GNRS 5669 UTMB FNP I Exam 1 Questions With Complete
Solutions
Actinic Keratosis Management
Prevention: sun protection
Lubricants
Low potency (1%) hydrocortisone
Cryotherapy with liquid nitrogen
Curettage after topical anesthesia
Levulan Rx
Atopic Dermatitis Chronic Management
Chronic Management:
Skin hydration and water trapping (oatmeal baths,
superfatted soap).
Consider oral antihistamines for itch.
Topical steroids: potent tapered to weak over time
Consider allergy testing
However, topical glucocorticoids may lead to skin
atrophy if used for prolonged periods of time and if
used excessively will lead to suppression of the
pituitary-adrenal axis, osteoporosis, growth
retardation. Another problem is "glucocorticoid
phobia." Patients or their parents are increasingly
aware of glucocorticoid side effects and refuse
their use, no matter how beneficial they may be.
,Allergy testing is beneficial if you suspect the triad
and can decrease irritants that exacerbate sx.
Atopic Dermatitis Exam
Erythematous
Acute: papular, vesicular
Chronic: lichenified
Typically symmetrical and on flexural surfaces.
Assess for secondary infection (rubor, calor,
drainage).
Atopic Dermatitis Acute Management
Wet dressings and topical glucocorticoids; topical
abx (mupirocin ointment) when indicated.
Hydroxyzine, 10-100 mg QID x daily for pruritus.
Oral abx (dicloxacillin, erythromycin) to eliminate
S. aureus and treat MRSA according to sensitivity
as shown by culture.
Acne Pharm Treatment
Mild 1- retin A, then add benzoyl peroxide.
Mild 2 - retin A > benzoyl peroxide > topical abx
(erythro, clinda, cleo, tetra)
Moderate - Same as above but add oral antibiotics,
in female consider antiandrogen therapy such as
OCPs or spironolactone.
Severe cases
For isotretinoin (accutane) therapy - oral retinoid
,related to vitamin A.
POTENT TERATOGEN (refer to Dermatology)
Acne Variants
Tropical Acne
Flare of acne, usually with severe folliculitis,
inflammatory nodules, and draining cysts on trunk
and buttocks in tropical climates; secondary
infection with Staphylococcus aureus.
Acne in the Adult Woman
Persistent acne in an (often) hirsute female with or
without irregular menses needs an evaluation for
hyper secretion of adrenal and ovarian androgens
(as in the polycystic ovary syndrome).
Perioral acne
Alopecia Management
Cosmetic and psychological support
Minoxidil 2% Solution
Propecia (Men only)
Hair Transplant
Average life expectancy of men
76.4 yrs
Leading cause of mortality among US men
CV
Cancer (Lung and Prostate)
, Prostatitis
Inflammation of the prostate is classified into four
categories according to a system developed by the
NIH
• Acute bacterial prostatitis
• Chronic bacterial prostatitis
• Chronic prostatitis (nonbacterial)/chronic
pelvic pain syndrome (subcategorized as A
[inflammatory] and B [noninflammatory])
• Asymptomatic inflammatory prostatitis
Prostatitis clinical presentation
fever
UTI symptoms (frequency, urgency, dysuria,
incomplete voiding and low back pain.
tender, warm, swollen or boggy prostate.
80% caused by e.coli, enterococcus, and proteus.
men less than 35, consider STI such as gonorrhea
and/or chlamydia.
Prostatitis treatment
acute bacterial, a broad-spectrum PCN, a 3rd gen
cephalosporin, and a fluoroquinolone are options.
An aminoglycoside may be added to any of
Solutions
Actinic Keratosis Management
Prevention: sun protection
Lubricants
Low potency (1%) hydrocortisone
Cryotherapy with liquid nitrogen
Curettage after topical anesthesia
Levulan Rx
Atopic Dermatitis Chronic Management
Chronic Management:
Skin hydration and water trapping (oatmeal baths,
superfatted soap).
Consider oral antihistamines for itch.
Topical steroids: potent tapered to weak over time
Consider allergy testing
However, topical glucocorticoids may lead to skin
atrophy if used for prolonged periods of time and if
used excessively will lead to suppression of the
pituitary-adrenal axis, osteoporosis, growth
retardation. Another problem is "glucocorticoid
phobia." Patients or their parents are increasingly
aware of glucocorticoid side effects and refuse
their use, no matter how beneficial they may be.
,Allergy testing is beneficial if you suspect the triad
and can decrease irritants that exacerbate sx.
Atopic Dermatitis Exam
Erythematous
Acute: papular, vesicular
Chronic: lichenified
Typically symmetrical and on flexural surfaces.
Assess for secondary infection (rubor, calor,
drainage).
Atopic Dermatitis Acute Management
Wet dressings and topical glucocorticoids; topical
abx (mupirocin ointment) when indicated.
Hydroxyzine, 10-100 mg QID x daily for pruritus.
Oral abx (dicloxacillin, erythromycin) to eliminate
S. aureus and treat MRSA according to sensitivity
as shown by culture.
Acne Pharm Treatment
Mild 1- retin A, then add benzoyl peroxide.
Mild 2 - retin A > benzoyl peroxide > topical abx
(erythro, clinda, cleo, tetra)
Moderate - Same as above but add oral antibiotics,
in female consider antiandrogen therapy such as
OCPs or spironolactone.
Severe cases
For isotretinoin (accutane) therapy - oral retinoid
,related to vitamin A.
POTENT TERATOGEN (refer to Dermatology)
Acne Variants
Tropical Acne
Flare of acne, usually with severe folliculitis,
inflammatory nodules, and draining cysts on trunk
and buttocks in tropical climates; secondary
infection with Staphylococcus aureus.
Acne in the Adult Woman
Persistent acne in an (often) hirsute female with or
without irregular menses needs an evaluation for
hyper secretion of adrenal and ovarian androgens
(as in the polycystic ovary syndrome).
Perioral acne
Alopecia Management
Cosmetic and psychological support
Minoxidil 2% Solution
Propecia (Men only)
Hair Transplant
Average life expectancy of men
76.4 yrs
Leading cause of mortality among US men
CV
Cancer (Lung and Prostate)
, Prostatitis
Inflammation of the prostate is classified into four
categories according to a system developed by the
NIH
• Acute bacterial prostatitis
• Chronic bacterial prostatitis
• Chronic prostatitis (nonbacterial)/chronic
pelvic pain syndrome (subcategorized as A
[inflammatory] and B [noninflammatory])
• Asymptomatic inflammatory prostatitis
Prostatitis clinical presentation
fever
UTI symptoms (frequency, urgency, dysuria,
incomplete voiding and low back pain.
tender, warm, swollen or boggy prostate.
80% caused by e.coli, enterococcus, and proteus.
men less than 35, consider STI such as gonorrhea
and/or chlamydia.
Prostatitis treatment
acute bacterial, a broad-spectrum PCN, a 3rd gen
cephalosporin, and a fluoroquinolone are options.
An aminoglycoside may be added to any of
