NURP 503 Exam 1 (With complete solution)

A 29-month-old female presents to a primary care clinic with 3 days of fever up to 101.8°F and then develops pinpoint flesh-to-red-colored bumps on her abdomen that then spreads out to her face and extremities including her hands. She continues with fever now up to 104°F and is seen in a primary care clinic on day 4 of this illness. She has raised red spots and flat confluent patches but no blisters or hemorrhages, dusky red, maculopapular rash. On exam, in addition to the rash, she has conjunctival injection and cervical lymphadenopathy. She has 2 gray/white spots on her right buccal mucosa. correct answers Measles A 68-year-old female on prednisone treatment for polymyalgia rheumatica comes in with a painful rash on her right axilla. The pain started a week ago and the rash started 4 days ago. She says that it burns and itches. linear across a dermatome with fluid-filled vesicles. Patchy erythema in the dermatomal area of involvement with grouped herpetiform vesicles correct answers Herpes zoster- shingles A 31-year-old medical resident presents to primary care clinic with a new mildly itchy rash that started on his upper back and has spread to most of his trunk and proximal extremities over the past 1 to 2 weeks. There is a larger patch on his upper back where the rash initially began. He denies any new meds, soaps or detergents. No recent travel. He is otherwise feeling well but had an upper respiratory infection (URI) recently. Herald patch which is a single papule and expands into a pink erythematous oval patch with raised border and scale. Then surrounding smaller lesions scattered over trunk appear and spread in a christmas tree pattern correct answers Pityriasis Rosea A 30 year old female presents for this lesion on her nose for several months which appears to be changing. She denies any trauma to lesion. You note when obtaining her social history that she is a professional surfer and she grew up in southern CA. correct answers Melanoma A 7 year old girl comes in for a rash for several days that is spreading. It is slightly painful. honey crusted, vesicular, blistering correct answers Impetigo Common contagious bacterial infection of the superficial layers of the skin. Usually caused by group A streptococcus (Streptococcus pyogenes), Staphylococcus aureus, or MRSA Mupirocin topical A 25 year old presents with a very pruritic rash on her forearm for 2-3 days. She has applied calamine lotion with little improvement. She otherwise feels well, no fever or chills. She just returned from a camping trip with her family. correct answers Poison Iy A 4 month old presents for a worsening diaper rash for 5 days. Her mother is applying zinc oxide and aquaphor ointment. There has been no change in brand of diapers or wipes. The baby is otherwise feeding well and has normal stools. Mom denies fevers. Erythematous. correct answers Contact dermatitis Single color, macular, dull (not waxy) Surrounding skin is unaffected. correct answers Atypical Nevi