AGNP BOARD EXAM: Dermatology Prescription
100 Questions with Answers and Explanations
1. Question: Systemic ivermectin (Stromectol), classified as an antiparasitic,:
a) Is primarily excreted in the urine.
b) Crosses the blood-brain barrier.
c) Has a high concentration in the liver.
d) Is not well absorbed.
Explanation: Systemic ivermectin (Stromectol) is well absorbed and is primarily excreted in the
feces. It is distributed and highly concentrated in the liver and adipose tissue. It is primarily
bound to albumin, with a half-life elimination of 18 hours. Time to peak serum is about 4 hours.
2. Question: Topical permethrin (Elimite) in the treatment of scabies should be left in
place for a minimum of:
a) 30 minutes.
b) 2 hours.
c) 6 hours.
d) 8 hours.
Explanation: Patients should massage permethrin cream (Elimite) thoroughly into the skin from
the neck to the soles of the feet, including areas under the fingernails and toenails. Thirty grams
is usually sufficient for an average adult. The hairline, neck, temples, and forehead may be
infested in infants and geriatric patients. In these populations, permethrin should also be applied
to the scalp and face, sparing the eyes and mouth. The cream should be removed by washing
(shower or bath) after 8 to 14 hours.
3. Question: The mechanism of action of clindamycin (Cleocin), used in the treatment
of cellulitis, is to:
a) Block synthesis of folic acid by bacteria and inhibit replication.
b) Uncouple mitochondrial oxidative metabolism and inhibit cell growth.
, c) Block the dissociation of peptidylt RNA from ribosomes.
d) Inhibit protein synthesis by preventing ribosomal translocation.
Explanation: Sulfa agents block synthesis of folic acid by bacteria and thus inhibit bacterial
replication. First-generation cephalosporins inhibit cell wall synthesis of bacteria. Antifungals
uncouple mitochondrial oxidative metabolism and inhibit cell growth. Macrolides inhibit
bacterial growth, possibly by blocking dissociation of peptidylt RNA from ribosomes, causing
RNA-dependent protein synthesis to arrest. Other antibacterials are bacteriostatic or bactericidal
and inhibit protein synthesis by preventing ribosomal translocation.
4. Question: Tretinoin topical (Retin-A) is indicated for the treatment of acne vulgaris
and:
a) Acne rosacea.
b) Dermatomyositis.
c) Inflammatory keratosis pilaris.
d) Mottled hyperpigmentation.
Explanation: Tretinoin topical (Retin-A) is indicated for the treatment of acne vulgaris,
palliation of fine wrinkles, mottled hyperpigmentation and facial skin roughness.
5. Question: The brand name of oral isotretinoin is:
a) Duac.
b) Absorica.
c) Accolate.
d) Accupril.
Explanation: The brand names of oral isotretinoin include Absorica, Amnesteem, Claravis, and
Zenatane. The generic name for Duac is clindamycin/benzoyl peroxide, used in the treatment of
acne. The generic name for Accolate is zafirlukast. It is a leukotriene inhibitor used in the
treatment of asthma. The generic name for Accupril is quinapril; it is an ACE inhibitor.
, 6. Question: Benzoyl peroxide (Benzac wash) is classified as a topical:
a) Antibiotic.
b) Astringent.
c) Antimicrobial.
d) Acetic acid-based cleanser.
Explanation: Benzoyl peroxide is a topical antimicrobial used in the treatment of acne. When
applied to the skin, benzoyl peroxide works by reducing the amount of acne-causing bacteria and
by causing the skin to dry and peel.
7. Question: The generic name for Elidel is:
a) Permethrin.
b) Pimecrolimus.
c) Tacrolimus.
d) Urea topical.
Explanation: The generic name for Elidel is pimecrolimus. Elidel is a dermatologic agent used
in the treatment of atopic dermatitis. The brand name of permethrin is Nix or Elimite. It is an
antiparasitic used in the treatment of lice. The brand name for tacrolimus is Prograf. It is an
immunosuppressive drug used after transplant. The brand name of urea topical is Keralac and it
is used in the treatment of hyperkeratosis.
8. Question: Which of the following conditions is NOT a side effect of long-term use of
topical steroids?
a) Cutaneous atrophy
b) Glaucoma
c) Hypotrichosis
d) Telangiectasia
Explanation: Cutaneous and systemic side effects can occur, particularly with super potent and
potent drugs, or extensive use of lower potency agents with or without occlusion. Treatment with
, topical corticosteroids should be restricted to the lowest and shortest duration of therapy required
to achieve the desired effect. Cutaneous atrophy, telangiectasia, hypertrichosis, striae, purpura,
hypopigmentation, glaucoma, and suppression of the hypothalamic-pituitary axis are side effects
that may occur with topical corticosteroid use.
9. Question: Patients using fluorouracil (Carac) for the treatment of actinic keratosis
should be advised to expect:
a) Hypopigmentation.
b) Eczema.
c) Pustular formation.
d) Vesiculation.
Explanation: When fluorouracil (Carac) is applied to a lesion, erythema followed by
vesiculation, desquamation, erosion and re-epithelialization occurs. Local reactions and
alterations in skin appearance may persist for several weeks after discontinuation.
10. Question: Tetracycline (Sumycin) is used in the treatment of skin and skin structure
infections caused by:
a) Bartonella bacilliformis.
b) Klebsiella species.
c) Escherichia coli.
d) Staphylococcus aureus.
Explanation: Tetracycline (Sumycin) is indicated for the treatment of skin and skin structure
infections caused by Staphylococcus aureus or Staphylococcus pyogenes (commonly found in
post burn infections).
11. Question: The most appropriate therapy for patients with chronic paronychia is a:
a) Systemic antifungal.
b) Systemic glucocorticoids.
c) Topical steroid.
d) Topical antibiotic.
100 Questions with Answers and Explanations
1. Question: Systemic ivermectin (Stromectol), classified as an antiparasitic,:
a) Is primarily excreted in the urine.
b) Crosses the blood-brain barrier.
c) Has a high concentration in the liver.
d) Is not well absorbed.
Explanation: Systemic ivermectin (Stromectol) is well absorbed and is primarily excreted in the
feces. It is distributed and highly concentrated in the liver and adipose tissue. It is primarily
bound to albumin, with a half-life elimination of 18 hours. Time to peak serum is about 4 hours.
2. Question: Topical permethrin (Elimite) in the treatment of scabies should be left in
place for a minimum of:
a) 30 minutes.
b) 2 hours.
c) 6 hours.
d) 8 hours.
Explanation: Patients should massage permethrin cream (Elimite) thoroughly into the skin from
the neck to the soles of the feet, including areas under the fingernails and toenails. Thirty grams
is usually sufficient for an average adult. The hairline, neck, temples, and forehead may be
infested in infants and geriatric patients. In these populations, permethrin should also be applied
to the scalp and face, sparing the eyes and mouth. The cream should be removed by washing
(shower or bath) after 8 to 14 hours.
3. Question: The mechanism of action of clindamycin (Cleocin), used in the treatment
of cellulitis, is to:
a) Block synthesis of folic acid by bacteria and inhibit replication.
b) Uncouple mitochondrial oxidative metabolism and inhibit cell growth.
, c) Block the dissociation of peptidylt RNA from ribosomes.
d) Inhibit protein synthesis by preventing ribosomal translocation.
Explanation: Sulfa agents block synthesis of folic acid by bacteria and thus inhibit bacterial
replication. First-generation cephalosporins inhibit cell wall synthesis of bacteria. Antifungals
uncouple mitochondrial oxidative metabolism and inhibit cell growth. Macrolides inhibit
bacterial growth, possibly by blocking dissociation of peptidylt RNA from ribosomes, causing
RNA-dependent protein synthesis to arrest. Other antibacterials are bacteriostatic or bactericidal
and inhibit protein synthesis by preventing ribosomal translocation.
4. Question: Tretinoin topical (Retin-A) is indicated for the treatment of acne vulgaris
and:
a) Acne rosacea.
b) Dermatomyositis.
c) Inflammatory keratosis pilaris.
d) Mottled hyperpigmentation.
Explanation: Tretinoin topical (Retin-A) is indicated for the treatment of acne vulgaris,
palliation of fine wrinkles, mottled hyperpigmentation and facial skin roughness.
5. Question: The brand name of oral isotretinoin is:
a) Duac.
b) Absorica.
c) Accolate.
d) Accupril.
Explanation: The brand names of oral isotretinoin include Absorica, Amnesteem, Claravis, and
Zenatane. The generic name for Duac is clindamycin/benzoyl peroxide, used in the treatment of
acne. The generic name for Accolate is zafirlukast. It is a leukotriene inhibitor used in the
treatment of asthma. The generic name for Accupril is quinapril; it is an ACE inhibitor.
, 6. Question: Benzoyl peroxide (Benzac wash) is classified as a topical:
a) Antibiotic.
b) Astringent.
c) Antimicrobial.
d) Acetic acid-based cleanser.
Explanation: Benzoyl peroxide is a topical antimicrobial used in the treatment of acne. When
applied to the skin, benzoyl peroxide works by reducing the amount of acne-causing bacteria and
by causing the skin to dry and peel.
7. Question: The generic name for Elidel is:
a) Permethrin.
b) Pimecrolimus.
c) Tacrolimus.
d) Urea topical.
Explanation: The generic name for Elidel is pimecrolimus. Elidel is a dermatologic agent used
in the treatment of atopic dermatitis. The brand name of permethrin is Nix or Elimite. It is an
antiparasitic used in the treatment of lice. The brand name for tacrolimus is Prograf. It is an
immunosuppressive drug used after transplant. The brand name of urea topical is Keralac and it
is used in the treatment of hyperkeratosis.
8. Question: Which of the following conditions is NOT a side effect of long-term use of
topical steroids?
a) Cutaneous atrophy
b) Glaucoma
c) Hypotrichosis
d) Telangiectasia
Explanation: Cutaneous and systemic side effects can occur, particularly with super potent and
potent drugs, or extensive use of lower potency agents with or without occlusion. Treatment with
, topical corticosteroids should be restricted to the lowest and shortest duration of therapy required
to achieve the desired effect. Cutaneous atrophy, telangiectasia, hypertrichosis, striae, purpura,
hypopigmentation, glaucoma, and suppression of the hypothalamic-pituitary axis are side effects
that may occur with topical corticosteroid use.
9. Question: Patients using fluorouracil (Carac) for the treatment of actinic keratosis
should be advised to expect:
a) Hypopigmentation.
b) Eczema.
c) Pustular formation.
d) Vesiculation.
Explanation: When fluorouracil (Carac) is applied to a lesion, erythema followed by
vesiculation, desquamation, erosion and re-epithelialization occurs. Local reactions and
alterations in skin appearance may persist for several weeks after discontinuation.
10. Question: Tetracycline (Sumycin) is used in the treatment of skin and skin structure
infections caused by:
a) Bartonella bacilliformis.
b) Klebsiella species.
c) Escherichia coli.
d) Staphylococcus aureus.
Explanation: Tetracycline (Sumycin) is indicated for the treatment of skin and skin structure
infections caused by Staphylococcus aureus or Staphylococcus pyogenes (commonly found in
post burn infections).
11. Question: The most appropriate therapy for patients with chronic paronychia is a:
a) Systemic antifungal.
b) Systemic glucocorticoids.
c) Topical steroid.
d) Topical antibiotic.
