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WorksheetsChapter 13
Total questions: 10
Worksheet time: 5mins
A patient with long-standing venous insufficiency presents with a chronic ulcer on the medial malleolus. The wound base is shallow, exudative, and surrounded by hyperpigmented skin. Which pathophysiologic process most directly caused the hyperpigmentation?
Increased melanin synthesis in basal keratinocytes
Collagen breakdown from protease activity
Hemosiderin deposition from red blood cell extravasation
Fibroblast apoptosis from oxidative stress
A 63-year-old man presents with a pearly papule on the scalp. Histology shows nests of basaloid cells with peripheral palisading in the dermis. Which pathophysiologic mechanism explains why this tumor rarely metastasizes?
Slow growth due to low mitotic index
Effective immune surveillance of keratinocyte antigens
Limited local invasion due to basement membrane adherence
Apoptosis triggered by ultraviolet light exposure
A 28-year-old woman with atopic dermatitis develops S. aureus superinfection. Her eczema is linked to a loss-of-function mutation in the filaggrin gene. How does this defect predispose to infection?
Inhibits dendritic cell migration to lymph nodes
Increases keratinocyte turnover rate
Impairs skin barrier by disrupting keratin aggregation and lipid organization
Stimulates sebaceous gland hyperactivity
A 34-year-old construction worker presents with hyperkeratotic papules on the hands caused by HPV. Which structural change in infected keratinocytes facilitates viral replication?
Loss of tight junction integrity
Proliferation of the stratum spinosum with koilocytosis
Reduced desmosome formation in basal cells
Flattening of the stratum granulosum
A 45-year-old man develops necrotizing fasciitis after a minor leg injury. The infection progresses rapidly despite antibiotic therapy. Which bacterial factor is most responsible for the extensive tissue destruction?
Endotoxin-mediated cytokine release
Capsule-mediated inhibition of phagocytosis
Exotoxin-induced proteolysis of fascia and subcutaneous tissue
Biofilm formation on damaged epidermis
A 50-year-old man presents with erythematous, scaly plaques on extensor surfaces. Histology shows acanthosis, parakeratosis, and elongation of rete ridges. Which immune pathway drives the keratinocyte hyperproliferation in this condition?
IgE-mediated mast cell degranulation
Th17-mediated release of IL-17 and IL-22
NK cell–mediated cytotoxicity
Complement activation via C3b deposition
A 67-year-old immobile patient develops a stage 3 pressure injury. Which pathophysiologic change initiates tissue breakdown in this condition?
Neutrophil infiltration into dermal vessels
Apoptosis of epidermal keratinocytes from UV exposure
Ischemia from sustained capillary compression exceeding arteriolar pressure
Basement membrane thickening from chronic inflammation
A 59-year-old man with a history of multiple blistering sunburns develops a dark lesion on his back. Biopsy reveals malignant melanocytes invading the papillary dermis. Which factor most accurately predicts his prognosis?
Presence of ulceration
Diameter of the lesion
Breslow depth of invasion in millimeters
Degree of pigmentation
A patient sustains a deep partial‑thickness burn over the forearm. Which immediate pathophysiologic change at the burn site is primarily responsible for rapid fluid loss?
Keratinocyte apoptosis from thermal injury
Melanocyte destruction from heat
Increased capillary permeability from histamine and inflammatory mediator release
Loss of desmosomal adhesion between epidermal cells
A 40‑year‑old woman presents with sharply demarcated hypopigmented patches on her arms. Skin biopsy shows absence of melanocytes in affected areas. Which immune process most likely caused these findings?
Antibody‑mediated complement activation
Neutrophil‑derived reactive oxygen species injury
Cytotoxic T‑lymphocyte–mediated apoptosis of melanocytes
NK cell perforin‑granzyme release targeting keratinocytes
