Pharm Practice Quizzes Flashcards by Lyndsey Maves

If the use of topical steroids in warranted for the treatment of a diaper rash, which of the following is the most appropriate therapeutic option?

A. Triamcinolone ointment 0.025%
B. Hydrocortisone cream 0.25%
C. Fluocinolone cream 0.025%
D. Fluocinonide ointment 0.05%

B. Hydrocortisone cream 0.25%

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The preferred treatment option for an infant with mild diaper dermatitis is:

A. Hydrocortisone cream
B. Nystatin ointment
C. Clotrimazole cream
D. Zinc oxide paste

D. Zinc oxide paste

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Which of the following symptoms of diaper rash should be referred to a physician for further diagnosis and treatment?

A. Red rash with a well-defined boundary
B. Rash that is not responsive to 7 days of OTC treatment
C. Rash contained within the general diaper region
D. None of these symptoms necessitate referral to a physician

B. Rash that is not responsive to 7 days of OTC treatment

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Which pathogen is most likely responsible for the development of fungal infections in diaper dermatitis?

A. S. aureus
B. Candida albicans
C. P. acnes
D. None of the above

B. Candida albicans

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A _______________________ is a lesion that is greater than 0.5cm in both width and depth.

A. Closed comedo
B. Cyst
C. Nodule
D. Papule

C. Nodule

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_______________ is a sulfone drug that has antimicrobial and anti-inflammatory properties and is used in the treatment of mild to moderate acne.

A. Sulfamethoxazole
B. Resorcinol
C. Dapsone
D. Sulfur

C. Dapsone

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Dispensing a prescription for isotretinoin requires participation in an online registration program because of which of the following adverse effects?

A. Increases in creatine phosphokinase
B. Increases in blood glucose
C. Teratogenicity
D. Photosensitivity

C. Teratogenicity

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Which of the following agents can cause allergic contact dermatitis?

A. Solvents
B. Mild acids
C. Cigarette smoke
D. Soaps

C. Cigarette smoke

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Symptoms of irritant contact dermatitis occur within several ___________ of exposure.

A. Seconds to minutes
B. Minutes to hours
C. Hours to days
D. Days to weeks

B. Minutes to hours

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What is the initial treatment goal for contact dermatitis?

A. Symptom relief
B. Eliminating exposure of causative substance
C. Identifying the causative substance
D. B and C

D. B and C

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Which of the following is/are pharmacologic therapy options for the treatment of contact dermatitis?

A. Astringents
B. Topical steroids
C. Antihistamines
D. All of the above

D. All of the above

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Which of the following symptoms of contact dermatitis can be treated with a topical steroid?

A. Erythema
B. Itching
C. Inflammation
D. All of the above

D. All of the above

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A patient with contact dermatitis should return to their healthcare provider if which of the following occur:

A. Rash has not improved or has worsened after several days of treatment
B. Rash has increased in size or has spread to other locations
C. Patient is experiencing adverse effects from the treatment regimen
D. All of the above

D. All of the above

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Which of the following statements is true?

A. Irritant contact dermatitis occurs from direct injury to the skin.
B. Symptoms of allergic contact dermatitis may take minutes to hours to develop.
C. Allergic contact dermatitis is not the result of an immunologic process.
D. High-potency topical steroids should be used on the axillae and groin areas.

A. Irritant contact dermatitis occurs from direct injury to the skin.

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Diaper rashes lasting longer than \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ are at increased risk for the development of fungal infections.
A)	12 to 24 hours
B)	24 to 48 hours
C)	48 to 72 hours
D)	5 to 7 days

C) 48 to 72 hours

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Which pathogen is most likely responsible for the development of secondary bacterial infections in diaper dermatitis?
	A)	Aspergillus
	B)	Streptococci
	C)	Streptococcus aureus
	D)	A and B
	E)	B and C

E) B and C

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A \_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ is a plugged follicle of sebum, keratinocytes and bacteria that remains beneath the surface of the skin.
	A)	Open comedo
	B)	Papule
	C)	Closed comedo
	D)	Pustule

C) Closed comedo

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Benzoyl peroxide is effective in the treatment of mild to moderate acne because of its:
A) Comedolytic effect
B) Ability to decrease the rate of cell turnover
C) Antibacterial activity
D) A and B
E) A and C

E) A and C

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Topical retinoids are indicated for which of the following types of acne:
A) Mild to moderate noninflammatory acne
B) Mild to moderate comedonal and inflammatory acne
C) Moderate to severe nodulocystic acne
D) All of the above

B) Mild to moderate comedonal and inflammatory acne

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Agents that cause allergic contact dermatitis include all of the following except:
	A)	Soaps
	B)	Poison ivy
	C)	Latex
	D)	Local anesthetics

A) Soaps

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Which of the following is an example of an astringent used in the treatment of contact dermatitis?
	A)	Colloidal oatmeal baths
	B)	Aluminum acetate
	C)	Diphenhydramine
	D)	Hydroxyzine

B) Aluminum acetate

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Which of the following statements is true?
A) Irritant contact dermatitis is the result of an immunologic process
B) Symptoms of allergic contact dermatitis may take several hours to several days to develop
C) Symptoms of irritant contact dermatitis occur within days of exposure
D) Allergic contact dermatitis is an immediate hypersensitivity reaction

B) Symptoms of allergic contact dermatitis may take several hours to several days to develop

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All the following types of lesions are found in mild acne except?
	A)	Closed comedone
	B)	Open comedone
	C)	Nodule
	D)	Papule
	E)	Pustule

C) Nodule

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Which topical agent is known to cause bleaching/discoloration to some fabrics?
	A)	Adapalene
	B)	Tretinoin
	C)	Tazarotene
	D)	Benzoyl peroxide
	E)	Erythromycin

D) Benzoyl peroxide

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``` Which topical agent is also useful in treating postinflammatory hyperpigmentation? A) Azelaic acid B) Benzoyl peroxide C) Tazarotene D) Erythromycin E) Adapalene ```

A) Azelaic acid

``` Which topical agent is associated with pseudomembranous colitis? A) Erythromycin B) Clindamycin C) Dapsone D) Benzoyl peroxide E) Adapalene ```

B) Clindamycin

``` When a systemic antibiotic is needed for gestational acne, which one is safest? A) Erythromycin B) Trimethoprim-sulfamethoxazole C) Tetracycline D) Minocycline E) Doxycycline ```

A) Erythromycin

``` Which antibiotic is associated with discoloration of the skin? A) Tetracycline B) Erythromycin C) Minocycline D) Doxycycline E) Azithromycin ```

C) Minocycline

``` Which of the following drugs is associated with elevated creatine phosphokinase? A) Erythromycin B) Dapsone C) Isotretinoin D) Oral contraceptives E) Tetracycline ```

C) Isotretinoin

Which of the following is a contraindication or relative contraindication for the use of oral isotretinoin? A) Female who is pregnant or may become pregnant B) Hyperlipidemia C) Diabetes mellitus D) Severe osteoporosis E) All of the above

E) All of the above

``` Which of the following is associated with tooth discoloration, skeletal growth disturbances, and phototoxic effects? A) Erythromycin B) Tetracycline C) Azithromycin D) Clindamycin E) Trimethoprim-sulfamethoxazole ```

B) Tetracycline

``` Which drug is associated with vestibular toxicity? A) Cyproterone acetate B) Flutamide C) Dapsone D) Minocycline E) Isotretinoin ```

D) Minocycline

``` Besides the antibiotic properties of tetracyclines, what other nonantibiotic properties do they possess? A) Proteolysis B) Apoptosis C) Antiinflammatory D) Inhibit angiogenesis E) All of the above ```

E) All of the above

``` Which agent is associated with drug-induced lupus? A) Cyproterone acetate B) Flutamide C) Dapsone D) Minocycline E) Isotretinoin ```

D) Minocycline

``` Which antibiotic is associated with intracranial hypertension especially when combined with systemic retinoids? A) Erythromycin B) Tetracycline C) Clindamycin D) Azithromycin E) Cotrimoxazole ```

B) Tetracycline

``` Which of the following are important considerations in assessing someone with a dermatologic condition? A) Age B) Hormonal status C) Race D) A and B E) All of the above ```

D) A and B (?) not sure if this is accurate

``` The thickness of the skin tends to be reduced in which type of population? A) Pediatric B) Geriatric C) Women D) Men E) None of the above ```

B) Geriatric

``` When assessing a patient with a rash, ruling out which of the following is of utmost importance? A) Fixed drug eruption B) Maculopapular rash C) Anaphylaxis D) Stevens-Johnson syndrome E) Urticaria ```

C) Anaphylaxis

``` What aspects of a lesion(s) are important to assess? A) Color B) Texture C) Size D) Temperature E) All of the above ```

E) All of the above

``` If a patient presents with oozing lesions, what medication/product should be used to initially to dry out the lesions? A) Aluminum acetate B) Colloidal oatmeal C) Corticosteroids D) Moisturizers E) None of the above ```

A) Aluminum acetate

``` Which of the following medications can be used to treat seborrheic dermatitis? A) Coal tar B) Ketoconazole C) Selenium sulfide D) Salicylic acid E) All of the above ```

E) All of the above

``` A maculopapular rash most resembles: A) Mumps B) Measles C) Fixed drug eruption D) Hyperpigmentation E) Sun-induced reaction ```

B) Measles

``` Which of the following does not contribute to hyperpigmentation of the skin? A) Amiodarone B) Hormonal fluctuations C) Sun exposure D) Acetaminophen E) None of the above ```

D) Acetaminophen

``` Topical imiquimod has been evaluated for use in treating: A) Atopic dermatitis B) Actinic keratosis C) Basal cell carcinoma D) Squamous cell carcinoma E) Malignant melanoma ```

C) Basal cell carcinoma

``` If a patient presents with a mole that has been changing in color, which of the following cancers should be of concern? A) Basal cell carcinoma B) Squamous cell carcinoma C) Actinic keratosis D) Malignant melanoma E) None of the above ```

D) Malignant melanoma

``` Which of the following is not a risk factor for developing skin cancers? A) Cumulative sun exposure B) Brown hair and medium-colored skin C) Family history D) Freckles E) Changing moles ```

B) Brown hair and medium-colored skin

Select the true statement regarding the epidemiology of acne vulgaris. A. Males present with an earlier onset in puberty. B. Females present with more severe signs and symptoms in puberty. C. Males have more severe symptoms in adulthood. D. There are no gender differences in acne prevalence. E. The lifetime prevalence of acne is 65%.

D. There are no gender differences in acne prevalence.

Which statement is true regarding the etiology of acne vulgaris? A. Acne is generally worse in the summer because of aggravation by ultraviolet light. B. Aggravation of acne through stress is a myth. C. Violinists may experience acne lesions due to occlusion where the instrument rests. D. Dietary influences do not effect the expression of acne. E. Acne is not more serious if there is an hereditary link.

C. Violinists may experience acne lesions due to occlusion where the instrument rests.

Select the most important of four pathophysiologic mechanisms underlying acne vulgaris. A. Increased follicular keratinization forming a microcomedone B. Increased production of sebum C. Bacterial lipolysis of sebum triglycerides to free fatty acids D. Inflammation

A. Increased follicular keratinization forming a microcomedone

Select the true statement regarding the clinical presentation of acne vulgaris. A. The open comedone is the first clinically visible lesion of acne. B. A pustule is usually greater than 5 mm in diameter. C. Nodules usually resolve within a few days without scarring. D. Cysts are suppurative nodules that may extend down to fat. E. The closed comedone is very stable and may persist for a long time.

D. Cysts are suppurative nodules that may extend down to fat.

For mild to moderate acne with predominantly noninflammatory lesions (comedones), active agents of first choice include: A. Retinoic acid, topical antibiotics, or benzoyl peroxide B. Retinoic acid, topical or oral antibiotics, or benzoyl peroxide C. Retinoic acid, salicylic acid, or benzoyl peroxide D. Tretinoin, adapalene, or benzoyl peroxide

C. Retinoic acid, salicylic acid, or benzoyl peroxide (?)

For severe acne with inflammatory lesions (papules, pustules), extensive nodules and cysts, and scars, the most appropriate drug regimens should include: A. Tretinoin, adapalene, or tazarotene B. Tretinoin or adapalene and isotretinoin C. Benzoyl peroxide, retinoic acid, or adapalene D. Isotretinoin or topical or oral antibiotics

B. Tretinoin or adapalene and isotretinoin

As a group, the topical retinoids are: A. Useful in the management of both comedonal and inflammatory acne B. Ranked in order of peeling efficacy as tretinoin

A. Useful in the management of both comedonal and inflammatory acne

``` Patients with acne who wish to increase ultraviolet light exposure to improve symptoms should use the following therapies with caution: A. Doxycycline and minocycline B. Minocycline and benzoyl peroxide C. Doxycycline and retinoic acid D. Retinoic acid and benzoyl peroxide E. Topical clindamycin and minocycline ```

C. Doxycycline and retinoic acid

Choose the most correct statement: A. Azelaic acid therapy should include monitoring for hyperpigmentation. B. Laboratory monitoring during isotretinoin therapy need not include triglycerides or complete blood counts. C. Patients on isotretinoin therapy should be monitored for signs of depression. D. Control of acne is reflected in a reduction of lesion counts by 50% decrease within 2 to 4 weeks. E. Comedones should resolve within a few weeks.

C. Patients on isotretinoin therapy should be monitored for signs of depression.

``` Baby Amy Tinker is a 7-month-old infant who has been diagnosed with atopic dermatitis. Clinical signs and symptoms she presented with may include all the following except: A. Pruritus B. Hypopigmentation C. Facial rash D. Urticaria ```

B. Hypopigmentation

Appropriate nonpharmacologic therapy for Amy includes all of the following except: A. Moisturizer applied liberally as needed B. Bathing five times a day C. Keep humidity at or above 50% D. Keep Amy cool—avoid situations of overheating

B. Bathing five times a day

``` Initial pharmacologic therapy for Amy should be: A. Topical corticosteroid B. Topical pimecrolimus C. Oral prednisone D. Phototherapy with UVB ```

A. Topical corticosteroid

Lichenification implies all of the following except: A. Repeated rubbing and scratching has occurred B. Thick, leathery skin is present C. A secondary bacterial infection has developed D. Flexural folds of the extremities are probably involved

C. A secondary bacterial infection has developed

``` An immune system change associated with atopic dermatitis is: A. Reduced serum IgE B. Increased interleukin-12 C. Increased Th2 cell activity D. Increased blood neutrophils ```

C. Increased Th2 cell activity

``` Susanne has yellow crusting lesions on her skin. They have been diagnosed as a bacterial infection. The most likely organism is: A. Staphylococcus aureus B. Pseudomonas aeruginosa C. Streptococcus viridans D. Xenotrophomonas maltophilia ```

A. Staphylococcus aureus

``` The following treatment alternative would be preferred in a pregnant patient with atopic dermatitis: A. Topical corticosteroid B. Oral cyclosporine C. Topical crude coal tar D. Phototherapy with PUVA ```

A. Topical corticosteroid

How many stages are in the FDA clinical trial process?

What is the first stage of the clinical trial process?

Preclinical Trials Involves testing in animals Monitoring efficacy, toxic effects, and untoward reactions.

When is the application for investigational use of a drug sent to the FDA?

After the Preclinical Trials are completed.

What does Phase I of clinical trials consist of?

The initial evaluation of the drug. Supervised studies of 20 - 100 healthy people. Focuses on absorption, distribution, metabolism, and elimination.

In what phase of clinical trials are effective administration routes and dosage ranges determined?

Phase I

What does Phase II of the clinical trial process consist of?

Several hundred patients with the disease for which the drug is intended are subjects. Same testing as Phase I

What does Phase III of the clinical trial process consist of?

Double-blind research are used for data collection. Proposed drug is compared to one already proven effective. Several thousand subjects Lasts several years.

When does Phase III of the clinical trial process begin?

When the FDA determines that the drug causes no apparent serious adverse effects and the dosage range is appropriate.

What happens at the end of Phase III of the clinical trial process?

The FDA evaluates data presented and accepts or rejects the application for the new drug.

What does FDA approval of a drug mean?

That a drug can be marketed but only by the company seeking approval

What does Phase IV of the clinical trial process consist of?

Drug is released initially on a limited basis then later on a more widespread basis. Everyone taking the drug is monitored for adverse drug reactions.

What objectives do the pharmaceutical companies have in late Phase III and IV studies?

1. compare drug with other drugs already available. 2. Monitor long-term effectiveness and impact on quality of life. 3. Detemine cost effectiveness in relation to other therapies.

What did the FDA's Controlled Substances Act of 1970 establish?

A schedule or ranking of drugs that have the potential for abuse or misuse.

What are Class 1 drugs?

Abuse - High No accepted medical use Heroin, LSD, Ecstasy

What are Class 2 drugs?

``` Abuse - High Accepted medical use, Abuse may lead to psychologic or physical dependence Ie Morphone No Refills ```

What are Class 3 drugs?

``` Abuse - Moderate Accepted medical use Moderate to low physical abuse potential High potential for pyschologic dependence Ie. codeine + acetaminophine (tylenol 3) Refills x 5/6 months ```

What are class 4 drugs?

``` Abuse - Limited Accepted medical use limited dependence potential Ie. Valium or Diazapam Refill: x 5/6 months ```

What are Class 5 drugs?

``` Abuse - Minimal Accepted medical use Limited dependence Ie. Cough Syrup w/ codeine (limited amt) Refill: x 5/6 months ```

Who can prescribe scheduled drugs?

Only practitioners who are registered and approved by the US Drug Enforcement Agency.

What must be written on a prescription for a controlled substance for the prescription to be valid?

DEA number.