NUR 720 exam 2 set 8 (dermatology/acne vulgaris/psorias)
Which of the following is the best tx for cellulitis? A. Cephalexin B. Amoxicillin C. Metronidazole D. Trimethoprim-sulfa
D. Trimethoprim-sulfa
A common plan for psoriasis is to use a ? to ? potency topical corticosteroid until plaques resolve and then use a ? topical corticosteroid for ?-? time per week to maintain remission.
medium to high, low, 3-4 times per week
A 45 y.o. patient presents with a raised lesion with flaking of skin >1cm that is silvery in color what is this lesion
plaque psoriasis
Treatment of fungal infection caused by Candida Albicans is topical? A. Metronidazole getl B. Nystatin or clotrimazole cream C. hydrocortisone ointment D. clindamycin cream
B. Nystatin or clotrimazole cream 1%
How many grams of a topical cream or ointment is needed for a single application to an arm? A. 1 B. 2 C. 3 D. 4
C. 3
You write a prescription for a topical agent and anticipate the greatest rate of absorption when it is applied will be to the: A. Palms of the hands B. soles of the feet C. Face D. abdomen
C. Face
Biological agents to tx psoriasis, such as infliximab and etanercept, work by blocking the action of : A. IL-9 B. CD4 C. TNF-a D. IgG
C. TNF-a
Leonard is an 18 y.o. man who has been taking istretinoin (Accutain) for the tx 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 visit? A. Are you having any problems remembering to take your medication? B. Have you noticed and dry skin around your mouth since you started using Accutane? C. Do yo notice any improvement in your skin? D. Have you noticed any recent changes in your mood?
D. Have you noticed any recent changes in your mood?
1 to 12. Match the following descriptions to the correct lesion or distribution name. ____ 1. multiple lesions blending together ____ 2. flat discoloration less than 1 cm in diameter ____ 3. circumscribed area of skin edema ____ 4. narrow linear crack into epidermis, exposing dermis ____ 5. vesicle-like lesion with purulent content ____ 6. flat discoloration greater than 1 cm in diameter ____ 7. raised lesion, larger than 1 cm, may be same or different color from the surrounding skin ____ 8. net-like cluster ____ 9. loss of epidermis and dermis ____ 10. loss of skin markings and full skin thickness ____ 11. skin thickening usually found over pruritic or friction areas ____ 12. in a ring formation ____ 13. flat red-purple lesion caused by red blood cells leaving the circulation and becoming trapped in the skin. A. ulcer B. atrophy C. fissure D. reticular E. wheal F. pustule G. patch H. plaque I. macule J. confluent or coalescent K. annular L. lichenification M. Purpura
1. J. confluent or coalescent 2. I. macule 3. E. wheal 4. C. fissure 5. F. pustule 6. G. patch 7. H. plaque 8. D. reticular 9. A. ulcer 10. B. atrophy 11. L. lichenification 12. K. annular 13. M. urpura
Which of the following is not a potential adverse effect with long-term high-potency topical corticosteroid use? A. lichenification B. telangiextasia C. skin atrophy D. adrenal suppression
A. lichenification
The use of which of the following medications contributes to the development of acne vulgaris? A. lithium B. propranolol C. sertraline D. clonidine
A. lithium phenytoin(dilantin) is another
Muprocin's spectrum of antimicrobial activity includes: A. Primarily gram negative organisms B. Select staphylococcus and Streptococcus species C. Pseudomonas species and anaerobic organisms D. Only organisms that don't produce beta-lactamase
B. Select staphylococcus and Streptococcus species
Which of the following isindicated for the tx of acne rosacea? A. Metronidazole gel B. Clindamycin lotion C. Erythromycin 2% solution D. Azelaic acid 20%
A. Metronidazole gel
For a 13 y.o. female patient with mild acne and who experiences an inadequate response to benzoyl peroxide tx an appropriate tx option would be to: A. add topical retinoid B. add an oral abx C. consider isotretinoin D. consider hormonal therapy
A. add topical retinoidA. add topical retinoid
Anthralin (Drithocreme) is helpful in the tx of psoriasis because it has what kind of activity? A. antimitotic B. exfoliative C. vasoconstrictor D. hemuctant
A. antimitotic
How many grams of topical cream or ointment are needed for a single application to the entire body? A. 10-30 B. 30-60 C. 60-90 D. 90-120
B. 30-60
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. a 20-year-old patient with cystic lesions who has tried various therapies with minimal effect
A 14 y.o. male presents wit acne consisting of 25 comedones and 20 inflammatory lesion with no nodules. This patient can e classified as having: A. mild acne B. moderate acne C. severe acne D. very severe acne.
B. moderate acne
The use of TNF modulators for the tx of psoriasis is associated with an increased risk for: A. gastrointestinal disorders B. nephrotoxicity C. QTc prolongation D. reactivation of latent tuberculosis
B. nephrotoxicity
Psoriatic lesions arise from: A. decreased skin exfoliation B. rapid skin cell turnover, leading to decreased maturation and keratinzation C. inflammatory change sin the dermis D. lichenification
B. rapid skin cell turnover, leading to decreased maturation and keratinzation
For severe, recalcitrant psoriasis that affects more than 30% of the body, all of the following tx are recommended except: A. methotrexate B. topical anthralin(Drithocreme) C. tumor necrosis factor (TNF)modulators D. cyclosporine
B. topical anthralin(Drithocreme)
When prescribing tretinoin (retin-A) the NP advises the patient to: A. use it with benzoyl peroxide to minimize irritating effects. B. use a sunscreen because the drug is photosensitizing 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. use a sunscreen because the drug is photosensitizing
You examine a patient with psoriasis vulgarism and expect to find the following lesions: A. lichenified areas n flexor areas B. well-demarcated plaques on the knees C. greasy lesions throughout the scalp D. vesicular lesions ove the upper thorax
B. well-demarcated plaques on the knees
Psoriasis vulgaris is a chronic skin disease caused by: A. bacterial colonization B. absence of melanin C. accelerated mitosis D. type I heprsensitivity reaction
C. accelerated mitosis
First-line therapy for acne vulgarism with closed comedones includes: A. oral antibiotics B. isotretinoin C. benzoyl peroxide D. hydrocortisone cream
C. benzoyl peroxide
In the tx of acne vulgarism, which lesions respond best to topical antibiotic therapy? A. open comedones B. cysts C. inflammatory lesions D. superficial lesions
C. inflammatory lesions
In a 22 y.o. woman using isotretinoin (Accutain) therapy, the NP ensure follow-up to monitor for all of the following tests except: A. hepatic enzymes B. triglycerid measurements C. pregnancy D. platelet count
D. platelet count
Tx options in generalized psoriasis vulgaris include all of the following except: A. psoralen with UV A light (PUVA) therapy B. methotrexate C. cyclosporine D. systemic corticosteroids
D. systemic corticosteroids
?/? is effective in cystic acne that does not respond to conventional therapy of Benzoyl peroxide. Women taking this medication Accutane need to have ? pregnancy tests including one on the 2nd day of their normal menstrual period, before beginning the medication. Women should use two forms of ? and have a pregnancy test done ? during therapy.
Isotretinoin(Accutane) two pregnancy tests, contraception, monthly
Anti mitotic medication such as anthralin/? and the topical vitamin ? derivative are more expensive than topical steroids but work for psoriasis.
anthralin(Drithocreme), calcipotriene (Vit D 3)
