Sarah Michelle – N P Review Exam 2026
Guide
1. Herpes Keratitis infection of the cornea due to HSV
sx: conjunctivitis, clear ocular drainage, irritation, itching, pain, and light sensitiv-
ity
dx: slit lamp and visualizing the cornea. -- will reveal dendritic lesion with a
terminal bulb and swollen borders and "fern like" appearance
tx: oral or ophthalmic acyclovir (Zovirax). refer to eye dr
2. dx cushing syn- -dexamethasone suppression test
drome -serum midnight plasma cortisol level
-24-hour urinary free cortisol test
3. dexamethasone administering 1 mg of dexamethasone around 11 PM and measuring a serum
suppression test cortisol level the next morning
4. serum midnight these patients' cortisol levels do not decrease at nighttime, as would be expected
plasma cortisol in patients without Cushing syndrome
level test
5. 24-hour urinary used to confirm hypercortisolism in patients with high midnight plasma cortisol
free cortisol test levels and abnormal dexamethasone suppression test results.
6. adrenocorti- -diagnosing adrenal insuflciency, which presents in cases of Addison disease
cotropic
hormone (ACTH)
stimulation test
7. Pterygiums benign, wedge-shaped growths of the conjunctivae that extend onto the cornea
typically flat, white, and bilateral.
often asymptomatic
8. pinguecula small, raised, yellow conjunctival growth that is benign
, Sarah Michelle – N P Review Exam 2026
Guide
9. aphthous stom-
atitis
10. herpes painful, cluster vesciles on eryethemtous or redden base
need to treat within 48-72 hrs
11. Chronic Ulcera- autoimmune with same oral lesions, but sores are larger in size and in number
tive Stomatitis -Can take weeks to months to resolve
(CUS -Symptomatic relief from tx doesnt otten happen
-caused by lichen planus.
first line tx: oral steroids. if severe enough hydroxoychloroquine
12. Keratosis Pilaris commonly cause "chicken spots"
tx: emollients and moisturizers. children often outgrow
13. impetigo honey crusted lesions:
bolus and non-bolus
two major organisms : strep and staph
14. bolus impetigo not usually seen with honey crusted -- they erupt.
need some oral abx- typically cefalexin, doxloxacinillin
15. non-bolus im- usually see with honey crusted spots
petigo
tx: topical mupirocin ointment
16. pityriasis rosea markings that occur before rash: christmas tree pattern"
start with herald patch and spreads across back and abdomen
, Sarah Michelle – N P Review Exam 2026
Guide
-usually goes away on its own
17. brown recluse spot became tender and became dark color with white halo. also systemic symp-
spider bite toms are present
18. rocky mountain caused by tick bite
spotted fever -rash pops up 3-5 days after symptoms begin. Usually presents palms of hands
and soles of feet
tx: ALWAYS with doxycycline (high mmortality rate if not treated with this)
19. lyme disease "also known as erythema migrans"
mention of a tick bite. bullseye or target lesion
tx: doxycycline or amoxicllin
20. measels (rubeo- usually starts with fever and then the 3 C's -
la) congestion
cough
conjuctivitis
-rash usually begins 3-5 after initial symtpoms. Also have Koplik spots in mouth
(tiny grains of white sand surrounded)
prevent with vaccination --usually after 12 months unless traveling outside US
21. Mumps noticable parotid gland swelling
22. actinic keratosis dry, scaly lesion, on sun exposed lesion
pink, tan, yellow, brown , pale
can develop into SCC
23. SCC slow growing, scaley ulceration, red and bleeds easily
, 24. Cafe au lait spots Smooth edged tan-to-brown pigmentations on the skin seen in NF1
25. neurofibromato- genetic disorder with multiple benign fibrous tumors that grow anywhere in the
sis nervous system including the brain, spinal cord, and peripheral nerves
associated findings: cafe au lait spots, skin folds freckling, neurofibromas, lisch
nodules
26. malignant A - asymetric
melanoma tool B - border regularity
C - color
D - diameter greater than 6mm
E- evolution
27. black line on nail ask about injury?
if none -- could be melanoma or possible splinter from endocarditis
28. seborrheic ker- benign and looks "pasted" on
atosis do NOT need to be removed
29. Basal cell carci- pearly grey, shiny, waxy, telangiectasis present
noma (BCC) MOST COMMON TYPE
tx: biopsy and refer to derm
30. Eczema pruritic with itch-scratch, itch scratch cycle
found on flexor surfaces
tx: with emollients and topical steroids
3 A's that usually go together:
Asthma, Atopic dermatitis, Allergies
31. Plaque Psoriasis thick, silver lesions
Guide
1. Herpes Keratitis infection of the cornea due to HSV
sx: conjunctivitis, clear ocular drainage, irritation, itching, pain, and light sensitiv-
ity
dx: slit lamp and visualizing the cornea. -- will reveal dendritic lesion with a
terminal bulb and swollen borders and "fern like" appearance
tx: oral or ophthalmic acyclovir (Zovirax). refer to eye dr
2. dx cushing syn- -dexamethasone suppression test
drome -serum midnight plasma cortisol level
-24-hour urinary free cortisol test
3. dexamethasone administering 1 mg of dexamethasone around 11 PM and measuring a serum
suppression test cortisol level the next morning
4. serum midnight these patients' cortisol levels do not decrease at nighttime, as would be expected
plasma cortisol in patients without Cushing syndrome
level test
5. 24-hour urinary used to confirm hypercortisolism in patients with high midnight plasma cortisol
free cortisol test levels and abnormal dexamethasone suppression test results.
6. adrenocorti- -diagnosing adrenal insuflciency, which presents in cases of Addison disease
cotropic
hormone (ACTH)
stimulation test
7. Pterygiums benign, wedge-shaped growths of the conjunctivae that extend onto the cornea
typically flat, white, and bilateral.
often asymptomatic
8. pinguecula small, raised, yellow conjunctival growth that is benign
, Sarah Michelle – N P Review Exam 2026
Guide
9. aphthous stom-
atitis
10. herpes painful, cluster vesciles on eryethemtous or redden base
need to treat within 48-72 hrs
11. Chronic Ulcera- autoimmune with same oral lesions, but sores are larger in size and in number
tive Stomatitis -Can take weeks to months to resolve
(CUS -Symptomatic relief from tx doesnt otten happen
-caused by lichen planus.
first line tx: oral steroids. if severe enough hydroxoychloroquine
12. Keratosis Pilaris commonly cause "chicken spots"
tx: emollients and moisturizers. children often outgrow
13. impetigo honey crusted lesions:
bolus and non-bolus
two major organisms : strep and staph
14. bolus impetigo not usually seen with honey crusted -- they erupt.
need some oral abx- typically cefalexin, doxloxacinillin
15. non-bolus im- usually see with honey crusted spots
petigo
tx: topical mupirocin ointment
16. pityriasis rosea markings that occur before rash: christmas tree pattern"
start with herald patch and spreads across back and abdomen
, Sarah Michelle – N P Review Exam 2026
Guide
-usually goes away on its own
17. brown recluse spot became tender and became dark color with white halo. also systemic symp-
spider bite toms are present
18. rocky mountain caused by tick bite
spotted fever -rash pops up 3-5 days after symptoms begin. Usually presents palms of hands
and soles of feet
tx: ALWAYS with doxycycline (high mmortality rate if not treated with this)
19. lyme disease "also known as erythema migrans"
mention of a tick bite. bullseye or target lesion
tx: doxycycline or amoxicllin
20. measels (rubeo- usually starts with fever and then the 3 C's -
la) congestion
cough
conjuctivitis
-rash usually begins 3-5 after initial symtpoms. Also have Koplik spots in mouth
(tiny grains of white sand surrounded)
prevent with vaccination --usually after 12 months unless traveling outside US
21. Mumps noticable parotid gland swelling
22. actinic keratosis dry, scaly lesion, on sun exposed lesion
pink, tan, yellow, brown , pale
can develop into SCC
23. SCC slow growing, scaley ulceration, red and bleeds easily
, 24. Cafe au lait spots Smooth edged tan-to-brown pigmentations on the skin seen in NF1
25. neurofibromato- genetic disorder with multiple benign fibrous tumors that grow anywhere in the
sis nervous system including the brain, spinal cord, and peripheral nerves
associated findings: cafe au lait spots, skin folds freckling, neurofibromas, lisch
nodules
26. malignant A - asymetric
melanoma tool B - border regularity
C - color
D - diameter greater than 6mm
E- evolution
27. black line on nail ask about injury?
if none -- could be melanoma or possible splinter from endocarditis
28. seborrheic ker- benign and looks "pasted" on
atosis do NOT need to be removed
29. Basal cell carci- pearly grey, shiny, waxy, telangiectasis present
noma (BCC) MOST COMMON TYPE
tx: biopsy and refer to derm
30. Eczema pruritic with itch-scratch, itch scratch cycle
found on flexor surfaces
tx: with emollients and topical steroids
3 A's that usually go together:
Asthma, Atopic dermatitis, Allergies
31. Plaque Psoriasis thick, silver lesions
