Exam 1 - Questions from Leik review book Questions with complete solutions

Exam 1 - Questions from Leik review book Questions with complete solutions A 30 yr old with chief complaint of pruritic hives over her chest and arms but denies difficulty swallowing or breathing. Reports family history of allergic rhinitis and asthma. Which of the following interventions is most appropriate? A. Perform a complete and thorough history B. Prescribe an oral antihistamine such as diphenhydramine 25 mg po qi C. Give an injection of epinephrine 1:1000 IM stat D. Call 911 A All of the following are infections that affect mostly the labia and vagina except: A. Bacterial vaginosis B. Candidiasis C. Trichomoniasis D. Chlamydia trachomatis D Which of the following symptoms is assoc. with vitamin B 12 deficiency> A. Spoon-shaped nails and pica B. An abnormal neurological exam C. A vegan diet D. Tingling and numbness of b/l feet D Rocky Mountain spotted fever is caused by the bite of the: A. Mosquito B. Tick C. Insect D. Flea B All of the following are false statement about atopic dermatitis except: A. Contact with cold objects may exacerbate the condition B. It does not have a linear distribution C. It is assoc. with bullae D. The lesions have vesicles that are full of serous exudate B Koplik's spots are assoc. with A. Poxvirus infections B. Measles C. Kawasaki's disease D. Reye's syndrome B Measles symptoms include Symptoms include fever over 101 F, coryza, cough, conjunctivitis, rash, and koplik's spots on the buccal mucosa An NP is giving dietary counseling to an alcoholic male who has recently been dx with folic acid deficiency anemia. Which of the following foods should the NP recommend? A. Tomatoes, oranges, and bananas B. Cheese, yogurt, milk C. Lettuce, beef, and dairy products D. Spinach, liver and whole wheat bread D 10 yr old patient, concerned about dx of actinic keratosis which is the following the best explanation to the client? A. It is a benign condition B. It is a precancerous lesion and should be followed up with her dermatologist C. Apply hydrocortisone cream 1% bid x 2 wks D. It is important for her to follow up with oncologist B Physiologic anemia in pregnant is due to A. An increase in cardiac output at end of 2 nd trimester B. A physiologic decrease in the production of RBCs in pregnant women C. An increase up to 50% of plasma volume during pregnancy D. Increase in the need for dietary iron in pregnancy C A fawn tail nevus is a sign of which of the following? A. Down syndrome B. Infantile scoliosis C. Congenital heart disease D. Spina bifida D Café au lait spots look like tan to light brown stains that have irregular borders. That can be located anywhere on the body. Which of the following is a correct statement? A. They are associated with neurofibromatosis or von Recklinghausen's disease B. They may be considered as precancerous after a biopsy C. They are more common in darker skinned children D. They are associated with Wilson's disease A Which of the following is the recommended treatment for erythema migrans or early Lyme disease? A. Doxycycline (Vibramycin) 100 mg BID x 21 days B. Ciprofloxacin (cipro) 250 mg bid x 14 days C. Erythromycin (E-mycin) 333 mg po TID x 10 days D. Dicloxacillin 500 mg po BID x 10 days A You are checking a 75 yr old woman's breast during an annual gyn exam. The left nipple and areola are scaly and reddened. The patient denies pain and pruritus. She has noticed this scaliness on her left nipple for the past 8 months. Her dermatologist gave her a potent topical steroid, which she used twice a day for 1 month. The patient never went back for the follow up. She still has the rash and wants and evaluation. Which of the following is the best intervention for this patient? A. Prescribe another potent topical steroid and tell the patient to use it twice a day for 4 wks B. Order a mammogram and refer the patient to breast surgeon C. Advise her to stop using soap on both breasts when she bathes to avoid drying up the skin on her areolae and nipples D. Order a sonogram and fine needle biopsy of the breast B What does a KOH (potassium hydroxide) prep help the nurse practitioner diagnose? A. Herpes zoster B. Yeast infections C. Herpes simplex D. Viral infections B The following skin findings are considered macules except: A. A freckle B. Petechiae C. Acne D. A flat, 0.5 cm brown birthmark C Koilonychia is associated with which of the following conditions? A. Lead poisoning B. Beta thalassemia trait C. B12 deficiency anemia D. Iron deficiency anemia D Which of the following tests is positive in a large number of patients with SLE? A. Antinuclear antibody (ANA) B. Rheumatoid factor C. Antiparietal antibody D. Immunoglobulin A A 72 yr old female c/o a crusty and non healing small ulcer on her upper lip that she has had for several years. Which of the following would you recommend? A. Triamcinolone acetonide (Kenalog) cream bid x 2 wks B. Triple antibiotic ointment bid x 2 wks C. Hydrocortisone 1% cream BID x 2 wks D. The patient needs to be evaluate d by a dermatologist D Heberden's nodes are commonly found in which the following diseases? A. Rheumatoid arthritis B. Degenerative joint disease C. Psoriatic arthritis D. Septic arthritis B The red blood cells in pernicious anemia will show: A. Microcytic and hypochromic cells B. Microcytic and normochromic cells C. Macrocytic and normochromic cells D. Marcrocytic and hypochromic cells C A small abscess on a hair follicle on the eyelid is called: A. Hordeolum B. Pterygium C. Pinguecula D. Ptosis A Beta thalassemia minor is considered a: A. Macrocytic anemia B. Normocytic anemia C. Microcytic anemia D. Hemolytic anemia C A new patient is complaining of severe pruritus that is worse at night. Several family members also have the same symptoms. Upon examination, areas of excoriated papules are noted on some of the interdigital webs of both hands and on the axillae. This finding is most consistent with: A. Contact dermatitis B. Impetigo C. Larva migrans D. Scabies D Which of the following findings are seen in a patient with folate-deficiency anemia? A. Microcytic and hypochromic RBCs B. Microcytic and normochromic RBCs C. Normal size and color of the RBCs D. Macrocytic and normocytic RBCs D You note bony nodules located at the proximal interphalangeal joints on both the hands of your 65 yr old female patient. Which of the following is most likely? A. Bouchard's nodes B. Heberden's nodes C. Osteoarthritis nodules D. Tophi deposits A A bulla is defined as: A. A solid nodule less than 1 cm in size B. A superficial vesicle filled with serous fluid greater than 1 cm in size C. A maculopapular lesion D. A shallow ulcer B Which of the following is the confirmatory test for HIV screening test? A. ELISA test for HIV B. Western Blot C. HIV polymerase chain reaction test D. HIV antibody B Lead poisoning can cause what kind of anemia? A. A mild macrocytic anemia B. Normocytic anemia C. Microcytic anemia D. A mild hemolytic anemia C All of the following conditions are associated with an increased risk for normocytic anemia except: A. Rheumatoid arthritis B. Lupus C. Chronic autoimmune disorders D. Pregnancy D Pregnancy can cause ____ Microcytic hypochromic anemia Which of the following would you see an Auspitz sign? A. Contact dermatitis B. Seborrheic dermatitis C. Systemic lupus erythematosus D. Psoriasis D Auspitz sign Is the presence of pinpoint bleeding spots from psoriasis where the skin is scraped off A first grader presents to a school nurse practitioner with a few blisters on one arm and on the face. The child keeps scratching the affected areas. Some of the lesions have ruptured with yellow serous fluid that crusts easily. This best describes: A. Acute cellulitis B. Herpes zoster C. Bullous impetigo D. Erysipelas C Bullous impetigo - Skin infection seen on hands and face with yellow honey colored fluid blisters with drainage that turns into scabbed lesions that continue to spread until treated The mother of an 8 yr old boy reports the presence of a round red rash on the child's left lower leg. It appeared 1 wk after the child returned from visiting his grandparents in Massachusetts. During the skin exam, the maculopapular rash is noted to have areas of central clearing making it resemble a round target. Which of the following is best described? A. Erythema migrans B. Rocky mountain spotted fever C. Meningococcemia D. Larva migrans A All of the following are included in the criteria used to diagnose patients with AIDS except: A. Profound fatigue B. Thrush C. Kaposi's sarcoma D. Hairy leukoplakia of the tongue A A new patient who is a 40 yr old female postal worker is being evaluated for complaints of a new onset of an erythematous rash on both her cheeks and on the bridge of her nose that is accompanied by fatigue. She reports a history of Hashimoto's thyroiditis and is currently being treated with Synthroid 1.25 mg daily. Which of the following conditions is most likely: A. Atopic dermatitis B. Thyroid disease C. Lupus erythematosus D. Rosacea C The most common type of skin malignancy is: A. Squamous cell cancer B. Basal skin cancer C. Melanoma D. Dysplastic nevi B Laura who is 18 yrs old, is being followed up for acne by the nurse practitioner. The facial exam reveals that papules and pustules are present mostly on the forehead and chin area. The patient has been using prescription topicals and OTC medicated soap daily for 6 months without much improvement. Which of the following would you recommend? A. Isotretinoin (Accutane) B. Tetracycline (Sumycin) C. Clindamyacin topical solution (Cleocin T) D. Minoxidil (Rogaine) B First line tx of acne is OTC medicated soap and water with topical antibiotic gels. The next step is tetracycline (Sumycin)