KMU Past Paper Practice

Question:

A 20-year-old student with inflammatory acne develops dizziness and a sensation of imbalance after starting an oral antibiotic. The drug is effective against acne-associated bacteria but is stopped because of this characteristic adverse effect. Which drug was most likely prescribed?

Options:

Correct Answer: Minocycline

Explanation: Minocycline is a tetracycline-class acne antibiotic that can produce vestibular adverse effects such as dizziness and imbalance.

Question:

A patient with acne cannot receive a tetracycline-class antibiotic. The physician considers an alternative antibacterial group but explains that widespread resistance limits its routine use. Which group best fits this description?

Options:

Correct Answer: Macrolides

Explanation: Macrolides may be used when tetracyclines are unsuitable, but increasing bacterial resistance limits their routine role in acne.

Question:

A teenager begins a topical preparation for predominantly comedonal acne. After several days, she develops erythema, peeling and increased sensitivity to sunlight. Which pharmacological class most likely produced these effects?

Options:

Correct Answer: Topical retinoids

Explanation: Tretinoin, adapalene and tazarotene normalize follicular keratinization but commonly cause irritation, peeling and photosensitivity.

Question:

A woman receiving treatment for severe acne develops marked dryness of the lips and nasal mucosa. Laboratory monitoring later shows abnormalities in serum lipids. Which medication most likely explains the combined findings?

Options:

Correct Answer: Isotretinoin

Explanation: Systemic isotretinoin characteristically causes mucocutaneous dryness and may produce abnormalities in serum lipids and liver biochemical tests.

Question:

A 34-year-old woman with facial atopic dermatitis is switched from a topical corticosteroid to another anti-inflammatory drug. After the first applications she reports transient burning, but examination shows no thinning of the skin. Which property favors this alternative for sensitive sites?

Options:

Correct Answer: It does not characteristically cause skin atrophy

Explanation: Topical tacrolimus can cause transient burning but provides a steroid-sparing option because cutaneous atrophy is not a characteristic adverse effect.

Question:

A patient with an external genital wart receives a topical immunomodulator. During treatment the lesion becomes red, inflamed and superficially eroded. The clinician explains that this local reaction reflects the same process responsible for therapeutic benefit. Which drug was used?

Options:

Correct Answer: Imiquimod

Explanation: Imiquimod enhances local cell-mediated immunity; erythema, inflammation and erosion can occur because immune activation is part of its action.

Question:

Several residents of a hostel are treated for scabies. One affected student improves, but new infestation develops after untreated close contacts continue sharing bedding. Which additional measure most directly reduces this type of treatment failure?

Options:

Correct Answer: Treat close contacts and address contaminated bedding

Explanation: Reinfection can occur if close contacts remain untreated or contaminated clothing and bedding are not addressed along with pharmacological therapy.

Question:

A child with pediculosis is being considered for an older ectoparasiticide. The clinician avoids one agent because excessive exposure has been associated with significant neurological toxicity. Which drug is being avoided?

Options:

Correct Answer: Lindane

Explanation: Lindane is an older ectoparasiticide whose use is limited because systemic absorption can produce clinically important neurotoxicity.

Question:

A woman with hyperpigmented facial macules is prescribed a topical retinoid as part of treatment. The clinician explains that its benefit differs from direct destruction of melanocytes. Which effect best accounts for improvement in pigmentation?

Options:

Correct Answer: Increased epidermal turnover and pigment removal

Explanation: Topical retinoids increase epidermal turnover and promote more even dispersion and removal of epidermal pigment.

Question:

A patient receiving psoralen-based photochemotherapy is counselled about precautions after taking the photosensitizing drug. Which additional tissue requires protection because it may also be affected by photosensitization?

Options:

Correct Answer: Ocular tissues

Explanation: Psoralens produce systemic photosensitization, so appropriate eye protection is required to reduce ultraviolet-related ocular injury.

Question:

A man with plaque psoriasis begins a topical vitamin D analogue. He applies excessive amounts over widespread areas. Which pharmacological disturbance becomes a concern because of the drug class involved?

Options:

Correct Answer: Disturbance of calcium metabolism

Explanation: Calcipotriol is a vitamin D analogue; excessive exposure can affect calcium metabolism in addition to producing local irritation.

Question:

A patient with plaque psoriasis is prescribed a topical retinoid. The lesions improve, but local erythema and irritation develop. Which additional consideration is particularly important before continuing this drug in a woman of reproductive age?

Options:

Correct Answer: Risk of fetal toxicity

Explanation: Tazarotene is a topical retinoid used in psoriasis and is avoided in pregnancy because retinoids can cause fetal harm.

Question:

A patient with moderate-to-severe psoriasis receives a biological agent directed against an inflammatory cytokine pathway. The plaques improve markedly. Which complication should be considered because of the fundamental therapeutic mechanism?

Options:

Correct Answer: Increased susceptibility to infection

Explanation: Biological drugs suppress key inflammatory pathways such as TNF, IL-17 or IL-23, so impaired host defence and infection are important concerns.

Question:

A man with chronic plaque psoriasis is offered an older topical preparation that can reduce epidermal proliferation and inflammation. He is reluctant because the treatment is messy, has a strong odor and may stain clothing. Which preparation is being described?

Options:

Correct Answer: Coal tar

Explanation: Coal tar has antiproliferative and anti-inflammatory effects in psoriasis, but odor, staining, irritation and poor cosmetic acceptability limit its use.

Question:

A patient has used a potent topical corticosteroid over an area of fungal infection. Redness and itching initially decrease, but the infection becomes more extensive and its appearance becomes less typical. Which pharmacological effect best explains this outcome?

Options:

Correct Answer: Suppression of local inflammatory and immune responses

Explanation: Topical corticosteroids suppress local immunity and inflammation, which can mask the appearance of infection and permit it to worsen.

Question:

A dermatologist must choose corticosteroid potency for two inflammatory lesions. One is thin facial eczema and the other is lichen simplex chronicus with marked thickening from repeated scratching. Which lesion is expected to be relatively less responsive and may require greater potency?

Options:

Correct Answer: Lichen simplex chronicus

Explanation: Thickened lesions such as lichen simplex chronicus are relatively resistant because increased keratin limits drug penetration compared with thin inflammatory dermatoses.

Question:

A patient with localized pruritus but little visible inflammation is given a topical drug that reduces transmission from cutaneous sensory nerves rather than suppressing the immune system. Which agent is most appropriate?

Options:

Correct Answer: Pramoxine

Explanation: Pramoxine is a topical local anesthetic that decreases sensory nerve transmission and can therefore relieve localized pruritus.

Question:

A patient applies an antipruritic preparation and experiences a cooling sensation that temporarily reduces the perception of itching. The preparation works through stimulation of cold-sensitive cutaneous pathways. Which agent is most likely responsible?

Options:

Correct Answer: Menthol

Explanation: Menthol activates cold-sensitive sensory pathways, producing a cooling sensation that can reduce the perception of itch.

Question:

A woman applies a topical medication for persistent pruritus. The itching improves, but she becomes drowsy after using it over a relatively large area. Which drug best explains the combination of antipruritic benefit and possible systemic sedation?

Options:

Correct Answer: Doxepin

Explanation: Topical doxepin has strong antihistaminic activity and can relieve pruritus, but systemic absorption may cause sedation.

Question:

A man using topical minoxidil for androgenetic alopecia notices improvement in scalp hair while treatment continues. He asks whether the benefit will persist permanently after stopping the drug. Which explanation is most appropriate?

Options:

Correct Answer: The benefit declines because the underlying follicular tendency persists

Explanation: Minoxidil supports susceptible follicles while treatment continues; stopping therapy allows the underlying process of androgenetic follicular miniaturization to re-emerge.