Commonly Confused Topics - Sarah
Michelle Exam Questions and Answers
actinic keratosis vs. seborrheic keratosis - more concerning? - Correct Answers -Actinic
Keratosis
AK: form b/c of atypical growth of keratinocytes in the epidermal layer
ACT=ACT fast with actinic keratosis b/c precursor to squamous cell carcinoma skin
cancer; risk factor is SUN EXPOSURE (scalp, legs, arms, face)
AK Tx: cryotherapy or 5FU aka fluorouracil (topical chemotherapy drug)
seborrheic keratosis - Correct Answers -seen in older population, benign, will not
develop into cancer; appear as well-defined brown, tan, black growths that have a stuck
on appearance
Erythema Migrans vs. Erythema Infectiosum - tickborne illness? - Correct Answers -
Erythema Migrans! - rash associated with Lyme Disease
Bulls Eye Lesion
Erythema Infectiosum (Fifth Disease) - Correct Answers -A viral disease characterized
by a face that appears as "slapped cheeks," a fiery red rash on the cheeks.
Retinal Detachment vs. Acute Angle Closure Glaucoma - which painLESS? - Correct
Answers -Retinal Detachment - patients report blurry vision, flashes of light, and
floaters; feel as though a curtain / something being pulled over field of vision
Acute Angle Closure Glaucoma - Correct Answers -due to increased intraocular
pressure; PAINFUL with blurry vision and seeing halos; eye may feel firm to palpation
upon assessment
Mononucleosis - Correct Answers -Mononucleosis: caused by Epstein Barr Virus, teens
and young adults, transmitted through saliva
s/s: prolonged severe fatigue, posterior cervical lymphadenopathy, sore throat, fever,
SPLEEN enlargement (no contact sports - spleen rupture)
Dx: mono spot blood test; get ultrasound to ensure spleen has returned to normal size
, Strep Throat (Streptococcal Pharyngitis) - Correct Answers --Caused by Group A
streptococcus (GAS) Streptococcus pyogenes, Gram-positive cocci; grow in chains
s/s: anterior cervical lymphadenopathy, palatine petechiae, sore throat, fever, swollen
tonsils
Dx: rapid strep test
Tx: Amoxicillin; can be treated by Penicillin-based drugs or Macrolide drugs for patients
allergic to penicillin (e.g., erythromycin)
Mono/Strep Co-Infection - Correct Answers -if a patient has both strep and mono YOU
WOULD prescribe antibiotics BUT NO AMOXICILLIN b/c morbilliform rash could
develop (erythematous, maculopapular, measles-like); treat with macrolide like
azithromycin or cephalosporin like cephalexin/keflex
Note: the only penicillin that won't cause the morbilloform rash is penicillin VK
TZDs vs. Thiazide Diuretics - Correct Answers -TZDs: used for DM2; medication
example is Pioglitazone (Actos)
SE: fluid retention, peripheral edema
CI: heart failure, liver issues, bladder cancer
Thiazide Diuretics: include medications like HCTZ or chlorthalidone (Thalitone); used in
the tx of HTN and heart failure to treat edema
Note: chlorthalidone (Thalitone) is cardioprotective
Remember: TZDs cause fluid retention and Thiazide Diuretics remove fluid
Scabies vs. Pinworms (Enterobiasis) - Correct Answers -Scabies: intense pruritis in
webs of fingers, inner thighs, arm pits; worse at night; "linear burrows" hallmark feature
Tx: permetherin cream applied from neck to feet 8-14 hours after application; household
members must be treated as well; wash all clothes and linens in hot water
Pinworms (Enterobiasis): spread via fecal-oral route and intense pruritis is s/s
specifically in the perianal area; search for worms 2-3 hours after infected individual has
fallen asleep or scotch tape test in morning; needs 3 morning tests; pinworm eggs can
be seen under microscope
Tx: mebendazole or albendazole "bend over" to get tape test
Michelle Exam Questions and Answers
actinic keratosis vs. seborrheic keratosis - more concerning? - Correct Answers -Actinic
Keratosis
AK: form b/c of atypical growth of keratinocytes in the epidermal layer
ACT=ACT fast with actinic keratosis b/c precursor to squamous cell carcinoma skin
cancer; risk factor is SUN EXPOSURE (scalp, legs, arms, face)
AK Tx: cryotherapy or 5FU aka fluorouracil (topical chemotherapy drug)
seborrheic keratosis - Correct Answers -seen in older population, benign, will not
develop into cancer; appear as well-defined brown, tan, black growths that have a stuck
on appearance
Erythema Migrans vs. Erythema Infectiosum - tickborne illness? - Correct Answers -
Erythema Migrans! - rash associated with Lyme Disease
Bulls Eye Lesion
Erythema Infectiosum (Fifth Disease) - Correct Answers -A viral disease characterized
by a face that appears as "slapped cheeks," a fiery red rash on the cheeks.
Retinal Detachment vs. Acute Angle Closure Glaucoma - which painLESS? - Correct
Answers -Retinal Detachment - patients report blurry vision, flashes of light, and
floaters; feel as though a curtain / something being pulled over field of vision
Acute Angle Closure Glaucoma - Correct Answers -due to increased intraocular
pressure; PAINFUL with blurry vision and seeing halos; eye may feel firm to palpation
upon assessment
Mononucleosis - Correct Answers -Mononucleosis: caused by Epstein Barr Virus, teens
and young adults, transmitted through saliva
s/s: prolonged severe fatigue, posterior cervical lymphadenopathy, sore throat, fever,
SPLEEN enlargement (no contact sports - spleen rupture)
Dx: mono spot blood test; get ultrasound to ensure spleen has returned to normal size
, Strep Throat (Streptococcal Pharyngitis) - Correct Answers --Caused by Group A
streptococcus (GAS) Streptococcus pyogenes, Gram-positive cocci; grow in chains
s/s: anterior cervical lymphadenopathy, palatine petechiae, sore throat, fever, swollen
tonsils
Dx: rapid strep test
Tx: Amoxicillin; can be treated by Penicillin-based drugs or Macrolide drugs for patients
allergic to penicillin (e.g., erythromycin)
Mono/Strep Co-Infection - Correct Answers -if a patient has both strep and mono YOU
WOULD prescribe antibiotics BUT NO AMOXICILLIN b/c morbilliform rash could
develop (erythematous, maculopapular, measles-like); treat with macrolide like
azithromycin or cephalosporin like cephalexin/keflex
Note: the only penicillin that won't cause the morbilloform rash is penicillin VK
TZDs vs. Thiazide Diuretics - Correct Answers -TZDs: used for DM2; medication
example is Pioglitazone (Actos)
SE: fluid retention, peripheral edema
CI: heart failure, liver issues, bladder cancer
Thiazide Diuretics: include medications like HCTZ or chlorthalidone (Thalitone); used in
the tx of HTN and heart failure to treat edema
Note: chlorthalidone (Thalitone) is cardioprotective
Remember: TZDs cause fluid retention and Thiazide Diuretics remove fluid
Scabies vs. Pinworms (Enterobiasis) - Correct Answers -Scabies: intense pruritis in
webs of fingers, inner thighs, arm pits; worse at night; "linear burrows" hallmark feature
Tx: permetherin cream applied from neck to feet 8-14 hours after application; household
members must be treated as well; wash all clothes and linens in hot water
Pinworms (Enterobiasis): spread via fecal-oral route and intense pruritis is s/s
specifically in the perianal area; search for worms 2-3 hours after infected individual has
fallen asleep or scotch tape test in morning; needs 3 morning tests; pinworm eggs can
be seen under microscope
Tx: mebendazole or albendazole "bend over" to get tape test
