Dermatology — Prometric Style Questions, Set 2

What this deck covers

Dermatology – Prometric Style Questions, Set 2 in 50 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for board, MRCPCH and Prometric examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 50 cases, in order

1. Blackheads, and little else
2. Worse on the back after four months
3. Nodules that leave marks
4. Four washes with a rough cloth
5. Brown marks where spots were
6. Growing over the eyelid
7. One whole side of the face
8. Flat, purple, and not fading
9. Pinker when he cries
10. Noisy breathing, red chin
11. A hairy patch and many small
12. A pale ring round the mole
13. A pink dome on the cheek
14. One brown patch, nothing else
15. Round, regular, and pink
16. Pinpoint dents and a lifting edge
17. One thick yellow toenail
18. Twenty sandpaper nails
19. A groove down both thumbs
20. One line across every finger
21. One coat for the whole day
22. Burnt where the sun reached
23. Bumps after the first sun
24. Streaks after a picnic
25. Blisters in twenty minutes
26. Mouth ulcers every few weeks
27. Patches that move each week
28. Cracked at both corners
29. A clear rim beside the lip
30. White plaques, and asthma
31. Scrubbed, and still dark
32. Sore lumps on both shins
33. Bigger after the biopsy
34. Itching with nothing to see
35. Spongy nails, wet cough
36. Three years of armpit lumps
37. Sandpaper arms in winter
38. Bumps since the new razor
39. Two pits and a tuft of hair
40. Spots a day after training
41. A lump beyond the piercing
42. Raised, but along the cut
43. Six weeks after the burn
44. A mole on a scarring chest
45. He cannot straighten the arm
46. It soaks in within seconds
47. Thin skin after four weeks
48. Scratching through the night
49. Eyelids that keep flaring
50. A candle in his room

Diagnoses and management options tested

Across the fifty cases you are asked to choose between options such as: A topical retinoid, Scrubbing makes it worse, Investigation for PHACE syndrome, Laryngomalacia, A pyogenic granuloma, A fungal infection of the nail plate, Repeated picking at the nail fold, A phototoxic reaction to the drug, Xeroderma pigmentosum, Saliva pooling at the angles, Poor hygiene, Investigate for a systemic cause, It is harmless and often eases with age, Occlusion of the hair follicles.

Clinical pearls from this deck

• Look at what the lesions actually are before choosing. Blackheads and whiteheads are a plumbing problem, and only a retinoid unblocks the pipe.
• Never leave an oral antibiotic running alone in acne. Benzoyl peroxide beside it is what keeps the organism sensitive.
• Scarring changes the clock. Once a child is scarring, the argument for waiting disappears, because what is being lost does not come back.
• Correct the belief, not just the routine. A family who think acne is dirt will blame the child every time it flares.
• Run a finger over the mark. Flat means pigment and it will fade; a dip or a bump means scar and it will not.
• Most haemangiomas are watched. The exceptions are the eye, the airway, ulceration and a large face, and in those the clock is against you.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all dermatology case decks · pediatric reference values.