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Dermatology and Wounds MCQ
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Dermatology and Wounds MCQ
1
All of the following statements about erythroderma are true EXCEPT
A
There is > 90% body surface involvement
B
It is more common in males .
C
The most common cause is drug reaction
D
High output cardiac failure is a recognised sequelae
2
The feature you would NOT expect to find in a case of erythema multiforme after cefaclor use is
A
Itch
B
Target lesions
C
No cross sensitivity with cefotaxime
D
Complete resolution in 2-3 weeks, without sequelae
3
Which of the following features is consistent with scarlet fever
A
Punctate rash on neck and truck
B
Perioral erythema
C
Geographic tongue
D
Resolution without desquamation
4
Erythema Nodosum is an example of
A
Panniculitis
B
Vasculitis
C
Serum sickness
D
Erythroderma
5
Geographic tongue is caused by
A
Kawasaki disease
B
Syphilis
C
Acromegaly
D
None of These
6
The toxic reaction you would least expect with bupivocaive is
A
Anaphylaxis
B
Sense of impending doom
C
Fitting
D
Arrythmia
7
Which of the following is associated with a lower incidence of wound infection (given adequately cleanedwounds)
A
Steristrips
B
Staples
C
Histoacryl
D
All of the above
8
Which of the following is not associated with poor wound healing
A
Lower limb lacerations in the elderly
B
Broad based flap lacerations
C
Long flap lacerations
D
Haematoma beneath a flap laceration
9
If a patient presents with DIC after dog bite the likely organism would be
A
Pseudomonas Aeruginosa
B
Staphylococcus Aureus
C
Streptococcus Viridans
D
Capnocytophaga Caniniosus
10
A backpacker returns from Thailand claiming to have been bitten by a dog in Bangkok the week before. There is a healing wound with scab on the right forearm ulnar aspect of the extensor surface. She cannot remember her vaccination status. Which statement is most correct
A
You should give 250U TIG, 0.5mL of ADT, commence oral antibiotic and refer back to the GP for further care – complete ADT vaccinations B. There is a strong risk that cellulitis due to pasturella multocida will develop in the next week
B
There is a strong risk that cellulitis due to pasturella multocida will develop in the next week
C
ADT is contraindicated if she is either haemophilliac or pregnant
D
You should give 250U TIG, 0.5mL of ADT 3 x in the next 3 months, 20U/kg RIG once and 0.1mL HDCV 5 times in the next month
11
Which rash is not characteristically found on the hands?
A
secondary syphilis
B
erythema multiforme
C
gonococcus
D
herpes simplex
12
In what dermatological condition is a Tsanck smear used to aid diagnosis?
A
Skin lesions of meningococcus
B
Herpes vesicular lesions
C
Secondary syphilis
D
Urticaria
13
Which is not true of erythema multiforme?
A
less than 30% of the skin must be blistered to make this diagnosis B. D. E.
B
classically there are target lesions, especially on the periphery
C
it settles within 7-10 days if left untreated
D
steroids orally quicken the recovery
14
Which drug is not likely to cause toxic epidermal necrolysis?
A
penicillin
B
trimethoprim
C
carbamazepine
D
cimetidine
15
Which is not a possible cause of a blistered patient?
A
molluscum contagiosum
B
hand, foot and mouth disease
C
eczema herpeticum
D
allergic contact dermatitis
16
Which is NOT TRUE of staphylococcal scalded skin syndrome?
A
it tends to be less severe than toxic epidermal necrolysis
B
it is toxin mediatied
C
there is no mucosal invovement
D
None of these
17
Which infectious erythema is purely caused by toxin alone and not from the infectious process as well?
A
toxic shock syndrome
B
scarlet fever
C
streptococcal toxic shock syndrome
D
staphylococcal scalded skin syndrome
18
Which rash is not usually itchy?
A
urticaria
B
eczema
C
scabies
D
scarlet fever
19
Which is not true of scarlet fever?
A
the erythema appears very early after the prodrome begins
B
the rash does not blanche
C
there is circumoral pallor
D
there is often pharyngotonsillitis
20
Which is not one of the five criteria other then fever required to make the diagnosis of Kawasakis disease?
A
cervical LN
B
peripheral changes. Eg erythema and oedema
C
polymorphous rash
D
pustular tonsillitis
21
Which dose not tend to produce palpable purpura?
A
meningococcus
B
vasculitis
C
SLE, rheumatoid arthritis
D
Clotting disorders
22
Which is not associated with erythema nodosum?
A
crohns disease
B
salmonella
C
leukemia
D
hep
23
Which is not associated with pyoderma gangrenosum?
A
Rheumatoid arthritis
B
Leukemia
C
salmonella
D
myeloma
24
Which is NOT TRUE of pemphigus and pemphigoid?
A
the prognosis of pemphigoid is better
B
pemphigous lesions are intra dermal where as the lesions in pemphigoid are subdermal C. mucosa is more often involved in pemhigous D. clinically the two can be usually differentiated with a good exa
C
mucosa is more often involved in pemhigous
D
clinically the two can be usually differentiated with a good examination
25
Which is the usual causative organism in toxic shock syndrome?
A
staph aureus
B
e coli
C
pneumococcus
D
strep pyogenes
26
Which medication does not commonly cause photosensitivity eruptions?
A
thiazide diuretics
B
spironolactone
C
loop diuretics
D
amioderone
27
Which is not true of antiviral medications if given within 72 hours of vesicle formation in herpes zoster?
A
it decreases time to healing
B
it decreases new lesion formation
C
it decreases recurrence
D
it possibly decreases pain
28
Which is not true of measles?
A
Koplicks spots are seen a few days after the onset of rash
B
The rash appears a few days after the prodrome, starting at the head and moving downwards
C
Unimmunised contacts should be given MMR within 72 hours if over 6 months of age
D
If greater than 72 hours immunoglobulin should be given i.m.
29
Which is not true of henoch schonlein purpura?
A
purpura are classically on the lower limbs
B
abdominal pain and malena are documented
C
renal disease is a potentially serious complication
D
steroids diminish the likelihood of renal complications
30
How many days it take a wound to reach 100% of its original tensile strength?
A
40
B
100
C
150
D
250
31
Which imaging modality is most successful at detecting suspected foreign bodies in wounds?
A
normal plain xray
B
plain xray ‘soft tissue view’
C
ultrasound
D
CT
32
Which is the best irrigation fluid for most wounds?
A
normal saline
B
povodine – iodine
C
aquesous chlorhexidine
D
chlorhexidine with cetramide
33
Which is the correct regimen for wound irrigation?
A
21 gauge needle, 50 ml syringe
B
21 gauge needle, 20 ml syringe .
C
19 gauge needle, 50 ml syringe
D
19 gauge needle, 20 ml syringe
34
When antibiotics are given for a wound with a high risk of infection, how should they be given in the ED?
A
orally prior to wound manipulation, with discharge prescription
B
iv prior to wound manipulation, with discharge prescription
C
a prescription to be filled on discharge
D
both A and B give the same result
35
Which wound is most likely to produce tetanus?
A
A. Intraoral laceration
B
scalp laceration with underlying skull fracture
C
crush injury to distal phalynx
D
puncture wounds
36
Which suture should be used for wounds at risk of infection?
A
monofilament, natural
B
monafilament, synthetic
C
multifilament, natural
D
multifilament, synthetic
37
Which is false regarding staples?
A
they have a higher rate of infection than sutures
B
they are cheaper than sutures
C
they are quicker to insert than sutures
D
they are more painful to remove than sutures
38
At which distance should two point discrimination be possible?
A
A. 2mm
B
5mm
C
7.5mm
D
10mm
39
Which is not readily seen on Xray?
A
all glass greater than 2mm
B
gravel
C
teeth
D
fish bone
40
Human bites to what area have the highest rate of infection?
A
face
B
shin
C
back
D
hand
41
Regarding bites which is false?
A
all hand bites (animal and human) should be managed by delayed primary closure or secondary intention
B
primary wound closure to the head and neck is acceptable after appropriate wound irrigation
C
wounds less than1-2 cm have a lower rate of infection and can be safely treated with primary closure
D
infection with pasturella multicodia is specific to cat bites
42
Which antibiotic regimen is recommended in antibiotic guidelines for bites with a high risk of infection?
A
augmentin duo forte
B
penicillin
C
ampicillin
D
cephalexin
43
Which wound does not require antibiotic prohylaxis upon discharge (assuming seen within 3 hours and appropriate wound care applied)?
A
complicated dog bites
B
complicated human bites
C
all cat bites
D
xillary
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