Question 1

Josie has severe cystic acne and is requesting treatment with Accutane. The appropriate treatment for her would be:&#10;A) Order a pregnancy test and if it is negative prescribe the isotretinoin (Accutane).&#10;B) Order Accutane after educating her on the adverse effects.&#10;C) Recommend she try oral antibiotics (minocycline).&#10;D) Refer her to a dermatologist for treatment.&#10;

Accepted Answer

Accutane (isotretinoin) is a highly regulated and potentially dangerous medication that should be prescribed by a dermatologist. They will evaluate the severity of the acne and weigh the risks and benefits of Accutane treatment. A dermatologist can also closely monitor any adverse effects and ensure proper use of contraceptive measures to avoid fetal exposure to the drug, which can lead to severe birth defects. Therefore, referring Josie to a dermatologist is the best choice.

Question 2

Scabies treatment for a 4-year-old child includes a prescription for:&#10;A) Permethrin 5% cream applied from the neck down&#10;B) Pyrethrin lotion&#10;C) Lindane 1% shampoo&#10;D) All of the above&#10;

Accepted Answer

Permethrin 5% cream is the recommended treatment for scabies in children over 2 months old. Pyrethrin lotion and Lindane shampoo are not recommended for use in children due to potential toxicity concerns.

Question 3

Long-term treatment of moderate atopic dermatitis includes:&#10;A) Topical corticosteroids and emollients&#10;B) Topical corticosteroids alone&#10;C) Topical antipruritics&#10;D) Oral corticosteroids for exacerbations of atopic dermatitis&#10;

Accepted Answer

Long-term treatment of moderate atopic dermatitis includes the use of both topical corticosteroids (for controlling inflammation) and emollients (for maintaining skin hydration and integrity). Topical antipruritics may also be used to provide additional relief from itching. Oral corticosteroids should be reserved for severe exacerbations and not used as a long-term treatment due to their potential side effects.

Question 4

Tobie presents to the clinic with moderate acne. He has been using OTC benzoyl peroxide at home with minimal improvement. A topical antibiotic (clindamycin) and a topical retinoid adapalene (Differin) are prescribed. Education of Tobie would include:

A) He should see an improvement in his acne within the first 2 weeks of treatment.
B) If there is no response in a week, double the daily application of adapalene (Differin).
C) He may see an initial worsening of his acne that will improve in 6 to 8 weeks.
D) Adapalene may cause bleaching of clothing.

Accepted Answer

Topical retinoids can cause an initial flare-up of acne, which may persist for 6 to 8 weeks before improvement is seen. Options A and B are incorrect as improvement usually takes longer than 2 weeks and increasing the dose without consulting a healthcare provider is not recommended. Option D is true, but not as important for education as the potential initial worsening of acne.

Question 5

When choosing a topical corticosteroid cream to treat diaper dermatitis, the ideal medication would be:&#10;A) Intermediate potency corticosteroid ointment (Kenalog)&#10;B) A combination of a corticosteroid and an antifungal (Lotrisone)&#10;C) A low-potency corticosteroid cream applied sparingly (hydrocortisone 1%)&#10;D) A high-potency corticosteroid cream (Diprolene AF)&#10;

Accepted Answer

For diaper dermatitis, a low-potency corticosteroid cream applied sparingly, such as hydrocortisone 1%, is the recommended choice. High-potency corticosteroids can cause skin thinning and should be avoided. A combination of corticosteroids and antifungal creams, such as Lotrisone, is not necessary unless there is a documented fungal infection.

Question 6

Rick has male pattern baldness on the vertex of his head and has been using Rogaine for 2 months. He asks how effective minoxidil (Rogaine) is. Minoxidil:&#10;A) Provides a permanent solution to male pattern baldness if used for at least 4 months&#10;B) Will show results after 4 months of twice-a-day use&#10;C) May not work for Rick's type of baldness&#10;D) Works better if he also uses hydrocortisone cream daily on his scalp&#10;

Accepted Answer

Minoxidil typically takes at least 4 months of twice-a-day use to show results. However, it does not provide a permanent solution to male pattern baldness and may not work for all types of baldness. There is no evidence that using hydrocortisone cream daily on the scalp improves the effectiveness of minoxidil.

Question 7

The most cost-effective treatment for two or three impetigo lesions on the face is:&#10;A) Mupirocin ointment&#10;B) Retapamulin (Altabax) ointment&#10;C) Topical clindamycin solution&#10;D) Oral amoxicillin/clavulanate (Augmentin)&#10;

Accepted Answer

Mupirocin ointment is the most cost-effective treatment for impetigo lesions on the face. It is a topical antibiotic that is effective against the most common bacteria that cause impetigo. Retapamulin is also an effective topical antibiotic, but it is more expensive than mupirocin. Topical clindamycin solution and oral amoxicillin/clavulanate are not recommended as first-line treatments for impetigo.

Question 8

Appropriate initial treatment for psoriasis would be:&#10;A) An immunomodulator (Protopic or Elidel)&#10;B) Wet soaks with Burrow's or Domeboro solution&#10;C) Intermittent therapy with intermediate potency topical corticosteroids&#10;D) Anthralin (Drithocreme)&#10;

Accepted Answer

Intermittent therapy with intermediate potency topical corticosteroids is the appropriate initial treatment for psoriasis. This is the first-line treatment for mild to moderate psoriasis and can be effective in reducing inflammation and controlling symptoms. While immunomodulators, wet soaks, and anthralin may be used in some cases, they are not typically the first choice for initial treatment.

Question 9

Nicolas is a football player who presents to the clinic with athlete's foot. Patients with tinea pedis may be treated with:&#10;A) OTC miconazole cream for 4 weeks&#10;B) Oral ketoconazole for 6 weeks&#10;C) Mupirocin ointment for 2 weeks&#10;D) Nystatin cream for 2 weeks&#10;

Accepted Answer

Athlete's foot is a fungal infection caused by dermatophytes. Topical antifungals such as miconazole, clotrimazole or terbinafine are usually effective treatment options. Oral ketoconazole has potential for liver toxicity and is reserved for persistent infections or those with extensive disease. Mupirocin is for bacterial infections, not fungal infections, and nystatin is usually reserved for candidal infections.

Question 10

Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:&#10;A) Topical antipruritics&#10;B) Oral corticosteroids for 2 to 3 weeks&#10;C) Thickly applied topical intermediate-dose corticosteroids&#10;D) Isolation of the patient to prevent spread of the dermatitis&#10;

Accepted Answer

Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with oral corticosteroids for 2 to 3 weeks to reduce inflammation and itching. Topical antipruritics and thickly applied topical intermediate-dose corticosteroids can also provide some relief, but they are not typically sufficient for severe cases. Isolation of the patient is not necessary, as poison ivy and poison oak rashes are not contagious.

Question 11

Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:&#10;A) Miconazole cream&#10;B) Ketoconazole cream&#10;C) Oral griseofulvin&#10;D) Mupirocin cream&#10;

Accepted Answer

The answer of Jim presents with fungal infection of two...

Question 12

Mild acne may be initially treated with:&#10;A) Topical combined antibiotic&#10;B) Minocycline&#10;C) Topical retinoid&#10;D) OTC benzoyl peroxide&#10;

Accepted Answer

The answer of Mild acne may be initially treated with:&#10;A)...

Question 13

Catherine has head lice and her mother is asking about what products are available that are not neurotoxic. The only non-neurotoxin head lice treatment is:&#10;A) Permethrin 1% (Nix)&#10;B) Lindane shampoo&#10;C) Malathion (Ovide)&#10;D) Benzoyl alcohol (Ulesfia)&#10;

Accepted Answer

The answer of Catherine has head lice and her mother...

Question 14

Dwayne has classic tinea capitis. Treatment for tinea on the scalp is:&#10;A) Miconazole cream rubbed in well for 4 weeks&#10;B) Oral griseofulvin for 6 to 8 weeks&#10;C) Ketoconazole shampoo daily for 6 weeks&#10;D) Ciclopirox cream daily for 4 weeks&#10;

Accepted Answer

The answer of Dwayne has classic tinea capitis. Treatment for...

Question 15

Topical immunomodulators such as pimecrolimus (Elidel) or tacrolimus (Protopic) are used for:&#10;A) Short-term or intermittent treatment of atopic dermatitis&#10;B) Topical treatment of fungal infections (Candida)&#10;C) Chronic, inflammatory seborrheic dermatitis&#10;D) Recalcitrant nodular acne&#10;

Accepted Answer

The answer of Topical immunomodulators such as pimecrolimus (Elidel) or...

Question 16

Patient education when prescribing the vitamin D₃ derivative calcipotriene for psoriasis includes: A) Apply thickly to affected psoriatic areas two to three times a day. B) A maximum of 100 grams per week may be applied. C) Do not use calcipotriene in combination with their topical corticosteroids. D) Calcipotriene may be augmented with the use of coal tar products.

Accepted Answer

The answer of Patient education when prescribing the vitamin D₃...

Question 17

When a patient has contact dermatitis, wet dressings with Domeboro solution are used for:&#10;A) Cleaning the weeping area of dermatitis&#10;B) Bathing the patient to prevent infection&#10;C) Relief of inflammation&#10;D) Providing a barrier layer to protect the surrounding skin&#10;

Accepted Answer

The answer of When a patient has contact dermatitis, wet...

Question 18

Vanessa has been diagnosed with scabies. Her education would include:&#10;A) She should apply the scabies treatment cream for an hour and wash it off.&#10;B) Scabies may need to be retreated in a week after initial treatment.&#10;C) All members of the household and close personal contacts should be treated.&#10;D) Malathion is flammable and she should take care until the solution dries.&#10;

Accepted Answer

The answer of Vanessa has been diagnosed with scabies. Her...

Deck 32: Dermatologic Conditions