chap 32: Dermatological Conditions

Question 1

1.When choosing a topical corticosteroid cream to treat diaper dermatitis, the ideal medicationwould be:

1. Intermediate potency corticosteroid ointment (Kenalog)
2. A combination of a corticosteroid and an antifungal (Lotrisone)
3. A low-potency corticosteroid cream applied sparingly (hydrocortisone 1%)
4. A high-potency corticosteroid cream (Diprolene AF)

Answer 1

3.A low-potency corticosteroid cream applied sparingly (hydrocortisone 1%)

Question 2

2.Topical immunomodulators such as pimecrolimus (Elidel) or tacrolimus (Protopic) are used for:

1. Short-term or intermittent treatment of atopic dermatitis
2. Topical treatment of fungal infections (Candida)
3. Chronic, inflammatory seborrheic dermatitis
4. Recalcitrant nodular acne

Answer 2

1.Short-term or intermittent treatment of atopic dermatitis

Question 3

3.Long-term treatment of moderate atopic dermatitis includes:

1. Topical corticosteroids and emollients
2. Topical corticosteroids alone
3. Topical antipruritics
4. Oral corticosteroids for exacerbations of atopic dermatitis

Answer 3

1.Topical corticosteroids and emollients

Question 4

4.Severe contact dermatitis caused by poison ivy or poison oak exposure often requires treatment with:

1. Topical antipruritics
2. Oral corticosteroids for 2 to 3 weeks
3. Thickly applied topical intermediate-dose corticosteroids
4. Isolation of the patient to prevent spread of the dermatitis

Answer 4

2.Oral corticosteroids for 2 to 3 weeks

Question 5

5.When a patient has contact dermatitis, wet dressings with Domeboro solution are used for:

1. Cleaning the weeping area of dermatitis
2. Bathing the patient to prevent infection
3. Relief of inflammation
4. Providing a barrier layer to protect the surrounding skin

Answer 5

3.Relief of inflammation

Question 6

6.Appropriate initial treatment for psoriasis would be:

1. An immunomodulator (Protopic or Elidel)
2. Wet soaks with Burrow’s or Domeboro solution
3. Intermittent therapy with intermediate potency topical corticosteroids
4. Anthralin (Drithocreme)

Answer 6

3.Intermittent therapy with intermediate potency topical corticosteroids

Question 7

7.Patient education when prescribing the vitamin D3 derivative calcipotriene for psoriasis includes:

1. Apply thickly to affected psoriatic areas two to three times a day.
2. A maximum of 100 grams per week may be applied.
3. Do not use calcipotriene in combination with their topical corticosteroids.
4. Calcipotriene may be augmented with the use of coal tar products.

Answer 7

2.A maximum of 100 grams per week may be applied.

Question 8

8.Mild acne may be initially treated with:

1. Topical combined antibiotic
2. Minocycline
3. Topical retinoid
4. OTC benzoyl peroxide

Answer 8

4. OTC benzoyl peroxide

Question 9

9. 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:
10. He should see an improvement in his acne within the first 2 weeks of treatment.
11. If there is no response in a week, double the daily application of adapalene (Differin).
12. He may see an initial worsening of his acne that will improve in 6 to 8 weeks.
13. Adapalene may cause bleaching of clothing.

Answer 9

3. He may see an initial worsening of his acne that will improve in 6 to 8 weeks.

Question 10

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

Answer 10

4. Refer her to a dermatologist for treatment.

Question 11

11. The most cost-effective treatment for two or three impetigo lesions on the face is:
12. Mupirocin ointment
13. Retapamulin (Altabax) ointment
14. Topical clindamycin solution
15. Oral amoxicillin/clavulanate (Augmentin)

Answer 11

1. Mupirocin ointment

Question 12

12. Dwayne has classic tinea capitis. Treatment for tinea on the scalp is:
13. Miconazole cream rubbed in well for 4 weeks
14. Oral griseofulvin for 6 to 8 weeks
15. Ketoconazole shampoo daily for 6 weeks
16. Ciclopirox cream daily for 4 weeks

Answer 12

2. Oral griseofulvin for 6 to 8 weeks

Question 13

13. Nicolas is a football player who presents to the clinic with athlete’s foot. Patients with tinea pedis
    may be treated with:
14. OTC miconazole cream for 4 weeks
15. Oral ketoconazole for 6 weeks
16. Mupirocin ointment for 2 weeks
17. Nystatin cream for 2 weeks

Answer 13

1. OTC miconazole cream for 4 weeks

Question 14

14. Jim presents with fungal infection of two of his toenails (onychomycosis). Treatment for fungal infections of the nail includes:
15. Miconazole cream
16. Ketoconazole cream
17. Oral griseofulvin
18. Mupirocin cream

Answer 14

3. Oral griseofulvin

Question 15

15. Scabies treatment for a 4-year-old child includes a prescription for:

Answer 15

1. Permethrin 5% cream applied from the neck down
2. Pyrethrin lotion
3. Lindane 1% shampoo
4. All of the above

Question 16

16. Vanessa has been diagnosed with scabies. Her education would include:
17. She should apply the scabies treatment cream for an hour and wash it off.
18. Scabies may need to be retreated in a week after initial treatment.
19. All members of the household and close personal contacts should be treated.
20. Malathion is flammable and she should take care until the solution dries.

Answer 16

1. She should apply the scabies treatment cream for an hour and wash it off.

Question 17

17. 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:
18. Permethrin 1% (Nix)
19. Lindane shampoo
20. Malathion (Ovide)
21. Benzoyl alcohol (Ulesfia)

Answer 17

4. Benzoyl alcohol (Ulesfia)

Question 18

18. 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:
19. Provides a permanent solution to male pattern baldness if used for at least 4 months
20. Will show results after 4 months of twice-a-day use
21. May not work for Rick’s type of baldness
22. Works better if he also uses hydrocortisone cream daily on his scalp

Answer 18

2. Will show results after 4 months of twice-a-day use