APMLE Dermatology and Nail Disorders 2

Question 1

What is the most appropriate initial treatment for an acute paronychia without abscess formation?

Accepted Answer

Warm soaks and topical antibiotics

Answer

Oral antifungal therapy

Answer

Incision and drainage

Answer

Partial nail avulsion

Question 2

A subungual hematoma covering less than 25% of the nail plate in a patient with an intact nail and no distal phalanx fracture is best treated by:

Accepted Answer

Trephination (nail decompression)

Answer

Nail avulsion and wound exploration

Answer

Observation alone

Answer

Oral anticoagulation therapy

Question 3

Which clinical feature best differentiates a plantar wart from a corn (heloma durum)?

Accepted Answer

Interruption of normal skin lines (dermatoglyphics)

Answer

Location on the metatarsal head

Answer

Pain with direct pressure

Answer

Presence of a central keratotic plug

Question 4

A nevus (mole) located within the nail unit that causes longitudinal melanonychia should be evaluated carefully because it may represent:

Accepted Answer

Acral lentiginous melanoma

Answer

Subungual exostosis

Answer

Hematoma of the nail bed

Answer

Glomus tumor

Question 5

Which clinical sign (Hutchinson's sign) in nail pigmentation is an indicator of possible subungual melanoma?

Accepted Answer

Periungual pigmentation extending onto the skin of the proximal or lateral nail folds

Answer

Pale proximal lunula with distal brown discoloration

Answer

Transverse white bands across the nail plate

Answer

Uniform darkening of the entire nail plate

Question 6

Which Wood's lamp (UV light) finding is characteristic of tinea versicolor on the skin?

Accepted Answer

Copper-orange fluorescence

Answer

Bright green fluorescence

Answer

Yellow-green fluorescence

Answer

Coral red fluorescence

Question 7

Contact dermatitis presenting on the dorsum of the foot with well-demarcated erythema and vesicles in the shape of a shoe is most commonly caused by which allergen?

Accepted Answer

Rubber accelerators (thiurams/carbamates)

Answer

Nickel sulfate

Answer

Formaldehyde resin

Answer

Colophony (rosin)