Q.1 Which of the following is the most common autoimmune blistering disorder in adults?
Pemphigus vulgaris
Bullous pemphigoid
Dermatitis herpetiformis
Linear IgA disease
Explanation - Bullous pemphigoid is the most common autoimmune blistering disorder in adults, typically affecting elderly patients and presenting with tense bullae.
Correct answer is: Bullous pemphigoid
Q.2 Which antigen is targeted in pemphigus vulgaris?
Desmoglein 1 and 3
BP180 and BP230
Transglutaminase 3
Type VII collagen
Explanation - Pemphigus vulgaris is caused by autoantibodies against desmoglein 1 and 3, which are components of desmosomes in the epidermis.
Correct answer is: Desmoglein 1 and 3
Q.3 A patient presents with itchy, grouped vesicles on elbows and knees. Which blistering disorder is most likely?
Bullous pemphigoid
Dermatitis herpetiformis
Pemphigus foliaceus
Linear IgA disease
Explanation - Dermatitis herpetiformis presents with intensely itchy, grouped vesicles over extensor surfaces and is associated with gluten sensitivity.
Correct answer is: Dermatitis herpetiformis
Q.4 Which immunofluorescence pattern is characteristic of bullous pemphigoid?
Intercellular IgG in epidermis
Linear IgG and C3 along basement membrane
Granular IgA deposits in dermal papillae
IgG deposits along dermal blood vessels
Explanation - Direct immunofluorescence of bullous pemphigoid shows linear deposition of IgG and C3 along the basement membrane zone.
Correct answer is: Linear IgG and C3 along basement membrane
Q.5 Which blistering disorder is most commonly associated with HLA-DQ2 and HLA-DQ8?
Pemphigus vulgaris
Bullous pemphigoid
Dermatitis herpetiformis
Epidermolysis bullosa acquisita
Explanation - Dermatitis herpetiformis has a strong association with HLA-DQ2 and HLA-DQ8, which are linked to gluten sensitivity and celiac disease.
Correct answer is: Dermatitis herpetiformis
Q.6 Which of the following is a characteristic feature of pemphigus foliaceus?
Mucosal involvement
Superficial blisters without mucosal lesions
Tense bullae on the trunk
Grouped vesicles on extensor surfaces
Explanation - Pemphigus foliaceus presents with superficial crusted erosions, usually sparing mucosa, caused by autoantibodies against desmoglein 1.
Correct answer is: Superficial blisters without mucosal lesions
Q.7 Which of the following is a common trigger for linear IgA bullous dermatosis?
Medications such as vancomycin
Viral infections
UV exposure
Contact allergens
Explanation - Linear IgA bullous dermatosis can be triggered by medications like vancomycin, presenting with tense vesicles and a ‘string of pearls’ pattern.
Correct answer is: Medications such as vancomycin
Q.8 Which of the following is true regarding epidermolysis bullosa acquisita?
It is a hereditary disorder
Blisters form at trauma sites and heal with scarring
It primarily affects mucosa only
It resolves spontaneously without treatment
Explanation - Epidermolysis bullosa acquisita is an autoimmune blistering disorder where blisters occur at trauma sites and heal with scarring and milia formation.
Correct answer is: Blisters form at trauma sites and heal with scarring
Q.9 A positive Nikolsky sign is most characteristic of which disorder?
Pemphigus vulgaris
Bullous pemphigoid
Dermatitis herpetiformis
Epidermolysis bullosa
Explanation - In pemphigus vulgaris, gentle lateral pressure on the skin causes epidermal detachment (positive Nikolsky sign) due to loss of keratinocyte adhesion.
Correct answer is: Pemphigus vulgaris
Q.10 Which antibody is typically involved in epidermolysis bullosa acquisita?
Anti-type VII collagen
Anti-desmoglein 3
Anti-BP180
Anti-transglutaminase
Explanation - Epidermolysis bullosa acquisita involves autoantibodies against type VII collagen, leading to subepidermal blister formation.
Correct answer is: Anti-type VII collagen
Q.11 Which blistering disorder is associated with gluten-sensitive enteropathy?
Bullous pemphigoid
Dermatitis herpetiformis
Pemphigus vulgaris
Linear IgA disease
Explanation - Dermatitis herpetiformis is strongly associated with celiac disease, presenting with pruritic vesicles over extensor surfaces.
Correct answer is: Dermatitis herpetiformis
Q.12 Which blistering disorder typically presents with flaccid bullae that rupture easily?
Pemphigus vulgaris
Bullous pemphigoid
Epidermolysis bullosa acquisita
Linear IgA disease
Explanation - Pemphigus vulgaris presents with flaccid blisters that rupture easily, leading to painful erosions and mucosal involvement.
Correct answer is: Pemphigus vulgaris
Q.13 Which of the following is the first-line treatment for bullous pemphigoid?
High-dose corticosteroids
Dapsone
Gluten-free diet
Antiviral therapy
Explanation - Bullous pemphigoid is primarily treated with systemic corticosteroids to control inflammation and blister formation.
Correct answer is: High-dose corticosteroids
Q.14 Which test confirms the diagnosis of pemphigus vulgaris?
Direct immunofluorescence showing intercellular IgG
ELISA for BP180 antibodies
Skin biopsy showing subepidermal bullae
Indirect immunofluorescence for IgA
Explanation - Diagnosis of pemphigus vulgaris is confirmed by direct immunofluorescence showing IgG deposition in the intercellular spaces of the epidermis.
Correct answer is: Direct immunofluorescence showing intercellular IgG
Q.15 Which blistering disorder often spares the mucous membranes?
Pemphigus foliaceus
Pemphigus vulgaris
Bullous pemphigoid
Epidermolysis bullosa acquisita
Explanation - Pemphigus foliaceus typically involves superficial blisters on the skin without mucosal involvement.
Correct answer is: Pemphigus foliaceus
Q.16 Which of the following medications is commonly used in dermatitis herpetiformis?
Dapsone
Methotrexate
Prednisone
Azathioprine
Explanation - Dapsone is the drug of choice for controlling pruritus and lesions in dermatitis herpetiformis, alongside a gluten-free diet.
Correct answer is: Dapsone
Q.17 A child presents with tense bullae and mucosal involvement. Biopsy shows IgA deposition along the basement membrane. Most likely diagnosis?
Linear IgA disease
Bullous pemphigoid
Pemphigus vulgaris
Dermatitis herpetiformis
Explanation - Linear IgA bullous dermatosis in children presents with tense blisters and mucosal involvement; immunofluorescence shows linear IgA along the basement membrane.
Correct answer is: Linear IgA disease
Q.18 Which of the following is true about mucous membrane pemphigoid?
It primarily affects mucosa and may cause scarring
It is associated with gluten sensitivity
It has flaccid bullae that rupture easily
It is caused by anti-desmoglein antibodies
Explanation - Mucous membrane pemphigoid affects mucosal surfaces, often leading to scarring, and involves antibodies against components of the basement membrane.
Correct answer is: It primarily affects mucosa and may cause scarring
Q.19 Which of the following features differentiates bullous pemphigoid from pemphigus vulgaris?
Tense bullae in bullous pemphigoid vs flaccid in pemphigus vulgaris
Mucosal involvement in bullous pemphigoid only
Early onset in bullous pemphigoid
Positive Nikolsky sign in bullous pemphigoid
Explanation - Bullous pemphigoid shows tense bullae due to subepidermal cleavage, whereas pemphigus vulgaris shows flaccid blisters due to intraepidermal cleavage.
Correct answer is: Tense bullae in bullous pemphigoid vs flaccid in pemphigus vulgaris
Q.20 Which of the following blistering disorders can be triggered by trauma, known as the Koebner phenomenon?
Epidermolysis bullosa acquisita
Pemphigus vulgaris
Dermatitis herpetiformis
Linear IgA disease
Explanation - Epidermolysis bullosa acquisita shows blistering at trauma sites (Koebner phenomenon) and heals with scarring and milia formation.
Correct answer is: Epidermolysis bullosa acquisita
Q.21 Which of the following is a common complication of chronic bullous pemphigoid?
Secondary bacterial infection
Gluten-sensitive enteropathy
Scarring alopecia
Hyperpigmented macules only
Explanation - Chronic bullous pemphigoid can lead to secondary bacterial infections due to persistent erosions and crusts.
Correct answer is: Secondary bacterial infection
Q.22 Which blistering disorder is characterized by subepidermal bullae with neutrophilic microabscesses in dermal papillae?
Dermatitis herpetiformis
Bullous pemphigoid
Pemphigus vulgaris
Linear IgA disease
Explanation - Dermatitis herpetiformis shows subepidermal vesicles with neutrophilic microabscesses in dermal papillae on histology.
Correct answer is: Dermatitis herpetiformis
Q.23 Which of the following is the hallmark of neonatal pemphigus?
Transplacental transfer of maternal IgG antibodies
Autosomal recessive inheritance
Exposure to gluten in utero
Drug-induced blistering
Explanation - Neonatal pemphigus occurs due to transplacental transfer of maternal IgG antibodies causing transient blistering in newborns.
Correct answer is: Transplacental transfer of maternal IgG antibodies
Q.24 Which of the following is true about IgA pemphigus?
It presents with flaccid pustules and vesicles
It always involves mucosa
It is associated with celiac disease
It resolves spontaneously within days
Explanation - IgA pemphigus presents with flaccid pustules and vesicles, usually on the trunk and proximal limbs, and is confirmed by intercellular IgA deposition on immunofluorescence.
Correct answer is: It presents with flaccid pustules and vesicles