Q.1 Which dermatologic emergency is characterized by widespread epidermal necrosis and detachment, often triggered by medications?
Toxic Epidermal Necrolysis (TEN)
Stevens-Johnson Syndrome (SJS)
Bullous Pemphigoid
Pemphigus Vulgaris
Explanation - TEN is a life-threatening skin condition with extensive epidermal detachment, often triggered by drugs such as sulfonamides or anticonvulsants.
Correct answer is: Toxic Epidermal Necrolysis (TEN)
Q.2 A patient presents with sudden onset of urticaria, angioedema, hypotension, and respiratory distress after eating peanuts. What is the first-line treatment?
Oral antihistamines
Intravenous corticosteroids
Intramuscular epinephrine
Topical corticosteroids
Explanation - Anaphylaxis requires immediate intramuscular epinephrine to reverse life-threatening airway and cardiovascular compromise.
Correct answer is: Intramuscular epinephrine
Q.3 Which of the following is considered a dermatologic emergency requiring hospital admission?
Cellulitis without systemic symptoms
Necrotizing fasciitis
Mild eczema flare
Acne vulgaris
Explanation - Necrotizing fasciitis is a rapidly progressing soft tissue infection with high mortality, requiring surgical debridement and IV antibiotics.
Correct answer is: Necrotizing fasciitis
Q.4 What is the hallmark clinical feature of staphylococcal scalded skin syndrome (SSSS) in children?
Target lesions
Flaccid bullae and desquamation
Pustular eruptions on palms and soles
Hyperpigmented patches
Explanation - SSSS presents with widespread superficial blisters and skin peeling due to exfoliative toxins produced by Staphylococcus aureus.
Correct answer is: Flaccid bullae and desquamation
Q.5 A patient develops purplish, necrotic skin lesions with fever and hypotension. Which dermatologic emergency is most likely?
Purpura fulminans
Erythema multiforme
Psoriasis flare
Drug-induced exanthem
Explanation - Purpura fulminans is a life-threatening thrombotic disorder often associated with sepsis, causing rapidly progressive necrotic skin lesions.
Correct answer is: Purpura fulminans
Q.6 Which drug is most commonly associated with triggering Stevens-Johnson Syndrome?
Acetaminophen
Sulfonamide antibiotics
Aspirin
Metformin
Explanation - Sulfonamides are a well-known trigger for SJS, a severe mucocutaneous reaction involving skin and mucous membranes.
Correct answer is: Sulfonamide antibiotics
Q.7 Which dermatologic emergency is characterized by painful, widespread erythema with mucosal involvement, often with systemic symptoms?
Erythema multiforme major
Psoriasis
Bullous impetigo
Rosacea
Explanation - Erythema multiforme major involves target lesions, mucosal involvement, and sometimes systemic symptoms, distinguishing it from minor forms.
Correct answer is: Erythema multiforme major
Q.8 A patient presents with tense bullae on erythematous skin and severe pruritus. Which emergency should be considered?
Bullous pemphigoid
Pemphigus vulgaris
Contact dermatitis
Urticaria
Explanation - Bullous pemphigoid presents with tense bullae on inflamed skin; though usually less acute than pemphigus, severe cases can require hospitalization.
Correct answer is: Bullous pemphigoid
Q.9 Which of the following is a life-threatening drug reaction with mucocutaneous involvement and systemic symptoms?
Stevens-Johnson Syndrome
Psoriasis
Seborrheic dermatitis
Tinea corporis
Explanation - SJS is a severe, potentially fatal drug reaction with skin and mucous membrane detachment and systemic symptoms.
Correct answer is: Stevens-Johnson Syndrome
Q.10 A patient presents with fever, hypotension, and rapidly spreading erythema with bullae. Which immediate intervention is critical?
Topical antibiotic application
Oral antihistamines
Aggressive intravenous antibiotics and surgical consultation
Observation only
Explanation - Rapidly spreading necrotizing skin infections, like necrotizing fasciitis, require IV antibiotics and prompt surgical debridement.
Correct answer is: Aggressive intravenous antibiotics and surgical consultation
Q.11 Which of the following skin findings is a red flag for meningococcemia?
Petechial or purpuric rash
Erythematous maculopapular rash
Scaly plaques
Localized vesicles
Explanation - Meningococcemia can cause a rapidly progressive petechial or purpuric rash and is a medical emergency requiring immediate antibiotics.
Correct answer is: Petechial or purpuric rash
Q.12 A patient presents with widespread exfoliation, positive Nikolsky sign, and recent antibiotic exposure. The most likely diagnosis is:
Toxic Epidermal Necrolysis
Psoriasis
Eczema
Cellulitis
Explanation - TEN presents with widespread skin detachment, positive Nikolsky sign, and often follows drug exposure, requiring ICU care.
Correct answer is: Toxic Epidermal Necrolysis
Q.13 Which condition presents with sudden-onset, intensely pruritic urticarial plaques that migrate over hours?
Acute urticaria
Erythema multiforme
Psoriasis
Cellulitis
Explanation - Acute urticaria involves transient, itchy wheals that appear and resolve within 24 hours, often triggered by allergens.
Correct answer is: Acute urticaria
Q.14 A newborn presents with flaccid bullae and superficial desquamation. This is most likely caused by:
Staphylococcus aureus toxin
Herpes simplex virus
Candida infection
Neonatal eczema
Explanation - Staphylococcal scalded skin syndrome in neonates is caused by exfoliative toxins from S. aureus leading to superficial blistering.
Correct answer is: Staphylococcus aureus toxin
Q.15 Which of the following is a common trigger for acute generalized exanthematous pustulosis (AGEP)?
Antibiotics
Ultraviolet light
Topical corticosteroids
Fungal infection
Explanation - AGEP is usually triggered by medications, particularly antibiotics, and presents with sudden pustular eruptions and fever.
Correct answer is: Antibiotics
Q.16 A patient presents with target lesions, mucosal erosions, and recent herpes simplex virus infection. The likely diagnosis is:
Erythema multiforme
Psoriasis
Contact dermatitis
Bullous pemphigoid
Explanation - Erythema multiforme is often triggered by infections, particularly HSV, and presents with target lesions and mucosal involvement.
Correct answer is: Erythema multiforme
Q.17 Which feature differentiates pemphigus vulgaris from bullous pemphigoid?
Flaccid vs. tense bullae
Pruritus intensity
Presence of fever
Distribution on face
Explanation - Pemphigus vulgaris presents with flaccid bullae that easily rupture, whereas bullous pemphigoid has tense, intact bullae.
Correct answer is: Flaccid vs. tense bullae
Q.18 A patient develops rapidly progressive erythema, pain, and crepitus in the leg after minor trauma. What is the next best step?
Topical antibiotics
Immediate surgical evaluation
Oral NSAIDs
Observation
Explanation - Necrotizing fasciitis is a surgical emergency; early debridement is critical for survival.
Correct answer is: Immediate surgical evaluation
Q.19 Which dermatologic emergency is commonly associated with septicemia and rapidly progressing purpura?
Purpura fulminans
Urticaria
Cellulitis
Contact dermatitis
Explanation - Purpura fulminans is a severe complication of sepsis with thrombotic skin necrosis, requiring urgent management.
Correct answer is: Purpura fulminans
Q.20 A patient presents with diffuse erythema, desquamation, hypotension, and fever after starting a new medication. The most likely cause is:
Drug reaction with eosinophilia and systemic symptoms (DRESS)
Psoriasis
Eczema
Tinea corporis
Explanation - DRESS is a severe drug-induced reaction with systemic involvement, including fever, rash, and organ involvement.
Correct answer is: Drug reaction with eosinophilia and systemic symptoms (DRESS)
Q.21 Which feature is most suggestive of anaphylaxis rather than isolated urticaria?
Hypotension and respiratory compromise
Transient wheals
Localized pruritus
Mild edema
Explanation - Anaphylaxis involves systemic symptoms such as hypotension and airway compromise, requiring emergency treatment.
Correct answer is: Hypotension and respiratory compromise
Q.22 Which dermatologic condition is considered a life-threatening emergency in neonates?
Staphylococcal scalded skin syndrome
Neonatal acne
Milia
Erythema toxicum neonatorum
Explanation - SSSS in neonates can rapidly progress and requires hospitalization and systemic antibiotics.
Correct answer is: Staphylococcal scalded skin syndrome
Q.23 Which of the following is a key management step in toxic epidermal necrolysis?
Supportive care in burn unit
Topical corticosteroids only
Oral antihistamines only
Outpatient observation
Explanation - TEN requires ICU or burn unit care with fluid management, infection control, and wound care; systemic therapy may be needed.
Correct answer is: Supportive care in burn unit