daily cold-induced urticaria for 5 years. He has been trialled on high-dose antihistamines with partial relief. His symptoms are triggered by mild cold exposure and have impacted his occupation.

 

Which of the following are associated with a poorer prognosis in chronic urticaria (including inducible types)? Select four (4) correct answers.

A 62-year-old man presents to the emergency department with swelling of the lips and tongue. He denies itching or rash. He recently started lisinopril for hypertension, allopurinol for gout and Crestor for high cholesterol. His symptoms developed over a few hours. There is no family history of similar episodes.

 

Which of the following are recognised risk factors for developing angioedema in this patient population? Select four (4) correct answers.

A 24-year-old woman presents with recurrent facial swelling and abdominal pain episodes since childhood. She denies rash or itching. Her father had similar symptoms and required hospitalisation in the past. C4 complement is low during attacks.

 

Which of the following are risk factors or features associated with hereditary angioedema (HAE)? Select four (4) correct answers.

A 58-year-old man presents with sudden swelling of his tongue and lips. He is unable to speak clearly but is maintaining his airway. He is on lisinopril for hypertension. There is no associated rash or urticaria. He is diagnosed with ACE inhibitor-induced angioedema.

 

Which of the following are appropriate management steps in this patient? Select four (4) correct answers.

A 21-year-old woman with hereditary angioedema (HAE) presents with swelling of the face and abdominal pain. She has had several previous episodes, and testing has confirmed C1 esterase inhibitor deficiency. She is not in respiratory distress.

 

Which of the following are appropriate acute or long-term management strategies for her condition? Select four (4) correct answers.

A 54-year-old man presents with facial swelling and difficulty speaking. He is diagnosed with ACE inhibitor-induced angioedema. He is treated in the emergency department and does not require intubation. He is concerned about possible risks if this happens again.

 

Which of the following are recognised complications of angioedema? Select four (4) correct answers.

A 23-year-old woman with hereditary angioedema (HAE) presents with her third episode of abdominal pain, nausea, and limb swelling this year. She is not on prophylactic treatment and has missed multiple university classes due to her condition.

 

Which of the following are potential complications or long-term impacts of HAE? Select four (4) correct answers.