Internal-Medicine

Questions: 32–42 43
also involvement of the flexural regions of the
arms. Which of the following is the most likely
diagnosis?
(A)
(B)
(C)
(D)
(E)
ichthyosis
acquired zinc deficiency
Paget’s disease
candidiasis
herpes simplex
39. A 26-year-old woman develops discomfort on
her lower legs and notices a skin rash. On
examination, there are tender nodules on her
shins with an erythematous base. Which of the
following conditions is this rash associated
with?
(A)
(B)
(C)
(D)
(E)
caused by aspergillosis
usually occurs in children
more common in males than females
only caused by malignant disease
can occur with streptococcal infection
40. Which of the following differentiates a patch
from a macule?
(A)
(B)
(C)
(D)
(E)
it is more easily palpable
a patch is erythematous
a patch can contain fluid
the etiology is very different
it is larger
41. A 19-year-old man develops a rash in the groin
area. On examination, it is a large welldemarcated
area of tan-brown discoloration
around his left inguinal area. There is some
scaling of the lesion when brushed with a
tongue depressor. Which of the following is
the most appropriate initial diagnostic test?
(See Fig. 2–10.)
(A) punch biopsy of skin
(B) Tzanck smear
(C) potassium hydroxide (KOH)
preparation of scrapings
(D) blood culture for fungi
(E) diascopy
Figure 2–10.
(Reproduced, with permission, from Wolff K and Johnson RA,
Fitzpatrick’s Color Atlas & Synopsis of Clinical Dermatology, 5th ed.
New York: McGraw-Hill, 2005:699.)
42. A 7-year-old boy develops a skin rash in the
right axillary area. On examination, there are
superficial small pustules, with some that have
ruptured and formed golden-yellow crusts.
The area is itchy, but not painful, and he has no
systemic symptoms. Treatment with oral
antibiotics is started. Which of the following
statements about this condition is most likely
correct?
(A)
(B)
(C)
(D)
(E)
caused by fungi of the Microsporum
species
caused exclusively by staphylococcal
infections
characterized by premalignant changes
treated by improved hygiene
characterized by papulosquamous
lesions