Chapter 22 (3)

Question 1

Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive-treatment. Which medication would be the best choice for treatment?

Answer 1

Bacitracin and polymixin B (generic double antibiotic ointment)

Question 2

Juakeem is a nasal methicillin resistant staphylococcus aureus (MRSA) carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes:

Answer 2

Insert one-half of the dose in each nostril twice a day.

Question 3

Instructions for applying a topical antibiotic or antiviral ointment include:

Answer 3

Wash hands before and after application of topical antimicrobials

Question 4

When Sam used clotrimazole (Lotrimin AF) for athlete’s foot he developed a red, itchy rash consistent with a hypersensitivity reaction. He now has athlete’s foot again. What would be a good
choice of antifungal for Sam?

Answer 4

Terbinafine (Lamisil) cream

Question 5

When prescribing griseofulvin (Grifulvin V) to treat tinea capitis it is critical to instruct the patient or parent to:

Answer 5

Griseofulvin is best absorbed if ingested with a high-fat food

Question 6

First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete’s foot) would be:

Answer 6

OTC topical azole (clotrimazole, miconazole)

Question 7

When prescribing topical penciclovir (Denavir) for the treatment of herpes labialis (cold sores) patient education would include:

Answer 7

Penciclovir therapy is started at the first sign of a cold sore outbreak

Question 8

Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck’s Depression Scale
indicates she has mild to moderate depression. What would be the best care for her at this point?

Answer 8

Contact her dermatologist about discontinuing the isotretinoin

Question 9

Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for?

Answer 9

He is at risk for bone injuries and needs to be evaluated for fracture

Question 10

Catherine calls the clinic with concerns that her acne is worse 1 week after starting topical tretinoin. What would be the appropriate care for her?

Answer 10

Reassure her that the worsening of acne is normal and it should improve with continued use

Question 11

Li is a 6-month-old infant with severe eczema. She would benefit from topical corticosteroid therapy. Instructions for using topical corticosteroids in children include:

Answer 11

Apply sparingly to eczema areas

Question 12

Jose has had eczema for many years and reports that he thinks his corticosteroid cream is not working as well as it was previously. He may be experiencing tolerance to the corticosteroid. Treatment options include:

Answer 12

Recommend an interrupted or cyclic schedule of application.

Question 13

When prescribing tacrolimus (Protopic) to treat atopic dermatitis patients should be informed that

Answer 13

The FDA has issued a Black Box warning about the use of tacrolimus and the development of cancer in animals and humans.

Question 14

Patients who are treated with greater than 100 grams per week of topical calcipotriene for psoriasis need to be monitored for:

Answer 14

Hypercalcemia

Question 15

Jesse is prescribed tazarotene for his psoriasis. Patient education regarding topical tazarotene includes instructing them:

Answer 15

That tazarotene is applied in a thin film to the psoriasis plaque lesions

Question 16

Instructions for the use of selenium sulfide shampoo (Selsun) to treat scalp seborrhea include:

Answer 16

Shampoo twice a week for 2 weeks, then weekly

Question 17

Topical diphenhydramine (Benadryl) is available OTC to treat itching. Patients or parents should be instructed regarding the use of topical diphenhydramine that:

Answer 17

Topical diphenhydramine should not be used in children younger than age 2 years.

Question 18

A patient has been prescribed silver sulfadiazine (Silvadene) cream to treat burns on his leg. Normal adverse effects of silver sulfadiazine cream include:

Answer 18

Transient leukopenia on days 2 to 4 that should resolve

Question 19

Instructions for the use of malathion (Ovide) for head lice include:

Answer 19

Rinse the malathion (Ovide) off and shampoo hair after 8 to 12 hours.

Question 20

When writing a prescription of permethrin 5% cream (Elimite) for scabies, patient education would include:

Answer 20

All members of the household and personal contacts should also be treated.