Rita's Derm Questions Flashcards
At what age do a stork bite/telangiectatic nevi/salmon patch over eyes disappear?
a) 6 mos
b) 12 mos
c) 15 mos
d) 18 mos
a) 6 mos
What is the most common complication in a child with a severe case of GABHS impetigo?
a) Strep pneumonia
b) Rheumatic fever
c) Nephrotic syndrome
d) Glomerulonephritis
d) Glomerulonephritis
What is the first line tx for well-localized impetiginized lesions?
a) penicillin
b) Bactroban (mupirocin)
c) Third-generation cephalosporin
d) Azithromycin
b) Bactroban (mupirocin)
A child has a few flat slightly hypo pigmented lesions on the face and forearms. What is the most likely dx?
a) Tinea corporis
b) Pityriasis rosea
c) Pityriasis versicolor
b) Pityriasis rosea
–Tinea Corporis = well-demarcated, circular lesion
In a well newborn exam, there are erythematous papules in newborn on chin, cheeks, and forehead? What is the most likely dx?
a) Neonatal acne
b) milia
c) Erythema toxic
d) Herpes simplex
a) Neonatal acne
–milia = “pinpoint white” papules
–erythema toxicum= more truncal, not localized to face
–herpes simplex = grouped vesicles
A 5yo presents w/several papules with linear burrow lesion on the right foot. What is the most likely dx?
a) hand foot and mouth disease
b) scabies
c) Atopic dermatitis
d) Tinea corporis
b) scabies
What is the natural hx of small strawberry hemangioma?
a) Tend to regress over time
b) Will get bigger
c) Need imaging
a) Tend to regress over time
A 3yo girl presents with two circumscribed areas of baldness without any crusting, flaking. What is the most likely dx?
a) traction alopecia
b) tinea capitis
c) trichotillomania
c) trichotillomania
–“without any crusting, flaking” –> eliminates tinea capitis
–traction alopecia–> not well-circumscribed
Which of the following is the first-line tx for tinea capitis?
a) griseofulvin
b) Nizoral
c) Amoxil
a) griseofulvin
A child is treated with griseofulvin 20mg/kg/day for tinea capitis for 3 weeks. He is w/out improvement. What do you next?
a) continue for another 3 weeks
b) change to another oral anti fungal
c) Add Nizoral shampoo
d) Add topical antifungal
b) change to another oral antifungal
–topical antifungal: do not use. doesn’t get to root.
Nizoral shampoo is also a topical anti-fungal
What is a painful, flat lesion on the foot?
a) verruca planus
b) molluscum contagiosum
c) abscess
a) verruca plants
molluschi contagiosum = umbilicated papules
At what age can a mother apply sunscreen?
a) newborn
b) 3 mos
c) 6 mos
d) 9 mos
c) 6 mos
What is not true about sunscreens?
a) prevents tanning
b) zinc oxide is an acceptable sunscreen
c) people with sulfonamide allergy should use a product containing PABA
d) can lead to skin cancer
d) can lead to skin cancer
Which of the following is true about sunscreens?
a) do not use sunscreen for
a) do not use sunscreen for
A 7yo has 3 small patches of hair loss with central clearing. The most appropriate management is:
a) Lotrimin
b) griseofulvin V
c) Elimite
d) nystatin cream
b) griseofulvin V
–is tinea capitis!
Which is the best tx for mild atopic dermatitis?
a) good moisturizing of affected areas
b) frequent bathing with mild soap
c) fluorinated hydrocortisone ointment
a) good moisturizing of affected areas
A 10 month old presents with erythematous, well-demarcated diaper rash, which has satellite lesions and goes into the folds. Which would be the best choice for tx?
a) Nystatin
b) Desitin
c) Clotrimazole
d) Vitamin A&D ointment
a) Nystatin
nystatin = 1st line drug for candidiasis/diaper dermatitis
What is the pathogenesis of the primary lesion of acne?
a) infection of the sebaceous gland
b) an immunologic response to bacteria
c) plugging of the sebaceous gland
d) inflammation of the deep dermal layer
c) plugging of the sebaceous gland
You note superficial pearly papules with umbilicated centers. What is the most likely dx?
a) Molluscum contagiosum
b) Pityriasis rosea
c) Scabies
d) Verruca vulgaris
a) Molluscum contagiosum
pityriasis rosea = truncal, papulosquamous
Verruca vulgaris = single papule or few in a line
You note multiple weepy lesions around 3yo’s upper lip. Closer inspection reveals honey colored crusts. What is the most likely dx?
a) herpes simplex
b) varicella
c) nummular eczema
d) impetigo
d) impetigo
nummular eczema = flat, dry, circular lesion
During a physical, you note multiple brown macules, ranging in size from .5cm to 1.0cm on the trunk and arms. There is freckling in the axilla. You would:
a) educate about sunscreen application
b) explain the lesions will fade over time
c) screen the rest of the family and refer
d) document your findings and re-evaluate in 6 mos
c) screen the rest of the family and refer
–macules = cafe o’alit spots
–freckling in the axilla = hallmark of neurofibromatosis
The best tx for the adolescent with mild to moderate acne is:
a) oral isotretinoin
b) topical tretinoin and benzoyl peroxide gel
c) Tetracycline orally
d) Clean with benzoyl peroxide wash
b) topical tretinoin and benzoyl peroxide gel
tretinoin = retinoid
Tetracycline = oral antibiotic
–> for severe, modular acne
A child has a cluster of yellow-crusted vesicles on the right hand. When can he go back to school?
a) After the antibiotics are complete
b) 24 hrs after starting antibiotics
c) can go back right away
b) 24 hrs after starting antibiotics
What is the most appropriate first aid for a burn on the hand?
a) ice
b) cold water
c) margarine
b) cold water
Which of the following body sites are usually affected in young infants with scabies?
a) finger webs and sides of the digits
b) head and neck
c) fingers and waistline
d) umbilical and groin
b) head and neck
Which of the following os the tx of choice for an 8yo with a pruritic rash b/t the fingers?
a) Ivermectin
b) Lindane
c) Permethrin
d) Hydrocortisone cream
c) Permethrin
- -> = 1st line tx for scabies!
- -> an insecticide/kills scabies and lice. brand name: Nix
- -Ivermectin = shampoo for lice (Sklice)
- -Lindane: treats scabies but has major ADE: seizures
- -hydrocortisone cream: will reduce pain/inflamm. but will not treat
A 10yo is placed on Griseofulvin for 4-6 wks for Tinea capitis. How long should the child be excluded from school?
a) They can go back once they start on tx.
b) 24 hrs after starting the tx
c) 48 hrs after starting the tx
c) 72 hrs after starting the tx
c) 48 hrs after starting the tx
A child presents with mumps on the first day of illness. How long does the child need to be excluded from school?
a) 2 days
b) 5 days
c) 7 days
d) 9 days
b) 5 days
A 5 yo is diagnosed with measles. He already has a rash when you see him. How long does the child need to be excluded from school?
a) 2 days
b) 4 days
c) 7 days
d) 9 days
b) 4 days
An infant has candida dermatitis. What would you expect to find on physical exam?
a) Lesions limited to the perianal region
b) Pustular vesicular lesions in the diaper area
c) Red confluent, papular lesions with sharply demarcated borders
d) a macular, bright pink, shining rash in the diaper area with the inguinal folds spared
c) Red confluent, papular lesions with sharply demarcated borders
A 15yo presents with a draining abscess under the arm. What is the best advice to give the pt?
a) stay out of school until the abscess stops draining
b) cover the drainage area and go to school
c) cover the drainage area and you are not contagious
d) Keep the area covered and do not participate in gym activities.
a) stay out of school until the abscess stops draining
c) cover the drainage area and you are not contagious
d) Keep the area covered and do not participate in gym activities.
…no clear answer! maybe depends on pain?
A child has pruritic papules between the fingers. What is the best tx?
a) Lindane
b) Permethrin
c) Ivermectin
d) Hydrocortisone
b) Permethrin
A 5 mos old has red excoriated skin with numerous pustules in the diaper area. What is the most likely dx?
a) Candidal diaper dermatitis
b) Irritant diaper dermatitis
c) Staphylococcal diaper dermatitis
d) Atopic dermatitis
c) Staphylococcal diaper dermatitis
A child has linear, vesicular rash following a dermatome and is on the left side of the trunk. It does not cross the midline. What is the most likely dx?
a) Scabies
b) Impetigo
c) Herpes zoster
d) Tinea corporis
c) Herpes zoster
The NP gives a patient griseofulvin. What are the best instructions to give the parents?
a) to enhance absorption, give with a high fat meal
b) tx should be continuous until the hair is starting to grow back
c) the most common side effects include nausea and a HA
d) labs to monitor liver functions should be done every 2 weeks
a) to enhance absorption, give with a high fat meal
A slightly obese 14yo was sent to the school based health clinic due to a pink, itchy, slightly scaly rash on the upper, inner aspect of the thighs. What is the most likely dx?
a) Scabies
b) Tinea cruris
c) Contact dermatitis
d) Urticaria
c) Contact dermatitis
– Tinea cruris: see over pubic area
A 3yo has a fine pink truncal rash. There was a previous hx of fever for 2 days. When is the child no longer contagious?
a) When the child’s fever is gone
b) When the child’s rash is gone
c) 10 days before the sx appear
d) 3 days before the onset of sx
a) When the child’s fever is gone
–true for most viral exanthems
A child has a non-blistering red sunburn. What is the recommended tx?
a) Cool baths and wet compresses
b) Application of petroleum to soothe the skin
c) Cover the area with a cotton shirt
d) A cool shower several times/day
a) Cool baths and wet compresses
–> to reduce pain
A child has an ash leaf hypopigmented macule on the trunk. What is the most likely dx?
a) Congenital myopathies
b) Sturge Weber syndrome
c) Tuberous sclerosis
d) Duchenne muscular dystrophy
c) Tuberous sclerosis
A 7 month old has a small congenital nevi that appeared at age 3 months. What is the best management of the patient?
a) Referral to derm
b) Reassurance
c) Monitor at well-child visits
c) Monitor at well-child visits
A 9yo has small discrete papules with mild redness on the edges of the scalp around the face. There is some hair shaft breakage. What is the most likely dx?
a) Traction alopecia
b) Trichotillomania
c) Tinea capitis
d) Alopecia areata
a) Traction alopecia
“small discrete papules” –> folliculitis
A child presents with painful red fingers and toes, a maculopapular rash, hypertension, peripheral neuropathy, and kidney dysfunction. What is the most likely dx?
a) Lead poisoning
b) Cyanide poisoning
c) Mercury poisoning
d) sulfide poisoning
c) Mercury poisoning
What substance can cause methemoglobinemia?
a) Tylenol
b) Benzocaine
c) Fennel seed
b) Benzocaine
What color is the blood in methemoglobinemia?
a) black
b) red
c) brown
d) orange tinted
c) brown
You are seeing a child with a positive strep test. When do you screen the siblings?
a) on dx of the child
b) when the child becomes symptomatic
c) you do not need to worry as contagiousness is limited
d) on every visit for the next month
b) when the child becomes symptomatic
A 12yo presents with arthralgias and a butterfly facial rash over the cheeks and nose. The child has mild hematuria. What is the most likely dx?
a) Parvovirus
b) Streptococcal pharyngitis
c) Lupus erythematous
d) Lyme disease
c) Lupus erythematous
butterfly facial rash –> lupus!
A child has grouped vesicles on the right side of his chest. He reports a burning sensation in the area of the vesicles. What is the most likely dx?
a) Herpes simplex
b) Fixed drug reaction
c) Varicella zoster
d) Allergic contact dermatitis
c) Varicella zoster
