NSG 554 TEST 2 PRACTICE EXAM-
REALISTIC QUESTIONS AND
ANSWERS
Meds that may cause AGEP - Answer-aminopenicillins, macrolides, antifungals, CCB
diltiazem, antimalarials SX onset hours to days
Signs of exanthematous drug reactions - - Answer-most common form - usually involves
mucous membranes and the face , marked with diffuse and symmetric distribution of
erythematous macules and papules, pruritis, low grade fever, mild eosinophilia.
Drugs associated with Exanthematous drug rxns - Answer-bactrim,
anticonvulsants(carbamazepine and phenytoin), NSAIDs, sx take days to weeks more
susceptible in patient with immunodeficiency
Fixed Drug Eruption - Answer-Painful purple patch
same spot every time
might be a bullae
dc the drug
NSAIDs, sudafed, Sulfa, ABX
Drug reaction with eosinophilia and systemic symptoms (DRESS) - Answer-Eruption
develops on the face and upper body becomes edematous and may be accompanied
by vesicle, bullae, and follicular or non-follicular pustules. Facial edema is hallmark and
occurs in 75% of patients. Systemic symptoms may include fever, malaise,
lymphadenopathy, and arthralgia. Eosinophilia and Leukocytosis is usually present. S/S
acute hepatitis, myocarditis, interstitial pneumonitis, interstitial nephritis, and thyroiditis
are complications that may require hospitalization and serial monitoring. Severe
hepatitis is responsible for most DRESS related deaths.
MEDS: anticonvulsants, allopurinol, dapsone, and sulfonamides
Stevens-Johnson Syndrome - Answer-A severe, possibly fatal reaction that mimics a
burn; may be due to a medication.
Toxic Epidermal Necrolysis - Answer--severe erythema multiforme with widespread
involvement
-due to drug hypersensitivity
-target lesion--> widespread full thickness necrosiss of skin >30% body
-prodrome fever, flue sx
-mucous membranes affected
-tx: hospitalization, fluids, systemic steroids
, Nikelsky sign - Answer-skin that shears easily and is tender to touch
Classic presentation of SJS - Answer-fever, sore mouth, burnign eyes, congestion,
aches, rash starts on trunk and extends to limbs, rash diffuse red/purple that may blister
Medications associated with SJS/TENS - Answer-macrolides, valproic acid, NSAIS,
bactrim, allopurinol, anticonvulsants, PCN
Indications for sulfonamides - Answer-UTI, MRSA, SKin infections - should be renally
dosed!!
CI for sulfonamides - Answer-sulfa allergy, hx of drug induced thrombocyopenia
Adverse rxns - Answer-leukopenia, neutropenia, thrombocytopenia, RASH, SJS,
tinnitus, GI SE
Atopic dermatitis symptoms/ treatment - Answer-incessant itching that leads to
lichenification and if left untreated = crusting and oozing
Most common in 3-6mnth old
Antihistamines, nonsedating antihistamines (cetirizine/zyrtec, loratiadine/claritin),
hydrocortisone ointment, nonsteroidal calsineurin inhibitor topical meds
Two groups of cellulitis: - Answer-Purulent and non prurulent
Three types of purulent cellulitis - Answer-Epidermoid cyst, furuncle (follicle and into
dermis), carbuncle (group of furuncles)
Two types of non-purulent cellulitis - Answer-Erysipelas and necrotizing fascitis
What is erysipelas? - Answer-lower legs, face, ears s/s erythema that spreads,
induration and is painful and may include systemic sx like chlls, fever, malaise. TX PCN
500mg 4x/day for 10 days
prevalent organism responsible for cellulitis and treatment - Answer-Group A strep
S. Aureaus - especially if deep/penetration
Pateurella considered in animal bites
TMP-SMX, Doxycycline
Treatment for MRSA - Answer-Uncomplicated - PO bactrim
IV - Vancomycin
REALISTIC QUESTIONS AND
ANSWERS
Meds that may cause AGEP - Answer-aminopenicillins, macrolides, antifungals, CCB
diltiazem, antimalarials SX onset hours to days
Signs of exanthematous drug reactions - - Answer-most common form - usually involves
mucous membranes and the face , marked with diffuse and symmetric distribution of
erythematous macules and papules, pruritis, low grade fever, mild eosinophilia.
Drugs associated with Exanthematous drug rxns - Answer-bactrim,
anticonvulsants(carbamazepine and phenytoin), NSAIDs, sx take days to weeks more
susceptible in patient with immunodeficiency
Fixed Drug Eruption - Answer-Painful purple patch
same spot every time
might be a bullae
dc the drug
NSAIDs, sudafed, Sulfa, ABX
Drug reaction with eosinophilia and systemic symptoms (DRESS) - Answer-Eruption
develops on the face and upper body becomes edematous and may be accompanied
by vesicle, bullae, and follicular or non-follicular pustules. Facial edema is hallmark and
occurs in 75% of patients. Systemic symptoms may include fever, malaise,
lymphadenopathy, and arthralgia. Eosinophilia and Leukocytosis is usually present. S/S
acute hepatitis, myocarditis, interstitial pneumonitis, interstitial nephritis, and thyroiditis
are complications that may require hospitalization and serial monitoring. Severe
hepatitis is responsible for most DRESS related deaths.
MEDS: anticonvulsants, allopurinol, dapsone, and sulfonamides
Stevens-Johnson Syndrome - Answer-A severe, possibly fatal reaction that mimics a
burn; may be due to a medication.
Toxic Epidermal Necrolysis - Answer--severe erythema multiforme with widespread
involvement
-due to drug hypersensitivity
-target lesion--> widespread full thickness necrosiss of skin >30% body
-prodrome fever, flue sx
-mucous membranes affected
-tx: hospitalization, fluids, systemic steroids
, Nikelsky sign - Answer-skin that shears easily and is tender to touch
Classic presentation of SJS - Answer-fever, sore mouth, burnign eyes, congestion,
aches, rash starts on trunk and extends to limbs, rash diffuse red/purple that may blister
Medications associated with SJS/TENS - Answer-macrolides, valproic acid, NSAIS,
bactrim, allopurinol, anticonvulsants, PCN
Indications for sulfonamides - Answer-UTI, MRSA, SKin infections - should be renally
dosed!!
CI for sulfonamides - Answer-sulfa allergy, hx of drug induced thrombocyopenia
Adverse rxns - Answer-leukopenia, neutropenia, thrombocytopenia, RASH, SJS,
tinnitus, GI SE
Atopic dermatitis symptoms/ treatment - Answer-incessant itching that leads to
lichenification and if left untreated = crusting and oozing
Most common in 3-6mnth old
Antihistamines, nonsedating antihistamines (cetirizine/zyrtec, loratiadine/claritin),
hydrocortisone ointment, nonsteroidal calsineurin inhibitor topical meds
Two groups of cellulitis: - Answer-Purulent and non prurulent
Three types of purulent cellulitis - Answer-Epidermoid cyst, furuncle (follicle and into
dermis), carbuncle (group of furuncles)
Two types of non-purulent cellulitis - Answer-Erysipelas and necrotizing fascitis
What is erysipelas? - Answer-lower legs, face, ears s/s erythema that spreads,
induration and is painful and may include systemic sx like chlls, fever, malaise. TX PCN
500mg 4x/day for 10 days
prevalent organism responsible for cellulitis and treatment - Answer-Group A strep
S. Aureaus - especially if deep/penetration
Pateurella considered in animal bites
TMP-SMX, Doxycycline
Treatment for MRSA - Answer-Uncomplicated - PO bactrim
IV - Vancomycin
