Multiple choice questions for residents
All the following are true regarding elliptical excision except:
Length of the ellipse is at least 2 times its total width
The angle at each of the apices is 30°
Incision lines are placed in relaxed skin tension lines
Long axis of the ellipse is oriented perpendicular to free margins.
While repairing a large cheek defect after flap surgery, you begin to anesthetize a patient who weighs 50 kg. What is the maximum amount of 1% lignocaine with 2.5% epinephrine that this patient can receive?
Aplasia cutis congenita occurs if the mother has taken which of the following medication?
Most common cause of shoe contact dermatitis?
Which of the following is true?
UVB erythema reaches a maximum in 24–36 h
Immediate pigment darkening is brought about by UVA and visible light
Delayed tanning occurs due to UVA
The chromophore involved with UVB erythema are melanosomes
Caterpillar bodies are seen in
Porphyria cutanea tarda
The ragged cuticle seen in dermatomyositis is also known as
Candy cane nails
How long is the life cycle of scabies mite?
Skin biopsy from the nodule over lumbar spine of a newborn reveals a lipoma. What would be your next appropriate step?
Excision of the lesion
Banana fingers in leprosy is a
The only significant Gram-negative residents which are part of normal flora of skin are?
In a BCC measuring <2 cm in diameter, what is the tumor-free margin considered?
What is the peculiar side effect of Valacyclovir which becomes prominent at doses >8 g/day, especially in immunocompromised patients?
Diamond, Feinberg, Whittington, and Kupferberg media are used for culturing which organism?
Which of the following is a human metabolite with inhibitory effect on M. leprae?
What is the plasma viral load cutoff above which the HIV patient is declared as having virological failure?
The given dermoscopic picture is suggestive of [refer Figure 1]
What is the current recommendation on “when to start ART”?
All positive patients irrespective of the CD4 count
Which of the following peel is derived from bitter almond?
Which targeted therapeutic agent used in the treatment of melanoma can produce vitiligo as a side effect?
For an optimum tissue diagnosis, wound closure and good cosmetic outcome the length of the ellipse should be 3 times its total width and angle at the apices of the ellipse should be 30°.
D: 35 ml
About 7 mg/kg is the maximum recommended dose of 1% lidocaine with 2.5% adrenaline. Hence, for a patient weighing 50 kg, it would be 350 mg or 35 ml (1% lidocaine has 10 mg of lidocaine per ml)
Other drugs implicated are carbimazole, valproate, cocaine, and marijuana
C: 2-Mercaptobenzothiazole is the most common cause of shoe contact dermatitis. The second most common cause is thiuram mix.
B: Immediate pigment darkening is brought about by UVA and visible light
UVB is the main contributor of erythema and reaches a maximum in 6–24 h. The chromophores involved with erythema are not clear but appear to involve nucleic acids. Immediate pigment darkening is due to UVA and visible light and fades within minutes after exposure. Delayed tanning is due to UVB and occurs 72 h after exposure.
C: Porphyria cutanea tarda, Caterpillar bodies are thought to be type 1V collagen
B: Samitz sign
B: 30 days
C: Imaging study
Cutaneous lesions along the midline of spine might give an important clue to the diagnosis of underlying neural tube defect. Clues to the diagnosis include a tuft of hair, lipoma, midline dimple, or vascular lesion. In these instances, imaging studies should be promptly initiated.
A: Specific deformity
A: 4 mm
About 4 mm margins are adequate for removal in 98% of cases of non-morpheaform BCC <2 cm in diameter. High-risk SCC requires 6 mm margins, with size >2 cm, poor differentiation, invasion to fat, and location in high-risk areas as they are associated with a greater risk of subclinical tumor extension.
A: Thrombotic microangiopathy
C: Trichomonas vaginalis
Viral load is recommended as the preferred monitoring approach to diagnose and confirm treatment failure. Virological failure is identified by the detectable viral load count of 1000 or more copies/ml, in targeted or routine viral load monitoring, at least 6 months after ART, with >95% of treatment adherence for each of the past 3 months.
C: Seborrheic keratosis
The classic dermoscopic criteria for seborrheic keratosis are milia-like cysts and comedo-like openings. In addition, there will be fissures, moth-eaten borders, sharp demarcation, and hairpin blood vessels.
D: All positive patients irrespective of the CD4 count
The guidelines on when to start ART have evolved over the years toward earlier initiation of ART; CD4 count cutoff point for ART initiation moving from <200 cells/cmm in 2004 to <350 cells/cmm in 2010 and then to <500 cells/cmm in 2013. The current recommendation is to treat all, regardless of the clinical stage or CD4 count. These changes have been based on the evidence from various randomized clinical trials and large observational cohorts which have revealed that with earlier ART initiation, there is a significant delay in progression to AIDS and reduction in the incidence of TB (NACO guidelines, October 2018)
B: Mandelic acid
Nivolumab is a programmed death-1 inhibitor. Vitiligo has been reported in as many as 10.7% of patients undergoing nivolumab therapy.