Week 12 – Dermatology Question and Answers,100% CORRECT

Week 12 – Dermatology Question and Answers When collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape which portion of the lesion? The active, leading border The papular lesions The area of central clearing The erythematous plaque A patient has a unilateral vesicular eruption which is described as burning and stabbing in intensity. To differentiate between herpes simplex and herpes zoster, which test will the provider order? Polymerase chain reaction analysis Serum immunoglobulins Tzanck test Viral culture A patient has been diagnosed with scabies. What is the medication of choice to treat this? Coal tar Mupirocin Ketoconazole Permethrin A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? Fungal Bacterial Parasitic Viral Under microscopic exam, hyyphae are long, thin and branching and indicate dermatophyte infections. A 15-month-old who is eating and behaving normally is found to have a high fever. After a few days, the fever resolves and the child breaks out in a maculopapular rash. This is a description of which with the following conditions: Erythema infectiosum Fifth disease Scarlet fever Roseola infantum Roseola is caused by herpes virus 6. Signs and symptoms including high fever for a few days with a maculopapular rash occurring after the fever breaks. A provider is considering an oral contraceptive medication to treat acne in an adolescent female. Which is an important consideration when prescribing this drug? A progesterone-only contraceptive is most beneficial for treating acne. Yaz, Ortho Tri-Cyclen, and Estrostep are approved for acne treatment. Oral contraceptives are effective because of their androgen enhancing effects. Combined oral contraceptives are effective for non-inflammatory acne only. A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection? Sulfamethoxazole-trimethoprim Doxycycline Clindamycin Amoxicillin-clavulanate A patient has seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to treat this? Powder Foam Cream Ointment Skin hairy areas over the body, foams are specifically used because they spread easily and are transparent. A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury? Sepsis from Capnocytophaga canimorsus infection Possible exposure to rabies virus Transmission of human immunodeficiency virus Potential septic arthritis or osteomyelitis The patient presents with small vesicles on the lateral edges of his fingers and intense itching. On close inspection, there are small vesicles on the palmar surface of the hand. What is just called? Varicella zoster Seborrheic dermatitis Herpes zoster Dyshidrotic dermatitis This dermatitis is intensely paretic and involves the palms and soles and lateral aspect of the fingers. Over a couple of weeks, the vesicles desquamate. The vesicles might raise suspicion of a viral infection, but this is not present in this case The mother of 80-year-old reports the presence of a round red rash on the child's left lower leg. It appeared one week after the child returned from visiting his grandparents, who live in Massachusetts. During the skin exam, the maculopapular rash is noted to have areas of central clearing making it resemble around target. Which with the following is best described? Erythema migrans Rocky Mountain spotted fever Meningococcemia Larva migrans Which is the primary symptom causing discomfort in patients with atopic dermatitis? Lichenification Pruritis Dryness Erythema A new patient who is a 40-year-old female postal worker being evaluated for complaints of new onset erythematous rash on both cheeks and the bridge of the nose, accompanied by fatigue. She reports a history of Hashimoto's thyroiditis and is currently being treated with Synthroid 1.25 mg daily. Which are the following conditions is most likely? Atopic dermatitis Rosacea Thyroid disease Lupus erythematosus Classic symptoms of lupus erythematosus or butterfly rash across both cheeks and the bridge of the nose, and fatigue. Risk factors also include being female and 40 years old. Which medications may be used as part of the treatment for a patient with hidradenitis suppurativa? (Select all that apply.) Correct Answer Isotretinoin Infliximab Erythromycin Chemotherapy Prednisone A patient has seborrheic dermatitis. Which vehicle would be most appropriate to use in the hairline area to treat this? Cream Powder Ointment Foam Skin hairy areas over the body, foams are specifically used because they spread easily and are transparent. Which is the primary symptom causing discomfort in patients with atopic dermatitis? Dryness Erythema Lichenification Pruritis The patient exhibits petechiae on both lower legs but has no other complaints. How should the NP proceed? Referr to hematology Order blood cultures Stop aspirin and reassess in 1 week Order a CBC The presence of petechia on the lower legs should prompt NP to consider a problem that is related to low platelet count. A CBC should be checked. Blood cultures are of no value to this patient. If platelets are found to be low, then a referral to hematology can be made. A patient has been diagnosed with scabies. What is the medication of choice to treat this? Coal tar Mupirocin Ketoconazole Permethrin A child has irritant contact dermatitis with lesions on the extremities and face. Which treatment is recommended for this patient? Antihistamines Medium- to high-potency topical corticosteroids Oral corticosteroids Topical calcineurin inhibitors A child has vesiculopustular lesions around the nose and mouth with areas of honey-colored crusts. The provider notes a few similar lesions on the child’s hands and legs. Which treatment is appropriate for this child? Amoxicillin-clavulanate Culture and sensitivity of the lesions Topical antiseptic ointment Sulfamethoxazole-trimethoprim A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication? Cream Gel Ointmen Powder A patient has been diagnosed with MRSA. She is allergic to sulfa. Which medication could be used to treat her? TMP/SMX Doxycycline Ceftriaxone Augmentin [Typically, MRSA are treated with TMP/SMX, but patients that are allergic to sulfa should not use this medication. An alternative can be doxycycline.] A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He complains of itching in the groin area. He is diagnosed with tinea cruris. The nurse practitioner is likely to identify: Well marginated half-moon macules on the inner thigh Swelling of the scrotum Macular lesions on the penis Maceration of the scrotal folds with erythema of the penis [Tinea cruris, also known as jock itch, his common during warm months and in humid areas. It is a fungal infection that affects the scrotum and inner thigh, but never affects the penis and is never evidenced by scrotal swelling.] When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug? Place an occlusive dressing over the medication Use a lotion or cream instead of an ointment preparation Put cool compresses over the affected area after application Apply a thick layer of medication over the affected area What is the initial approach when obtaining a biopsy of a potential malignant melanoma lesion? Excisional biopsy Shave biopsy Wide excision Punch biopsy The patient presents with plaques on the extensor surface of the elbows, knees, and back. The plaques are erythematous and take, silvery scales are present. This is likely: Guttate psoriasis Atopic dermatitis Staph cellulitis Plaque psoriasis This is a classic characterization of plaque psoriasis. A low potency topical hydrocortisone cream would be most appropriate in a patient who has been diagnosed with: Impetigo Cellulitis Atopical dermatitis Low dose steroid creams are almost never potent enough to treat psoriasis. Impetigo is a superficial bacterial infections and a steroid cream would be contraindicated. Cellulitis would require an oral antibiotic. Psoriasis A patient who has been exposed to poison ivy presents with inflammation and a vesicular rash on one arm. The provider recommends a topical steroid, but the next day the patient calls to report similar lesions appearing on the face. What will the provider tell this patient? The patient must have been re-exposed to the irritant. The vesicles may continue to develop for up to 2 weeks. The rash is spreading through self-inoculation. The rash may spread over the next 8 weeks. The patient has been in the sun for the past few weeks and has developed darkened skin and numerous 3-6 mm light colored, flat lesions on his s trunk. What is the likely etiology? Tinea versicolor Tinea versicolor typically visualized during the spring and summer months when the patient has become darkened after sun exposure. The areas that are infected did not tan and so become very noticeable. Tinea corporis Tinea unguium Human papilloma virus When counseling a patient with rosacea about management of this condition, the provider may recommend (Select all that apply.) using topical antibiotics. eliminating spicy foods. avoiding oil-based products. Which types of medications are associated with urticarial type rashes? (Select all that apply.) Erythromycin NSAIDs Penicillins A preschool girl who is home schooled is brought by her mother to a walk-in clinic because of acute onset of fever, runny nose, cough, sore throat, and red eyes with a morbilliform rash. The mother reports that her daughter has never been immunized. The family recently returned from vacation. Which is the following conditions is most likely? Fifth disease Rubella Rubeola Varicella Rubeola, also known as measles, is a very contagious virus and is transmitted via droplets like the common cold. Koplik's spots are present during the prodromal period. The blotchy pink rash is also known as a morbilliform rash. A 74 year old women is diagnosed with shingles. The NP is deciding how to best manage her care. What should be prescribed: A topical steroid only An oral antiviral An oral antiviral plus topical steroid An oral antiviral plus oral steroid And oral antiviral agent such as acyclovir should be prescribed, especially if it can be initiated within 72 hours after the onset of symptoms. The addition of oral corticosteroids to oral antiviral therapy demonstrates only modest benefit. Adverse events to therapy are more commonly reported in patients receiving oral Corticosteroids. there is no evidence that corticosteroid therapy decreases the incidence of duration of neurology or improved quality of life. They should be limited to use in patients with acute neuritis or who have not has benefit from analgesics. A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The provider notes all over wheals with pruritis, which the parent reports seem to come and go. Which action is correct? Admit the child to the hospital for treatment and observation Which type of bite is generally closed by delayed primary closure? (Select all that apply.) Bites to the hand Wounds 8 hours old Deep puncture wounds A patient comes to the clinic after being splashed by boiling water while cooking. The patient has partial thickness burns on both forearms, the neck, and the chin. What will the provider do? Refer the patient to the emergency department When counseling a patient who has dry skin about ways to minimize exacerbations, what will the provider include? (Select all that apply.) Cleanse the skin frequently Use topical corticosteroids regularly Use fragrance-free detergents Eat soups and stews frequently Take tepid-water baths A patient is taking a sulfonamide antibiotic and develops a rash that begins peeling. Which type of rash is suspected? Wheal and flare Stevens-Johnson Erythema multiforme Urticaria An infant has atopic dermatitis and seborrheic dermatitis with lesions on the forehead and along the scalp line. Which is correct when prescribing a corticosteroid medication to treat this condition? Initiate treatment with 0.1% triamcinolone acetonide (Kenalog lotion) Monitor the infant closely for systemic adverse effects during use Prescribe 0.05% fluocinonide (Lidex-E Cream) to apply liberally Place an occlusive dressing over the medication after application A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate results, the provider will blanch the lesions while examining them with a magnifying glass. perform a gram stain of exudate from the lesions. gently scrape the lesions with a scalpel onto a slide. remove the top of the vesicles and obtain fluid from the lesions. A patient suffers chemical burns on both arms after a spill at work. What is the initial action by the providers in the emergency department? Request the Material Safety Data information Contact the poison control center Remove the offending chemical and garments Begin aggressive irrigation of the site Which medication will the provider prescribe as first-line therapy to treat tinea capitis? Oral ketoconazol Topical tolnaftate Oral griseofulvin Topical clotrimazole An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella. What will the provider tell her? Contagion is possible until all of her lesions are crusted. An antiviral medication will prevent transmission to others. As long as her lesions are covered, there is no risk of transmission. Varicella zoster and herpes zoster are different infections. A child who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the provider recommend to help prevent these infections? Topical antibiotic ointments Bleach baths twice weekly Frequent bathing with soap and water Low-dose oral antibiotics A patient who has had a previous herpes zoster outbreak experiences a second outbreak and asks the provider about treatment to reduce the duration and severity of symptoms. What will the provider recommend? Lidocaine patch Oral corticosteroids Acyclovir Topical corticosteroids A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information? Antibiotic therapy is effective in clearing up the lesions. It is often progressive with relapses and permanent scarring. The condition is precipitated by depilatories and deodorants. The lesions are infective and the disease may be transmitted to others. Although lesions may be treated with antibiotics, other medications, and drainage, the disease is often progressive, with relapses and permanent scarring. Deodorants and depilatories are not implicated as a cause. The disease is not transmitted to others, although the organisms may cause other infections in other people. Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient’s nose. What will the provider do? Refer the patient for possible electrodessication and curettage Reassure the patient that this is a benign lesion Tell the patient this is likely a squamous cell carcinoma Consult with a dermatologist about possible melanoma A patient has acne and the provider notes lesions on half of the face, some nodules, and two scarred areas. Which treatment will be prescribed? Topical benzoyl peroxide and clindamycin Oral clindamycin for 6 to 8 weeks Topical erythromycin Oral isotretinoin The parent of a 10-month-old child with atopic dermatitis asks what can be done to minimize the recurrence of symptoms in the child. What will the provider recommend? Lubricants and emollients When examining a patient’s skin, a practitioner uses dermoscopy in order to (Select all that apply.) determine whether lesion borders are regular or irregular. visualize skin fissures, hair follicles, and pores in lesions. accentuate changes in color of pathologic lesions by fluorescence. assess changes in pigmentation throughout various lesions. A patient who has chronically dry skin who has been using emollients and moisturizers reports an uneven diamond pattern and redness on the lower legs and arms. What will the provider recommend? A topical antibiotic ointment Increasing sodium consumption Referral to a dermatologist Using antihistamines at night A patient with a purulent skin and soft tissue infection (SSTI). A history reveals a previous MRSA infection in a family member. The clinician performs an incision and drainage of the lesion and sends a sample to the lab for culture. What is the next step in treating this patient? Prescribe oral clindamycin Wait for culture results before ordering an antibiotic Begin treatment with amoxicillin-clavulanate Apply moist heat until symptoms resolve When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a Wood’s lamp and is unable to elicit fluorescence. What is the significance of this finding? The patient may have tinea capitis. When counseling a patient who has dry skin about ways to minimize exacerbations, what will the provider include? (Select all that apply.) Use fragrance-free detergents Use topical corticosteroids regularly Eat soups and stews frequently Cleanse the skin frequently Take tepid-water baths A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury? Sepsis from Capnocytophaga canimorsus infection Potential septic arthritis or osteomyelitis Possible exposure to rabies virus Transmission of human immunodeficiency virus A patient is taking a sulfonamide antibiotic and develops a rash that begins peeling. Which type of rash is suspected? Stevens-Johnson Wheal and flare Urticaria Erythema multiforme A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication? Gel Cream Ointment Powder An older patient experiences a herpes zoster outbreak and asks the provider if she is contagious because she is going to be around her grandchild who is too young to be immunized for varicella. What will the provider tell her? An antiviral medication will prevent transmission to others. Contagion is possible until all of her lesions are crusted. As long as her lesions are covered, there is no risk of transmission. Varicella zoster and herpes zoster are different infections. A low potency topical hydrocortisone cream would be most appropriate in a patient who has been diagnosed with: Impetigo Atopical dermatitis Cellulitis Psoriasis Low dose steroid creams are almost never potent enough to treat psoriasis. Impetigo is a superficial bacterial infections and a steroid cream would be contraindicated. Cellulitis would require an oral antibiotic. The patient presents with plaques on the extensor surface of the elbows, knees, and back. The plaques are erythematous and take, silvery scales are present. This is likely: Staph cellulitis Guttate psoriasis Atopic dermatitis Plaque psoriasis This is a classic characterization of plaque psoriasis. A microscopic examination of the sample taken from a skin lesion indicates hyphae. What type of infection might this indicate? Parasitic Fungal Viral Bacterial Under microscopic exam, hyyphae are long, thin and branching and indicate dermatophyte infections. A 15-month-old who is eating and behaving normally is found to have a high fever. After a few days, the fever resolves and the child breaks out in a maculopapular rash. This is a description of which with the following conditions: Fifth disease Scarlet fever Erythema infectiosum Roseola infantum Roseola is caused by herpes virus 6. Signs and symptoms including high fever for a few days with a maculopapular rash occurring after the fever breaks. A 15-year-old male has worked this summer as a lifeguard at a local swimming pool. He complains of itching in the groin area. He is diagnosed with tinea cruris. The nurse practitioner is likely to identify: Macular lesions on the penis Swelling of the scrotum Well marginated half-moon macules on the inner thigh Maceration of the scrotal folds with erythema of the penis Tinea cruris, also known as jock itch, his common during warm months and in humid areas. It is a fungal infection that effects the scrotum and inner thigh, but never affects the penis and is never evidenced by scrotal swelling.