Case 8 Questions 1-10

Scroll Down

Enjoy working thorugh the following questions. We hope they aid your learning. If you have any issues or feedback, please email [email protected].

Question 1

Which of the following should be used as first-line treatment in chronic plaque psoriasis on limbs and trunk?

  1. Methotrexate
  2. Topical corticosteroid
  3. Phototherapy
  4. Biologics
  5. Acitretin – Oral retinoid

The correct answer is option b Topical corticosteroid

Correct as it is topical and given by GPs, often with topical Vitamin D
a. This is a systemic option and not first line
c. This is not first line, and is more specialist in nature
d. This is systemic and more specialist when given
e. This is more specialised, and not given first line

Question 2

Which of the following is part of the sepsis 6 care bundle?

  1. Stop medications
  2. Take lactate levels
  3. Give painkillers
  4. Record an ECG
  5. Take a peak flow

The correct answer is option b Take lactate levels

This is part of your sepsis 6 – With Give O2,IV antibiotics and fluid and take Urine outputs, blood cultures and lactate
a. Whilst you may do this, it is not part of the sepsis 6 and may actually be detrimental to the patient
c. Whilst you may do this is not a immediate care order
d. This may be done in the ABCDE assessment but won’t be part of the sepsis 6 bundle
e. This is not part of the sepsis 6 bundle

Question 3

A 45-year old female presents with a 4 day history of erythema and swelling of her forearm. She has a history of severe asthma. On examination, you note that the erythematous area is widespread, tender and warm to touch. You diagnose her with cellulitis. Which of the following bacteria has most likely caused the cellulitis?

  1. Streptococcus pyogenes
  2. Pseudomonas aerigonosa
  3. E. coli
  4. Haemophilus influenzae
  5. Campylobacter

The correct answer is option a Streptococcus pyogenes

This is the most common presentation and bacteria causing cellulitis
b. This is a multidrug resistant bacteria that causes infection in immunocomprimised patient
c. This is common in gastro infections as well as some other skin infections, but less common
d. This commonly causes bacterial RTIs
e. This typically causes bacterial gastro diseases also

Question 4

A 30-year old female presents to A&E with a painful ulcer that has been growing rapidly since she sustained a cut on her shin. She also has a fever and a history of Ulcerative colitis. What is the diagnosis?

  1. Pyoderma gangrenosum
  2. Erythema nodosum
  3. Psoriasis
  4. Bruises
  5. Malignant melanoma

The correct answer is option a Pyoderma gangrenosum

Correct as it is a fast onset disease with causes in IBD
b. This is not typically associated with trauma
c. This is typically seen on the back of the neck as well as the extensor surfaces
d. These dont usually have fever
e. This is not associated with trauma

Question 5

Which of the following antibiotics attacks a bacteria’s cell wall?

  1. Clarithromycin
  2. Metronidazole
  3. Penicillin
  4. Doxycycline
  5. Rifampacin

The correct answer is option c Penicillin

This is correct as it is a beta lactam antibiotic that acts on the cell wall
a. This is a tetracyline that acts on the 50s subunit
b. Metronidazole effects the cytoplasm, not the cell wall
d. Doxycycline is a tetracycline that works on the 30s subunit
e. Rifampacin tagets RNA polymerase, stopping nucleic acid synthesis

Question 6

A 22-year old male attends out of hours GP with a 4 day history of sore throat, cough and a temperature of 38.5 degrees. On examination you see mildly enlarged tonsils without any exudate. No enlarged lymph nodes were found. What is the correct management for this patient?

  1. Admit to hospital with IV antibiotics
  2. Prescribe phenoxymethylpenicillin
  3. Delayed antibiotic prescription
  4. Reassure patient that infection is likely viral in nature
  5. Prescribe clarithromycin

The correct answer is option d Reassure patient that infection is likely viral in nature

Using FeverPAIN, the patient scores low so it is not likely to be bacterial in nature
a. Not high FeverPAIN to be this severe in nature
b. This is innapropriate prescription of antibiotics
c. b. This is innapropriate prescription of antibiotics
e. b. This is innapropriate prescription of antibiotics

Question 7

Which cell type found in the dermis is responsible for producing the extracellular matrix?

  1. Mast cells
  2. Fibroblasts
  3. Langerhans cells
  4. Melanocytes
  5. Merkel cells

The correct answer is option b Fibroblasts

This is correct as it produces collagen and elastin that allows the production of the extracellular matrix
a. This is a histamine containing cell that are involved in innate immunity
c. Langerhans cells are immune cells that are dendritic cells
d. These produce melanin, and pigmentation
e. These are sensory mechanoreceptors

Question 8

A 10-year old boy comes to A&E with his parents after he developed a dark purple raised rash on his buttocks and legs. He is also complaining of pain in his abdomen and knees. He had flu-like symptoms about 2 weeks prior to presenting with fever, headache and abdominal pain. What is the most likely diagnosis

  1. Kawasakis disease
  2. Eosinophilic grangulomatosis with polyangiitis
  3. Henoch-Schonlein purpira
  4. Meningitis
  5. Cutaneous Lupus erythematosus

The correct answer is option c Henoch-Schonlein purpira

Correct as this gives a symmetrical rash with turning purple after around 24h
a. This is inflammation of coronary arteries as well as lymph nodes, conjunctivitis and redness of libs
b. This has high eosinophils and can have other systemic symptoms
d. This is typically a non-blanchiing rash with photophobia and neck pain
e. This is seen with butterfly rash along the cheeks and will cause measle like rashes

Question 9

Which is not a layer found in thin skin

  1. stratum Corneum
  2. stratum lucidum
  3. stratum granulosum
  4. stratum spinosum
  5. stratum basale

The correct answer is option b stratum lucidum

This is only found in Thick skin
a. This is found in thin and thick skin
c. This is found in thin and thick skin
d. This is found in thin and thick skin
e. This is found in thin and thick skin

Question 10

What is the first thing a doctor should reccommend for a patient with acne

  1. Topical retinoid
  2. Topical antibiotic
  3. Lifestyle advice
  4. Oral antibiotic
  5. Anti-androgens

The correct answer is option c Lifestyle advice

This is correct as patients should have lifestyle advice, such as less greasy foods before treatments
a. This is a possible first line treatment
b. This is a possible first line treatment
d. This is in treatment-resistant acne
e. This is in treatment-resistant acne