. 51Which organism is most likely to cause fungemia in an immunosuppressed organ transplant patient?
52. Purpuric contact dermatitis is most likely associated with
D. propylene glycol
E. sorbic acid
53. A patient presents with a diffuse morbilliform eruption, lip edema, fever, lympadenopathy, hepatosplenomegaly, eosinophilia, and elevated liver enzyme levels. The medication most likely to cause these findings is
54. Coumarin necrosis of skin is associated with a deficiency of
A. protein C
D. factor VIII
E. factor IX
55. A patient develops a morbilliform to phenytoin. Which anticonvulsant would be least likely to be associated with a cross-reaction?
A. Valproic acid
B. Phenobarbi tal
E. Mephobarbi tal
56. Which of the following has been shown to relieve cheilitis associated with oral retinoids?
A. Ascorbic acid
57. Which of the following is associated with hepatitis C infection?
A. Essential mixed cryoglobulinemia
B. Rheumatoid arthritis
C. Relapsing arthritis
D. Wegener's granulomatosis
58. The most common side effect of dapsone is
A. peripheral neuropathy
C. renal failure
59. In a patient with dermatitis herpetiformis unable to tolerate dapsone because of peripheral neuropathy, the treatment of choice is
60. The microscopic finding of a ruffled cuticle without the usual attached root sheath on examination is indicative of which hair abnormality?
A. Telogen effluvium
B. Anagen effluvium
C. Alopecia areata
D. Loose anagen syndrome
E. Mercury intoxication
61. KTP Lasers are commonly used to treat
B. green tattoos
D. hypertrophic scars
E. dermal melanocytosis
62. Q-switched laser treatments are most likely to produce immediate darkening of which tattoo pigment?
63. Which of the following lasers is most likely to cause purpura?
B. Flash lamp pulsed eye
64. The preferred laser treatment of choice for port wine stains is
B. copper vapor.
C. pulsed eye.
E. Q-switched ruby.
65. Which of the following dietary supplements may inhibi t platelet function?
A. Vitamin A
B. Vitamin C
C. Vitamin D
D. Vitamin E
E. Vitamin K
66. Which of the following lasers emits visible radiation?
A. 694 nm ruby
B. 810 nm diode
C. 1,064 nm Nd:YAG
D. 2,940 nm Er: YAG
E. 10,600 nm CO2
67. The ocular structure at greater risk for injury from the 585 nm pulsed dye laser is the
A. ciliary body.
E. vitreous humor.
68. The ocular structure at most risk for injury from the Er:YAG laser is the
A. ciliary body.
E. vitreous humor
69. Of the following, the most likely location for a supernumerary nip ple is the
A. preauricular cheek
B. postauricualar sulcus
D. inguinal crease
E. popliteal fossa
70. For a 70-kg adu lt undergoing excisional surgery, the maximum amount of plain 1% lidocaine administered should not exceed
71. Which of the following tumors is most likely to arise in a nevus sebaceous?
B. Trichilemm oma
C. Sebaceous adenoma
E. Merkel cell carcinoma
72. A child with a large fac ial infantile hemangioma and cardiac abnormalities is most likely to manifest
A. menigeal calcification
B. melanotic stools
E. a posterior fossa defect
73. Opthalmologic abnormalities are characteristics of which of the following?
A. Xanthoma disseminatum
B. Congenistal self-healing reticulohistiocytosis
C. Juvenile xanthogranuloma
D. Eosinophilis granuloma
E. Generalized eruptive histiocytosis
74. Which of the following bodies is associated with an infectious process?
E. Weib el-Palade
75. Joseph Merrick, the "elephant man", showed progressive macrocephaly, asymmetric limb hypertrophy thickened soles, and large so ft tissues masses. He had normal intelligence and no family history of skin disease. This is most consistent with the diagnosis of
A. Noonan syndrome
B. proteus syndrome
C. Maffuci's syndrome
D. tuberous sclerosis
E. klippel-Trenaunay-we ber syndrome
76. A 37-year-old man develops a painful subungual-violaceous lesion. This most likely represents
B. eccrine spiradenoma
C. granular cell tumor
D. glomus tumor
77. Exogenous ochronosis occurs after the long-term use of which topical agent?
A. Superpotent corticosteroids
78. The most appropriate management for acute hemorrhagic edema is
D. intravenous immunoglobulin
79. Streptococcal toxic shock-like syndrome most commonly affects
A. patients with uncontrolled diabetes.
B. patients with peripheral vascular disease
C. burn victims.
D. the elderly
E. young, otherwise healthy patients.
80. The most common infections of extramedullary hemapoiesis in infants is
B. rube lla virus
E. human immunodeficiency virus
81. A 4-year-old child presents with a tender, well-demarcated, red, perianal eruption. The most likely cau sative organism is
A. Staphylococcus aureus
B. group A streptococcus
C. Haemophilus influenzae
D. Pseudomonas aeruginosa
E. Escherichia coli
82. Which of the following anesthetics has the longest duration of action?
83. The lea ding cause of acquired heart disease in children is
A. rheumatic fever
B. Kawasaki's disease
D. Still's disease
E. streptococcal toxic shock syndrome
84. A malnourished patient has symmetrically distributed, rough, keratotic papules of the arms and legs. Each papule contains a central keratotic plug and broken hair. The patient also has discrete plaques of keratinizing epithelium on the conjunctival surfaces. The most likely vitamin deficiency is
85. Ventricular arrhythmia (torsades de points) is a complication of the concomitant administration of itraconazole and which of the following?
86. The most common site of metastasis from basal cell carcinoma is
A. a lymph node
B. the lung
C. the brain
E. the thyroid gland
87. Toxicity due to azathioprine is increased by the concomitant administration of which of the following?
B. Non-steroidal anti-inflammatory agents
88. Terbinafine affects the same subset of cytochrome P450 as which of the following?
89. The most effective treatment for a patient with Well's Syndrome?
A. systemic corticosteroids
E. H1 plus H2 antihistamines
90. Waardenburg's syndrome is associated with
B. neutrophil dysfunction
C. optic neuritis
E. seizure disorders
91. Tinea nigra is most commonly associated with
A. Piedraia hortae
B. Phaeoannellomyces werneckii.
C. Fus arium solanae
D. Penicillium mafneffei
E. Trichophyton rubrum
92. Imiquimod induces which of the following cytokines?
93. Male pattern baldness of the vertex of the scalp has recently been associated with an enhanced risk of
A. coronary artery disease
C. prostate hypertrophy
94. The multiple hamartoma syndrome is associated with mutation of which of the following?
C. Proto-oncogene C-Kit
95. The most common cause of death in infants with diffuse neonatal hemangiomatosis is
B. transfusion syndrome
C. High output heart failure
D. gastrointestinal hemorrhage
E. intracerebral hemorrhage
96. PTEN is
B. tumor suppressor gene
C. DNA binding protein
D. stem cell factor
E. anti-apoptosis protein
97. Oral hairy leukoplakia is caused by
A. herpes simplex virus type 1
B. Epstein-Barr virus
D. herpes simplex virus type 8
E. varicella-zoster virus
98. A case-control study finds that individuals with a childhood history of three or more blistering sunburns have an adjusted odds ratio of 1.9(95% confidence interval 1.6-2.5) developing melanoma as compared to individuals without a childhood history of three or more severe blistering sunburns. Which of the following statements is correct?
A. Individuals with a childhood history of at least three blistering sunburns are approximately 1.9 times more likely to develop melanoma as are matched controls.
B. The study investigators are 95% confidence interval indicates that three or more childhood blistering sunburns result in a 1.9 fold risk of melanoma.
C. The average risk of developing three or more childhood blistering sunburns is midway between the upper and lower values of the 95% confidence interval.
D. Each childhood blistering sunburn increases the melanoma risk by 0.66
E. The study had a 95% pow er to detect a 1.6-2.5 increase in the melanoma risk in individuals with a childhood history of three or more blistering sunburns.
99. A major dermatology journal article reports an adjusted odds ration of 1.5 for development of basal cell carcinoma for individuals with risk factor "A" as compared to matched controls without risk factor "A" (95% confidence intervals 0.9-2.8%). Which of the following statements is correct?
A. The validity of this study depends on the p value.
B. The 95% confidence interval indicates that there may be no association between development of basal cell carcinoma and risk factor "A" .
C. The authors are 95% confident that their study shows a 1.5 greater risk of basal cell carcinoma with risk factor "A" as compared to matched controls without risk factor "A".
D. The study has 95% pow er to detect a 1.5 greater risk of basal cell carcinoma in individuals with risk factor "A".
E. Risk factor "A" causes basal cell carcinoma.
99. A new patient wants to know the comparative efficacy of two topical treatments for psoriasis. If all of the following types of studies were available with comparablepow er, statistical analysis, and pertinent patient populations, which study would give the most unbiased information?
A. sing le-blind, placebo-controlled studies of each agent
B. Double-blind, randomized comparison of these two therapies
C. Nested case control study
D. Interventional cohort study
E. Efficacy rates listed in the Physicians Desk Reference (PDR)
100. A patient is suspected of having lat ex allergy. Based on history and clinical symptomps, you are 80% certain that the patient actually has lat ex allergy. A lat ex RAST (radioallergosorbent) test is reported to be negative. The RAST test used by the laboratory has a sensitivity of 75% and a specificity of 80%. Which of the following statements is correct?
A. After receiving the RAST test results, you are 25% certain that the patient does not have lat ex allergy.
B. After receiving the RAST test results, you are 25% certain that the patient does have lat ex allergy.
C. The study has a 95% lat ex to detect a difference between placebo and treatment.
D. There is less than a 5% chance that the treatment is equal to or less efficacious than placebo.
E. Most patients will improve at least 5% in the parameters measured while on this new treatment.