Bullous, Autoimmune Disorders & Connective Tissue Disease Quiz

 

Question 1 of 27

1. You are assessing a rash on a G3P2 28-year-old female in her 1st trimester of pregnancy. She has widespread pruritic plaques and papules that favor her flexures. The most likely diagnosis is:

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Question 2 of 27

2. Which of the following is not a subepidermal blistering disease:

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Question 3 of 27

3. A 4yr old patient presents with diffuse vesicles and bullae on an erythematous base. One month ago, he was recently diagnosed with otitis media and treated. You press on the skin adjacent to a blister and his skin shears away easily. This is called:

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Question 4 of 27

4. A positive Nikolsky sign can observe in all of the following except:

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Question 5 of 27

5. Which of the following autoimmune blistering diseases has the highest mortality rate?

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Question 6 of 27

6. Rituximab is FDA approved therapy for:

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Question 7 of 27

7.

A 62 yr old male presents with tense  blisters on his trunk and extremities that started 3 weeks ago. Your assessment includes a comprehensive history and physical exam. You suspect an autoimmune blistering disease that may have been triggered by this class of medication.

Question 7 of 27

Question 8 of 27

8. You are monitoring a 36 year old female patient with bullous pemphigoid. You are treating her with mycophenolate mofetil. She is a smoker but otherwise has an unremarkable past medical history. Patient education and monitoring include all of the following except:

Question 8 of 27

Question 9 of 27

9. The ANA titer for a patient suspected with cutaneous symptoms of SLE is 1:320. Which of the following are considered a titer that is a significant positive result?

Question 9 of 27

Question 10 of 27

10. In counseling a patient with dermatitis herpetiformis, you explain that potential triggers for disease flare may be caused by:

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Question 11 of 27

11. A 54 year old female presents with extremely pruritic vesicles and crusted excoriations on her upper and lower extremities for the past 2 months. The lesions are clustered in rosettes (annular). She also reports erosions in her mouth. Based on her clinical presentation, you favor the diagnosis of:

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Question 12 of 27

12. You perform a direct immunofluorescence (DIF) on a patient you suspect has dermatitis herpetiformis. What pattern will be noted if your diagnosis is correct:

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Question 13 of 27

13. You order a serum ELISA for a patient suspected to have bullous pemphigoid, what circulation antibodies are you ordering?

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Question 14 of 27

14. A 72 yr male of Mediterranean descent presents with diffuse eruption of flaccid blisters and erosions for 5 weeks. He complains of severe pruritus and sores in his mouth. His PMH is unremarkable except for hypertension and taking metoprolol for years. You perform a Nikolsky test that is positive. Your favored diagnosis is:

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Question 15 of 27

15. You perform diagnostics to confirm your diagnosis. Which positive test does not support the differential diagnosis of pemphigus vulgaris?

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Question 16 of 27

16. A 58 yr female with erythematous patches on her forehead and shoulders also complains of erythema on her eyelids that has been worsening over the past 2 months. Your differential diagnosis includes dermatomyositis. What other history and exam findings support your diagnosis:

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Question 17 of 27

17.

You evaluate a 24 yr old female who is 4 months into her first pregnancy and complaining of a severely pruritic eruption. She reports a 2-week history of red papules and vesicles that started on her abdomen, including her umbilicus, and spreading. She has a history of hypothyroidism and denies any other symptoms. The most likely diagnosis is:

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Question 18 of 27

18. You counsel a patient with a new diagnosis of pemphigoid gestationis about her skin condition and explain:

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Question 19 of 27

19. You’re managing a 48-year-old male diagnosed with dermatitis herpetiformis. You consider treating with dapsone and stress the importance of gluten avoidance. Which underlying condition increases his risk of methemoglobinemia?

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Question 20 of 27

20. A 32-year-old female presents for an initial examination. She states that her facial atrophy has been stable since childhood but recently started to spread. She denies any other similar plaques on her body. You suspect:

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Question 21 of 27

21. Given the patient’s diagnosis, disfigurement, and possible disability, you discuss systemic treatment options with her. You recommend the following systemic therapy:

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Question 22 of 27

22. Side effects for rituximab include all of the following, except:

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Question 23 of 27

23. Patients with genetically low levels of ____ are at increased risk of bone marrow suppression when taking azathioprine.

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Question 24 of 27

24. You would like to start a patient on hydroxychloroquine. Which lab do you order prior to doing so?

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Question 25 of 27

25. 47 yr A.W. presents with a non-scarring, photo distributed, annular eruption for the past 4 days. In order to differentiate patients with ACUTE cutaneous lupus erythematosus (ACLE) from SUBACUTE cutaneous LE (SCLE), you consider that in ACLE the:

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Question 26 of 27

26. You review A.W.’s medication list and ask her about her use of over-the-counter drugs. You consider that subacute cutaneous LE (SCLE) is known to be induced by all except:

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Question 27 of 27

27. The presentation of Systemic Lupus Erythematosus includes an insidious onset of fatigue, low grade fever and weight and hair loss in early onset disease. 90% of patients will also exhibit:

Question 27 of 27