Practice Dermatology Questions on the Physician Assistant Exam - dummies

Practice Dermatology Questions on the Physician Assistant Exam

By Barry Schoenborn, Richard Snyder

From rashes to eczema and bacterial infections to viral exanthems, these practice questions are similar to the dermatology questions on the Physician Assistant Exam (PANCE).

Example PANCE Questions

  1. Which one of the following can develop into squamous cell carcinoma over time?

    (A) Onychomycosis

    (B) Actinic keratosis

    (C) Seborrheic keratosis

    (D) Psoriasis

    (E) Impetigo

  2. You’re evaluating a 25-year-old woman who presents with a rash on her face. She states she may be having a reaction to some food that she ate, but she isn’t sure. The rash is reddened and macular on both cheeks, and there is no sparing of the nasolabial fold. Which one of the following would you order at this point?

    (A) ANA and complement levels

    (B) Oral prednisone

    (C) Oral doxycycline (Vibramycin)

    (D) Oral amoxicillin (Trimox)

    (E) Rheumatoid factor

  3. You’re evaluating a 44-year-old man who presents with a new rash. He takes off his shirt and raises his arms to show you. In the left axillary area, you see a new hyperpigmented, macular rash. Which one of the following medical conditions could be associated with this skin lesion?

    (A) Diabetes mellitus

    (B) Hypertension

    (C) Benign prostatic hyperplasia

    (D) Kidney stones

    (E) Hepatitis B

  4. Which one of the following represents a manifestation of measles?

    (A) Coronary artery disease

    (B) Koplik spots

    (C) Pneumonitis

    (D) Slapped-cheek appearance

    (E) Impetigo

  5. Which one of the following is true concerning the evaluation and management of lipomas?

    (A) They are usually painful and tender on examination.

    (B) They are usually associated with a malignant condition.

    (C) They can usually be watched without surgical intervention.

    (D) They usually require surgical removal to prevent further complications.

    (E) They are associated with diabetes mellitus.

  6. Which of the following is the likely etiology of a paronychia?

    (A) A fungal infection

    (B) A viral infection

    (C) An autoimmune reaction

    (D) A prescribed medication

    (E) A bacterial infection

Example PANCE Answers and Explanations

Use this answer key to score the practice dermatology questions. The answer explanations give you some insight into why the correct answer is better than the other choices.

1. B. Actinic keratosis is a skin lesion that can develop into squamous cell carcinoma of the skin. This happens less than 10 percent of the time. Choice (A), onychomycosis, is a fungal infection of the nails. Choice (C), seborrheic keratosis, is a keratinized type of skin lesion that’s benign, but it’s associated with colon cancer (Leser-Trélat sign). Psoriasis, Choice (D), can be associated with the HLA-B27 antigen, which increases the risk of developing psoriatic arthritis. Choice (E), impetigo, is caused by a bacterium, namely Staph or Strep. When caused by Strep, it increases the risk of developing post-streptococcal glomerulonephritis.

2. C. This woman has acne rosacea. One big clue in the question is the statement “no sparing of the nasolabial fold.” If you see sparing of the nasolabial fold, then you’re dealing with the malar (butterfly) rash of lupus. The treatment of acne rosacea is oral doxycycline (Vibramycin) or a topical metronidazole (Flagyl). Choice (A), ANA and complement levels, would be a serological workup for systemic lupus erythematosis. Oral prednisone, Choice (B), is for Bell’s palsy or for temporal arteritis. Choice (D), oral amoxicillin (Trimox), is a first-line choice for acute bacterial sinusitis, impetigo, and otitis media. Choice (E), rheumatoid factor, is part of the evaluation for rheumatoid arthritis and other rheumatologic conditions.

3. A. This lesion is acanthosis nigricans. It’s associated with diabetes mellitus and can be a paraneoplastic phenomenon associated with certain cancers. You don’t see it with the other conditions listed (hypertension, benign prostatic hyperplasia, kidney stones, and hepatitis B).

4. B. Measles can cause Koplik spots. Concerning Choice (A), coronary artery involvement can be a complication of Kawasaki disease. Measles is not associated with a pneumonitis, Choice (C). A slapped-cheek appearance, Choice (D), is associated with erythema infectiosum, or fifth disease. Streptococcal and staphylococcal infections are common causes of impetigo, Choice (E).

5. C. A lipoma is a benign fatty tumor; it’s painless and freely movable and usually can be watched without surgical intervention. There’s no direct association between lipomas and diabetes mellitus.

6. E. A paronychia, an infection around the nail, is usually caused by bacteria. It usually requires incision and drainage (I&D) of the affected area as well as oral antibiotics. Onychomycosis is a fungal infection of the nail, Choice (A). Herpetic whitlow is a viral cause of nail infection, Choice (B), usually seen in healthcare workers. Choices (C) and (D), an autoimmune reaction and prescription drugs, aren’t thought to be causes of paronychia.