Internal-Medicine

44 2: Skin
DIRECTIONS (Questions 43 through 53): Each set
of matching questions in this section consists of a
list of lettered options followed by several numbered
items. For each numbered item, select the
appropriate lettered option(s). Each lettered
option may be selected once, more than once, or
not at all. EACH ITEM WILL STATE THE NUM-
BER OF OPTIONS TO SELECT. CHOOSE
EXACTLY THIS NUMBER.
Questions 43 through 48
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
(I)
(J)
(K)
generalized vitiligo
localized vitiligo
telangiectasia
erythroderma
tuberculoid leprosy
sarcoid
limited scleroderma
dermatomyositis
secondary syphilis
diabetes
eruptive xanthoma
For each patient with the skin lesion, select the
most likely diagnosis or associated condition.
43. A 20-year-old man who recently emigrated
from Southeast Asia has chronic skin lesions on
his back and chest. On examination, there are
multiple well-defined hypopigmented macules
with raised edges. They vary in size from 1.0 to
5.0 cm, and some have lost sensation to touch
and pinprick. (SELECT ONE)
44. A 47-year-old woman has symptoms of heartburn
and skin changes in her hands. She
notices pain and discomfort in her hands while
washing dishes with cold water, and that the
fingers sometimes become pale and colorless
when they are painful. The fingers then change
color to blue, and red after warming. On examination,
there are areas of telangiectasias on her
face. (SELECT ONE)
45. A 25-year-old woman presents with a diffuse
skin rash, starting a few days after starting
antibiotics for a urinary tract infection. On
examination, her skin was warm to touch, and
red in color. (SELECT ONE)
46. A 32-year-old man notices the sudden eruption
of tiny nodules on his lower arms and knees. On
examination, he has multiple crops of papules on
his lower arms and knees. They are dome
shaped, discrete, and have a yellow center with
surrounding areas of redness. (SELECT ONE)
47. A 24-year-old man presents with malaise, fever,
and a new rash on his abdomen. Eight weeks
ago he had a painless 1-cm ulcer on his penis
that resolved spontaneously. On examination,
there are faint pink brownish-red macules on
his abdomen ranging in size from 0.5 to 1.0 cm.
(SELECT ONE)
48. A 51-year-old man with obesity (body mass
index [BMI] >30) presents with skin changes in
his right axilla. On examination, there is
increased pigmentation and the skin appears
dirty. The area feels velvety and the skin folds
are accentuated. (SELECT ONE)
Questions 49 through 53
(A) dystrophic nail changes
(B) may mottle teeth
(C) black pigmentation of face
(D) erythema nodosum
(E) morbilliform eruption in patients with
acquired immune deficiency syndrome
(AIDS)
(F) gingival hyperplasia
(G) reactions in patients with nasal polyps
For the following medications, select the most
appropriate skin manifestations.
49. Bleomycin (SELECT ONE)
50. Chloroquine (SELECT ONE)
51. Birth control pills (SELECT ONE)
52. Tetracycline (SELECT ONE)
53. Sulfamethoxazole and trimethoprim (SELECT
TWO)