This quiz is just for fun. Test your diagnostic skills with the dermatological photos, then separate truth from fiction in the statements about chickenpox, shingles and carpal tunnel syndrome. Any of the statements below might be true… and any might just be us pulling your leg. Answers are below.
1. Four of these eight pictures show malignancy. Which four?
2. Fact or fib — which of these statements are true, and which are false?
a) Is normally spread by viral shedding from an infected person’s skin
b) Can be transmitted by bedsheets
c) Is most prevalent in the autumn months
d) The most common serious complication is pneumonitis caused by bacterial superinfection
e) Is most dangerous to the fetus when contracted by mother in 3rd trimester
a) Is commonly treated with acyclovir
b) Rarely recurs, except in the immunocompromised
c) May cause pain or headache several days before a rash appears
d) The commonest complication is post-herpetic neuralgia
e) Won’t occur in those given the new shingles vaccine Zostavax
3. Carpal tunnel syndrome
a) Is usually bilateral, but often worse in the dominant hand
b) Can be detected by lack of sensation in thenar eminence (palm adjacent to thumb)
c) Testing for Tinel’s sign gives fewer false positives than Phalen’s sign
d) Can be effectively treated with diuretics
e) Can be effectively treated with wrist splints at night
1. The malignancies are a, d, g and h.
The pictures show:
a) Basal cell carcinoma
b) Cherry hemangioma
d) Squamous cell carcinoma
e) Intradermal nevi
f) Sebhorreic keratosis
g) Superficial spreading malignant melanoma
h) Malignant melanoma
a) False. Chickenpox transmission is typically respiratory, by airborne droplets.
c) False. It’s most prevalent in winter and spring.
d) False. Contrary to popular belief, pneumonitis in chickenpox is generally caused by the virus itself, without bacterial superinfection.
e) False. Chickenpox is most dangerous to the fetus when acquired in early pregnancy.
e) False. Zostavax will prevent about half of all adult cases, with better efficacy in the over-60s.
3. Carpal tunnel syndrome
b) False. While the median nerve that innervates the muscles of the thenar eminence is the one trapped in this syndrome, the cutaneous sensory branch comes off before the carpal tunnel. So lack of sensation in the thenar eminence would signify a higher nerve entrapment, usually in the forearm.
c) False. Phalen’s sign is considered more sensitive than Tinel’s.
d) False. There is no evidence that diuretics help in carpal tunnel.
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