Basal layer of epidermis consists of

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Which disease is meant?

А. Primary syphilis

В. Secondary fresh syphilis

С. Squamous cell cancer

D. Chancriform pyoderma

Е. Streptococcal ecthyma

1. Explain your choice.

2. Give nosological units with which hard chancre is differentiated.

Skin appendage, in composition of which bulb, root, shaft are distinguished, is called:

А) nail;

В) sweat gland;

С) sebaceous gland;

D) hair; ✔

Е) mammary gland.

Which types of this skin derivative do you know?

A 23 year old patient, homosexualist, has been ill for 3 months, complains of general weakness, fever 37.5-380С, enlargement of lymph nodes (on the neck, in the axillae, groins), considerable weight loss, persistent diarrhea.

а). Which examination may be conducted to exclude diagnosis HIV?

А. Immunoblotting (western-blot)



D. Virological method

Е. All the above-mentioned✔

b). Compile plan for prevention of HIV-infection.

A 30-year old patient complains of rash on the skin of the face, itching, burning, pain in this region. He is ill for the third time during the year. The patient has chaotic sexual life (hetero- and homosexual).

Objectively: infiltrated bright-red foci with multiple vesicles, erosions are observed on the skin of the face along the two branches of trigeminal nerve. Submandibular lymph nodes are somewhat enlarged, movable, not fused with the surrounding tissues.

а). Your initial diagnosis?

А. Acne vulgaris

В. Parasitic sycosis

С. Recurrent herpes

D. Contact dermatitis

Е. Herpes zoster ✔

b). Which causes of this disease can be suspected?

In patient N., 28 years old, clinical diagnosis “scabies” was made. Rash was also localized on the skin of testicles and penis. Which additional examinations should be performed to this patient?

А. Auspitz sign

В. Baltzer test

С. Determination of Wickham striae

D. Koebner phenomenon

Е. Laboratory investigation for detection of venereal diseases. ✔

Which diseases should scabies be differentiated with, when typical rashes are localized in the region of reproductive organs in men? Describe differential diagnostics of diseases.

In a child, 8 months old, rash appeared on the face, accompanied by itching, after start of artificial feeding. Mother said that the rash had appeared approximately 2-3 weeks before. Objectively: pink-red infiltrate spots, numerous tiny erosions with serous exudates on their surfaces, layers of serous crusts are observed on a child’s cheeks. Give clinical diagnosis.

А. Microbial eczema;

В. Allergic dermatitis;

С. Impetigo vulgaris;

D. Infantile eczema; ✔

Е. Toxicodermia.

Describe principles of treatment and prevention of this disease.

A 23-year old student consulted a family doctor how to avoid HIV infection.

а). Which preventive measures would you recommend?

А. Protected sexual contacts

В. Use of disposable syringes

С. Use of individual toothbrushes, razor

D. Not to use illegal drugs

Е. All the mentioned ✔

b). Which groups of individuals should definitely be examined for HIV?

Man R., 63 years old, complains of color change of nail plates of the right foot. On examination: nail plates of the 1st and 5th toes of the right foot are thickened, brown-yellow color, nails crumble from the free border, hyperkeratosis subungualis. On culture investigation: Trichophyton mentagrophytes fungus was found. Give diagnosis.

A. Epidermophytosis of the nails ✔

B. Rubroonychomycosis

C. Candidiasis of the nails

D. Trichophytia

E. Microsporia

Administer treatment to this patient.
After alcohol use, a 28-year old patient had sexual contact with unfamiliar woman. On the third day – burning and itching appeared in the urethra, on the fourth day – sharp pain appeared during urination, slow purulent discharge from the urethral canal was observed. Margins of the outer opening of the urethra are swollen and red. The first portion of the urine is cloudy, contains many purulent threads and flakes.

Which initial diagnosis is most likely?

A. Acute gonorrheal urethritis ✔

B. Trichomonal urethritis

C. Chlamidial urethritis

D. Candidal urethritis

E. Non-specific bacterial urethritis

1. Substantiation of chosen diagnosis.

2. Further diagnostic tactics for verification of the diagnosis.
On examination of a patient, it was established that epidermal papulae of various sizes, covered with scales, were on the skin. Diagnosis was made – psoriasis. Which phase of diagnostics is it?

А) morphological; ✔

В) clinical;

С) ethiopathogenetic;

D) prior;

Е) epicrisis.

Which diagnosis is made after completion of this type of diagnostics?
Man V., 46 years old, was diagnosed with acne rosacea, papulopustular form. Which laboratory investigation should be performed to confirm diagnosis and administer treatment?

А. Determination of acantholytic cells

В. Detection of Sarcoptes scabiei hominis

С. Detection of pathological fungi

D. Detection of Demodex folliculorum✔

Е. Detection of Pediculus vestimenta

Administer treatment to this patient (Write out prescriptions of medicines).
A patient visited a dermatologists with complaints of the rash on the skin of the face, trunk, lower extremities, weight loss, diarrhea, fever persisting for over a month. Concomitant diseases: hairy leukoplakia, lung tuberculosis. Weight loss constitutes over 10%. From anamnesis it is known that the patient is a homosexualist. Objectively: multiple infiltrated symmetrical plaques of dark-brown color.

а). Which diagnosis is the most likely?

А. Basalioma

В. Kaposi sarcoma✔

С. Tuberculosis

D. Sarcoidosis

Е. Erysipelas

b). Which stage of HIV-infection does the patient have?

A 40-year old dentist was admitted to inpatient department with complaints of rash on the skin of the hands, itching at the sites of lesion. He has been suffering for 5 years. The patient links recurrence of the disease with frequent contact with novocaine. Local status: skin of the hands is erythematous, infiltrated with microvesicles, microerosions, bright-red color, papulae, yellowish crusts, weeping, fissures, and excoriations. Make initial diagnosis for this patient.

А. Occupational eczema; ✔

В. Fixed toxicodermia;

С. Simple contact dermatitis;

D. Allergic dermatitis;

Е. Microbial eczema.

Conduct differential diagnostics of this disease.

A 6-year old child was referred to a dermatovenereologist with complaints of nose deformation in the form of a saddle, as well as dystrophy of the first molar tooth. On laboratory examination: complex of serological reactions – weak positive. Which disease is meant?

А. Early congenital syphilis

В. Late congenital syphilis

С. Early latent syphilis

D. Late latent syphilis

Е. Secondary recurrent syphilis

1. To which signs are saddle-like nose and dystrophy of a molar tooth are referred?

2. Further tactics.

Patient Sh., 55 years old, works at the farm. He complains of fatigue, headache, temperature 380C, the presence of nodes on the scalp. Objectively: multiple infiltrates (inflammatory nodes), distinctly separated, dense, tender, the surface of which is covered with purulent crusts, are present on the scalp. Typical symptom of “honey combs” (Celsus kerion). Submandibular and cervical lymph nodes are swollen, tender. Which pathology that causes this picture is the most likely?

А. Infiltrative purulent trichophytia ✔

В. Favus

С. Microsporia of the scalp

D. Seborrhea

Е. Carbuncle

Administer treatment plan to this patient.
A 27-year old artist consulted a dermatologist with complaints of rash on the whole body, weight loss, constant fatigue, diarrhea lasting more than a month. From anamnesis: the patient injects drugs with friends, but he is sure they do not have HIV.

Objectively: multiple nodes with umbilicate depression, merging in some places, are present on the skin of the face, trunk, reproductive organs and thighs. Cheese-like mass discharges while pressing on them with tweezers.

а). Your initial diagnosis?

А. Psoriasis

В. Molluscum contagiosum ✔

С. Lichen ruber planus

D. Herpes

Е. Warts

b). Which examinations should be performed to exclude diagnosis of AIDS?

On examination of a patient’s skin, dermatovenereologist revealed multiple foci of skin reddening without relief changes, which in diascopy become paler, and in some places disappear completely. Which morphological element is meant?

А) plaque;

В) excoriation;

С) macula; ✔

D) tuberculoma;

Е) lichenification.

How does this element resolve?
A patient consulted a dermatologist complaining of skin itching in pubic region, reproductive organs, near anus. Objectively: pale-blue, pale-grey spots, approximately 10 mm in diameter, with hemorrhagic crust in the center are present in indicated sites. On diascopy, spots do not disappear. Make diagnosis.

А. Pruritus

В. Allergic dermatitis

С. Toxicodermia

D. Pediculosis✔

Е. Scabies

Give several methods of treatment of this disease.
A patient came for consultation to a doctor with complaints of the presence of rash in the region of upper limb and intensive itching, tingling sensation. Objectively: grouped hollow elements with transparent content, size of a millet grain were localized on somewhat hyperemic skin. Which morphological element is described?

А) pustule;

В) bulla;

С) vesicle; ✔

D) papula;

Е) ulcer.

Conduct differential diagnostics of this element with excoriation.
In patient P., 35 years old, erosions with border of white exfoliated epidermis is observed on the right hand, between the 3rd and the 4th fingers in the fold depth. Fissure is visualized in the depth of interdigital space. Initial diagnosis?

А. Dermatitis due to mechanical scratching

В. Candidiasis✔

С. Impetigo

Д. Erythrasma

Е. Tinea corporis

Administer treatment to this patient.
Patient M., 52 years old, consulted a dermatologist with complaints of skin rash on the right shin and itching sensation in damaged region. Objectively: single vesicles, pustules, crusts and excoriations are observed on the skin of the lower third of the right shin. Your diagnosis?

А. True eczema;

В. Microbial eczema; ✔

С. Ecthyma vulgaris;

D. Phytodermatitis;

Е. Bullous pemphigoid.

Write out prescriptions of agents for topical treatment of this disease.
A woman came to consult a doctor with a 7-year old child. She says that the child is suffering from severe itching in temporal and occipital regions. The child has become nervous and does not sleep well. It is seen from anamnesis that the disease while being in a child camp. On examination: numerous yellowish-brown crusts, scratchings, single folliculitis are present on the scalp in occipital and temporal regions. Which disease is the most likely?

А. Pruritus

В. Allergic dermatitis

С. Toxicodermia

D. Pediculosis✔

Е. Scabies

Administer treatment to this child.

On examination of a patient, multiple hollow elements with non-transparent yellow-green content were detected on the skin. Which elements are these?

А) crust;

В) scale;

С) fissure;

D) pustule; ✔

Е) vesicle.

Enumerate exo- and endogenous factors that you know, which may contribute to appearance of pathological changes of the skin.

A miner visited a dermatologist complaining of significant itching of both feet. He has been ill for a month. He links the disease with wearing of rubber boots. On examination: erosions and maceration of the epidermis are visualized in the interdigital space of the feet. Which additional methods of examination are necessary for making diagnosis?

А. Microscopic examination for fungi ✔

В. Microscopic examination for acantholytic cells

С. Microscopic examination for treponema pallidum

D. Microscopic examination for parasites

Е. Microscopic examination for streptobacillus

Make initial diagnosis to this patient and prescribe treatment.
On examination of a patient, skin defect of irregular form, unchanged color, elevated over skin surface, dense on palpation, painless, was detected. On histological examination the following changes were revealed: thickening of epidermis, growth of connective tissue fibers in dermis, thick collagen fibers located chaotically, present areas of homogenization of fibers, only fibroblasts from cell elements, skin appendages absent. Which morphological element is meant?

А) bulla;

В) vesicle;

С) pustule;

D) macula;

Е) scar. ✔

Indicate main differences between this element and papula.
In a 10-year old child, red papules with tendency to paired location are present in interdigital spaces of the hands, on abdominal skin, inner surface of the thighs. Vesicles and serous hemorrhagic crusts are present along with papules. The child complains of itching, which intensifies in the evening. Your diagnosis?

А. Pruritus

В. Allergic dermatitis

С. Toxicodermia

D. Scabies✔

Е. Pediculosis

Describe methods of laboratory diagnostics of this disease.
These are simple alveolar skin glands with ramified end divisions. These glands are commonly located near hair, rarely – localized separately. Which glands are described?

А) sweat;

В) sebaceous; ✔

С) mammary;

D) endocrine;

Е) mixed.

By which type is the secret of these glands produced?
Girl K., 9 years old, complains of baldness foci of the head skin. She has been ill for 3 weeks. Objectively: several small oval foci with indistinct borders are observed on the scalp skin. Skin in lesion areas is of pink-red color, hair is broken at the level of 1-4 mm. Pathological process resembles areas of “mowed grass”. Which pathology is the most likely?

А. Microsporia of the scalp

В. Trichophytosis capitis✔

С. Diffuse alopecia

D. Favus

Е. Syphilitic alopecia

Conduct differential diagnostics of this disease.
Patient L., 52 years old, complains of rash in the nose region, forehead and burning sensation, slight itching in rash sites. Status localis: Papulopustular rashes and erythema are present on the skin of the forehead and nasolabial region. On laboratory examination: Demodex folliculorum was detected in rash elements. Make clinical diagnosis.

А. Contact dermatitis

В. Seborrheic dermatitis

С. Lupus erythematosus

D. Acne rosacea ✔

Е. Psoriasis

Conduct differential diagnosis of this disease.
A mother of a 2-month old baby complains of skin redness in the region of intergluteal fold and groin regions on the 16th day after birth. Objectively: skin in these regions is of bright red color, foci are of large sizes with distinct margins, and their surface is wet. On the periphery is a crown of macerated epidermis. On foci surface is a white film, which is easily removed. On microscopic investigation: mycelium and fungus spores. Which pathology is the most likely?

А. Epidermophytosis of the folds

В. Diaper dermatitis

С. Epidemic pemphigus

D. Syphilitic pemphigus

Е. Candidiasis of the folds ✔

Prescribe treatment to this patient.

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