MCQ 1 - oxbridgemedica.org

MCQ 1

33 year old male printer complained of a 3 month history of

hand dermatitis. Patch testing was negative. A biopsy

showed spongiosis and lymphocytic exocytosis. No

Munro’s microabcesses are seen.

Identify the most likely diagnosis.

A. Prebullous pemiphigoid

B. Psoriasis vulgaris

C. Irritant/contact eczematous dermatitis

D. Mycosis fungoides

E. Drug reaction

MCQ 2a

Which statement is false.

Psoriasis:

a. Can result in alopecia

b. Sacrum affected

c. Pustular form exists

d. Histologically shows spongiform pustule

of Kogoj

e. Vascular ectasia is seen with margination

of neutrophils

MCQ 2b

A 34 year old patient presents with multiple silvery skin

plaques. A skin biopsy is performed to confirm the

diagnosis.

Identify the finding which would not be consistent with a

diagnosis of psoriasis.


b. Sacrum affected


d. Histologically shows spongiform pustule of Kogoj

e. Vascular ectasia is seen with margination of neutrophils

MCQ 2c


plaques involving the extensor surface of the limbs,

scalp and lower back. The condition is worse after

periods of stress and localises to areas of trauma. A

skin biopsy is performed to confirm the diagnosis.

Identify the finding which would not be expected in this

condition.


b. Sacrum affected


d. Histologically shows spongiform pustule of Kogoj

e. Vascular ectasia is seen with margination of neutrophils

MCQ 2d


plaques involving the extensor surface of the limbs,

scalp and lower back. The condition is worse after

periods of stress and localises to areas of trauma. A

skin biopsy is performed to confirm the diagnosis.

Identify the finding which would not be expected in this

condition.

a. Fibrous replacement of hair follicles

b. Parakeratosis

c. Neutrophilic pustules in the epidermis

d. Vascular ectasia is seen with margination of neutrophils

e. Loss of the granular cell layer

MCQ 3A 44 year old taxi-driver presents with an

sudden eruption on the trunk and limbs. Target

lesions are present on the hands and feet. His

skin biopsy shows basal cell damage with

apoptotic keratinocytes.


a. Lichen planus

b. Dermatomyositis

c. Erythema multiforme

d. Chronic graft versus host disease

e. Lichen nitidus

MCQ 4a

Which of the following conditions

does not show a leukocytoclastic

vasculitis?

A. Erythema nodosum

B. Microscopic polyangiitis

C. Wegeners granulomatosis

D. Polyarteritis nodosa

E. Urticarial vasculitis

MCQ 4b

A 42 year old patient presents with purpuric lesions

involving both limbs. Inflammatory markers are raised.

A skin biopsy is taken and shows features of a

leukocytoclastic vasculitis.

Identify the condition which does not show this feature.

A. Erythema nodosum

B. Churg Strauss syndrome



E. Urticurial vasculitis

MCQ 4c



A skin biopsy is taken and shows fibrinoid necrosis of

vessel walls with leukocytoclasis and red blood cell

extravasation.


A. Erythema nodosum

B. Eczematous dermatitis

C. Epidermolysis bullosa acquista

D. Erythema multiforme

E. Polyarteritis nodosa

MCQ 4d



A skin biopsy is taken and shows fibrinoid necrosis of

vessel walls with leukocytoclasis and red blood cell

extravasation.

Identify the condition which would not show these

features.

A. Erythema nodosum

B. Churg Strauss syndrome



E. Urticarial vasculitis

MCQ 5a

Which of the following conditions is not

associated with granulomatous

inflammation.

A. Sarcoidosis

B. Granuloma annulare

C. Pemiphigus vulgaris

D. Fungal infection

E. Tuberculosis

MCQ 5b

A 58 year year old woman presents with itchy annular

skin lesions. She has a history of Crohn’s disease for

which she is on systemic therapy. A skin biopsy show

aggregates of histiocytes. A Grocott silver stain is

positive.


A. Sarcoidosis

B. Granuloma annulare

C. Necrobiosis lipoidica

D. Fungal infection

E. Metastatic Crohn’s disease

MCQ 6A 68 year old female has a 1/52 history of tense

large blisters arising on erythematous skin. A

skin biopsy shows a subepidermal blister

containing eosinophils.

Identify the most likely diagnosis?

A.Pemphigus vulgaris

B.Pemphigus foliaceus

C.Darier’s disease

D.Bullous pemphigoid

E.Grover’ Disease

MCQ 7a

Predisposing factors for squamous cell

carcinoma are all the following except:

a. UVB exposure

b. HPV Infection

c. Immunosuppression

d. Scarring

e. HHV-8 Infection

MCQ 7b

A 35 year old presents with an invasive

poorly differentiated squamous cell

carcinoma of the scalp.

Identify the most likely aetiological factor.

A- Solar damage/sun exposure

B- Immunosuppression

C- HHV8 infection

D- Previous radiotherapy

E- Idiopathic

MCQ 8A 72 year old presents with a squamous cell

carcinoma of the scalp. An excision biopsy is

performed and reported as per the RCPath

dataset.

Identify which feature would upstage the tumour

to pT3.

A- Perineural invasion –subcutis nerves

B- Location in head and neck

C- Depth of invasion 5.5mm

D- Clinical diameter >20mm

E- Lymphovascular invasion

MCQ 9A 72 year old presents with an ulcerating tumour

of the scalp. He has had androgenetic alopecia

for many years. A biopsy shows basaloid nests

of atypical cells infiltrating the dermis.

Identify the most likely predisposing factor in this

case.

A- Solar damage

B- Immunosuppression

C- Gorlins syndrome

D- Xeroderma pigmentosum

E- Underlying lichen planopilaris

MCQ 10

All the following lesions are benign except

A. Spitz naevus

B. Lentigo maligna

C. Cellular blue naevus

D. Naevus of ota

E. Freckles

MCQ 11A 27 year old man presents with a pigmented

lesion on the upper arm. An excision biopsy is

performed. The lesion is compound in nature

with prominent Pagetoid ascent in the epidermis

and multiple dermal mitoses (3 per mm2).

Identify the most important prognostic factor.

A- Depth of invasion

B- Macroscopic diameter

C- Presence of dermal mitoses

D- Pagetoid ascent

E- Absence of tumour infiltrating lymphocytes

MCQ 12

A 23 year old woman presents with a

changing melanocytic lesion. An excision

biopsy shows malignant melanoma.

Identify the most likely genetic mutation.

A- cKIT

B- BRAF

C- ALK

D- k-RAS

E- Tyrosine kinase

Question EMQ 1Options

A. Trichoepithelioma

B. Basal cell carcinoma

C. Halo naevus

D. Compound melanocytic naevus

E. Intradermal melanocytic naevus

F. Blue naevus

G. Keratoacanthoma

H. Lichen planus

I. Malignant melanoma

J. Trichilemmoma

K. Seborrhoeic keratosis

L. Simple lentigo

M. Squamous cell carcinoma

Each of these subjects has a skin biopsy. For each one, select the most likely

condition form the list of options. Each may be use once, more than once, or not at

all.

Question 1

A 55 year old female present with a

pigmented lesion on the hand.

Histology shows naevus cells in the

dermis with pigmented dendiritic

processes with overlying normal

epidermis.

Options



C. Halo naevus



F. Blue naevus

G. Keratoacanthoma

H. Lichen planus


J. Trichilemmoma


L. Simple lentigo




all.

Question EMQ 1

Question 2

A 35 year old man present with a

pigmented lesion on the arm with an

outer hypo-pigmented area. Biopsy

shows a band of inflammatory cells

at the dermo-epidermal junction

with scattered bland nests of

naevus cells.

Options



C. Halo naevus



F. Blue naevus

G. Keratoacanthoma

H. Lichen planus


J. Trichilemmoma


L. Simple lentigo




all.

Question EMQ 1

Question 3

A 28 year old female with a papule

on the nose. Histology shows

islands of basaloid cells with

occasional mitotic activity and

papillary mesenchymal bodies.

Options



C. Halo naevus



F. Blue naevus

G. Keratoacanthoma

H. Lichen planus


J. Trichillemmoma


L. Simple lentigo




all.

Question EMQ 1

Question 4

A 70 year old man presents with a

ulcerated lesion on the face. Skin

biopsy shows squamous islands in

the dermis with atypia and

dyskeratosis.

Options



C. Halo naevus



F. Blue naevus

G. Keratoacanthoma

H. Lichen planus


J. Trichilemmoma


L. Simple lentigo




all.

Question EMQ 1

Question 5

A 68 year old man with multiple

papules on the face. Histology

shows epidermal proliferation with

glycogenated keratinocytes,

peripheral palisade and thickened

basement membrane. No atypia or

mitoses are seen.

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