7/29/25, 11:38 AM Dunphy. Primary care IIB
Dunphy Primary Care IIB ACTUAL EXAM 2025 \2026 LATEST
VERSION WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS \VERIFIED 100% ALREADY GRADED A+
Presentation:
Abnormal dryness of skin, mucus membranes, or
conjunctiva; Fine lines in skin; Scaling skin; Itching;
Large cracked scales w/ erythematous borders
Etiology: Arid climates, inherited disorder,
FH of atopy Pathophysiology:
Dry Skin Dermatitis Epidermis lacks moisture or sebum; Cracks on
epidermal barrier allow loss of water, invasion of
irritating substances dermatitis
Treatment:
Rehydrate: House humidifiers
2 - 5 minute baths/day followed by immediate
application of emollients containing urea or lactic acid
(Eucerin, Lubriderm), ointment (petrolatum), oils
Presentation:
Abnormal dryness of skin, mucus membranes, or
conjunctiva; Fine lines in skin; Scaling skin; Itching;
Large cracked scales w/ erythematous borders
Etiology: Arid climates, inherited disorder,
FH of atopy Pathophysiology:
Dry skin dermatitis Epidermis lacks moisture or sebum; Cracks on
epidermal barrier allow loss of water, invasion of
irritating substances dermatitis
Treatment:
/ 1/159
,7/29/25, 11:38 AM Dunphy. Primary care IIB
Rehydrate: House humidifiers
2 - 5 minute baths/day followed by immediate
application of emollients containing urea or lactic acid
(Eucerin, Lubriderm), ointment (petrolatum), oils
Hallmark sign: pruritic,
erythematous rash 5-20%
Irritant contact dermatitis: incidence of all dermatitis
non- immunological reaction: cases Severity depends on
common length of exposure May
occur w/i minutes or hours
later
In diaper area, usually a reaction
to disposable diapers or
prolonged contact with urine
Pruritic eczematous papules usually localized to site,
Allergic contact dermatitis:
but may experience widespread involvement with
immunologic acquired
erythematous pruritic papules distant from site of
sensitivity
contact
Poison ivy, oak, sumac
Nickel (buckles, snaps, jewelry)
Common contact dermatitis Neomycin, fragrance, Bacitracin,
irritants Thimerisol, antihistamines Rubber, latex
products, benzocaine
Soaps, detergents, organic solvents
Avoid irritant
Barrier protections such as zinc oxide or
Education for contact petrolatum (for irritant) Limited use of low-
dermatitis
potency steroids (eg. 1% Hydrocortisone)
Systemic steroids for severe or
widespread reactions Prednisone 2
mg/kg/day divided BID for 7 days
/ 2/159
,7/29/25, 11:38 AM Dunphy. Primary care IIB
Primary irritant diaper dermatitis in the area covered by diapers.
Affect 7-35% of children at some time, & greatest
prevalence is 9-12 months of age High potential
economic burden
diaper dermatitis
Glazed, red plaques; may
develop into erosions Mostly on
convex surface of perineum
Pathophysiology: fecal enzymes activated by contact
w/ alkaline urine Maceration (softening) of skin in the
presence of moisture, warmth, urine, feces & friction
Due to infection w/ candida
albicans (fungus) Part of
normal flora of GI tract
Candidal diaper dermatitis
Occurs in 80% diaper rashes & becomes more likely if
diaper rash persists > 72 hours Beefy red, sharply
marginated scaly plaques w/ small papules & pustules
Satellite lesions mainly on trunk
Found on convex surface & folds of perineum
Change diaper as soon as becomes wet
Gentle cleansing with water or fragrance-
and alcohol-free wipes Pat or air dry, do
General teaching for diaper
dermatitis not rub
Use disposable diapers
rather than cloth Avoid
occlusive clothing
Expose rash to air as much as possible
Miconazole (Lotrimen) topical
Medications for diaper
ointment 2-4 times/day Mycostatin
dermatitis caused by
(Nystatin)100,000 units/g topically
candida
4 x/day Infection control & hand
washing if Candida
Irritant diaper dermatitis
Cover diaper area w/ allergen-free paste or ointment
containing zinc oxide &/or petroleum; mineral oil helps
Irritant diaper dermatitis remove these products
Ointments are water in oil formulations w/ a lipid content
of > 50% provide superior moisture barrier
/ 3/159
, 7/29/25, 11:38 AM Dunphy. Primary care IIB
Hydrocortisone 1% or less may be considered in
moderate or severe case 2x/day for 1-3 days
Well-circumscribed, localized or generalized
erythematous raised wheals or welts of various sizes;
tend to appear quickly, spread irregularly, & fade within
a few hours or up to 24 hours; intensely pruritic
Etiology: IgE mediated hypersensitivity reaction
common allergic skin disorder May occur in response
What are hives to:
Foods: seafood, nuts, eggs,
food additives Medications:
PCN, sulfa, aspirin
Direct contact: plants
Injected agents: medications, blood products,
insect stings & bites Infectious agents: virus,
bacteria, fungus, parasite
Physical factors: cold, pressure,
sun/water exposure Psychological
factors: stress, anxiety
Systemic disease: collagen-vascular, serum sickness,
malignancy, hyperthyroidism, anaphylaxis
/ 4/159
Dunphy Primary Care IIB ACTUAL EXAM 2025 \2026 LATEST
VERSION WITH COMPLETE QUESTIONS AND CORRECT
DETAILED ANSWERS \VERIFIED 100% ALREADY GRADED A+
Presentation:
Abnormal dryness of skin, mucus membranes, or
conjunctiva; Fine lines in skin; Scaling skin; Itching;
Large cracked scales w/ erythematous borders
Etiology: Arid climates, inherited disorder,
FH of atopy Pathophysiology:
Dry Skin Dermatitis Epidermis lacks moisture or sebum; Cracks on
epidermal barrier allow loss of water, invasion of
irritating substances dermatitis
Treatment:
Rehydrate: House humidifiers
2 - 5 minute baths/day followed by immediate
application of emollients containing urea or lactic acid
(Eucerin, Lubriderm), ointment (petrolatum), oils
Presentation:
Abnormal dryness of skin, mucus membranes, or
conjunctiva; Fine lines in skin; Scaling skin; Itching;
Large cracked scales w/ erythematous borders
Etiology: Arid climates, inherited disorder,
FH of atopy Pathophysiology:
Dry skin dermatitis Epidermis lacks moisture or sebum; Cracks on
epidermal barrier allow loss of water, invasion of
irritating substances dermatitis
Treatment:
/ 1/159
,7/29/25, 11:38 AM Dunphy. Primary care IIB
Rehydrate: House humidifiers
2 - 5 minute baths/day followed by immediate
application of emollients containing urea or lactic acid
(Eucerin, Lubriderm), ointment (petrolatum), oils
Hallmark sign: pruritic,
erythematous rash 5-20%
Irritant contact dermatitis: incidence of all dermatitis
non- immunological reaction: cases Severity depends on
common length of exposure May
occur w/i minutes or hours
later
In diaper area, usually a reaction
to disposable diapers or
prolonged contact with urine
Pruritic eczematous papules usually localized to site,
Allergic contact dermatitis:
but may experience widespread involvement with
immunologic acquired
erythematous pruritic papules distant from site of
sensitivity
contact
Poison ivy, oak, sumac
Nickel (buckles, snaps, jewelry)
Common contact dermatitis Neomycin, fragrance, Bacitracin,
irritants Thimerisol, antihistamines Rubber, latex
products, benzocaine
Soaps, detergents, organic solvents
Avoid irritant
Barrier protections such as zinc oxide or
Education for contact petrolatum (for irritant) Limited use of low-
dermatitis
potency steroids (eg. 1% Hydrocortisone)
Systemic steroids for severe or
widespread reactions Prednisone 2
mg/kg/day divided BID for 7 days
/ 2/159
,7/29/25, 11:38 AM Dunphy. Primary care IIB
Primary irritant diaper dermatitis in the area covered by diapers.
Affect 7-35% of children at some time, & greatest
prevalence is 9-12 months of age High potential
economic burden
diaper dermatitis
Glazed, red plaques; may
develop into erosions Mostly on
convex surface of perineum
Pathophysiology: fecal enzymes activated by contact
w/ alkaline urine Maceration (softening) of skin in the
presence of moisture, warmth, urine, feces & friction
Due to infection w/ candida
albicans (fungus) Part of
normal flora of GI tract
Candidal diaper dermatitis
Occurs in 80% diaper rashes & becomes more likely if
diaper rash persists > 72 hours Beefy red, sharply
marginated scaly plaques w/ small papules & pustules
Satellite lesions mainly on trunk
Found on convex surface & folds of perineum
Change diaper as soon as becomes wet
Gentle cleansing with water or fragrance-
and alcohol-free wipes Pat or air dry, do
General teaching for diaper
dermatitis not rub
Use disposable diapers
rather than cloth Avoid
occlusive clothing
Expose rash to air as much as possible
Miconazole (Lotrimen) topical
Medications for diaper
ointment 2-4 times/day Mycostatin
dermatitis caused by
(Nystatin)100,000 units/g topically
candida
4 x/day Infection control & hand
washing if Candida
Irritant diaper dermatitis
Cover diaper area w/ allergen-free paste or ointment
containing zinc oxide &/or petroleum; mineral oil helps
Irritant diaper dermatitis remove these products
Ointments are water in oil formulations w/ a lipid content
of > 50% provide superior moisture barrier
/ 3/159
, 7/29/25, 11:38 AM Dunphy. Primary care IIB
Hydrocortisone 1% or less may be considered in
moderate or severe case 2x/day for 1-3 days
Well-circumscribed, localized or generalized
erythematous raised wheals or welts of various sizes;
tend to appear quickly, spread irregularly, & fade within
a few hours or up to 24 hours; intensely pruritic
Etiology: IgE mediated hypersensitivity reaction
common allergic skin disorder May occur in response
What are hives to:
Foods: seafood, nuts, eggs,
food additives Medications:
PCN, sulfa, aspirin
Direct contact: plants
Injected agents: medications, blood products,
insect stings & bites Infectious agents: virus,
bacteria, fungus, parasite
Physical factors: cold, pressure,
sun/water exposure Psychological
factors: stress, anxiety
Systemic disease: collagen-vascular, serum sickness,
malignancy, hyperthyroidism, anaphylaxis
/ 4/159
