Exam 1 Skin disorders from Fitzgerald
A 24-year-old woman presents with hive-form linear lesions that develop over areas where she has scratched. These resolve within a few minutes. This most likely represents: A. Dermographism B. Contact dermatitis C. Angioedema D. Allergic reaction
A
A 38-year-old woman with advanced human immunodeficiency virus (HIV) disease presents with a chief complaint of a painful, itchy rash over her trunk, Examination reveals linear vesicular lesions over the posterior thorax, This presentation is most consistent with: A. Herpes zoster B. Dermatitis herpetiformis C. Molluscum contagiosum D. Impetigo
A
Which of the following statement is most accurate regarding cellulitis? A. Insect bites, abrasion, or other skin trauma can be the origin or cellulitis B. Cellulitis most often occurs on the chest and abdomen C. Necrosis is a common complication of cellulitis D. Cellulitis often occurs spontaneously without any identifiable skin wound
A
When advising the patient about scabies contagion, you inform her that: A. Mites can live for many weeks away from the host B. Close personal contact with an infected person is usually needed to contract this disease C. Casual contact with an infected person is likely to result in infestation D. Bedding used by an infected person must be destroyed
B
When caring for an adult with an outbreak of shingles you advise that: A. There is no known treatment for this condition B. During outbreaks, the chickenpox (varicella) virus is shed C. Although they are acutely painful, the lesions heal well without scarring or lingering discomfort D. This condition commonly strikes young and old alike
B
When counseling a patient about the use of tacrolimus (Protopic) or pimecrolimus (Elidel), you mention that: A. This is the preferred atopic dermatitis treatment in infants B. There is a possibility of increased cancer risk with its use C. The product is used interchangeably with topical corticosteroids D. The product is a potent antihistamine
B
When counseling a person who has a 2-mm verrucaform lesion on the hand, you advise that: A. Bacteria are the most common cause of these lesions B. Lesions usually resolve without therapy in 12 to 24 months C. There is a significant risk for future dermatologic malignancy D. Surgical excision is the treatment of choice
B
When prescribing fluconazole, the NP considers that it is a cytochrome P450: A. 3A4 inhibitor B. 2C9 inhibitor C. 2D6 inducer D. 1A2 inducer
B
When prescribing tretinoin (Retina A), the nurse practitioner (NP) advises the patient to: A. Use it with benzoyl peroxide to minimize irritating effects B. Use a sunscreen because the drug is photo-sensitizing C. Add a sulfa-based cream to enhance anti-acne effects D. Expect a significant improvement in acne lesions after approximately 1 week of use
B
Which of the following best describes seborrheic dermatitis lesions? A. Flaking lesions in the antecubital and popliteal spaces B. Greasy, scaling lesions in the nasolabial folds C. Intensely itchy lesions in the groin folds D. Silvery lesions on the elbows and knees.
B
Which of the following findings is often found in a person with stage 2 Lyme disease? A. Peripheral neuropathic symptoms B. Atrioventricular heart block C. Conductive hearing loss D. Macrocytic anemia
B
Which of the following is not a recommended option to make cosmetic improvements for phymatous rosacea? A. Laser peel B. Ablative laser surgery C. Surgical shave technique D. Mechanical demabrasion
B
Which of the following is recommended for preventing a burn wound infection? A. topical corticosteroid B. Topical silver sulfadiazine C. Oral erythromycin D. Oral moxifloxacin
B
Which of the following represents the most important diagnostic test for the patient in the previous question? A. Complete blood cell count with white blood cell differential B. Serum testing for Borrelia burgdorferi infection C. Computed tomography (CT) scan of the head with contrasts enhancement D. Serum protein electrophoresis
B
Who is the best candidate for isotretinoin (Accutane) therapy? A. a 17-year-old patient with pustular lesions and poor response to benzoyl peroxide B. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect C. a 14-year-old patient with open and closed comedones and a family history of "ice pick" scars D. an 18-year-old patient with inflammatory lesions and improvement with tretinoin (Retin-A)
B
You examine a patient with a red, tender thermal burn that has excellent capillary refill involving the entire surface of the anterior right thigh. The estimated involved body surface area (BSA) is approximately: A. 5% B. 9% C. 13% D. 18%
B
You examine a patient with psoriasis vulgaris and expect to find the following lesions: A. lichenified areas in flexor areas B. well-demarcated plaques on the knees C. greasy lesions throughout the scalp D. vesicular lesions over the upper thorax
B
You see a 28-year-old man who is having an anaphylactic reaction following a bee sting and is experiencing trouble breathing. Your initial response is to administer: A. oral antihistamine B. injectable epinephrine C. supplemental oxygen D. vasopressor therapy
B
You seen a 42-year-old woman with a cluster of red, itchy spots on her left arm. She informs you that she recently stayed at a hotel that she later discovered was infected with bed bugs. You advise her that: A. She should immediately begin a regimen of oral antibiotics B. The reaction is usually self-limiting and should resolve in 1 to 2 weeks C. Given that bed bug bites are usually not itchy; an alternative diagnosis should be discovered D. She should wash all of her clothes in cold water
B
Flat discoloration less than 1 cm in diameter
macule
Flat discoloration greater than 1 cm in diameter
patch
Vesicle-like lesion with purulent content
pustule
Net-like cluster
reticular
Loss of epidermis and dermis
ulcer
CA-MRSA is most commonly spread from one person to another via airborne pathogen transmission. A. True B. False
B. False
If a skin and soft tissue infection does not improve in 48 to 72 hours with antimicrobial therapy, infection with a resistant pathogen is virtually the only cause. A. True B. False
B. False
Most acute-onset necrotic skin lesions reported in North America are caused by spider bites. A. True B. False
B. False
Skin lesions infected by community-acquired MRSA (CA-MRSA) often occur spontaneously on intact skin. A. True B. False
B. False
The mechanism of resistance of MRSA is via the production of beta-lactamase A. True B. False
B. False
The most important aspect of skin care for individuals with atopic dermatitis is: A. Frequent bathing with antibacterial soap B. Consistent use of medium-potency to high-potency topical steroids C. Application of lubricants D. Treatment of dermatophytes
C
The use of sunscreen has minimal impact on reducing the risk of which type of skin cancer? A. Squamous cell carcinoma B. Basal cell carcinoma C. Malignant melanoma D. All forms of skin cancer
C
The zoster vaccine (Zostavax) is A. An inactivated/killed virus vaccine B. A conjugate vaccine containing a virus-like particle (VLP) C. A live, attenuated vaccine D. An inactivated toxin vaccine
C
Topical therapies for the treatment of rosacea include all of the following except A. Metronidazole cream B. Azelaic acid gel C. Medium-potency corticosteroid cream D. Benzoyl peroxide
C
Type 1 hypersensitivity reactions, such as atopic dermatitis, involve the action of which antibodies binding to receptor sites on mast cells: A. IgG B. IgM C. IgE D. IgA
C
Type I hypersensitivity reaction is mediated through: A. TNF-α binding to T cells B. IgG antibodies binding to T cells C. IgE antibodies binding to mast cells D. IL-10 binding to basophils
C
What is the most effective protection against shingles? A. Previous episode of chickenpox as a child B. Prior episode of shingles C. receipt of varicella-zoster immunization D. Avoiding children and day-care centers
C
Which of the following is the least potent topical corticosteroid? A. Betamethasone dipropionate 0.1% (Diprosone) B. Clobetasol propionate 0.05% (Cormax) C. Hydrocortisone 2.5% D. Fluocinonided 0.05% (Lidex)
C
The use of TNF modulators for the treatment of psoriasis is associated with an increased risk for: A. gastrointestinal disorders B. nephrotoxicity C. QTc prolongation D. reactivation of latent tuberculosis
D
To transmit the bacterium that causes Lyme disease, an infected tick must feed on a human host for at least: A. 5 minutes B. 30 minutes C. 2 hours D. 24 hours
D
Treatment options in generalized psoriasis vulgaris include all of the following except: A. Psoralen with ultraviolet A light (PUVA) therapy B. Methotrexate C. Cyclosporine D. Systemic corticosteroids
D
When examining a mole for malignant melanoma, all of the following characteristics can indicate a melanoma except: A. Asymmetry with non-matching sides B. Color that is not uniform C. A recently formed lesion D. A lesion that has been present for a least 2 years
D
Which of the following findings is often found in a person with stage I Lyme disease? A. Peripheral neuropathic symptoms B. High-grade atrioventricular heart block C. Bell's palsy D. Single painless annular lesion
D
Which of the following is an oral antimicrobial option for the treatment of a community-acquired methicillin-resistant S. aureus cutaneous infections A. Amoxicillin B. Dicloxacillin C. Cephalexin D. Trimethoprim-sulfamethoxazole
D
You prescribe a topical medication and want it to have maximum absorption, so you choose the following vehicle A. Gel B. Lotion C. Cream D. Ointment
D
You see a 52-year-old woman who was bitten by a rat while opening a Dumpster. The examination reveals a wound approximately 1 cm deep that is oozing bright red blood. Treatment of this patient should include standard wound care with the addition of: A. rabies immune globulin B. rabies vaccine C. oral ciprofloxacin D. oral amoxicillin-clavulanate
D
You see a 67-year-old man with seborrheic dermatitis that has failed to respond to treatment with ketoconazole shampoo. An appropriate second-line treatment option can include all of the following except: A. oral fluconazole. B. a topical immune modulator. C. topical propylene glycol. D. high-potency topical corticosteroid
D
Circumscribed area of skin edema
wheal
Which of the following is the best treatment option for cellulitis when risk of infection with a methicillin-resistant pathogen is considered low? A. Dicloxacillin B. Amoxicillin C. Metronidazole D. Trimethoprim-sulfamethoxazole
A
Which of the following medications is likely to cause the most sedation? A. Chlorpheniramine B. Cetirizine C. Fexofenadine D. Loratidine
A
Which of the following represent the most effective method of cancer screening? A. Skin examination B. Stool examination for occult blood C. Pelvic examination D. Chest radiography
A
In an adult with BMI greater than 40 kg/m2 who is being treated with TMP-SMX for CA-MRSA, the recommended dose is two tablets BID A. True B. False
A. True
Stage 3 Lyme disease, characterized by joint pain and neuropsychiatric symptoms, typically occurs how long after initial infection? A. 1 month B. 4 months C. 1 year D. 5 years
C
The human papillomavirus responsible for nongenital warts is mainly passed through: A. Contact with infected surfaces B. Exposure to saliva from infected person C. Person-to-person contact D. Exposure to infected blood
C
A 78-year-old resident of a long-term care facility complains of generalized itchiness at night that disturbs her sleep. Her examination is consistent with scabies. Which of the following do you expect to find on examination? A. Excoriated papules on the interdigital area B. Annular lesions over the buttocks C. Vesicular lesions in a linear pattern D. Honey-colored crusted lesions that began as vesicles.
A
A Tzanck smear that is positive for giant multi-nucleated cells was taken from a lesion caused by: A. Herpesvirus B. S. aureus C. Streptococci D. Allergic reaction
A
A possible adverse effect with the use of a first generation antihistamine such as diphenhydramine in an 80-year-old man is: A. Urinary retention B. Hypertension C. Tachycardia D. Urticaria
A
A significant rabies risk is associated with a bite from all of the following except: A. Humans B. Foxes C. Bats D. Skunks
A
All of the following organisms have been implicated in the development of rosacea except: A. Viruses B. Bacteria C. Yeast D. Mites
A
An 88-year-old community-dwelling man who lives alone has limited mobility because of osteoarthritis. Since his last office visit 2 months ago, he has lost 5% of his body weight and has developed angular cheilitis. You expect to find the following on examination: A. Fissuring and cracking at the corners of the mouth B. Marked erythema of the hard and soft palates C. White plaques on the lateral borders of the buccal mucosa D. Raised, painless lesions of the gingival
A
An oral antimicrobial option for the treatment of methicillin-sensitive S. aureus includes all of the following except: A. amoxicillin. B. dicloxacillin. C. cephalexin. D. cefadroxil.
A
An urticarial lesion is usually described as a: A. wheal B. plaque C. patch D. papule
A
Anthralin (Drithocreme) is helpful in treating psoriasis because it has what type of activity? a. antimitotic b. exfoliative c. vasoconstrictor d. humectant
A
Characteristics of onychomycosis include all of the following except: A. It is readily diagnosed by clinical examination B. Nail hypertrophy C. Brittle nails D. Fingernails respond more readily to therapy than toenails
A
First line treatment of impetigo with fewer than five lesions of 1-2 centimeters in diameter of the legs of a 9-year-old girl is A. Topical mupirocin B. Topical neomycin C. Oral Cefixime D. Oral Doxycycline
A
In a 13-year-old female patient with mild acne and who experiences an inadequate response to benzoyl peroxide treatment, an appropriate treatment option would be to: A. Add a topical Retinoid B. Add an oral antibiotic C. Consider isotretinoin D. Consider hormonal therapy
A
In counseling a patient with seborrheic dermatitis on the scalp about efforts to clear lesions, you advise her to: A. Use ketoconazole shampoo B. Apply petroleum jelly nightly to the affected area C. Coat the area with high-potency corticosteroid cream three times a week D. Expose the lesions periodically to heat by carefully using a hair dryer.
A
Lyme disease is caused by the bacterium: A. Borrelia burgdorferi B. Bacillus anthracis C. Corynebacterium striatum D. Treponema pallidum
A
One of the most common trigger agents for contact dermatitis is: A. Exposure to nickle B. Use of fabric softener C. Bathing with liquid body wash D. Eating Spicy foods
A
Patients with rosacea are recommended to use daily: A. A sunscreen B. Astringents C. An Exfoliant D. An antimicrobial cream
A
Signs that bed bugs are present in a home include all of the following except: A. small drops of fresh blood on floorboards. B. blood smears on bed sheets. C. presence of light brown exoskeletons. D. dark specks found along mattress seams.
A
Skin lesions associated with actinic keratoses can be described as: A. Slightly rough, pink or flesh-colored lesion in a sun-exposed area B. A well-defined, slightly raised, red, scaly plaque in a skinfold C. A blistering lesion along a dermatome D. A crusting lesion along flexor aspects of the fingers
A
The mechanism of action of imiquimod is as: A. An immunomodulator B. An antimitotic C. A keratolytic D. An irritant
A
The mechanism of action of pimecrolimus (Elidel) in the treatment of atopic dermatitis is: A. An immunomodulator B. An antimitotic C. A mast cell activator D. an exfoliant
A
The most common human papillomavirus types associated with cutaneous, nongenital warts include: A. 1, 2, and 4 B. 6 and 11 C. 16 and 18 D. 32 and 36
A
The use of which of the following medications contributes to the development of acne vulgaris? A. Lithium B. Propranolol C. Sertraline D. Clonidine
A
Treatment options in postherpetic neuralgia include all of the following except: A. Injectable Methylprednisolone B. Oral Pregabalin C. Oral Nortriptyline D. Topical Lidocaine
A
When prescribing itraconazole (Sporanox), the NP considers that: A. The drug is a cytochrome P450 3A4 inhibitor B. One pulse cycle is recommended for fingernail treatment, and two cycles are needed for toenail therapy C. Continuous therapy is preferred in the presence of hepatic disease D. Taking the drug on an empty stomach enhances the efficacy of the product.
A
When prescribing pulse dosing with itraconazole for the treatment of fingernail fungus, the clinician realizes that: A. A transient increase in hepatic enzymes is commonly seen with its use B. Drug-induced leukopenia is a common problem C. the patient needs to be warned about excessive bleeding because of the drug's anti-platelet effect D. Its use is contraindicated in the presence of iron deficiency anemia
A
Which of the following do you expect to find in the assessment of the person with urticaria? A. Eosinophilia B. Low erythrocyte sedimentation rate C. Elevated thyroid-stimulating hormone level D. Leukopenia
A
Which of the following is not a potential adverse effect with long-term high-potency topical corticosteroid use? A. Lichenification B. Telangiectasia C. Skin atrophy D. Adrenal suppression
A
You have initiated therapy for an 18-year-old man with acne vulgaris and have prescribed doxycycline. He returns in 3 weeks, complaining that his skin is "no better." Your next action is to: A. counsel him that 6 to 8 weeks of treatment is often needed before significant improvement is achieved. B. discontinue the doxycycline and initiate minocycline therapy. C. advise him that antibiotics are likely not an effective treatment for him and should not be continued. D. add a second antimicrobial agent such trimethoprim-sulfamethoxazole.
A
You see a 33-year-old male with a minor dog bite on his hand. The examination reveals a superficial wound on the left palm. The dog is up-to-date on immunizations. In deciding whether to initiate antimicrobial therapy, you consider that ______ of dog bites become bacterially infected. A. 5% B. 20% C. 50% D. 75%
A
You see a 34-year-old man with atopic dermatitis localized primarily on the arms who complains of severe itching. The condition becomes worse at night and interferes with his sleep. You recommend: A. taking a bedtime dose of antihistamine B. taking a bedtime dose of acetaminophen C. taking a hot shower prior to bedtime D. applying a warm compress to the affected areas 30 minutes prior to bedtime
A
You see a 36-year old man with no chronic health problems who presents with two furuncles, each around 4 cm in diameter, on the right anterior thigh. These lesions have been present for 3 days, slightly increasing in size during this time. He has no fever or other systemic symptoms. You advise the following: a. incision and drainage of the lesion b. a systemic antibiotic empirically c. a topical antibiotic d. aspiration of the lesion contents and prescription of a systemic antibiotic based on culture results
A
You see a kindergartner with impetigo and advise that she can return ________ hours after initiating effective antimicrobial therapy. A. 24 B. 48 C. 72 D. 96
A
The likely causative organisms of nonbullous impetigo in a 6-year-old child include: A. H. influenzae and S. pneumoniae B. Group A streptococcus and S. Aureus C. M. catarrhalis and select viruses D. P. aeruginosa and select fungi
B
The use of lindane (Kwell) to treat scabies is discouraged because of its potential for: A. hepatotoxicity B. neurotoxicity C. nephrotoxicity D. pancreatitis
B
To enhance the potency of a topical corticosteroid, the prescriber recommends that the patient apply the preparation: A. to dry skin by gentle rubbing B. and cover with an occlusive dressing C. before bathing D. with an emollient
B
Treatment options for actinic keratoses include topical: A. Vitamin D-derivation cream B. 5-fluorouracil C. Acyclovir D. Doxepin
B
Third-degree burn (full thickness)
Affected area is white and leathery
First-degree burn
Affected skin blanches with ease
All CA-MRSA strains are capable of causing necrotizing infection. A. True B. False
B. False
In a ring formation
Annular
A 14-year-old male presents with acne consisting of 25 comedones and 20 inflammatory lesions with no nodules. This patient can be classified as having: A. Mild acne B. Moderate acne C. Severe acne D. Very severe acne
B
A 56-year-old truck driver presents with a new nodular, opaque lesion with non-distinct borders on his left forearms. This most likely represents A. An actinic keratosis B. A squamous cell carcinoma C. A basal cell carcinoma D. A malignant melanoma
B
A 64-year-old man with seborrhea mentions that his skin condition is "better in the summer when he gets outside more and much worse in the winter." You respond: A. Sun exposure is a recommended therapy for the treatment of this condition B. Although sun exposure is noted to improve the skin lesions associated with seborrhea, its use as a therapy is potentially associated with an increased rate of skin cancer C. The lower humidity in the summer months noted in many areas of North America contributes to the improvement in seborrheic lesions D. Use high-potency topical corticosteroids during the winter months, tapering these off for the summer months
B
A 72-year-old woman presents with a newly formed, painless, pearly, ulcerated nodule with an overlying telangiectasis on the upper lip. This most likely represents. A. An Actinic keratosis B. A Basal cell carcinoma C. A Squamous cell carcinoma D. Molluscum contagiosum
B
A burn that is about twice as large as an adult's palmar surface of the hand including the fingers encompasses a BSA of approximately: A. 1 B. 2 C. 3 D. 4
B
A common infective agent in domestic pet cat bites is: A. virdans streptococcus species B. Pasteurella multocida C. Bacteroides species D. Haemaophilus influenza
B
A common site for atopic dermatitis in an infant is: A. The diaper area B. The Face C. The neck D. The posterior trunk
B
A woman was treated as an inpatient for a serious soft tissue infection with parenteral linezolid and now is being seen on day 3 of her illness and is being discharged to home. She is feeling better and appears by examination to be clinically improved. Culture results reveal MRSA, sensitive to trimethoprim-sulfamethoxazole, linezolid, daptomycin, vancomycin,and clindamycin and resistant to cephalothin and erythromycin. Her antimicrobial therapy should be completed with: A. oral cephalexin. B. oral trimethoprim-sulfamethoxazole. C. parenteral vancomycin. D. oral linezolid
B
Clinical features of bullous impetigo include: A. Intense itch B. Vesicular lesions C. Dermatomal pattern D. Systemic symptoms such as a fever and chills
B
Common clinical conditions included in the atopy subgroup of type I hypersensitivity reactions include all of the following except: A. Allergic rhinitis B. Rosacea C. Atopic dermatitis D. Allergic gastroenteropathy
B
For severe, recalcitrant psoriasis that affects more than 30% of the body, all of the following treatments are recommended except: A. methotrexate B. topical anthralin (Drithocreme) C. tumor necrosis factor (TNF) modulators D. cyclosporine
B
How many grams of a topical cream or ointment are needed for a single application to the entire body? A. 10 to 30 B. 30 to 60 C. 60 to 90 D. 90 to 120
B
How many grams of a topical cream or ointment are needed for a single application to the hands? A. 1 B. 2 C. 3 D. 4
B
In counseling a patient with atopic dermatitis, you suggest all of the following can be used to alleviate the symptoms of a flare except: A. the use of oral antihistamines B. Applying a heating pad on the affected region for 30 minutes C. The use of topical corticosteroids D. Applying cool wet, dressings made from a clean cloth and water to the affected area
B
Oral antimicrobial treatments recommended for rosacea include all of the following except: A. metronidazole B. levofloxacin C. erythromycin D. doxycycline
B
Preferred antimicrobials for the treatment of adults with Lyme disease include all of the following except: A. a tetracycline. B. an aminoglycoside. C. a cephalosporin. D. a penicillin.
B
Psoriatic lesions arise from: A. Decreased skin exfoliation B. Rapid skin cell turnover, leading to decreased maturation and keratinization C. Inflammatory changes in the dermis D. Lichenification
B
Risk factors for malignant melanoma include: A. Asian ancestry B. History of blistering sunburn C. Family history of psoriasis vulgaris D. Presence of atopic dermatitis
B
Risk factors for the development of postherpetic neuralgia include: A. Age younger than 50 years at the time of the outbreak B. Severe prodromal symptoms C. Lumbar location of lesions D. Low volume of lesions
B
The Spectrum of antmicrobial activity of mupirocin (Bactroban) includes: A. Primary gram-negative organisms B. Select gram-positive organisms C. Pseudomonas species and anaerobic organisms D. only organisms that do not produce beta-lactamase
B
The most common causative organism in cellulitis are: A. Escherichia coli and Haemophilus influenzae B. Bacteroides species and other anaerobes C. Group A beta-hemolytic streptococci and Staphylococcus aureus D. pathogenic viruses
C
A 24-year-old man arrives at the walk-in center. he reports that while walking in the woods he was bitten in the thigh by a raccoon. The examination reveals a wound that is 1cm deep on his right thigh. The wound is oozing bright red blood. Your next best action is to: A. Administer high- dose parenteral penicillin B. Initiate antibacterial prophylaxis with amoxicillin C. Give rabies immune globulin and rabies vaccine D. Suture the wound after proper cleansing
C
A 28-year-old woman presents to your practice with chief complaint of a cat bite sustained on her right ankle. Her pet cat had bitten her after she inadvertently stepped on its paw while she was in her home. Her cat is 3 years old, is up to date on immunizations, and does not go outside. Physical examination reveals pinpoint superficial puncture wounds on the right ankle consistent with the presenting history. She washed the wound with soap and water immediately and asks whether she needs additional therapy. Treatment for this patient's cat bite would should include standard wound care with the addition of: A. Oral erythromycin B. Topical bacitracin C. Oral amoxicillin-clavulanante D. Parenteral rifampin
C
A 29-year-old woman has a sudden onset of right-sided facial asymmetry. She is unable to close her right eyelid tightly or frown or smile on the affected side. Her examination is otherwise unremarkable. This likely represents paralysis of cranial nerve: A. III B. IV C. VII D. VIII
C
A 62-year-old woman presents 2 days after noticing a "bug bite" on her left forearm. Examination reveals a warm, red, edematous area with sharply demarcated borders. The patient is otherwise healthy with no fever This most likely represents: A. Contract dermatitis B. An allergic reaction C. Cellulitis D. Erysipelas
C
A common cause of angular cheilitis is infection by: A. Escherichia coli B. Streptococcus pneumoniae C. Candida species D. Aspergillus species
C
A patient present with a painful, blistering thermal burn involving the first, second, and third digits of his right hand. The most appropriate plan of care is to: A. Apply an anesthetic cream to the area and open the blisters B. Apply silver sulfadiazine cream (Silvadene) to the area followed by a bulky dressing C. Refer the patient to a burn specialty care D. Wrap the burn loosely with a non-adherent dressing and prescribe an analgesic agent
C
An impetigo lesion that becomes deeply ulcerated is known as: A. cellulitis. B. erythema. C. ecthyma. D. empyema.
C
Antihistamines exhibit therapeutic effect by: A. Inactivating circulating histamine B. Preventing production of histamine C. Blocking activity at histamine receptor sites D. Acting as a procholinergic agent
C
Biological agents to treat psoriasis, such as infliximab and etanercept, work by blocking the action of A. IL-9 B. CD4 C. TNF-α D. IgG
C
Common triggers for anaphylaxis include exposure to certain types of all of the following except: A. Medications B. Food C. Pet dander D. Insect bites
C
Definitive diagnosis of skin cancer requires: A. Skin examination B. CT scan C. Biopsy D. Serum antigen testing
C
During Type 1 hypersensitivity reactions, histamine released from degraded mast cells causes all fo the following except: A. vasodilation B. Mucous gland stimulation C. Enhanced sebum production D. Tissue swelling
C
First-line therapy for acne vulgaris with closed comedones includes: A. Oral antibiotics B. Isotretinoin C. Benzoyl peroxide D. Hydrocortisone cream
C
First-line therapy for angular cheilitis therapy includes the use of: A. Metronidazole gel B. Hydrocortisone cream C. Topical nystatin D. Oral Ketoconazole
C
How many grams of a topical cream or ointment are needed for a single application to an arm? A. 1 B. 2 C. 3 D. 4
C
In counseling a patient on the use of the topical products to treat nail fungal infections, the NP considers that: A. Nail lacquers, such as ciclopirox olamine 8% solution (Penlac), offer similar effectiveness to oral antifungals B. Some herbal products, such as tea tree oil, can be an effective alternative to oral agents C. Topical products have limited penetration through the nail matrix to reach the site of infection D. Cream-based products are more effective than gel-based products in treating nail fungal infections
C
In counseling a patient with scabies, the NP recommends all of the following methods to eliminate the mite from bedclothes and other items except: A. Washing items in hot water B. Running items through the clothes dryer for a normal cycle C. Soaking items in cold water for at least 1 hour D. Placing items in a plastic storage bag for at least 1 week
C
In diagnosing onychomycosis, the NP considers that: A. Nails often have a single midline groove B. Pitting is often seen C. Microscopic examination reveals hyphae D. Beau lines are present
C
In the treatment of acne vulgaris, which lesions respond best to topical antibiotic therapy? A. Open comedones B. Cysts C. Inflammatory lesions D. Superficial lesions
C
Nonchemical means to eliminate bed bugs can include all of the following except: A. vacuuming crevices. B. washing bedding and other items in hot water. C. isolating the infested area from any hosts for at least 2 weeks. D. running bedding and other items in a dryer on high heat for 20 minutes
C
One of the mechanisms of action of a topical corticosteroid preparation is as: A. an antimitotic. B. an exfoliant. C. a vasoconstrictor. D. a humectant.
C
Oral antifungal treatment options for onychomycosis include all of the following except: A. Itraconazole B. Fluconazole C. Metronidazole D. Terbinafine
C
Psoriasis vulgaris is a chronic skin disease caused by: A. Bacterial colonization B. Absence of melanin C. Accelerated mitosis D. Type I hypersensitivity reaction
C
Seborrheic dermatitis is likely caused by: A. Accelerated mitosis of skin cells B. Colonization of skin by Staphylococcus aureus C. An inflammatory reaction to Malassezia species on skin D. Exposure to excessive UV radiation
C
Which of the following represents the most accurate patient information when using permethrin (Elimite) for treating scabies. A. To avoid systemic absorption, the medication should be applied over the body and rinsed off within 1 hour B. The patient should notice a marked reduction in pruritis within 48 hours of using the product C. Itch often persists for a few weeks after successful treatment D. It is a second-line product in the treatment of scabies
C
Which of the following would not be recommended to prevent Lyme disease when visiting a Lyme-endemic area A. Wear long pants and long-sleeved shirts B. Use insect repellent C. If a tick bite occurs, wait until after consulting a healthcare provider before removing the insect. D. If a tick bite occurs and the tick is engorged, administer a single 200mg dose of doxycycline
C
You see a 28-year-old man who was involved in a fight approximately 1 hour ago with another person. The patient states, "He bit me in the arm." Examination of the left forearm reveals an open wound consistent with this history. Your next best action is to: A. obtain a culture and sensitivity of the wound site B. refer for rabies prophylaxis C. irrigate the wound and débride as needed D. close the wound with adhesive strips
C
You write a prescription for a topical agent and anticipate the greatest rate of absorption when it is applied to the: A. palms of the hands B. soles of the feet C. face D. abdomen
C
A 49-year-old man presents with a skin lesion suspicious for malignant melanoma. You describe the lesion as having: A. Deep black-brown coloring throughout B. Sharp borders C. A diameter of 3mm or less D. Variable pigmentation
D
A common site for atopic dermatitis in an adult is on the: A. Dorsum of the hand B. Face C. Neck D. Flexor surfaces
D
A mother brings to the clinic her 3-year-old daughter, who presents with dry red patches on her face around the eyes. The mother has observed her daughter constantly rubbing the area, which has caused swelling around the eyes. Physical examination is consistent with atopic dermatitis. The NP considers that this is a diagnosis that: A. Requires a skin culture to confirm contributing bacterial organisms B. Should be supported by a biopsy of the affected area C. Necessitates obtaining peripheral blood eosinophil levels D. Is usually made by clinical assessment alone
D
A skin biopsy result indicates the presence of malignant melanoma for a 53-year-old woman. You recommend: A. Excision of the entire lesion B. Electrodissection with curettage C. Initiating treatment with topical cancer chemotherapy D. Consultation with a skin cancer expert to direct next best actions
D
All of the following characteristics about bed bugs are true except: A. They can be found in furniture, carpeting, and floorboards B. Their peak feeding time is at dawn C. During feeding, they are attracted to body heat and carbon dioxide D. they prefer to harbor unsanitary environments
D
All of the following statements are true regarding skin reactions to bed bugs except A. Skin reactions are more common with repeated exposure to bed bug bites B. Skin reactions can typically involve papules, macules, or wheals C. Allergic reactions can be treated with topical corticosteroids D. Systemic skin reactions frequently occur following an initial exposure to bed bug bites
D
Among the following, who is at greatest risk of developing seborrheic dermatitis? A. A 15-year-old boy residing in a rural setting B. A 34-year-old woman who smokes two packs per day (PPD) C. A 48-year-old male truck driver D. A 72-year-old man with Parkinson disease
D
Analgesia options for a patient with shingles can include all of the following except: A. topical lidocaine gel 5% with oral acetaminophen B. Burow's solution with a high-potency oral NSAID C. Burow's solution with an oral opioid D. fentanyl transdermal patch and a topical medium-potency corticosteroid on the affected area
D
Common clinical manifestations of anaphylaxis can include all of the following except: A. Upper airway edema B. Itch without rash C. Dizziness with syncope D. Hypertension
D
Gram-negative bacteria that commonly cause burn wound infections include all of the following except: A. P. aeruginosa B. E. coli C. K. pneumoniae D. H. influenzae
D
In a 22-year-old woman using isotretinoin (Accutane) therapy, the NP ensures follow-up to monitor for all of the following tests except: A. Hepatic enzymes B. Triglyceride Measurements C. Pregnancy D. Platelet count
D
Leonard is an 18-year-old man who has been taking isotretinoin (Accutane) for the treatment of acne for the past 2 months. Which of the following is the most important question for the clinician to ask at his follow-up office visit? A. Are you having any problems remembering to take your medication? B. Have you noticed any dry skin around your mouth since you started using Accutane? C. Do you notice any improvement in your skin? D. Have you noticed any recent changes in your mood?
D
Nonsurgical options for the treatment of squamous and basal cell carcinoma include all of the following except: A. Cryotherapy B. Electrodissection with curettage C. Topical cancer chemotherapy D. Oral Hydroxyurea
D
Recommended non-pharmacological options to treat actinic keratosis include all of the following except: A. A chemical peel B. Cryotherapy C. Laser resurfacing D. Mohs micrographic surgery
D
Risk factors for angular cheilitis in adults include all of the following except: A. Advanced age B. HIV infection C. Alteration of facial vertical dimensions due to loss of teeth D. Obesity
D
Shingles most commonly involve the dermatomes of the: A. legs and pubic area. B. face. C. upper arms and shoulders. D. thorax
D
The most common sites for squamous and basal cell carcinoma include: A. Palms of hands and soles of feet B. Pelvic and lumbar regions C. The abdomen D. The face and scalp
D
Narrow linear crack into epidermis, exposing dermis
Fissure
Skin thickening usually found over pruritic or friction areas
Lichenification
Raised lesion, larger than 1 cm, may be same or different color from the surrounding skin
Plaque
Second-degree burn (partial thickness)
Surface is raw and moist
Loss of skin markings and full skin thickness
atrophy
Multiple lesions blending together
confluent or coalescent
