Common Conditions of the Eyes and Ears, Common Skin Conditions

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A patient is purchasing Lamasil AT cream for a fungal foot infection. What is the active ingredient? A. Terbinafine B. Butenafine C. Clotrimazole D. Toinaftate E. Undecylenic acid

A

Choose the correct counseling statement for Timoptic XE gel: A. The gel should be inverted and shaken once prior to use. B. Contact lenses do not need to be removed before applying the gel. C. Wait 5 minutes after using other eye drops before inserting Timoptic XE. D. Unopened bottles of the gel should be stored in the fridge. E. Timoptic XE can cause a brown coloring of the iris.

A

Choose the correct counseling statement that a pharmacist should provide to a patient beginning prostaglandin analog therapy for glaucoma: A. Eyelash growth and darkening of the iris may occur. B. If using xalatan, the patient should administer three times daily. C. The dose should be administered in the morning. D. Contact lenses may be left in when administering this medication. E. Blood work will be needed to check that the drug is working.

A

Correct application instructions for topical steroid products should include the following points except: A. Lower potency steroids (OTC strengths) are usually applied three or four times daily. B. Overuse of this product can cause thinning of skin, striae in the skin folds, and can worsen acne. C. Do not use mroe than directed. D. All of the choices are correct counseling statements. E. Higher potency steroids (prescription strengths) are usually applied once daily.

A

Jennifer Wong, a 44-year old Asian female, has struggled with eczema patches since she was a child. She typically uses Aveeno colloidal oatmeal bath. She has never used anything else and found that this product provided moderate relief. She is at her annual physical and the physician has written a prescription for Elidel. Choose the correct statement: A. Elidel is not indicated currently. B. She should be using diphenhydramine (oral) or a similar product instead prior to use of this agent. C. This drug is considered first line for this type of presentation. D. She should be using oral steroids instead. E. It is likely that the insurance company will provide coverage.

A

Prostaglandin analogs decrease intraocular pressure by: A. Increasing the outflow of aqueous humor B. Decreasing production of aqueos humor C. Increasing the outflow and decreasing the production of aqueous humor D. Decreasing the outflow of aqueous humor E. Decreasing the outflow and increasing the production of aqueous humor

A

Which drug class should be avoided in patients with a sulfonamide allergy? A. Carbonic Anhydrase Inhibitors B. Cholinergics (Mitotics) C. Adrenergic alpha-2 agonists D. Beta-blockers E. Rho kinase inhibitors

A

Which of the following is used to increase lash growth? A. Latisse B. Timoptic C. Cosopt D. Restasis E. Patanol

A

Which of the following statements concerning sun exposure and sunscreens are correct? (Select ALL that apply.) A. "Broad-spectrum" sunscreens protect against both UVA and UVB. B. It is advisable to stay out of the sun when it is strongest between 10am and 4pm. C. Sunscreen should be applied at leas every two hours and after swimming. D. On a cloudy, overcast day there is little risk of burning. E. A sunscreen of an SPF of 50 or higher should be chosen for infants less than 6 months of age.

A, B, C

Which of the following statements concerning sunscreens are correct? (Select ALL that apply.) A. UVA and UVB exposure increases the risk of skin cancer B. If a patient would normally burn in 10 minutes, if they used a sunscreen with an SPF of 5 they would burn in 50 minutes (5x10=50) C. Water-resistant means the sunscreen is resistant for somewhere between 40-80 minutes. D. If a person is avoiding the sun they may require vitamin E supplementation; this fat-soluble vitamin is produced through sun exposure on the skin, and can be consumed in dietary sources. E. All sunscreens should be reapplied at least every two hours and after going in the water; no sunscreens are truly "waterproof"

A, B, C, E

A pharmacist is discussing oral isotretinoin with a prescriber. Which statements are correct? (Select ALL that apply) A. The progestin-only "mini pill" is not as adequate as a form of birth control in females using oral isotretinoin. B. This medication is Pregnancy Category X; use causes severe birth defects if pregnancy occurs while using this medication. C. The patient cannon get pregnant while taking this medication and for 6 months afterwords. D. Patients should be instructed that they will have dry skin; use a lip moisturizer and carry a water bottle to keep well-hydrated. E. Due to the birth defect risk, this is a REMS drug. It can only be dispensed by a pharmacy registered with the pregnancy risk management iPledge program.

A, B, D, E

Which medications cannot be used if patient is taking oral isotretinoin? (Select ALL that apply.) A. St. John's Wort B. Tetracyclines C. Vitamin D supplements D. Vitamin A supplements E. Steroids

A, B, D, E

Which of the following medications can increase intraocular pressure? (Select ALL that apply.) A. Oxybutynin B. Prednisolone C. Acetazolamide D. Topiramate E. Scopolamine F. Guaifenesin G. Metoprolol

A, B, D, E

A father is picking up a prescription of Elidel for his child. Counseling statements should include the following: (Select ALL that apply.) A. Wash hands after application. Keep the skin well hydrated by using a good moisturizer. B. Limit sun and ultraviolet ray exposure if using this medication. C. Use the smallest amount needed to control symptoms. Continue as long as signs and symptoms persist; discontinue if resolution occurs. D. This medication cannot be used in children who are not at least 36 months of age; use is contraindicated in infants. E. This drug may add to the child's chance of getting lymphoma or other cancers.

A, B, E

To prevent the spread of pink eye, patients should be instructed to. (Select ALL that apply.) A. Discard eye cosmetics, particularly mascara. B. Use Debrox to flush irritants out of the eyes. C. Avoid touching their eyes D. Wash hands thoroughly and frequently. E. Start antibiotics when symptoms first appear.

A, C, D

Zoe Brown is a fifteen year old girl who was hiking in the woods near her home in California. She picked up a rash that is itchy and spreading. The pharmacist suspects this rash is from contact with poison oak. The pharmacist should offer the following advise to Ms. Brown: (Select ALL that apply.) A. If the rash worsens she can ask her physician for stronger medicine, such as an oral steroid. B. Avoid baths until the rash is healed. C. Use a product such as Aveeno or Caladryl that may provide relief. Cold compress may help. D. This skin should be washed with soap and water; it is best to try and remove the toxin. E. Remove the oil from the skin using 70% propyl alcohol.

A, C, D

Which of the following statements concerning athlete's foot are correct? (Select ALL that apply.) A. It is usually treatable with topical OTC agents B. It is also called tinea cruris. C. Patients should be careful to wear sandals or other foot coverings in public showers and locker rooms in order to avoid infection (and avoid spreading it.) D. Pharmacists should not recommend OTC treatment without first obtaining a potassium hydroxide smear. E. Symptoms include itching, peeling and redness.

A, C, E

Rank the following topical steroids in order from highest to lowest potency. (Left-click the mouse to highlight, drag, and order the answer options: ALL options must be used) A. Halobetasol 0.05% B. Mometasone (cream) 0.1% C. Hydrocortisone 1% D. Fluocinonide 0.05%

A, D, B, C

A patient will begin therapy with Retin-A Micro. Which of the following are correct counseling statements? (Select ALL that apply.) A. Use daily, if irritation occurs, decrease frequency to every other day B. The topical retinoids are safe to use in pregnancy C. This medication does not cause photosensitivity D. It will take 1-3 months to see improvements and acne may worsen initially. E. Use a pea-sized amount and spread over entire face.

A, D, E

A 29-year old male patient uses the local gym daily. He was not careful to use sandals in the shower and his feet are itchy, particularly between the toes. Choose appropriate OTC medications that will eradicate the infection and are recommended for this purpose: (Select ALL that apply.) A. Lamasil AT B. Diphenhydramine oral tablet C. Hydrocortisone 1% cream D. Clotrimazole 7-day treatment E. Lotrimin AF

A, E

A patient asks the pharmacist for information on preventing and treating cold sores. Which of the following is true? A. Zovirax cream is a treatment that can be purchased over the counter. B. Abreva cream is a treatment that is applied five times daily. C. Cold sores are not easily spread through kissing and sharing drinks. D. Cold sores are commonly caused by herpes zoster virus. E. Aloe is a natural product that is common used for prevention and treatment.

B

A patient has suspected onychomycosis and the physician is considering systemic terbinafine therapy. Choose the correct statement: A. Potassium hydroxide smears are rarely required for this condition; it is generally sufficient to use a visual inspection. B. If starting terbinafine, monitor for hepatotoxicity. C. The brand name for terbinafine is Sporanox. D. Four weeks is a usual treatment duration for treatment of fingernail onychomycosis. E. Eight weeks are required for treatment of toenail onychomycosis.

B

Choose the correct application instructions/safety information for a topical retinoid: A> Products should be used as "spot" therapy only. B. Limit sun exposure; skin will burn more easily. C. It works best if salicylic acid is used while taking this product; be sure to apply the retinoid first. D. These products are available over the counter. E. Use several times a day in the beginning of treatment to improve intolerance.

B

Differin is a popular dermatological drug. Differin is used for this condition: A. Psoriasis B. Acne C. Eczema D. CA-MRSA E. Poison ivy, oak or sumac

B

Jennifer Lewis comes to the pharmacy and asks to speak to a pharmacist. She states that she has uncomfortable symptoms of vaginal itching and burning on urination. She states that she has never had this before and just wants it to go away quickly. Which of the following would be the best recommendation for Ms. Lewis? A. Vagistat 1 B. Refer patient to see a physician for diagnosis; recommend OTC antifungal C. Mycelex 7 D. Fluconazole 150mg PO x 1 E. Monistat 7

B

Which natural product is used in a topical formulation for a soothing effect after sunburn? A. Fenugreek B. Aloe C. Saw palmetto D. Acacia E. Feverfew

B

Which of the following eye drops can cause bradycardia? A. Pataday B. Cosopt C. Lumigan D. Xalatan E. Polytrim

B

Which of the following is a side effect of timolol eye drops? A. Pupil constriction B. Burning/stinging C. Darkening of the iris D. Eyelash Growth E. Yellow/green vision

B

Which of the following statements concerning mupirocin is correct? A. The brand name is Bacitracin. B. It is a topical product that provides very good staph and strep coverage. C. It does not provide coverage against MRSA and would not be a useful option for MRSA-colonizers. D. It provides only gram negative coverage. E. It is available over the counter.

B

A patient asks the pharmacist to recommend a sunscreen that is "broad spectrum". What is the correct meaning of the term "broad spectrum"? (Select ALL that apply.) A. It provides an SPF of at least 30. B. It protects against UVA, which causes aging. C. It provides an SPF of at least 15. D. It protects against UVB, which causes burning. E. It provides an SPF of at least 60.

B, C

Which of the following medications are first-line treatments for lice? (Select ALL that apply.) A. Lindane B. Permethrin C. Nix D. RID E. Imiquimod

B, C, D

Which of the following brand-generic matches are correct? (Select ALL that apply.) A. Undecylenic acid-Desenex B. Betamethasone/Clotrimazole-Lotrisone C. Butenafine-Lotrimin Ultra D. Toinaftante-Tinactin E. Terbinafine-Lamasil AT

B, C, D, E

A patient asks for help choosing an over-the-counter acne product. She is also asking what causes acne. She has a friend who used the product Duac and asks if she can have it. Which of the following statements are correct? (Select ALL that apply.) A. Salicylic acid is a stronger agent than benzoyl peroxide. B. Common times to get acne are during puberty, in infants, and women around the time of their menstrual cycle. C. Benzoyl peroxide comes in combinations with the antibiotics clindamycin or erythromycin; these require a prescription. D. Androgens (male sex hormones) are the primary determinant of acne, which is why boys usually get acne worse than girls. In addition, the presence of an organism called mycobacterium that lives in the skin and fatty acids in oil glands in the skin must be present; all three in combination produce a bad case of acne. E. Some women find benefit in treating acne using birth control pills.

B, C, E

Which of the following steroid topical formulations are available over-the-counter? (Select ALL that apply.) A. Betamethasone 0.5% B. Betamethasone 0.25% C. Hydrocortisone 2.5% D. Hydrocortisone 0.5% E. Hydrocortisone 1%

B, D

Which of the following drugs can cause visual damage? (Select ALL that apply.) A. ofloxacin B. Ethambutol C. Olopatadine D. Hydroxychloroquine E. Amiodarone F. Linezolid

B, D, E, F

The topical retinoids such as tretinoin (Avita, Retin-A), adapalene (Differin) and tazarotene (Tazorac, Avage) are first line prescription agents for treating most cases of acne. Choose the correct statements concerning these agents. (Select ALL that apply.) A. They are safe to use in breastfeeding. B. They are applied in a pea sized amount, which is divided into 4 equal parts and applied. C.. They are applied on each acne pimple as "spot" therapy. D. They are safe to use in pregnancy. E. They are derivatives of vitamin A.

B, E

A patient approaches the pharmacy counter to ask if she should purchase a steroid cream, ointment or lotion. She wants to treat an itchy rash on her palm. She reports that sometimes she gets topical reactions to things that she touches, which appear similar to the current reaction and it generally dissipates on its own. The skin appears thick and calloused. Which formulation would be most appropriate? A. A lotion B. A cream C. An ointment D. To treat the palm, she needs a systemic product. E. She should be referred to the physician.

C

A patient asks the pharmacist what to do about a circular patch on her forearm that has raised, red edges. The inner part of the circle is clear. The circle edges have small bumps that look like blisters. The patch is about 3/4" in diameter. Which product should the pharmacist recommend? A. Hydrocortisone 1% cream B. Diphenhydramine cream C. Terbinafine D. Hydrocortisone 0.05% cream E. Ivy Block

C

Counseling instructions for the use of a topical antifungal for athlete's foot (tinea pedis) should include all of the following except: A. Do not walk barefoot to avoid spreading it. B. Wear sandals in public showers to avoid catching it. C. Apply the medicine directly on the rash; do not extend the application beyond the visible rash. D. Use for at least 2-4 weeks, even if the rash appears to be healed.

C

If one squeezes out enough steroid cream to stretch the length from the fingertip to the first joint, what appropriate area of skin would this amount of medication treat? A. about the area of one finger B. about one leg, front and back C. about the area of the hand D. About the area from the foot to the knee E. About the area of the hand and arm

C

Select the correct statment concerning oral isotretinoin: A. Isotretinoin is Pregnancy Category D B. This medication is for mild to moderate acne. C. If female, only patients who can remember to use two effective forms of birth control can use the drugs similar to Accutane. D. None of the statements are correct. E. This medication is only for male patients due to the high risk of birth defects; and, males typically get worse acne than females.

C

Which of the following agent is not used first line for scabies (mites), due to neurotoxicity/seizures, and requires a Medication Guide if dispensed? A. Spinosad B. Ovide C. Lindane D. Benzyl alcohol lotion E. Permethrin

C

Which of the following agents used to treat lice is flammable? A. Spinosad B. Permethrin C. Ovide D. Benzyl alcohol lotion E. Lindane

C

Which of the following statements concerning pimecrolimus is correct? A. oral tacrolimus is preferred for intermittent eczema B. Use on a continual basis even if resolution of eczema occurs. C. Use is associated with lymphoma and skin malignancies. D. This product can be used in children ages 12 months or older. E. Apply a thin layer only to the affected skin areas, once a day.

C

Put the instructions in order for use of an ophthalmic preparation that contains benzalkonium chloride. A. Close your eye and press a finger between the eye and the nose for one minute B. Gently squeeze the bottle to dispense 1 drop into the space between the eye and the lower lid C. After washing hands thoroughly, shake the bottle a few times before opening it. D. Insert soft contact lenses, if worn. E. While looking up, use one finger to pull down the lower lid.

C, E, B, A, D

A new user of Xalatan wears contact lenses. How should the pharmacist instruct the patient regarding contact lenses and the use of Xalatan? A. Wait 30 minutes after inserting the medication before putting in contact lenses. B. Patients who wear contact lenses should use Lumigan instead. C. Wait five minutes after inserting the medication before putting in contact lenses. D. Remove the contact lenses prior to using the medication. E. Patients who wear contact lenses cannot use this medication.

D

A patient diagnosed with hypotrichosis. Which medication can help this condition? A. Ketoconazole B. Finasteride C. Toinaftate D. Bimatoprost E. Pimecrolimus

D

A patient with heart failure, COPD, diabetes and HTN is diagnosed with onychomycosis. Which medication, used to treat this condition, should be avoided in this patient? A. Terazol 7 B. Tinactin C. Clotrimazole D. Itraconazole E. Lamisil

D

After each lice treatment, the hair should be checked and nits/lice removed with a nit comb every: A. 4-6 days B. 7-10 days C. 15-17 days D. 2-3 days E. 10-14 days

D

Based on the instructions given in the prescription, where should the drops be placed? A. Left eye B. Right eye C. Right ear D. Left ear E. Both eyes

D

Choose the correct statement concerning Nizoral A-D. A. It does not cause skin irritation. B. It is the first-line OTC treatment for alopecia. C. Shampoo daily. D. Rub shampoo in well and leave in for 5 minutes, then rinse out. E. It contains itraconazole.

D

EM has advanced COPD and has recently been diagnosed with glaucoma. If a beta-blocker is required, which medication would be the best option for EM? A. Timolol B. Metipranolol C. Carteolol D. Betaxolol E. Levobunolol

D

Which OTC acne product is considered the first-line recommendation due to higher efficacy for acne than the others? A. Resorcinol B. Lactic acid C. Sulfur D. Benzoyl peroxide E. Salicylic acid

D

Which acne products are available over-the-counter? A. Salicylic acid, benzoyl peroxide, clindamycin B. Salicylic acid, benzoyl peroxide, tazarotene C. Salicylic acid, benzoyl peroxide, dapsone gel D. Salicylic acid, benzoyl peroxide, adapalene E. Salicylic acid, benzoyl peroxide, isotretinoin

D

Which medication classes does Cosopt contain? A. Carbonic anhydrase inhibitor/Cholinergic B. Adrenergic alpha-2/Beta-blocker C. Beta-blocker/Prostaglandin analog D. Beta-blocker/Carbonic anhydrase inhibitor E. Beta-blocker/Rho kinase inhibitor

D

Which of the following agents is used for alopecia? A. Avodart B. Tegretol C. Proscar D. Minoxidil E. Valproic acid

D

Choose the correct statement concerning ketoconazole shampoo (Nizoral AD): A. This shampoo should be applied continuously (daily) in order to prevent flaking. B. This shampoo is the first-line recommendation for dandruff. C. It is important to use acid-suppressing agents when using Nizoral AD. D. This is a prescription-only product. E. This product should not be applied to open sores or Irritated skin.

E

Floppy iris syndrome can be caused by which of the following medications? A. Voriconazole B. Amiodarone C. Digoxin D. Linezolid E. Doxazosin

E

How should an unopened box of Xalatan be stored? A. In a locked cabinet B. In the freezer C. In a humid location D. At room temperature E. In the refrigerator

E

Occasionally, antifungal agents such as ketoconazole are given as intermittent "pulse" therapy when being used long-term. What is the purpose of pulse therapy? A. Easier to remember to take the doses as prescribed B. Increased hair growth. C. It kills the organism more effectively. D. Higher risk of liver damage than with daily administration. E. Less side effects and less costly.

E

The primary goal of therapy when treating a patient with glaucoma is to: A. Increase production of aqueous humor B. Decrease aqueous humor outflow C. Decrease histamine release D. Decrease the risk of infection E. Decrease intraocular pressure

E

What are the ingredients in the OTC "triple antibiotic" products? A. Polymyxin, bacitracin, gentamicin B. Polymyxin, bacitracin, colistin C. Polymyxin, bacitracin, amikacin D. Polymyxin, bacitracin, mupirocin E. Polymyxin, bacitracin, neomycin

E

What does SPF indicate on a sunscreen product? A. The amount of time the product will last if the patient stays in the sun, up to 5 hours duration. B. The product's moisturizing efficacy. C. The amount of time the product will last if the patient gets wet. D. The degree of protection from UVA. E. The degree of protection from UVB.

E

What is Silvadene used for? A. Lacerations B. Bites C. Wound debridement D. Nosebleeds E. Burns

E

What is the preferred treatment for most cases of blepharitis? A. Topical NSAIDs B. Polytrim eye drops C. Systemic NSAIDs D. Vigamox eye drops E. Warm compress

E

Which of the following prescription agents may be prescribed to a teenager with acne? A. Ketoconazole B. Nizoral C. Lamisil AT D. CLearasil E. Solodyn

E

Which of the following topical steroids is considered a very high potency agent? A. Hydrocortisone valerate 0.2% B. Fluocinolone acetonide 0.01% C. Desonide 0.05% D. Hydrocortisone 2.5% E. Clobetasol propionate 0.05%

E

Which product is used to remove cerumen? A. Ciprodex B. Acular C. Systane D. Restasis E. Debrox

E


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