DERM

Question 1

A.J went to a birthday party 2 days ago and was informed by a parent that her child K.A has broken out with chicken pox today. Was A.J exposed?
When can K.A go back to school? When did K.A become contagious?

Answer 1

Yes A.J was exposed, K.A is contagious 48 hours before onset of rash. K.A can go back to school 48 hours after last vesicle dries up.

Question 2

what do you use to treat tinea versicolor?

Answer 2

selenium sulfide shampoo

Question 3

what do you use to treat tinea corporis?

Answer 3

topical antifungal (ketoconazole, miconazole)

Question 4

pt S.O presents with atopic dermatitis you know to expect that what levels will be elevated?
IgG
IgM
IgE

Answer 4

IgE- eosinophils

Question 5

A pt has sharply defined plaques to elbows and knees with silvery scales with + Auspitz sign what is your diagnosis?

what is your tx?

Answer 5

Psoriasis

topical steroids for 2-3 weeks, triamcinolone acetonide, betamethasone dipropionate, moisturizer

(auspitz sign is droplets of blood when scales are removed, dumb but sometimes on tests)

Question 6

macular oval lesion with crinkled appearance and christmas tree distribution, herald patch present to back what is your diagnosis and tx?

Answer 6

pityriasis rosea, usually NO tx but can do antihistamine, topical steroids, oral steroids

not typical but can do oral erythromycin (this dries up the rash) if rash needs to be gone quickly.

Question 7

Group A strep, common in children 5-15 years, sandpaper rash, what is your diagnosis and tx?

Answer 7

scarlet fever

amox for 10-15 days (cephalosporin for PCN allergy)

Question 8

Honey crusted lesions usuall caused by what bacteria? what is the diagnosis?

what is tx for systemic?

Answer 8

staph aureus
mupirocin

augmentin, Keflex, erythromycin,

Question 9

how long should kids be kept out of school when they have impetigo?

Answer 9

48 hours after begining abx

Question 10

linear/ snake like/ burrowing lesions, to neck, palms, interdigital. What is your diagnosis and tx?

Answer 10

Scabies

permethrin or ivermectin (no ivermectin for pregnant women or kids under 15kg)

Question 11

which rashes are dangerous for pregnant mothers?

Answer 11

rubella (risk for PDA)

Fifths (risk for spontaneous abortion)

Question 12

which disease affects the salivary glands, is highly contagious and can cause swelling under the jaw line?

Answer 12

mumps

Question 13

a patient presents with bells palsy what disease would the PNP want to r/o to ensure bells palsy isnt a secondary symptom?

Answer 13

lyme disease

Question 14

for lyme disease what is the treatment for a child under 7 years? over 7 years?

Answer 14

[For Test purposes]

Under 7= amoxicillin or cefuroxime
Over 7= doxycycline

(however according to AAP and CDC doxycycline can be used for short durations (ie, 21 days or less) without regard to patient age)

Question 15

E.C has been diagnosed with fifths disease when can she return to school?
A) 24 hours after fever breaks
B) Once her rash appears
C) 48 hours after fever breaks
D) once her rash resolves

Answer 15

C) 48 hours after fever breaks (according to barkley)

rash can take days to weeks to disappear.

(according to orange book the old silbert flagg, after rash appears pt is no longer contagious) something to note also…

(After you get the rash you are not likely to be contagious, so it is usually safe for you or your child to go back to work or school. CDC)