Posted on September 14, 2015 by Archer USMLE Reviews
A 2-week-old infant is brought to the office for a regular postnatal follow-up. She was born after an uneventful term pregnancy to a 29-year-old G2P2 woman. Mother reports that the infant is feeding well and seems active. No evidence of any fever. The parents are worried about the ‘rash’ that appeared over the infant’s left cheek. On examination, a lesion is noted on the infant’s left cheek as shown below. Vital signs are within normal limits. What is the most appropriate next step in management of this finding?
| A |
Surgical excision of the entire lesion |
| B |
Biopsy of the lesion |
| C |
Laser removal of the lesion |
| D |
Reassurance and observation |
| E |
Topical 5-fluoro-uracil |
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Filed under: USMLE STEP III QUESTION BANK, USMLE Test Prep | Tagged: archer dermatology, archer pediatrics, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, usmle step 3 pediatrics | 9 Comments »
Posted on February 7, 2012 by Archer USMLE Reviews
321) A 45 – year-old obese woman presents to your office complaining of a skin lesion on her left shin. This lesion started spontaneously 3 weeks ago and appeared like a small bruise. Over the past two weeks, the lesion has enlarged and the overlying skin has become hardened and raised with reddish border. There is no pain or itching. She denies any recent trauma. She lives in Texas but one month ago, she traveled to New England region to visit a friend. She is sexually active with one partner and occasionally, uses condoms.. Her past medical history is unremarkable. On physical examination, there is an oval shaped lesion on her left shin. The border is indurated and red in color with yellowish, atrophic appearance in the center. An image of the lesion is shown below:
Which of the following investigations should be ordered next?
A) Lyme serology
B) Hemoglobin A1C
C) Anti-Myeloperoxidase ( P-ANCA)
D) Colonoscopy
E) Herpes Simplex Virus (HSV) Serology
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Filed under: Uncategorized, USMLE Test Prep | Tagged: archer dermatology, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images | 22 Comments »
Posted on February 7, 2012 by Archer USMLE Reviews
319) A 64-year-old man with history of diabetes mellitus and end-stage renal disease is admitted for complaints of weakness and contractures in his extremities associated with tight and thickened skin. He denies any past history of finger or toe discoloration on exposure to cold. He is dialysis dependent and undergoes hemodialysis three times in a week. His most recent dialysis was a day ago. His symptoms started 3 days prior to presentation and have progressively worsened. Three weeks prior to admission , the patient had a transient ischemic attack. An MRI with Gadolinium performed at that time did not reveal any abnormalities. He denies any neurological symptoms at this time. The patient’s medications upon admission include Aspirin, Insulin Glargine and Lisinopril. On physical examination, the patient appears chronically ill. He is afebrile, blood pressure 120/70 mmHg and pulse rate was 82/minute. Skin examination reveals diffuse nonerythematous thickening and tightening of the skin over the abdomen, arms and legs. Chest and the face are spared. There are contractures in upper and lower extremities extremely limiting the range of motion of the involved joints. Erythrocyte sedimentation rate and C-reactive protein are elevated. Calcium is 8.0mg% and phosphorous 4mg% with calcium – phosphorous product of 32. An image of his upper extremity is shown below
Which of the following is the most likely diagnosis?
A) Systemic sclerosis
B) Calciphylaxis
C) Nephrogenic Systemic Fibrosis
D) Cryoglobulinemia
E) Eosinophilc Fascitis
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Filed under: Uncategorized, USMLE Test Prep | Tagged: archer dermatology, ARCHER NEPHROLOGY, dermatology usmle, dermatology usmle step 3 questions, dr.red nephrology lecture, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, usmle step 3 nephrology | 10 Comments »
Posted on December 30, 2011 by Archer USMLE Reviews
296) A 6 month old Asian infant is brought by his concerned aunt for evaluation of dark blue areas on the child’s buttocks. She says she was called to baby-sit the infant since his mother found a new job 2 days ago. She noted the rash and became suspicious that the child may have been abused. The mother arrives in Emergency room an hour later and reports that the rash has been present since birth. The mother is divorced and lives alone with the child. On examination, there are bluish-green patches on bilateral buttocks and on the lower back. They are irregular in shape and margins are indistinct. There is no swelling or tenderness. An image of the skin findings is shown below:
Which of the following is the most appropriate next step ?
A) Order Skeletal Survey
B) Reassure that rash may fade away in few years
C) Contact Child Protection services
D) Obtain Coagulation parameters
E) Obtain Platelet count
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Filed under: Uncategorized, USMLE Test Prep | Tagged: archer dermatology, archer pediatrics, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, USMLE STEP3 PEDIATRICS | 10 Comments »
Posted on December 30, 2011 by Archer USMLE Reviews
295) A 10 year old boy is brought to your office for evaluation of rash in bilateral axillae and groin for the past 2 months. He denies any itching or any other skin rashes. However, he reports that the area has become progressively rough to touch. He is otherwise, healthy. On examination, there are reddish brown patches in bilateral axillae and groin. There is maceration and scaling in the web spaces between the toes of bilateral feet. Rest of the examination is normal. A KOH mount is obtained and is negative. Wood’s lamp examination reveals coral red fluorescence. A picture of the rash is shown below:
Which of the following is the most appropriate next step ?
A) Topical corticosteroid
B) Topical Selenium Sulfide
C) Oral erythromycin
D) Topical Clotrimazole
E) Oral Metronidazole
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Filed under: Uncategorized, USMLE Test Prep | Tagged: archer dermatology, archer pediatrics, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, USMLE STEP3 PEDIATRICS | 7 Comments »
Posted on August 9, 2011 by Archer USMLE Reviews
249 ) A 64 year old man is evaluated in your office for a left sided headache that started 24 hours ago. He describes the headache as a burning sensation over his left temple and the forehead. He also reports fatigue and malaise for the past one day. He has no significant past medical history. On examination, he has a low grade fever at 100.4F, Blood pressure is 120/70 mm Hg. Physical examination reveals hyperesthesia on his left forehead and skin findings as shown in the picture below:
Which of the following is the most appropriate immediate next step in management ?
A) Mupirocin cream
B) Start Oral Cephalexin
C) Refer to Ophthalmology
D) Refer to Dermatology
E) Topical Acyclovir
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Filed under: USMLE Test Prep | Tagged: archer dermatology, Archer Infectious Diseases, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 dermatology images, USMLE STEP 3 INFECTIOUS DISEASES | 11 Comments »
Posted on June 14, 2011 by Archer USMLE Reviews
183) A 65 year old woman presents with a white plaque on her vulva. It is associated with occasional itching. She has no other hypo-pigmented lesions on her body. She denies any post-coital bleeding. Physical examination reveals a white colored plaque on the vulva. The lesion is atrophic, thin with a crinkled surface and is well-demarcated. There is atrophy of the labia minora. Most appropriate next step in managing this patient?
A) Topical Corticosteroids
B) Fluconazole
C) Vulvar Biopsy
D) HPV testing
E) Topical Testosterone
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Filed under: USMLE Test Prep | Tagged: Archer Gynecology, archer usmle step 3, dermatology usmle, dermatology usmle step 3 questions, USMLE STEP 3 DERMATOLOGY, usmle step 3 gynecology, usmle step 3 questions, Vulvar Lesions, vulvar white plaque | 4 Comments »
