NURS 366 EXAM #3 QUESTIONS AND
CORRECT ANSWERS
Molluscum contagiosum ANSW✅✅= benign superficial skin disease caused by the poxvirus
> Self-limited infection if left alone - best to encourage kids not to touch
> Diagnosis through clinical evaluation
> Small pearly, flesh-covered, papules, 2-5 mm
> Central depression and cheesy core, umbilicated
> Transmitted by contact, person can auto inoculate
> Tx - (may be needed) cryotherapy, topical creams or ointments, laser therapy, curettage,
cimetidine
Fungal infections ANSW✅✅> Superficial infections that live on the skin, not in the skin
> Multiple at the same rate of keratin (so they don't die off)
> Transmission - person-to-person, animal-to-human
> Diagnosis can typically by clinical, but diagnostic is with scraping examination, KOH, fungal culture
Tinea capitis ANSW✅✅= present as lesions on scalp that may extend to hairline and neck,
characteristic scaly patches of alopecia with itching
> Tx - griseofulvin (oral antifungal), adjunct treatment with selenium sulfide shampoos a couple
times a week, topical antifungal
- Instruct patients that Griseofulvin is better absorbed with fatty foods
> Severity - single or multiple scaly patches with alopecia, patches of alopecia with black dots,
widespread scaling with subtle hair loss, boggy edematous painful plaque called a kerion
> Hair loss is rarely permanent
> May have some cervical lymphadenopathy
Tinea corporis (ringworm) ANSW✅✅= presents as round/scaly patch of rough erythema
> Annular plaque with central clearing
> Spreads peripherally with central clearing
> Tx - griseofulvin and/or topical antifungal (topical tx or oral for more extensive involvement or
failed topical)
,Contact dermatitis ANSW✅✅= inflammatory reaction of skin to chemical agent (allergic & irritant,
perfumes/jewelry-nickel/plants-poison ivy/animals-dander)
> S/S - characteristic sharp delineation between inflamed and normal skin, dermatitis is only in areas
of direct contact, itching, erythema, edema with varying lesions (papules, vesicles, denudation)
> Tx - depends on the type of dermatitis, allergic vs contact
- Topical corticosteroids used for allergic or contact types, oral steroid used for more severe cases
- Cold compresses to soothe
- Calamine lotion is useful in cases like poison ivy
- Lotions and ointments are useful in cases of irritant dermatitis like atopic dermatitis (dishwashers,
nurses, hairdressers)
- Avoid irritating agent asap - can be difficult
Scabies ANSW✅✅= scabies mite females burrow into the stratus corneum of the epidermis to
deposit eggs and feces
> Transmitted by person-to-person direct contact, not usually by fomite (clothing, furniture, etc.)
> Inflammation occurs between 30-60 days later, or sooner with previous sensitization
> Look like miniature grayish-brown threadlike, pruritic, itchy
> Distribution - intertriginous areas (interdigital, axillary-cubital, popliteal, inguinal)
- Children > 2 years - mainly hands and wrists
- Children < 2 years - primarily feet and ankles
> Tx - Treat whole family and persons who were in contact, antihistamines/topical steroids for
itching, topical scabicides, permethrin (anti-parasite) 5% cream has less neurotoxicity than Lindane
(safe infants and children), hot water laundry/dry clean bag for 72 hours
Pediculosis wapitis (head lice) ANSW✅✅= very common, especially in school-age children, not
particular to age (older adults can get), adult lives only 48 hours without a human host, females lay
eggs (nits) at base of hair shaft (like cement), nits hatch in 7-10 days
> More common in females
> Typically found in occipital, behind ears, nape of neck - itching main symptom
> Transmitted person-person, hospital requires contact precautions
Arthropod bites/stings ANSW✅✅* Arthropods = mites, ticks, bees, scorpions, spiders (brown
recluse & black widow bad)
,> Tx - compresses, calamine lotion, prevention of secondary infection
> immediate medical attention for scorpion or the 2 spider bites
> Bee stingers should be removed asap
- Tx with epinephrine if allergic
> Ticks can cause rocky mountain fever and lyme disease development (need to be attached 1-2
hours to transmit disease)
Rocky mountain spotted fever ANSW✅✅= carried by ticks, causes a red spotty rash,
maculopapular or petechial, caused by Rickettsia
> Gradual onset - fever, malaise, anorexia, myalgia
> Abrupt onset - rapid fever elevation, chills, vomiting, myalgia, severe headache
> Rash - maculopapular or petechial, primarily on extremities, characteristically on palms and soles
> Tx - tetracycline or chloramphenicol, supportive therapy, usually self-limiting in children
Lyme disease ANSW✅✅= most common tickborne disorder in the US, causes a red donut shaped
or bulls-eye rash, annular erythema
> Caused by Borrelia burgdorferi
> Usual habitat is wooded areas, most common from deer ticks
> 3 stages to disease - diagnosis clinically in early stages by recognition of rash or by serological
testing in later stages of the disease
> Tx - children older than 8 years use oral doxycycline, children younger than 8 years use oral
amoxicillin
Atopic dermatitis (eczema) ANSW✅✅= causes itching and irritation, unknown cause (theory that
it is related to a defective epidermal barrier that allows irritants and allergens to penetrate causing a
dysregulated inflammatory response)
> Commonly associated with asthma, allergic rhinitis, food allergies, family hx
> Common sites - antecubital & popliteal most common in those 2 years and older,
scalp/face/cheeks/extensor surfaces most common in infants
Atopic dermatitis therapeutic management ANSW✅✅* Goal to reduce symptoms and prevent
exacerbations
> Hydrate the skin - lotions and emollients (ointments/creams are better than lotions, apply several
times daily mainly after bathing)
, > Relieve pruritus
> Reduce flare-ups or inflammation - eliminate potential irritants
> Topical steroids - usually twice daily, use lowest potency for effect
> Antihistamines to help with sleep
> Use mild soaps/detergents, avoid abrasive (wool/fabric), astringents, excessive heat, low humidity
> Prevent and control secondary infection
> May have remissions and exacerbations
> Dietary modifications if foods make a difference
Seborrheic dermatitis (cradle cap) ANSW✅✅= chronic/recurrent inflammatory rxn mainly on the
scalp, also on eyelids, nasolabial folds, and ears, no known cause, not r/t family
> S/S - lesions that are thick, adherent, yellowish, scaly, oily patches, may be pruritic
> Tx - hygiene, soak and remove crusts, antiseborrheic shampoo (sulfur and salicylic acid)
- Directed at removing the crusts
-- Daily shampooing with mild or baby soap (antiseborrheic shampoo can be used but is not
necessary)
-- Leave the shampoo on the scalp long enough to soften the crusts
-- Thoroughly rinse the scalp
-- Loosen the crusts with a fine-tooth comb
- Prevention with adequate scalp hygiene
Types of diaper rash ANSW✅✅* Mainly irritant dermatitis but can be fungal, bacterial, allergic, or
viral
Irritant dermatitis ANSW✅✅= repetitive contact with irritant such as urine/feces
> Involves convex surfaces, buttocks, genitalia, lower abdomen, upper thighs and will usually spare
the folds
> Tx - maintaining dry skin, changing diapers frequently, avoiding irritants to skin, using barrier
creams, short course of low strength topical steroids (1% hydrocortisone creams)
> D/C regular baby wipes if dermatitis is present
> Instruct care giver to gently clean with damp rag
> Clean soiled areas but don't try to remove old barrier cream, reapply cream liberally
CORRECT ANSWERS
Molluscum contagiosum ANSW✅✅= benign superficial skin disease caused by the poxvirus
> Self-limited infection if left alone - best to encourage kids not to touch
> Diagnosis through clinical evaluation
> Small pearly, flesh-covered, papules, 2-5 mm
> Central depression and cheesy core, umbilicated
> Transmitted by contact, person can auto inoculate
> Tx - (may be needed) cryotherapy, topical creams or ointments, laser therapy, curettage,
cimetidine
Fungal infections ANSW✅✅> Superficial infections that live on the skin, not in the skin
> Multiple at the same rate of keratin (so they don't die off)
> Transmission - person-to-person, animal-to-human
> Diagnosis can typically by clinical, but diagnostic is with scraping examination, KOH, fungal culture
Tinea capitis ANSW✅✅= present as lesions on scalp that may extend to hairline and neck,
characteristic scaly patches of alopecia with itching
> Tx - griseofulvin (oral antifungal), adjunct treatment with selenium sulfide shampoos a couple
times a week, topical antifungal
- Instruct patients that Griseofulvin is better absorbed with fatty foods
> Severity - single or multiple scaly patches with alopecia, patches of alopecia with black dots,
widespread scaling with subtle hair loss, boggy edematous painful plaque called a kerion
> Hair loss is rarely permanent
> May have some cervical lymphadenopathy
Tinea corporis (ringworm) ANSW✅✅= presents as round/scaly patch of rough erythema
> Annular plaque with central clearing
> Spreads peripherally with central clearing
> Tx - griseofulvin and/or topical antifungal (topical tx or oral for more extensive involvement or
failed topical)
,Contact dermatitis ANSW✅✅= inflammatory reaction of skin to chemical agent (allergic & irritant,
perfumes/jewelry-nickel/plants-poison ivy/animals-dander)
> S/S - characteristic sharp delineation between inflamed and normal skin, dermatitis is only in areas
of direct contact, itching, erythema, edema with varying lesions (papules, vesicles, denudation)
> Tx - depends on the type of dermatitis, allergic vs contact
- Topical corticosteroids used for allergic or contact types, oral steroid used for more severe cases
- Cold compresses to soothe
- Calamine lotion is useful in cases like poison ivy
- Lotions and ointments are useful in cases of irritant dermatitis like atopic dermatitis (dishwashers,
nurses, hairdressers)
- Avoid irritating agent asap - can be difficult
Scabies ANSW✅✅= scabies mite females burrow into the stratus corneum of the epidermis to
deposit eggs and feces
> Transmitted by person-to-person direct contact, not usually by fomite (clothing, furniture, etc.)
> Inflammation occurs between 30-60 days later, or sooner with previous sensitization
> Look like miniature grayish-brown threadlike, pruritic, itchy
> Distribution - intertriginous areas (interdigital, axillary-cubital, popliteal, inguinal)
- Children > 2 years - mainly hands and wrists
- Children < 2 years - primarily feet and ankles
> Tx - Treat whole family and persons who were in contact, antihistamines/topical steroids for
itching, topical scabicides, permethrin (anti-parasite) 5% cream has less neurotoxicity than Lindane
(safe infants and children), hot water laundry/dry clean bag for 72 hours
Pediculosis wapitis (head lice) ANSW✅✅= very common, especially in school-age children, not
particular to age (older adults can get), adult lives only 48 hours without a human host, females lay
eggs (nits) at base of hair shaft (like cement), nits hatch in 7-10 days
> More common in females
> Typically found in occipital, behind ears, nape of neck - itching main symptom
> Transmitted person-person, hospital requires contact precautions
Arthropod bites/stings ANSW✅✅* Arthropods = mites, ticks, bees, scorpions, spiders (brown
recluse & black widow bad)
,> Tx - compresses, calamine lotion, prevention of secondary infection
> immediate medical attention for scorpion or the 2 spider bites
> Bee stingers should be removed asap
- Tx with epinephrine if allergic
> Ticks can cause rocky mountain fever and lyme disease development (need to be attached 1-2
hours to transmit disease)
Rocky mountain spotted fever ANSW✅✅= carried by ticks, causes a red spotty rash,
maculopapular or petechial, caused by Rickettsia
> Gradual onset - fever, malaise, anorexia, myalgia
> Abrupt onset - rapid fever elevation, chills, vomiting, myalgia, severe headache
> Rash - maculopapular or petechial, primarily on extremities, characteristically on palms and soles
> Tx - tetracycline or chloramphenicol, supportive therapy, usually self-limiting in children
Lyme disease ANSW✅✅= most common tickborne disorder in the US, causes a red donut shaped
or bulls-eye rash, annular erythema
> Caused by Borrelia burgdorferi
> Usual habitat is wooded areas, most common from deer ticks
> 3 stages to disease - diagnosis clinically in early stages by recognition of rash or by serological
testing in later stages of the disease
> Tx - children older than 8 years use oral doxycycline, children younger than 8 years use oral
amoxicillin
Atopic dermatitis (eczema) ANSW✅✅= causes itching and irritation, unknown cause (theory that
it is related to a defective epidermal barrier that allows irritants and allergens to penetrate causing a
dysregulated inflammatory response)
> Commonly associated with asthma, allergic rhinitis, food allergies, family hx
> Common sites - antecubital & popliteal most common in those 2 years and older,
scalp/face/cheeks/extensor surfaces most common in infants
Atopic dermatitis therapeutic management ANSW✅✅* Goal to reduce symptoms and prevent
exacerbations
> Hydrate the skin - lotions and emollients (ointments/creams are better than lotions, apply several
times daily mainly after bathing)
, > Relieve pruritus
> Reduce flare-ups or inflammation - eliminate potential irritants
> Topical steroids - usually twice daily, use lowest potency for effect
> Antihistamines to help with sleep
> Use mild soaps/detergents, avoid abrasive (wool/fabric), astringents, excessive heat, low humidity
> Prevent and control secondary infection
> May have remissions and exacerbations
> Dietary modifications if foods make a difference
Seborrheic dermatitis (cradle cap) ANSW✅✅= chronic/recurrent inflammatory rxn mainly on the
scalp, also on eyelids, nasolabial folds, and ears, no known cause, not r/t family
> S/S - lesions that are thick, adherent, yellowish, scaly, oily patches, may be pruritic
> Tx - hygiene, soak and remove crusts, antiseborrheic shampoo (sulfur and salicylic acid)
- Directed at removing the crusts
-- Daily shampooing with mild or baby soap (antiseborrheic shampoo can be used but is not
necessary)
-- Leave the shampoo on the scalp long enough to soften the crusts
-- Thoroughly rinse the scalp
-- Loosen the crusts with a fine-tooth comb
- Prevention with adequate scalp hygiene
Types of diaper rash ANSW✅✅* Mainly irritant dermatitis but can be fungal, bacterial, allergic, or
viral
Irritant dermatitis ANSW✅✅= repetitive contact with irritant such as urine/feces
> Involves convex surfaces, buttocks, genitalia, lower abdomen, upper thighs and will usually spare
the folds
> Tx - maintaining dry skin, changing diapers frequently, avoiding irritants to skin, using barrier
creams, short course of low strength topical steroids (1% hydrocortisone creams)
> D/C regular baby wipes if dermatitis is present
> Instruct care giver to gently clean with damp rag
> Clean soiled areas but don't try to remove old barrier cream, reapply cream liberally
