Bates’ Guide to Physical Examination and History Taking, 11th Edition
Chapter 6: The Skin, Hair, and Nails
Multiple Choice
1. A 35-year-old
... [Show More] archaeologist comes to your office (located in Phoenix, Arizona) for a regular
skin check-up. She has just returned from her annual dig site in Greece. She has fair skin and
reddish-blonde hair. She has a family history of melanoma. She has many freckles scattered
across her skin. From this description, which of the following is not a risk factor for melanoma in
this patient?
A) Age
B) Hair color
C) Actinic lentigines
D) Heavy sun exposure
Ans: A
Chapter: 06
Page and Header: 165, Health Promotion and Counseling
Feedback: The risk for melanoma is increased in people over the age of 50; our patient is 35
years old. The other answers represent known risk factors for melanoma. Especially with a
family history of melanoma, she should be instructed to keep her skin covered when in the sun
and use strong sunscreen on exposed areas.
2. You are speaking to an 8th grade class about health prevention and are preparing to discuss
the ABCDEs of melanoma. Which of the following descriptions correctly defines the ABCDEs?
A) A = actinic; B = basal cell; C = color changes, especially blue; D = diameter >6 mm; E =
evolution
B) A = asymmetry; B = irregular borders; C = color changes, especially blue; D = diameter >6
mm; E = evolution
C) A = actinic; B = irregular borders; C = keratoses; D = dystrophic nails; E = evolution
D) A = asymmetry; B = regular borders; C = color changes, especially orange; D = diameter >6
mm; E = evolution
Ans: B
Chapter: 06
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Page and Header: 165, Health Promotion and Counseling
Feedback: This is the correct description for the mnemonic.
3. You are beginning the examination of the skin on a 25-year-old teacher. You have previously
elicited that she came to the office for evaluation of fatigue, weight gain, and hair loss. You
strongly suspect that she has hypothyroidism. What is the expected moisture and texture of the
skin of a patient with hypothyroidism?
A) Moist and smooth
B) Moist and rough
C) Dry and smooth
D) Dry and rough
Ans: D
Chapter: 06
Page and Header: 168, Techniques of Examination
Feedback: A patient with hypothyroidism is expected to have skin that is dry as well as rough.
This is a good example of how the skin can give clues to systemic diseases.
4. A 28-year-old patient comes to the office for evaluation of a rash. At first there was only one
large patch, but then more lesions erupted suddenly on the back and torso; the lesions itch. On
physical examination, you note that the pattern of eruption is like a Christmas tree and that there
are a variety of erythematous papules and macules on the cleavage lines of the back. Based on
this description, what is the most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema
Ans: A
Chapter: 06
Page and Header: 176, Table 6–2
Feedback: This is a classic description of pityriasis rosea. The description of a large single or
“herald” patch preceding the eruption is a good way to distinguish this rash from other
conditions.
5. A 19-year-old construction worker presents for evaluation of a rash. He notes that it started on
his back with a multitude of spots and is also on h [Show Less]