ABFM Practice Exam 2025 – Comprehensive Prep Resource

The condition indicated by severe pain and skin changes such as bullae and discoloration, which are not typical of cellulitis, is necrotizing fasciitis. This severe, rapidly progressing soft tissue infection affects the fascia and can lead to extensive tissue necrosis. The hallmark of necrotizing fasciitis is the combination of intense pain, swelling, and systemic symptoms that can escalate quickly. The presence of skin changes, such as bullae (blisters) and discoloration (indicating changes in blood flow and possible tissue death), alongside the severe pain, points towards this diagnosis.

In contrast, cellulitis generally presents with localized redness, swelling, and warmth, often without the severe pain or systemic symptoms seen in necrotizing fasciitis. Bullae and discoloration are not typical signs of cellulitis, which makes it distinct from necrotizing fasciitis. Cirrhosis relates to liver dysfunction and does not directly cause skin changes or pain of this nature, while deep vein thrombosis usually presents with swelling and pain in a limb without the cutaneous changes seen in necrotizing fasciitis. Thus, the symptoms clearly align with the features characteristic of necrotizing fasciitis.