October Practice Questions

---

All answers with explanations can be found at the end of the page!

---

1. A 45-year-old woman presents for review. She has noticed a number of patches of 'pale skin' on her hands over the past few weeks. The patient has tried using an emollient and topical hydrocortisone with no result. On examination, you note a number of depigmented patches on the dorsum of both hands. Her past medical history includes thyrotoxicosis for which she takes carbimazole and thyroxine.

Image by theconversation.com

What is the most likely cause of her symptoms?

A. Vitiligo

B. Medication related hypopigmentation

C. Fungal Infection

D. Guttate hypomelanosis

E. Pityriasis Versicolour

2. Which of the following is the least likely to have a role in the management of the above patient?

A. Sun cream

B. Topical ketoconazole

C. Topical tacrolimus

D. Topical corticosteroids

E. Phototherapy

3. Spot diagnosis! Are you able to recognize this lesion?

Image by pcds.org.uk

What condition can be associated with the image above?

A. Guttate Psoriasis

B. Eczema Herpeticum

C. Sebhorreic Dermatitis

D. Pompholyx eczema

E. Scabies

4. A 53 year old man comes in the the GP complaining of darkened, velvety plaques which are on his axilla and neck. This has been bothering him for the past few weeks.

What is the least likely cause of this condition?

Image by usdermatologypartners.com

A. Type 2 Diabetes

B. Hypothyroidism

C. Obesity

D. PCOS

E. Hypertension

5. Patient presents to ED with immense itching and some superficial swelling can be seen on the skin. It does not seem to be causing any distress except some itching.

What is your next step in management?

image by medicalnewstoday.com

A. Give 500ml IV Saline

B. Prescribe Cetirizine

C. Prescribe Emollients

D. Reassure and send patient home with worsening advice

E. Admit to ICU

---

We hope you found these questions useful. For the answers, please refer below

---

Answer 1: A Vitiligo is more common in patients with known autoimmune conditions such as thyrotoxicosis.

Answer 2: B There is no role for antifungals in Vitiligo.

Answer 3: A Tear drop papules on trunk and limbs.

These appear pink on paler skin tones. Darker brown on darker skin

Answer 4: E The common causes of acanthosis nigricans are T2DM, GI malignancy, obesity, PCOS, acromegaly, Cushing’s disease and COCP). Could also be familial \

Answer 5: B his patient is presenting with hives/ urticaria. antihistamines are the first line treatment.

Watch out for indicators of severe episodes (angioedema, respiratory distress)- systemic corticosteroids (prednisolone) are indicated on these cases.