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OVERVIEW
This page is dedicated to organizing various examples of standardized exam questions whose answer is pemphigus vulgaris. While this may seem a odd practice, it is useful to see multiple examples of how pemphigus vulgaris will be characterized on standardized exams (namely the boards and the shelf exams). This page is not meant to be used as a traditional question bank (as all of the answers will be the same), however seeing the classic “test” characterization for a disease is quite valuable.
KEY CHARACTERISTICS OF THIS CONDITION (ON EXAMS)
When it comes to standardized exams, each condition has its own “code” marked by key buzzwords, lab findings, clues, etc. If you are well versed in this code you will be able to more quickly identify the condition that is being discussed, and get the right answer on the exam you are taking. Below is the “code” for pemphigus vulgaris.
- Flaccid bullae are present on the skin (they are intraepidermal)
- Histology: separation of keratinocytes, resembling a “row of tombstones” appearance.
- Immunoflorescance: antibodies around epidermal cells in reticular/net-like pattern
QUESTION EXAMPLES
Question # 1
60-year-old male comes to the clinic because of sores on his skin. He explains that he has developed pain for ulcerations in his mouth that began about a month ago, followed by diffuse onset of large, painful blisters affecting both his trunk and his limbs. His temperature is 98.6°F, blood pressure is 140/85 mmHg, his heart rate is 85 bpm, and his respirations are 14/min. Physical exam shows or only Tosa that contain several erosions and also rations. The scan shows many scattered large erosions and a few facet bullae. Light rubbing of the skin causes easy separation of the epidermis. A punch biopsy of the skin is performed, and IF microscopy shows intracellular the positive IgG. What is the most likely diagnosis in this patient?
Explanation # 1
Ulcers + flaccid bullae + intracellular IgG = pemphigus vulgaris
Question # 2
Explanation # 2
TESTABLE FACTS ABOUT THIS CONDITION (BEYOND ITS IDENTIFICATION)
Many questions on standardized exams go beyond simply recognizing the underlying condition. Often there are specific testable facts regarding some aspect of the disease’s pathophysiology/management/clinical implications that are commonly asked. Some of these are listed below:
- Cause: autoantibodies targeting desmosome proteins (anti-desmoglein/anti-desmosome)
- Type of hypersensitivity: type II hypersensitivity reaction
Page Updated: 02.15.2017