Molluscum Contagiosum Indian Medical PG Practice Questions and MCQs
Practice Indian Medical PG questions for Molluscum Contagiosum. These multiple choice questions (MCQs) cover important concepts and help you prepare for your exams.
Molluscum Contagiosum Indian Medical PG Question 1: Koebner's phenomenon is seen in all of the following except:
- A. Darier's disease
- B. Molluscum contagiosum
- C. Scleromyxedema
- D. Erythema multiforme (Correct Answer)
Molluscum Contagiosum Explanation: ***Erythema multiforme***
- **Erythema multiforme** is an acute hypersensitivity reaction that does **NOT** typically demonstrate the Koebner phenomenon.
- Unlike chronic papulosquamous disorders, EM lesions arise from immunologic triggers (infections, drugs) rather than trauma-induced spread.
- The characteristic **target lesions** develop in response to antigenic stimuli, not mechanical trauma.
*Darier's disease*
- **Darier's disease** (keratosis follicularis) is an autosomal dominant disorder that exhibits the Koebner phenomenon.
- New keratotic papules develop at sites of trauma, scratching, or friction.
- This trauma-induced lesion development is a **key clinical feature** of the disease.
*Molluscum contagiosum*
- **Molluscum contagiosum** demonstrates the Koebner phenomenon through **autoinoculation**.
- Scratching can cause viral spread, resulting in **linear arrangements of lesions** along scratch marks.
- This is a classic example of trauma-induced spread in viral skin infections.
*Scleromyxedema*
- **Scleromyxedema** (generalized lichen myxedematosus) can exhibit the Koebner phenomenon.
- New papules may develop at sites of trauma in some cases.
- While less commonly emphasized than in psoriasis or lichen planus, Koebnerization has been reported in this condition.
Molluscum Contagiosum Indian Medical PG Question 2: Koebner's phenomenon is seen in all except
- A. Psoriasis
- B. Warts
- C. Tinea corporis (Correct Answer)
- D. Molluscum contagiosum
Molluscum Contagiosum Explanation: ***Tinea corporis***
- **Koebner's phenomenon**, also known as the isomorphic response, is the appearance of skin lesions characteristic of a **pre-existing dermatosis** at sites of **trauma** to previously uninvolved skin.
- **Tinea corporis**, a **superficial fungal infection**, does NOT exhibit true Koebner's phenomenon.
- Its spread occurs through **direct fungal contact or autoinoculation**, not through an isomorphic response to non-specific trauma.
*Psoriasis*
- **Psoriasis** is the **classic example** of Koebner's phenomenon.
- New psoriatic plaques can appear at sites of **skin trauma** such as scratches, surgical scars, burns, or tattoos within **10-20 days** of injury.
- This occurs in approximately **25-50%** of psoriasis patients.
*Warts*
- **Warts** (verruca vulgaris), caused by **human papillomavirus (HPV)**, can show what is sometimes called **pseudo-Koebner's phenomenon**.
- Trauma facilitates **viral inoculation** and seeding of HPV into the skin, leading to new wart formation along scratch lines.
- However, this is technically **viral spread through trauma**, not a true isomorphic response of a pre-existing dermatosis.
*Molluscum contagiosum*
- **Molluscum contagiosum** can similarly demonstrate **pseudo-Koebner's phenomenon**.
- Scratching spreads the **molluscum contagiosum virus** to adjacent areas, creating linear arrays of lesions.
- Like warts, this represents **direct viral inoculation** rather than true isomorphic response, but is often grouped with Koebner's phenomenon in clinical practice.
Molluscum Contagiosum Indian Medical PG Question 3: Ivermectin is indicated in the treatment of:
- A. Scabies (Correct Answer)
- B. Dermatophytosis
- C. Tuberculosis
- D. Syphilis
Molluscum Contagiosum Explanation: ***Scabies***
- **Ivermectin** is an effective oral antiparasitic agent used to treat **scabies**, particularly in cases of widespread infestation, crusted scabies, or when topical treatments fail.
- It acts by paralyzing and killing the **Sarcoptes scabiei mites** responsible for the infestation.
*Dermatophytosis*
- **Dermatophytosis** (ringworm) is a **fungal infection** of the skin, hair, or nails.
- It is typically treated with **antifungal medications** (e.g., azoles, terbinafine), not ivermectin.
*Tuberculosis*
- **Tuberculosis** is a bacterial infection caused by **Mycobacterium tuberculosis**, primarily affecting the lungs.
- Treatment involves a multi-drug regimen of **antibiotics** (e.g., rifampin, isoniazid), for several months.
*Syphilis*
- **Syphilis** is a sexually transmitted bacterial infection caused by **Treponema pallidum**.
- The primary treatment for syphilis is **penicillin**, usually administered via injection.
Molluscum Contagiosum Indian Medical PG Question 4: Which cytopathic effect would confirm molluscum contagiosum virus infection?
- A. Cowdry type B inclusions
- B. Owl's eye inclusions
- C. Negri bodies
- D. Henderson-Paterson bodies (Correct Answer)
Molluscum Contagiosum Explanation: ***Henderson-Paterson bodies***
- These are characteristic **large, eosinophilic intracytoplasmic inclusion bodies** seen in keratinocytes infected with the **molluscum contagiosum virus**.
- Their presence confirms a diagnosis of molluscum contagiosum upon histological examination.
*Cowdry type B inclusions*
- These are **intracytoplasmic inclusion bodies** associated with **adenovirus** and **poliovirus** infections.
- They are not characteristic of molluscum contagiosum virus, which forms distinct Henderson-Paterson bodies.
*Owl's eye inclusions*
- These are large, **intranuclear inclusion bodies with a clear halo** surrounding a dense central core, classically seen in cells infected with **cytomegalovirus (CMV)**.
- They are distinct from the cytoplasmic inclusions of molluscum contagiosum.
*Negri bodies*
- These are **eosinophilic cytoplasmic inclusions** found in the cytoplasm of hippocampal pyramidal cells and Purkinje cells of the cerebellum, pathognomonic for **rabies virus infection**.
- They are associated with a different viral family and are distinct from molluscum contagiosum inclusions.
Molluscum Contagiosum Indian Medical PG Question 5: A child presents with grouped vesicles on the lips. What is the bedside investigation that you would like to do?
- A. Wood's lamp
- B. Slit skin smear
- C. Tzanck smear (Correct Answer)
- D. KOH
Molluscum Contagiosum Explanation: ***Tzanck smear***
- A **Tzanck smear** is a rapid bedside test that can identify **multinucleated giant cells**, which are seen in herpes simplex virus infections.
- The presence of **grouped vesicles on the lips** is highly suggestive of **herpes labialis** (HSV-1), which is primarily a **clinical diagnosis**.
- Among the options provided, Tzanck smear is the only relevant bedside investigation, though it has **limited sensitivity and specificity** and **cannot distinguish between HSV and VZV**.
- In modern practice, **PCR or direct immunofluorescence** are preferred when laboratory confirmation is needed, but Tzanck smear remains a low-cost option in resource-limited settings.
*Wood's lamp*
- A Wood's lamp uses **ultraviolet light** to detect certain fungal or bacterial infections by revealing characteristic fluorescence.
- It is useful for conditions like **tinea capitis** (green fluorescence) and **erythrasma** (coral-red fluorescence), but has no role in diagnosing viral vesicular lesions.
*Slit skin smear*
- A **slit skin smear** is used to detect **acid-fast bacilli** in the diagnosis of **leprosy**.
- It is not indicated for vesicular lesions and is irrelevant to herpes simplex infection.
*KOH*
- A **KOH (potassium hydroxide) mount** is used to diagnose **fungal infections** by dissolving keratinocytes and revealing fungal hyphae or spores.
- It has no utility in diagnosing viral infections such as herpes simplex.
Molluscum Contagiosum Indian Medical PG Question 6: A woman presents with lesions on the inner thighs and peri-anal region. They are nodular, 4-6 mm in size and appear pale. The histopathological image shows multiple intracytoplasmic inclusion bodies consistent with Henderson-Patterson bodies. The diagnosis is:
- A. Trichodysplasia spinulosa
- B. Molluscum contagiosum (Correct Answer)
- C. Condyloma acuminata
- D. Donovanosis
Molluscum Contagiosum Explanation: ***Molluscum contagiosum***
- The clinical presentation of **nodular, pale lesions** in the inner thighs and peri-anal region, combined with histopathology showing **Henderson-Patterson bodies** (large eosinophilic intracytoplasmic inclusions), is pathognomonic for molluscum contagiosum.
- Henderson-Patterson bodies represent viral factories within infected keratinocytes, a key diagnostic feature of this **poxvirus** infection.
*Trichodysplasia spinulosa*
- This condition is characterized by **follicular papules** with prominent keratin spines, typically occurring on the face, and is associated with the **Trichodysplasia spinulosa-associated polyomavirus**.
- It does not present with Henderson-Patterson bodies or the typical nodular lesions seen in molluscum contagiosum.
*Condyloma acuminata*
- These are **genital warts** caused by the **human papillomavirus (HPV)**, presenting as verrucous or cauliflower-like growths.
- Histologically, they show **koilocytic atypia** (vacuolated cells with nuclear abnormalities), not Henderson-Patterson bodies.
*Donovanosis*
- Also known as **granuloma inguinale**, this is a chronic, progressive, ulcerative granulomatous disease caused by **Klebsiella granulomatis**.
- Histopathology reveals **Donovan bodies** (intracellular bacteria within macrophages), which are distinct from Henderson-Patterson bodies and the clinical presentation of nodular lesions.
Molluscum Contagiosum Indian Medical PG Question 7: Which of the following statements about molluscum contagiosum is FALSE?
- A. Lesions contain characteristic inclusion bodies
- B. Autoinoculation can spread the infection to new sites
- C. It is caused by a poxvirus
- D. Laboratory confirmation is required for diagnosis (Correct Answer)
Molluscum Contagiosum Explanation: ***Laboratory confirmation is required for diagnosis***
- The diagnosis of **molluscum contagiosum** is primarily **clinical**, based on the characteristic appearance of the lesions (small, flesh-colored, dome-shaped papules with central umbilication).
- While histology can confirm the diagnosis by revealing **molluscum bodies**, it is **not routinely required** for typical cases.
*Lesions contain characteristic inclusion bodies*
- This statement is **true**. Histological examination of molluscum contagiosum lesions reveals large, eosinophilic cytoplasmic inclusions, known as **molluscum bodies** or **Henderson-Paterson bodies**, within infected epidermal cells.
- These inclusion bodies contain viral particles and are a **hallmark of the infection**.
*Autoinoculation can spread the infection to new sites*
- This statement is **true**. Molluscum contagiosum is highly contagious, and scratching or touching existing lesions can lead to the spread of the virus to previously unaffected skin areas on the same individual.
- This process of **autoinoculation** explains why lesions often appear in clusters or linear arrays (Koebner phenomenon).
*It is caused by a poxvirus*
- This statement is **true**. Molluscum contagiosum is caused by the **molluscum contagiosum virus (MCV)**, which belongs to the **Poxviridae family**.
- Poxviruses are known for their relatively large size and the ability to replicate entirely in the cytoplasm of host cells.
Molluscum Contagiosum Indian Medical PG Question 8: A young man presented with painful vesicular lesions distributed along a dermatomal pattern on one side of his body. What is the likely diagnosis?
- A. Lymphangioma circumscriptum
- B. Molluscum contagiosum
- C. Herpes simplex
- D. Herpes Zoster (Correct Answer)
Molluscum Contagiosum Explanation: ***Herpes Zoster***
- This condition is characterized by a **unilateral rash** that respects the **dermatomal distribution**, meaning it follows the path of a single nerve.
- The lesions are typically **painful vesicles** and crusts, often associated with a burning sensation due to reactivation of the **varicella-zoster virus** (chickenpox virus).
*Lymphangioma circumscriptum*
- This is a rare **lymphatic malformation** presenting as clusters of **vesicles** or papules, often described as 'frog spawn' or 'tapioca pudding' in appearance.
- While it can be painful, it usually does not follow a dermatomal pattern and is a congenital condition, not an acute viral eruption.
*Molluscum contagiosum*
- This is a viral skin infection producing small, firm, **umbilicated papules** that are typically flesh-colored or pearly.
- While contagious, these lesions are generally **asymptomatic** and do not present with the acute pain, blistering, or dermatomal distribution characteristic of herpes zoster.
*Herpes simplex*
- This infection causes localized clusters of painful **vesicles** on an erythematous base, most commonly around the mouth (cold sores) or genitals.
- Unlike herpes zoster, herpes simplex lesions typically recur in the same small area and do **not follow a dermatomal distribution**.
Molluscum Contagiosum Indian Medical PG Question 9: Multinucleated giant cell on Tzanck smear is not seen in?
- A. Herpes simplex
- B. Molluscum contagiosum (Correct Answer)
- C. Varicella
- D. Herpes zoster
Molluscum Contagiosum Explanation: **Molluscum contagiosum**
- Tzanck smear typically reveals **Henderson-Paterson bodies**, which are large eosinophilic intracytoplasmic inclusions within epithelial cells.
- **Multinucleated giant cells** are not characteristic findings in lesions caused by the molluscum contagiosum virus (a poxvirus).
*Herpes simplex*
- Tzanck smear often shows **multinucleated giant cells** and **acantholytic cells**, which are specific cytopathic effects of HSV.
- The presence of these cells helps in the rapid diagnosis of **herpes simplex viral infections**.
*Varicella*
- Similar to herpes simplex, **varicella-zoster virus (VZV)** infection also produces **multinucleated giant cells** on Tzanck smear.
- These cells are a hallmark of **herpesvirus infections**, indicating viral cytopathic effects in epithelial cells.
*Herpes zoster*
- Herpes zoster, caused by the **reactivation of VZV**, also presents with **multinucleated giant cells** on Tzanck smear.
- This finding aids in confirming the diagnosis of **shingles**, distinguishing it from other vesicular rashes.
Molluscum Contagiosum Indian Medical PG Question 10: Which of the following is not a poxvirus?
- A. Molluscum contagiosum
- B. Orf virus
- C. Vaccinia virus
- D. Coxsackie virus (Correct Answer)
Molluscum Contagiosum Explanation: ***Coxsackie virus***
- The **Coxsackie virus** belongs to the family **Picornaviridae**, not Poxviridae.
- It is known for causing diseases such as **hand, foot, and mouth disease**, herpangina, and myocarditis.
*Vaccinia virus*
- **Vaccinia virus** is a well-known member of the **Poxviridae** family, historically used in the smallpox vaccine.
- It is a **large, complex DNA virus** that replicates in the cytoplasm of infected cells.
*Molluscum contagiosum*
- **Molluscum contagiosum virus (MCV)** is a **poxvirus** that causes a mild skin infection characterized by raised, pearly, umbilicated lesions.
- It primarily infects **humans**, causing localized lesions that are spread through direct contact.
*Orf virus*
- **Orf virus**, also known as contagious pustular dermatitis virus, is a **poxvirus** that primarily affects sheep and goats.
- It can be transmitted to humans, causing single papular or nodular lesions, usually on the fingers, hands, or forearms.
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