Deck 47: Infections and Infestations

Question 1

When recommending ongoing treatment for a patient who has recurrent intertrigo, what will the provider suggest? (Select all that apply.)

A) Aluminum sulfate solution
B) Burrow's solution compresses
C) Cornstarch application
D) Nystatin cream
E) Topical steroid cream

Answer 1

A, B

Question 2

When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a Wood's lamp and is unable to elicit fluorescence. What is the significance of this finding?

A) The patient does not have tinea capitis.
B) The patient is less likely to have tinea capitis.
C) The patient is positive for tinea capitis.
D) The patient may have tinea capitis.

Answer 2

D

Question 3

A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?

A) Amoxicillin-clavulanate
B) Clindamycin
C) Doxycycline
D) Sulfamethoxazole-trimethoprim

Answer 3

A

Question 4

A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order?

A) Polymerase chain reaction analysis
B) Serum immunoglobulins
C) Tzanck test
D) Viral culture

Question 5

A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient?

A) Apply moist heat until symptoms resolve.
B) Begin treatment with amoxicillin-clavulanate.
C) Prescribe trimethoprim-sulfamethoxazole.
D) Wait for culture results before ordering an antibiotic.

Question 6

A patient has a pruritic eczematous dermatitis which has been present for 1 week and reports similar symptoms in other family members. What will the practitioner look for to help determine a diagnosis of scabies?

A) Bullous lesions on the soles of the feet and palms of the hands
B) Intraepidermal burrows on the interdigital spaces of the hands
C) Nits and small bugs along the scalp line at the back of the neck
D) Pustular lesions in clusters on the trunk and extremities

Question 7

A patient has vesiculopustular lesions around the nose and mouth with areas of honey-colored crusts. The provider notes a few similar lesions on the patient's hands and legs. Which treatment is appropriate for this patient?

A) Mupirocin, 2% ointment
B) Culture and sensitivity of the lesions
C) Sulfamethoxazole-trimethoprim
D) Surgical referral

Question 8

A patient who has had lesions for several days is diagnosed with primary herpes labialis and asks about using a topical medication. What will the provider tell this patient?

A) Oral antivirals are necessary to treat this type of herpes.
B) Preparations containing salicylic acid are most helpful.
C) Topical medications can have an impact on pain and discomfort.
D) Topical medications will significantly shorten the healing time.

Question 9

An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella. What will the provider tell her?

A) An antiviral medication will prevent transmission to others.
B) As long as her lesions are covered, there is no risk of transmission.
C) Contagion is possible until all her lesions are crusted.
D) Varicella-zoster and herpes zoster are different infections.

Question 10

A patient who has never had an outbreak of oral lesions reports a burning sensation on the oral mucosa and then develops multiple painful round vesicles at the site. A Tzanck culture confirms HSV-1 infection. What will the provider tell the patient about this condition?

A) Antiviral medications are curative for oral herpes.
B) The initial episode is usually the most severe.
C) There are no specific triggers for this type of herpesvirus.
D) Transmission to others occurs only when lesions are present.

Question 11

A patient who has recurrent, frequent genital herpes outbreaks asks about therapy to minimize the episodes. What will the provider recommend as first-line treatment?

A) Acyclovir
B) Famciclovir
C) Topical medications
D) Valacyclovir

Question 12

What instructions will the primary care provider give to parents of a child who has scabies who is ordered to use 5% permethrin cream? (Select all that apply.)

A) Apply the cream at bedtime and rinse it off in the morning.
B) It is not necessary to wash bedding or clothing when using this cream.
C) Massage the cream into the skin from head to toe.
D) The rash should disappear within a day or two after using the cream.
E) Use once now and repeat the treatment in 1 to 2 weeks.

Question 13

A patient with intertrigo shows no improvement and persistent redness after treatment with drying agents and antifungal medications. The patient reports an onset of odor associated with a low-grade fever. What will the provider do next to manage this condition?

A) Culture the lesions to determine the cause.
B) Evaluate the patient for HIV infection.
C) Order topical nystatin cream.
D) Prescribe a cephalosporin antibiotic.

Question 14

The provider is prescribing 5% permethrin cream for an adolescent patient who has scabies. What will the provider include in education for this patient?

A) All household contacts will be treated only if symptomatic.
B) Itching 2 weeks after treatment indicates treatment failure.
C) Stuffed animals and pillows should be placed in plastic bags for 1 week.
D) The adolescent's school friends should be treated.

Question 15

Although some fungal species causing tinea capitis are fluorescent with a Wood's lamp, Trichophyton tonsurans, the most common cause or tinea capitis, does not, so lack of fluorescence does not rule out the infection, make it less likely, or diagnose it. Which medication will the provider prescribe as first-line therapy to treat tinea capitis?

A) Oral griseofulvin
B) Oral ketoconazole
C) Topical clotrimazole
D) Topical tolnaftate