Dermatology and Wounds | Set 1

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

E. Splenomegaly is associated in about 15%

Correct : C. The most common cause is drug reaction

2. The feature you would NOT expect to find in a case of erythema multiforme after cefaclor use is

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

E. Only occurs in association with streptococcal pharyngitis

Correct : A. Punctate rash on neck and truck

6. The toxic reaction you would least expect with bupivocaive is

7. Which of the following is associated with a lower incidence of wound infection (given adequately cleaned wounds)

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

E. All of the above are associated with poor wound healing

Correct : B. Broad based flap lacerations

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

E. Pasturella Multocida

Correct : 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

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

E. Her risk of contracting rabies would not be reduced if she had cleaned the initial wound thoroughly straight after the injury occurred

Correct : 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?

12. In what dermatological condition is a Tsanck smear used to aid diagnosis?

13. Which is not true of erythema multiforme?

A. less than 30% of the skin must be blistered to make this diagnosis

B. classically there are target lesions, especially on the periphery

C. there tends to be associated fever and arthralgia

D. it settles within 7-10 days if left untreated

E. steroids orally quicken the recovery

Correct : E. steroids orally quicken the recovery

14. Which drug is not likely to cause toxic epidermal necrolysis?

15. Which is not a possible cause of a blistered patient?

16. Which is NOT TRUE of staphylococcal scalded skin syndrome?

A. it is most commonly seen in infants

B. it is toxin mediatied

C. there is no mucosal invovement

D. it tends to be less severe than toxic epidermal necrolysis

E. the focus for infection may be non cutaneous

Correct : C. there is no mucosal invovement

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

E. all of the above

Correct : A. toxic shock syndrome

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

E. there is a strawberry tongue

Correct : B. the rash does not blanche

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. bilateral non purulent conjunctivitis

D. polymorphous rash

E. pustular tonsillitis

Correct : E. pustular tonsillitis

21. Which dose not tend to produce palpable purpura?

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 examination

E. they are both autoimmune disorders

Correct : D. clinically the two can be usually differentiated with a good examination

25. Which is the usual causative organism in toxic shock syndrome?

26. Which medication does not commonly cause photosensitivity eruptions?

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

E. it possibly decreases duration of post herpetic neuralgia

Correct : C. it decreases recurrence

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.

E. Unimmunised contacts should be excluded from school for 2 weeks

Correct : A. Koplicks spots are seen a few days after the onset of rash

29. Which is not true of henoch schonlein purpura?

A. it is a vasculitis of unknown cause

B. purpura are classically on the lower limbs

C. abdominal pain and malena are documented

D. renal disease is a potentially serious complication

E. steroids diminish the likelihood of renal complications

Correct : E. steroids diminish the likelihood of renal complications

31. Which imaging modality is most successful at detecting suspected foreign bodies in wounds?

32. Which is the best irrigation fluid for most wounds?

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

E. 1 litre bag with giving set wide open

Correct : C. 19 gauge needle, 50 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

E. infiltrated around wound i.m

Correct : B. iv prior to wound manipulation, with discharge prescription

35. Which wound is most likely to produce tetanus?

A. Intraoral laceration

B. scalp laceration with underlying skull fracture

C. crush injury to distal phalynx

D. frostbite

E. puncture wounds

Correct : E. puncture wounds

36. Which suture should be used for wounds at risk of infection?

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

E. they do not provide as accurate a finish as sutures

Correct : A. they have a higher rate of infection than sutures

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

E. infection with capnocytophaga caninorsus is secific to dog bites

Correct : C. wounds less than1-2 cm have a lower rate of infection and can be safely treated with primary closure

42. Which antibiotic regimen is recommended in antibiotic guidelines for bites with a high risk of infection?

43. Which wound does not require antibiotic prohylaxis upon discharge (assuming seen within 3 hours and appropriate wound care applied)?

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