Basal layer of epidermis consists of

A. Pemphigus foliaceus B

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A. Pemphigus foliaceus

B. Herpetiform dermatosis (Duhring’s disease)

C. Pemphigus vulgaris

D. Seborrheic pemphigus ✔

E. Seborrheic dermatitis

Conduct differential diagnostics of this disease.

A 52-year old patient complains of rash on the skin of the shins, thighs, buttocks, tenderness and moderate itching. From anamnesis: he has been ill for 2 weeks, when rash of a pea-size, filled with serous content, which later became purulent-bloody, appeared on the shins. He was not treated, rash spread. Concomitant diseases: alcoholic hepatitis. Status localis: multiple erosions, covered with multi-layer crusts, firmly attached, are in the foci. Initial diagnosis?

А. syphilitic ecthyma

В. scrofuloderma

С. sporotrichosis

D. ecthyma vulgaris ✔

Е. Erythema induratum of Bazin

Describe further evolution of elements.
An 18-year old patient complains of rash on face skin in the region of the nostrils, mouth, eye fissures and scalp, intensive itching. She has been ill for 5 days, and was not treated. Status localis: phlyctenae with purulent content are in the foci on erythematous, slightly infiltrated background. Initial diagnosis?

А. impetigo vulgaris ✔

В. impetiginous syphilid

С. bullous dermatitis

D. herpes simplex

Е. epidemic pemphigus of the newborns

Treatment plan. Differential diagnosis
A man, 42 years old, complains of severe itching and skin reddening. Rash appeared after use of new cream for shaving. Face skin is hyperemic, swollen, vesicles and exfoliation are present. What is the most likely initial diagnosis?

А. Simple contact dermatitis;

В. Acute eczema;

С. Urticaria;

D. Allergic contact dermatitis; ✔

Е. Toxicodermia.

Conduct differential diagnostics of this disease.
Patient F., 52 years old, was admitted to dermatological department complaining of skin itching, insomnia, poor work capacity, irritability and rash on the skin. His condition rapidly deteriorated and rash spread on the skin of entire trunk after treatment of the skin with 5% iodine solution. On examination: tight tiny vesicles, bullae and papules with the tendency to grouping are detected on the skin of the trunk and extremities. Nikolsky’s symptom is negative. Which diagnosis may be suspected?

А. Pemphigus vulgaris

В. Duhring’s dermatosis ✔

С. Bullous pemphigoid

D. Pemphigoid foliaceus

Е. Mycosis of the mucous membranes

Prescribe treatment to this patient.
On examination of a patient, a doctor presses on damaged skin region with glass slide. Which method of examination does a doctor use?

А) grattage;

В) palpation;

С) diascopy; ✔

D) curettage;

Е) three-glass test.

Which characteristics of rash can be revealed with this method?
Patient K., 49 years old, complains of itching and rash in the nose region and chin. She links the disease with onset of menopause. Objectively: Papulopustular rashes and slight erythema are on the skin of the chin, forehead, and nasolabial region. On laboratory examination, Demodex folliculorum was detected. Which diagnosis may be made?

А. Psoriasis

В. Seborrheic dermatitis

С. Acne rosacea ✔

D. Discoid lupus erythematosus

Е. Acne vulgaris

Compile treatment plan for this patient
A patient consulted a dermatologist, complaining of discharge from the urethra and colic during urination. He mentions an accidental sexual contact 6 days ago. Objectively: swelling and hyperemia of sponges of the urethra; yelowish-green pus discharges from the urethra opening. In two-glass test: the first portion of urine – cloudy, the second – clear. On bacterioscopic examination: gram-negative diplococci, leukocytosis in the whole field of vision are in the smears from the urethra.

Your initial diagnosis?

A. Acute anterior gonorrheal urethritis

B. Trichomonal urethritis

C. Genital herpes

D. Chronic gonorrheal urethritis ✔

E. Chlamydial urethritis

1. Substantiation of diagnosis.

2. Administration of treatment.
A patient, 27 years old, visited a doctor with complaints of itching, rash on the skin of the trunk and extremities. She linked the disease to nervous stress. Local status: pearl miliary papulae, fused in the form of a lace are observed on oral mucosa. Lenticular polygonal papulae of pink-violet color with waxy surface and umbilicate depression in the center are visualized on the skin of the trunk and flexor surfaces. Initial diagnosis?

А) Lichen ruber planus;✔

В) Extensive psoriasis;

С) Molluscum contagiosum;

D) Lupus erythematosus;

Е) Flat warts.

Diagnostic criteria for making final and differential diagnoses.
Patient Sh., 54 years old, consulted a doctor for rash on the skin of the face, extremities, severe skin itching in these regions. On examination: numerous vesicles, size from a millet grain to a pea, are on the skin of the cheeks, forehead, forearms, axillary and inguinal folds on distinctly hyperemic background. Papulovesicles with a tendency to grouping are also observed. Which disease is most likely based on the described clinical picture?

А. Lichen ruber planus

В. Psoriasis

С. Duhring’s dermatosis ✔

D. Herpes

Е. Eczema

Which special dermatologic investigations should be performed to verify the diagnosis?
Patient K, 28 years old, complains of itching, rash on the skin of the trunk, which he links with intake of polyvitamins. In anamnesis – similar rash after consumption of chocolate, alcohol. Rash is ephemeral, of paste consistency, disappears completely. Which initial diagnosis can be made in this case?

А. Microbial eczema;

В. True eczema;

С. Toxicodermia;

D. Allergic contact dermatitis;

Е. Urticaria. ✔

Prescribe treatment to this patient.
Vascular damage is typical of this type of inflammation, thus, permeability of vessels changes and erythrocytes combine with any exudate. Which type of inflammation is mentioned?

А) immune;

В) hemorrhagic; ✔

С) serous;

D) purulent;

Е) proliferative.

Which phases of inflammation do you know?
After alcohol use, a patient had sexual contact with unfamiliar woman. On the second day – burning and itching appeared in the urethra, on the third day – sharp pain appeared during urination, moderate mucous discharge from the urethral canal was observed.

Which initial diagnosis is most likely?

A. Acute gonorrheal urethritis

B. Trichomonal urethritis✔

C. Chlamydial urethritis

D. Candidal urethritis

E. Non-specific bacterial urethritis

1. Confirmation of initial diagnosis.

2. Further tactics.
A 3-year old child is being treated at pediatric dermatological department with the diagnosis “scabies”. Which of the following medicines may be used for scabies treatment of children?

А. 20 % benzyl benzoate emulsion

В. 10% benzyl benzoate emulsion ✔

С. Advantan ointment

D. 33% ordinary sulphur ointment

Е. Herpevir ointment

Name variations of scabies. Describe clinical picture of scabies ventricosa.
A 23-year old patient, single, was treated for quinsy by an otolaryngologist, taking sulpha drugs for 10 days. Improvement was not observed.

Objectively: left tonsil is swollen, inflammatory signs are absent, no tenderness on swallowing. Submandibular lymph nodes on the left are enlarged. Tactics for identification of diagnosis:

А. Detection of agent in lesion foci

В. General blood analysis

С. Specific serological tests✔

D. Consideration of only clinical picture of the disease

Е. All the above-mentioned is true

1. Give causes of formation of cysts and L-forms of treponema pallidum.

2. Your further tactics.

A 10-year old boy complains of general weakness, dizziness, unexpected appearance of rash, fever. In anamnesis – intake of 2 aspirin tablets. Objectively: red spots, bullae are present on the skin of the trunk and extremities; exfoliation of epidermis with formation of erosive surfaces. Skin lesions resemble second-degree burns, body temperature – 39.40 C. His mother says that temperature increased approximately in 4 hours after intake of drugs. Which is the most likely diagnosis?

А. Acute epidermal necrolysis – Lyell’s syndrome; ✔

В. Pemphigus vulgaris;

С. Erythema multiforme;

D. Bullous dermatitis;

Е. Dermatitis herpetiformis (Duhring’s disease);

Compile treatment plan for the patient.
Patient P., 12 years old, was admitted to dermatological department with diagnosis “pediculosis of the head”. The following is used for the treatment of this dermatozoonosis:

А. Para plus✔

В. Dermazolon

С. Nizoral

D. Freederm

Е. Synaflan

Conduct differential diagnostics of this dermatozoonosis.
A 29-year old patient came complaining of colic during urination, discharge from the urethra. It is known from anamnesis that 6 days before the patient had accidental sexual contact with unfamiliar woman. He denies having other sexual contacts and he did not treat himself. The patient is married, has a 2-year old daughter. The last sexual contaxct with his wife was 3 days ago. Which diseases should be suspected first of all?

A. Hepatitis B, C.

B. Pointed condylomas, genital herpes.

C. Trichomoniasis, gonorrhea, chlamydiosis

D. Scabies, pediculosis

E. Candidosis, inguinal epidermophytosis

1. Make final diagnosis.

2. Prescribe treatment
During prophylactic examination of a 37-year old woman, bilateral enlargement of inguinal lymph nodes, hyperemia with bluish tint of the right labium majorum was detected, which she had noticed 5 weeks before. On examination: other groups of lymph nodes are not enlarged, no rash on the skin.

Which diagnosis is the most likely?

А. Bartholinitis

В. Syphilis I seropositive, chancre-amygdalitis

С. Syphilis I seronegative, typical hard chancre

D. Syphilis I seropositive, indurated swelling✔

Е. Syphilis I latent

1. Which diagnostic examinations should be performed?

2. Further tactics

A patient came to consult dermatologist, scratching marks were observed on examination, other rash elements were not detected. The patient said that in the morning, several hours earlier, bright red rash had been present on the skin, elevated over skin surface, and accompanied by intensive itching. Which morphological element does the patient describe?

А) urtica; ✔

В) macula;

С) papula;

D) pustula;

Е) vesicle.

Indicate basic differences between this element and bulla.

In patient M., 45 years old, lesion foci of various sizes with indistinct margins are observed symmetrically on the skin of the back of the hands and thighs. Objectively: tiny papulae and vesicles are visualized on erythematous background, erosions and crusts, weeping are in the centre. Give initial diagnosis.

А. Scabies;

В. Streptodermia;

С. Microbial eczema;

D. Neurodermitis;

Е. True eczema.✔

Which diagnostic test is performed for verification of the diagnosis? Describe technique of conduction of this examination method.
Numerous papular and pustular rashes, telangiectasia are observed in a patient with acne rosacea and simultaneously severely hyperemic skin. Determine stage of the disease.

А. Nodular

В. Erythematous

С. Erythematous papular

D. Papulopustular ✔

Е. Rhinophyma

Administer treatment to this patient (Write out prescriptions of medicines).
A 25 year-old driver complains of rash on the skin of the trunk, which appeared a week ago. Weakness, muscle ache, joint pain, which were worse at night, preceded the appearance of rash. Multiple rashes in the form of pink-red spots, approx. 1 cm in diameter with distinct borders, are on the skin of the trunk. Elements are located separately, they do not disturb. Peripheral lymphatic nodes are moderately enlarged, painless, with dense elastic consistency, movable, not fused. Make initial diagnosis:

А. Toxicoderma

В. Gilbert’s pityriasis rosea

С. Secondary fresh syphilis✔

D. Secondary recurrent syphilis

Е. Pityriasis versicolor

1. Conduct differential diagnosis with pityriasis versicolor.

2. Substantiate chosen diagnosis.

A patient came to a dermatovenereologist with diagnosis urogenital chlamydiosis, made on the basis of clinical signs and data of laboratory examination. The main medicine, prescribed to this patient, should be:

A. Sulpha drugs

B. Cycloferone or other immunomodulators

C. Macrolid antibiotics✔

D. Antibiotics of penicillin group

E. Medicines of imidazole group

1. Substantiate your choice.

2. What should not be included in complex treatment of chlamydiosis?

Parents took a 6-year boy to a dermatologist. On examination, multiple lesion foci were revealed on the scalp, characterized by impaired hair growth, size 1х1 cm, with distinct margins, where pieces of hair were present at the level 3-5 mm. Which type of lesion is mentioned in this case?

А) vellus;

В) long; ✔

С) short;

D) bristly;

Е) lanugo.

Indicate skin regions that are covered with this hair type.
A young woman after continuous stay outside in winter consulted a dermatologist with complaints of itchy rash. Objectively: rash in the form of bullae is on the skin of the hands and face. The patient says that rash disappeared and appeared again. Your diagnosis?

А. Eczema;

В. Urticaria;✔

С. Contact dermatitis;

D. Allergic dermatitis;

Е. Neurodermitis.

Conduct differential diagnostics of this disease.
A patient with diagnosis primary seropositive syphilis was prescribed treatment with penicillin at the department of skin and venereal diseases. In 10 hours after the first injections, the patient’s body temperature rose to 380С, malaise and headache appeared, roseola rash appeared on the skin. How should these symptoms be regarded?

А. As an allergic reaction

В. As a toxic reaction ✔

С. As idiosyncrasy

D. As an infectious disease

Е. As a viral disease

1. Your therapeutic recommendations.

2. Further tactics.

In a teenager, 13 years old, multiple paired papulovesicles, itch burrows, excoriations are present on anterolateral trunk surfaces, lumbar region, buttocks, hands, and in the region of radial carpal joints. Subjectively: night skin itching. Taking into account data of clinical and laboratory examinations, diagnosis “scabies” was made. Relief of itch burrow is contoured with:

А. 2% boric acid solution

В. 0.5% tannin solution

D. Aniline dyes (iodine solution, fucorcin, etc.)

C. 20% benzyl benzoate solution ✔

Е. 6% solution of diluted hydrochloric acid

Name and describe methods of laboratory diagnostics of scabies.
A 34-year old patient consulted a doctor complaining of discomform during urination, discharge from the urethral canal, which appeared after sexual contact with a hardly familiar person 4 days ago. Objectively: purulent greenish copious discharge from the urethra, which leave specific spots on the underwear, sponges of the outer opening are hyperemic, swollen. In smears – Neisseria gonorrhoeae is detected inside and outside leukocytes, concomitant flora is absent, leukocytes in the whole field of vision, epithelial cells are absent. The most likely diagnosis?

A. Fresh gonorrheal urethritis, acute form✔

B. Fresh gonorrheal urethritis, subacute form

C. Fresh gonorrheal urethritis, torpid form

D. Chronic gonorrheal urethritis

E. Bacterial urethritis

1. Substantiate your choice.

2. Prescribe treatment.

A 26-year old patient, injection drug user, complains of rash on the skin.

Objectively: numerous pale-pink spots of round and oval form, 3-5 mm in diameter, which do not slough off, are observed on the skin of the trunk, upper and lower extremities. After desensitizing therapy for several days, the rash disappeared completely.

а). Which clinical diagnosis can be suspected?

А. Gilbert’s pityriasis rosea


С. Toxicoderma

D. Syphilis

Е. Measles

b). Which examinations should be performed?

A 40-year old patient was admitted to the department of infectious diseases complaining of fever, general weakness and perspiration. He had been ill for a month. The disease started with fever, and then general weakness and perspiration appeared. He is a laboratory assistant at blood transfusion center. More than a month before he hurt himself during manipulations with blood.

Objectively: skin is pale, wet, and free from rash. The pharynx is hyperemic, swollen; cervical lymph nodes are enlarged. The abdomen is soft, enlarged liver and spleen are palpated.

а). Your initial diagnosis?

А. Hepatitis


С. Tuberculosis

D. Syphilis

Е. Mononucleosis

b). Compile plan of examination.

A 19-year old patient presented with severe candidal stomatitis, which had been present for 3 months and did not respond to treatment. She has had a status of HIV-infected for 3 years. She ceased antiretroviral treatment deliberately.

а). Which combination of drug families should be prescribe first of all?

А. Antiretroviral +antifungal ✔

В. Antifungal +antibiotics

С. Antiretroviral+ antibiotics

D. Antibiotics +vitamins

Е. Antifungal+ vitamins

b). How does a clinical picture of candida stomatitis differ in individuals without HIV?

Patient 54 years old, complains of skin rash, accompanied by severe itching. He links the rash with treatment for ulcer at therapeutic department. Objectively: rash on the trunk and upper extremities in the form of spots from 2 mm to 2-3 cm, which disappear on pressing. In anamnesis – similar rash was noticed after consumption of citrus fruit and alcohol. Make initial diagnosis.

А. True eczema;✔

В. Allergic dermatitis;

С. Toxicodermia;

D. Chronic ulcerous pyodermia;

Е. Neurodermitis;

Compile treatment plan for this patient.
In 28-year old patient M, numerous hypopigmented spots of various configurations and sizes, are on the trunk, located separately on tanned skin. Rash appeared after summer season. Single yellow-brown spots with distinct borders and branny scales are observed in some places. Which dermatosis is most likely in this case?

А. syphilitic leukoderma

В. pityriasis rosea

С. vitiligo

D. scleroderma

Е. pityriasis versicolor ✔

Conduct differential diagnosis of this dermatosis.

Woman C., 50 years old, complains of face redness and feeling of fever. On examination: face skin is congestive hyperemic; inflammatory papules, telangiectasia are observed. Make initial diagnosis.

А. Psoriasis

В. Seborrheic dermatitis

С. Acne vulgaris

D. Scabies

Е. Acne rosacea ✔

Administer treatment to this patient (Write out prescription of medicines).

A 35-year old patient came to dispensary of skin-venereal diseases complaining of enlargement and tenderness of the penis. Objectively: the penis is enlarged due to inflammatory swelling of preputial sac, external layer of which is of bright red color. Glans of the penis does not open, on palpation of the prepuce: dense focus 2 cm in diameter is palpated on the right; under the prepuce is heavy purulent discharge. Inguinal lymph nodes are enlarged to the size of a plum; other groups of lymph vessels are not enlarged. Serological reactions are positive.

The most likely diagnosis:

А. Syphilis I seropositive, paraphimosis

В. Syphilis I seropositive, phagedenism

С. Syphilis I seropositive, balanoposthitis

D. Syphilis I seropositive, indurated swelling

Е. Syphilis I seropositive, phimosis✔

1. Which clinical consequences may develop?

A 36-year old patient came to a doctor for rash on the trunk and the extremities without subjective sensation. The day before, she had experienced weakness and fever. Objectively: tiny roseola rashes of bright color, polyadenitis. In anamnesis – sexual contact with a hardly familiar man 10 weeks before.

Your diagnosis?

А. Secondary reccurent syphilis

В. Toxicoderma

С. Gilbert’s pityriasis rosea

D. Pityriasis versicolor

Е. Secondary fresh syphilis✔

Which methods of examination should be performed to make clinical diagnosis?

A 35-year old patient has had a status of HIV-infected for 3 years. No complaints. Objectively: slight enlargement of all groups of lymph nodes. General condition is normal.

а). What HIV stage of the patient is the most likely?

А. Acute of initial stage

В. Latent or asymptomatic stage ✔

С. AIDS-associated symptom complex


Е. Any stage

b). Plan of prevention of infection spread.

A 24-year old patient, drug addict had been ill for a year when he noticed weakness, perspiration, weight loss, frequent respiratory infections. In the last 2 days, he had temperature approximately 37.50C, perspiration; weakness intensified; diarrhea with mucus and blood appeared.

Objectively: lymphadenopathy, multiple vesicular rashes in the oral cavity, hepatosplenomegaly on palpation of the abdomen.

а). Your initial diagnosis?

А. Hepatitis

В. Syphilis

С. Tuberculosis


Е. Mononucleosis

b). Compile plan of examination.

Due to the absence of milk in a parturient woman, the baby received milk from a donor, who was diagnosed with a secondary fresh syphilis the next day. Your tactics concerning the baby:

А. Pediatrician’s consultation

В. Conduction of a Wassermann reaction to the baby the next day

С. Immunofluorescence reaction up to 3 days

D. Treponema pallidum immobilization test up to 5 days

Е. Clinical serological monitoring for 3 months✔

1. Which routes of infection with syphilis are differentiated?

2. Further tactics.

A patient with diagnosis trichomoniasis, made on the basis of clinical signs and data of laboratory examination, consulted a dermatovenereologist. The main medication, prescribed to this patient, should be:

A. Sulpha drugs

B. Immunomodulators

C. Antiprotozoal medicines✔

D. Antiviral medicines

Е. Macrolide antibiotics

1. Which medicines are in this group?

2. Give approximate treatment regimen for a patient with trichomoniasis.

Patient R., 9 years old, was admitted to dermatological dispensary complaining of rash on the scalp. He has been ill for 2 weeks. Erythematous-squamous focus, size approx. 20 mm in diameter, is observed on the scalp in occipital region. Hair in the focus region is broken at the level 5 mm. on luminescent examination with Wood’s lamp, a bright green fluorescence is detected. Your initial diagnosis?

А. Microsporia of the scalp ✔

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