Derm

Question 1

22 yom with a 3-month history of rash on his face. He has tried no treatment. The appearance of the scale bothers him but the rash is otherwise asymptomatic. On exam he has some scaling in his external ear canals and in his eyebrows. What is the most likely diagnosis?
A) Acne
B) Acute malar rash of lupus erythematosus
C) Rosacea
D) Seborrheic dermatitis

What is the most appropriate first-line therapy?
A) Oral antibiotics
B) oral antifungals
C) Topical antibiotics
D) Topical antifungal

Answer 1

D) Seborrheic dermatitis

D) topical antifungal

Question 2

31 yof has a 1-2 year hx of increasing redness on her face. She also reports some “bumps like pimples” that come and go. She tried some OTC acne washes but they “really irritated” her skin. ROS negative. What is the most likely dx?
A) Acute malar rash of lupus erythematosus
B) Acne vulgaris
C) atopic eczema
D) rosacea

Which tx is typically CONTRAINDICATED for this condition?
A) Topical metronidazole cream
B) Topical sulfur lotion
C) Topical triamcinolone cream
D) oral Doxycycline

Answer 2

D) rosacea

C) Topical triamcinolone cream

Question 3

44 yof has had a scaling itchy rash on her eyelids for 2 months.  Hx of eczema as child.  Wears makeup most days and tried to cutback when this rash started but she "needs to war some to cover up the rash.  No other rash.  No meds, OWH. You think she has a form of eczema, an eyelid dermatitis.  What tx for this eyelid rash?
A) Topical clobetasol
B) Topical clotrimazole
C) Topical desonide 
D) Topical nystatin

Answer 3

C) Topical desonide

Question 4

19 yom has treated his acne with oral antibiotics for 3 months, topical retinoids nightly, and topical antibiotics in the morning.  He continues to get new painful nodules on his temples.  What next step in tx?
A) Continue same regimen for 3-6 months
B) Add oral steroid
C) Add topical steroid 
D) refer to derm

Answer 4

D) refer to derm

Question 5

4 month old male infant brought to the derm clinic by his adoptive mother for evaluation of an itchy rash that has been present most of his life. He gets a bath every few days with gentle non-soap cleanser. She applies a generic petrolatum ointment daily.  Which is most likely dx?
A) Atopic dermatitis
B) contact dermatitis 
C) pityriasis alba
D) psoriasis 
E) tinea corporis 

Most appropriate topical steroid to treat?
A) Clobetasol 0.05% ointment 
B) Fluocinonide 0.05% ointment
C) Hydrocortisone 2.5% cream
D) Hydrocortisone 2.5% ointment
E) Triamcinolone 0.1% ointment

Answer 5

A) Atopic dermatitis

erythematous papules, patches and or plaques with overlying scale. Onset MC 3-6 months

D) Hydrocortisone 2.5% ointment

This low potency topical steroid is safe and usually effective for the face. Ointments are preferred vehicles over creams

Question 6

7 yom has a dx of atopic dermatitis. They have been using hydrocortisone 2.5% ointment BID for a few weeks with min improvement. Which of the following is the next step in management?
A) Increase frequency of hydrocortisone 2.5% ointment to TID
B) increase potency o triamcinolone 0.1% oint BID
C) Mix the topical steroid c petrolatum oint
D) Start topical calcineurin inhibitor BID
E) Start topical phosphodiesterase inhibitor BID

Answer 6

B) Increase potency of triamcinolone 0.1% ointment BID

Increasing the potency of this topical steroid will likely be more effective and subsequently shorten the duration of steroid application for the acute flare.

Question 7

Pt c hx of atopic dermatitis has similar lesions on the upper and lower extremities.  Which is the next best step in the evaluation of this pt?
A) apply potent topical steroid
B) apply topical abx
C) obtain a skin bacterial culture
D) Perform a skin Bx

Answer 7

C) Obtain a skin bacterial culture

Obtaining a wound culture for sensitivities is advised when starting systemic abx

Question 8

Parents of patient c atopic dermatitis c lesions on upper and lower extremities are worried that food allergies may be contributing to sons atopic dermatitis and would like guidance regarding which foods to avoid. Which is most accurate regarding the association of food allergy and atopic dermatitis?
A) +allergen test proves that the allergy is clinically relevant
B) Food all is a known trigger in 20-30% of patients with moderate -severe Atopic dermatitis
C) most common cutaneous manifestation of IgE-mediated food allergy is atopic derm
D) Recommend to strictly eliminate any suspected foods from the diet
E) There is no correlation

Answer 8

B) Food allergy is a known trigger in 20-30% of patients with moderate - severe atopic dermatitis

Food allergy is a known trigger in 20-30%of patients c moderate to severe atopic dermatitis

Question 9

This 3 month old infant has an itchy rash on the ankles.  Which is most likely dx?
A) atopic dermatitis 
B) candida intertrigo 
C) impetigo 
D) Psoriasis 
E) Scabies

Answer 9

A) atopic dermatitis

Question 10

A 25 yof presents to you with a rash over her eyelids after using a new cosmetic brand. What is the BEST test to confirm the cause of the rash depicted in the photo?
A) indirect immunofluorescent antibody (IIF) test
B) Patch testing
C) Prick skin testing
D) punch Bx
E) radioallergosorbent Test (RAST)

Answer 10

B) Patch testing

There is a high suspicion for eyelid contact dermatitis. Common causes include fragrances and preservatives in cosmetics. Patch testing would be the best test to confirm the cause of the rash

Question 11

A 30 yof nurse is transferred to new hospital and begins to develop red, painful, chapped hands.  He has been working on a unit with multiple pts on contact precautions, and he has been washing this hands frequently c soap and water.  On exam there are multiple fissures and scaling, but no vesicles are seen.  What is the most likely Dx?
A) allergic contact dermatitis
B) Dyshidrotic dermatitis
C) Irritant contact dermatitis
D) nummular dermatitis 
E) psoriasis

Answer 11

C) irritant contact dermatitis

History and clinical exam are suggestive of an irritant hand dermatitis from repeat exposure to hand washing chemicals

Question 12

A 30 yof is dx c allergic contact dermatitis of the face, likely due to a nickel allergy from the frames of her glasses.  What tx would you recommend other than avoidance of nickel?
A) Clobetasol ointment
B) Desonide cream
C) Fluconazole gel
D) ketoconazole cream
E) triamcinolone ointment

Answer 12

B) Desonide cream

For a limited period and on thinner skin areas such as the face, class VII-VI are preferred

Question 13

You Dx a 25 yo college student with contact dermatitis on the dorsum of the hands.  She continues to have chronic scaly, erythematous, pruritic plaques despite use of Clobetasol ointment twice daily for 1 month.  The most appropriate next step is:
A) Order a RAST test
B) Punch Bx of a plaque
C) recommend increased hand washing
D) refer to derm
E) switch to triamcinolone cream BID

Answer 13

D) Refer to Derm

refer to derm for potential patch testing in cases of contact dermatitis where allegic contact is possible

Question 14

A 78 yo nonatopic woman c a hx o HTN and CAD underwent a dipyridamole stress echo. During this procedure her BP was monitored for 45 min. Two days later and intensely pruritic, sharply demarcated, erythematous vesicular eruption developed on her Rt arm. Which is most likely Dx?
A) Allergic contact dermatitis due to black rubber BP cuff
B) Atypical seborrheic dermatitis triggered by sweating
C) fixed drug eruption from the dipyridamole
D) hospital acquired cellulitis caused by S. aureus
E) irritant contact dermatitis from soaps

Answer 14

A) Allergic contact dermatitis due to bllack rubber BP cuff

The geometric nature of the leasion and

Question 15

You are evaluating a pt c a pruritic eruption on the back. The pt recently had a surgical repair of a compound femur fx and the primary team is worried she has herpes zoster. Which of the following statements is most accurate?
A) This is a acneiform eruption, which will resolve s Tx
B) This is an infection and she should be started on oral acyclovir
C) this is an infestation and hospital infection control should be notified
D) This is a delayed hypersensitivity rxn for which topical steroids can be given

Answer 15

D)delayed hypersensitivity rxn for which topical steroids can be given

Linear erythematous, edematous wheels and plaques suggestive of a Rhues dermatitis, which is a delayed hypersensitivity.

Question 16

What is the appropriate treatment for a fully vaccinated child with a low grade fever and erythematous macules and papules distributed over the face, trunk, arms and legs?  He has received no meds.
A) 
B)
C)
D) Supportive care
E) Triamcinolone cream 0.1%

Answer 16

D) Supportive care

Question 17

What is the appropriate treatment for children presenting with Hand-Foot-Mouth disease?
A) Acyclovir cream 5%
B) Acyclovir by mouth
C) Adapaline cream 0.1%
D) Supportive care
E) Triamcinolone cream 0.1%

Answer 17

D) supportive care

Question 18

While counseling your pts parents, you tell them that Hand-Foot-Mouth disease usually resolves on its own in 
A) 3 days
B) 10 days
C) 3 weeks
D) 1 month
E) 2-3 years

Answer 18

B) 10 days

Question 19

Which statement would you include while counseling a pregnant woman exposed to children c erythema infectiosum?
A) Acyclovir can be taken prophylactically to prevent infection
B) Following infection, the risk of fetal death ranges from 30-40%
C) Infection of the fetus can lead to chronic hemolytic anemia
D) Parvovirus B19 does not pass from mother to fetus
E) There is a small risk of infection and serologic testing is available

Answer 19

E) There is a small risk of infection andserologic testing is available

Question 20

What region is included in the typical distribution of hand-foot-mouth disease?
A) Buttocks
B) Periorbital Skin
C)
D) Trunk
E) Umbilicus

Answer 20

A) Buttocks

Question 21

A 25 yof notes a 2 month hx of itchy, intermittent welts that appear all over her body, with individual lesions lasting less than a day.  She notes that topical hydrocortisone 1% cream does not offer much relief.  What is the best 1st line tx for her condition?
A) Antihisamines
B) ASA
C) corticosteroids
D) Methotrexate
E) NSAIDS

Answer 21

A) antihistamines

Question 22

Which of the following is the cardinal symptom of urticaria?
A) Anesthesia
B) Bullae
C) Paresthesia
D) Pruritus
E) Target lesions

Answer 22

D) Pruritus

Question 23

A 62 yom has been struggling with urticaria for over 3 years.  He has been tested several times for allergies, but all have been negative.  What is the most common cause of urticaria?
A) ASA
B) Food allergies
C) Idiopathic
D) meds
E) preservatives

Answer 23

C) Idiopathic

Question 24

There are several medications used to treat urticaria, including antihistamines. Which of the following is considered the most potent treatment for urticaria?
A) ASA
B) 1st Gen H1 antihistamines
C) H2 antihistamines
D) 2nd Gen H1 antihistamines
E) Topical corticosteroids

Answer 24

B) 1st Gen H1 antihistamines

Question 25

A 9 yom ate ice cream topped c peanuts and began to develop erythematous wheals on the lips, face, and trunk. He had slight wheezing during the episode, but was not taken to the hospital and felt better w/in an hr. The family present for tx options several weeks later. Which is recommended?
A) 2nd gen antihistamine taken in the evening
B) applying topical corticosteroid during the day
C) avoiding spicy foods
D) Epi pen c sufficient instruction on how and when to use it
E) Methotrexate injection weekly

Answer 25

D) Epi pen with sufficient instruction on how and when to use it

Question 26

A 23 yof has had chronic urticaria for 2 years and is frustrated. She denies difficulty breathing, throat tightness, GI symptoms. She has tried several 2nd gen antihistamines c only partial relief. She is concerned about sedation during the day. Which would help her?
A) 1st gen antihistamine taken in the evening
B) Applying topical corticosteroid during the day
C) avoiding spicy food
D) Epi pen c sufficient instruction on how and when to use it
E) Methotrexate injection weekly

Answer 26

A)

Question 27

A 68 yo italian male comes to your clinic for evaluation of HTN and high cholesterol. He asks you in passing acout some dryness and mild itching on both feet for several years that has not improved c OTC hydrocortisone 1% cream and moisturizers. What is the next step in determining the Dx?
A) Patch testing for allergic contact dermatitis
B) Potassium hydroxide test
C) Biopsy to rule out skin cancer
D) Bacterial swab culture

Answer 27

B) Potassium hydroxide test

Question 28

A 26 yo Lebanese male presents with two years of white spots on his neck, upper chest, and back, that are more noticeable in the spring and summer months and get better in winter.  You perform a KOH exam.  What treatment would you recommend?
A) Desonide cream
B) Pimecrolimus cream
C) Oral prednisone
D) Selenium sulfide wash
E) Ultraviolet light therapy

Answer 28

D) Selenium sulfide wash

Question 29

30 yo asian indian female who presents c several months of worsening pruritic dry scaly skin btw the toes and over the lateral aspects of her right foot. More recently she developed blisters on the plantar aspect of the foot beneath the toes that opened and started peeling. She does not report any skin changes on her foot or anywhere else on her body. She did not have any change in her shoes or skin care regimen. Which diagnosis is mot likely?
A) Contact dermatitis (eczema)
B) Dyshidrotic eczema
C) Friction blisters
D) Psoriasis 
E) Tinea pedis

Answer 29

E) Tinea Pedis

Question 30

A potassium hydroxide test is performed and you see the following through the microscope. What are the findings?
A) Budding yeast forms, no hyphae
B) Mites, eggs, and scybala
C) Multinucleated giant cells
D) Normal keratinocytes (skin cells) only
E) Septate branching hyphae

Answer 30

E) Septate branching hyphae

Question 31

This 54 yo white male presents with several years of erythema and greasy scale on his central face, including the glabella, eyebrows, and nasolabial folds. The most appropriate next step:
A) Avoidance of spicy foods, alcohol, or hot liquids
B) Clobetasol cream twice daily
C) Ketoconazole cream once to twice daily
D) Moisturized 2-3 times daily
E) topical retinoid cream

Answer 31

C) Ketoconazole cream once to twice daily

Question 32

28 yo white female developed an itchy rash on her wrist about 2 months ago. She used clotrimazole cream daily for 2 weeks w/o much help. She was prescribed topical triamcinolone which decreased the redness and itching, but now the rash is expanding after 3 weeks of tx. A KOH exam was floridly positive. What is the next appropriate tx?
A) Naftifine cream or gel twice daily for 4 weeks
B) Nystatin cream or ointment twice daily for 6 weeks
C) Oral ketoconazole 400mg daily for 5 days
D) Oral terbinafine 250 mg for 4 weeks
E) selenium sulfide shampoo for 2 weeks then 2-3 times a week

Answer 32

D) Oral terbinafine 250 mg for 4 weeks

Question 33

32 yo black male complains of 5 years of progressive thickening and discoloration of his first toenails and he is worried it is spreading to other toes. Which of the follwing do you recommend first?
A) Zciclopirox nail lacquer twice daily
B) Empirically begin oral fluconazole 150mg weekly
C) Empirically begin oral ketoconazole
D) Empirically begin oral terbinafine 250mg Daily
E) perform fungal culture or KOH to confirm diagnosis

Answer 33

E) Perform fungal culture or KOH to confirm diagnosis

Question 34

For a patient with seborrheic dermatitis of the scalp, what advice would you give with regard to using anti-dandruff shampoos?
A) allow them to sit on the scalp overnight then rinse out in the morning
B) Avoid using any topical steroids on the scalp if you are using antidandruff shampoos
C) Leave them in for at least 3-5 minutes before rinsing out
D) They should be applied to a dry scalp
E) you should avoid conditioner after using them

Answer 34

C) Leave them in for at least 3-5 minutes before rinsing out

Question 35

48 yo white female complains of redness under both her breasts for the past 7 months. It is mildly itchy and did not get better after her husband suggested she use athlete’s foot cream on it. What do you tell her?
A) Air dry the area after showers and consider repeating this once more during the day
B) Biopsy is usually recommended to rule out other conditions
C) It is important to keep the area hydrated c creams or lotions
D) If this were caused by yeast, OTC athletes foot creams like miconazole would not help
E) The majority of these cases are caused by Candida yeast

Answer 35

A) Air dry the area after showers and consider repeating this once more during the day

Question 36

What clinical finding in intertrigo suggests it may be caused by Candida yeast?
A) A yellowish transudate over symmetric erythematous patches
B) Annular scaling patches with central clearing
C) Lichenified erythematous plaques with hyperpigmentation
D) Satellite macules, papules, or pustules
E) Ulceration in the center of the intertriginous folds

Answer 36

D) Satellite macules, papules, or pustules

Question 37

A 5 yof developed a rash on her hand that was itchy. She was treated by her pediatrician c a topical steroid and it initially improved, but then worsened and became bullous (developed blisters). A course of oral abx was not helpful. What is the most likely dx?
A) Atopic dermatitis 
B) Bullous impetigo
C) Dyshidrotic eczema
D) Tinea of the hand (manuum)
E) Tinea versicolor

Answer 37

D) Tinea of the hand (manuum)

Question 38

A 12 yom developed scaly, dar patches on the upper chest. They were not symptomatic. What is the most likely Dx?
A) Atopic dermatitis 
B) Bullous impetigo
C) Dyshidrotic eczema
D) Tinea cruris
E) Tinea versicolor

Answer 38

E) Tinea versicolor

Question 39

A 9 yof presents c an annular plaque on the arm with peripheral scale. Topical nystatin ointment is prescribed and 2 weeks later the rash is unchanged. What is the next best step?
A) Prescribe an appropriate antifungal c efficacy against dermatophytes such as an imidazole
B) Prescribe an oral antibiotic
C) Recommend dilute bleach baths
D) Prescribe a potent topical corticosteroid
E) Recommend a longer course of nystatin

Answer 39

A) Prescribe an appropriate antifungal with efficacy against dermatophytes such as an imidazole

Question 40

An 11 yom presents c several patches of hair loss on the scalp. There are “black dots” w/in (broken hairs), scaling and occipital lymphadenopathy. After a dx test is performed, what is the next best step in management?
A) Prescribe a topical antifungal shampoo such as ketoconazole
B) Prescribe an oral antibiotic
C) Prescribe an oral antifungal agent such as griseofulvin as well as an antifungal shampoo
D) Prescribe a potent topical corticosteroid
E) Prescribe nystatin ointment

Answer 40

C) Prescribe an oral antifungal agent such as griseofulvin as well as an antifungal shampoo

Question 41

A 7 yof presents c a painful, boggy mass on the scalp c purulent exudate and broken hairs. A bacterial culture was negative. What is the next best step?
A) Prescribe a topical antifungal shampoo such as ketoconazole
B) Prescribe an oral antibiotic
C) Refer to a derm immediately for evaluation and management
D) Prescribe a potent topical corticosteroid
E) Prescribe nystatin ointment

Answer 41

C) Refer to derm

Question 42

A 4 month female presents c beefy red plaques in the groin area with satellite pustules for 1 week. She cries c diaper changes and has not improved c good barrier creams such as zinc oxide paste. What is the best next step?
A) Prescribe a topical antifungal agent such as nystatin or an imidazole
B) prescribe an oral antibiotic
C) Prescribe a combination therapy c high potency topical steroid plus an antifungal agent
D) prescribe a potent topical corticosteroid
E) Prescribe a topical antibacterial agent such as mupirocin

Answer 42

A) Prescribe a topical antifungal agent such as nystatin or an imidazole

Question 43

The patient has dermatomal grouping of vesicles on an erythematous base, on his truck. What is the most like dx?
A) Allergic contact dermatitis
B) Fixed drug eruption
C) Atopic dermatitis 
D) Herpes simplex type 2
E) Herpes zoster

Answer 43

E) Herpes zoster

Question 44

50 yof presents to you c blisters on her abd. Which of the following is best description of these lesions?
A) Linear erythematous papules
B) Dermal nodules
C) Grouped vesicles on an erythematous base
D) Erythematous, scaly plaques
E) Erythematous patches

Answer 44

C) Grouped vesicles on an erythematous base

Question 45

You dx a 17 yof c genital herpes simplex. She has no health insurance. Which of the following would you prescribe?
A) Oral acyclovir 
B) Oral cephalexin
C) oral fluconazole
D) Oral gancyclovir 
E) Oral valacyclovir

Answer 45

A) oral acyclovir

Question 46

40 yom comes to you with this finding on the bottom of his left foot. He has no other skin changes elsewhere. He volunteers that it appeared today after he worse a new pair of boots to his construction job and they felt like they were "rubbing". He took some naproxen this eveing because of the pain but takes no other medications. What is the most likely dx.
A) Allergic contact dermatitis 
B) Bullous impetigo
C) Erythema multiforme
D) Fixed drug eruption
E) Friction blister

Answer 46

E) friction blister

Question 47

A 30 yof presents to you with this finding. You perform a complete skin exam and find that she has similar findings on the other arm but no other skin changes. SHe reports that they are itchy but that she afraid to scratch them so she put bandaids over them to protect them. She otherwise feels well and reports that she recently had a conference and stayed in a hotel. What is the most likely dx?
A) Allergic contact dermatitis 
B) Bullous insect bites
C) cellulitis 
D) Herpes zoster
E) Pemphigus vulgaris

Answer 47

B) bullous insect bites

Question 48

7 yom is brought into the office by his mother for this rash on his cheek. He has no other rash elsewhere. He says it is more painful than itchy. He has never had anything like it before. He feels well otherwise. What is the most likely dx?
A) Acne
B) Allergic contact dermatitis 
C) Erythema multiforme
D) Herpes simplex
E) Varicella zoster

Answer 48

D) Herpes simplex

Question 49

This 66 yof presents c this itchy and painful rash. It began on her neck and spread around her trunk. She also had some “soreness in her mouth about that time too”. She has taken hydrochlorothiazide and simvastatin for over 7 years. She has not treated this rash in any way. What is the most appropriate next step?
A) Apply nystatin ointment to affected areas
B) CT scan and lumbar puncture
C) Order silvadene cream to apply twice daily
D) Urgent dermatology consultation
E) Urgent surgical consultation for debridement

Answer 49

D) urgent dermatology sonsultation

Question 50

This 5 yof is brought into the urgent clinic by her parents for this rash. It started 1 day ago and began on her face and trunk. The girl wouldn't eat b/c her mouth was sore and now she is hot and lethargic. She normally doesn't take medicine, but her parents say she has been taking "an abx" for the past 3 days. What is the most likely dx for this pt?
A) Atopic eczema
B) Bullous impetigo 
C) Pemphigus vulgaris
D) Stevens Johnson Syndrome
E) Urticaria

Answer 50

D) Stevens Johnson Syndrome

Question 51

A 20 yom presents to clinic c a rash on the scalp, extensor elbows, knees, and umbilicus. You note sharply demarcated erythematous plaques c silvery scale in those locations; there is no central clearing. The soles of the feet are normal. What is most likely Dx.
A) Allergic contact dermatitis 
B) Atopic dermatitis 
C) Psoriasis 
D) Secondary syphilis 
E) Seborrheic dermatitis

Answer 51

C) Psoriasis

Question 52

A 22 yof was referred to the dermatology clinic for a presumed dx of psoriasis. Her rash is limited to the area in the picture shown. Which of the following tx would you recommend this pt?
A) Calcineuin inhibitors
B) Moderate potency topical steroid (e.g. fluocinonide ointment
C) Methotrexate
D) Tumor necrosis factor inhibitor (e.g adalimumab)
E) Ultraviolet light therapy

Answer 52

B) Moderate potency topical steroid (e.g. fluocononide ointment)

Question 53

A 34 yof presents to the dermatology clinic c plaque psoriasis well controlled c topical steroids. Which of the following conditions do you think you might find when you perform a total body exam?
A) Eyelid dermatitis 
B) Multiple vesicles and pustules
C) Non-melanoma skin cancer
D) Subcutaneous nodules
E) Swelling of the PIP and DIP joints

Answer 53

E) Swelling of the PIP and DIP joints

Question 54

A 14 yom presents to his pediatrician c a 3 year hx of well controlled psoriasis primarily located on the elbows, knees and scalp. His current skin regimen includes high potency topical steroids and vit D analogues. Recently, the psoriasis has spread to involve more than 15% of this body surface area and the topical treatments are not working. He is embarrassed to participate in gym class b/c of his appearance. What is the next step?
A) add an abx for superinfection
B) increase the frequency of application of the topical medications to 3 times daily
C) refer him to a dermatologist for consideration of systemic tx
D) Start him on oral prednisone
E) tell him there is nothing more than can be done for his disease

Answer 54

C) Refer him to a dermatologist for consideration of systemic tx

Question 55

A 6 yof presents c a new sudden-onset of 3-6mm round scaly pink flat psoriatic papules distributed symmetrically over her body. Which of the following is most likely underlying etiology?
A) Excessive sun exposure
B) Exposure to new shampoo
C) Ingestion of shitake mushroom
D) Recent oral abx use
E) Steptococcal pharyngitis

Answer 55

E) Streptococcal pharyngitis

Question 56

A 30 yom presents to clinic c 60% body surface area involved c psoriasis. He has no joint discomfort. He has not followed by a primary care doctor and has no known medical problems. On clinical exam he is noted to be obese. In addition to discussing management of his skin condition, his derm suggests he establish c a primary care provider because psoriasis is associated c a increased risk of which the following?
A) Cardiovascular disease
B) Gastric CA
C) Hepatitis B
D) Pneumothorax
E) Spinal stenosis

Answer 56

A) Cardiovascular disease

Question 57

22 yom c a 3 month hx of a rash on his face. He has tried no tx. The appearance of the scale bothers him but the rash is otherwise asymptomatic. On exam he has some scaling in his external ear canals and in his eyebrows. What is the most likely dx?
A) Acne
B) Acute malar rash of lupus erythematosus
C) Rosacea
D) Seborrheic dermatitis

Most appropriate first line therapy?

Answer 57

D) Seborrheic dermatitis

Topical antifungal

Question 58

This 31 yof has a 1-2 year hx of increasing redness on his face. She also reports some “bumps like pimples” that come and go. She tried some OTC acne washes but they “really irritated” her skin. She is
A) Acute malar rash of lupus erythematosus
B) Acne vulgaris
C) Atopic eczema
D) Rosacea

Which tx is typically contraindicated?
A) Topical metronidazole cream
B) Topical sulfur lotion 
C) Topical triamcidolone cream
D) Oral doxy

Answer 58

D) Rosacea

C) Topical triamcinolone cream

Question 59

A 44 yof has had a scaling itchy rash on her eyelids for 2 months. She has a hx of eczema as a child. She wears make-up most days and tried to cut back when this rash started but she "Needs to wear some to cover up the rash when she "goes out". She has no other areas of rash. She is otherwise healthy and takes no meds. You think she has a form of eczema, an eyelid dermatitis. What is the appropriate tx for this pts eyelid rash?
A) Topical clobetasol
B) Topical clotrimazole
C) topical desonide
D) Topical nystatin

Answer 59

C) Topical desonide

Question 60

19 yom has treated his acne c oral abx for 3 months, topical retinoids nightly, and topical abx in the morning. He continues to get new painful nodules on his temples. What is the most appropriate tx?
A) Continue same regimen for another 3-6 months
B) Add oral steroid
C) Add topical steroid
D) Refer to derm

Answer 60

D) refer to derm