ANCC FNP
Board-Prep Qs & Review Terms
900+ Prep Qs & Review Terms
Board-Exam Preparation
Main Features:
• Focused ANCC FNP board-exam review
• Board-Prep Questions and Review Terms
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield concepts
• Supports structured study and final revision
,1. An older adult reports waking up that morning with one side of his face paralyzed.
Complains of difficulty chewing and swallowing food on the same side. Unable to fully
close eyelid on affected side.
Answer: Bell’s Palsy
2. An 18-year-old female patient is being followed up for acne by the nurse practitioner.
During the facial exam, papules and pustules are noted mostly on the forehead and the
chin areas. The patient has been using over-the-counter topical antibiotic gels and
medicated soap daily for 6 months without much improvement. The nurse practitioner
will recommend:
A. Isotretinoin (Accutane)
B. Tetracycline (Sumycin)
C. Clindamycin topical solution (Cleocin T)
D. Minoxidil (Rogaine)
Correct Answer: B - Tetracycline (Sumycin)
Rationale: First-line treatment for acne vulgaris includes over-the-counter medicated soap
and water with topical antibiotic gels. The next step in treatment would be the initiation of oral
tetracycline.
,3. Which diagnosis describes a chronic disease of the apocrine follicles and glands,
characterized by clusters of abscesses and pustules in the axilla, groin, and perianal
area?
A. Mulloscum contagiosum
B. Hidradenitis suppurativa
C. Folliculitis
D. Furuncle
Correct Answer: B - Hidradenitis suppurativa
Rationale: Hidradenitis suppurativa is a chronic disease and recurrent inflammatory disorder
of the apocrine glands that results in painful pustules, nodules, and abscesses in areas such
as the axilla, groin, perianal, and mammary areas. It is more common in women; risk factors
include obesity and a history of smoking. Mulloscum contagiosum is a relatively common viral
infection of the skin that results in round, firm, painless bumps ranging in size from a pinhead
to a pencil eraser. Folliculitis is a common skin condition in which hair follicles become
inflamed. It is usually caused by a bacterial or fungal infection. At first, it may look like small
red bumps or white headed pimples around hair follicles. It is not a chronic condition. A
furuncle, also known as a boil, is a painful infection that forms around a hair follicle and
contains pus. It is not a chronic condition.
4. A child diagnosed with eczema was treated with over-the-counter 1% hydrocortisone
ointment. During a follow-up visit, the mother reports that the rash does not seem to be
improving. What level steroid should the nurse practitioner prescribe next?
A. Group 6
B. Group 5
C. Group 4
D. Group 3
Correct Answer: A - Group 6
Rationale: The patient is currently using a potency Group 7 (over-thecounter topical
hydrocortisone, 0.5%–1.0%) for eczema. The nurse practitioner should prescribe the next
level of topical steroids, a Group 6, such as desonide cream or lotion (0.05%) and then
reevaluate for effectiveness. The topical steroid strengths range from 7 (least potent) to 1
(very potent). For example, a Group 5 is fluticasone propionate cream (0.05%), a Group 4 is
triamcinolone acetonide cream (0.1%), and a Group 3 is amcinonide (0.1%). Children should
not be prescribed topical steroids for more than 2 weeks.
,5. A patient has several well-defined, primary lesions <20 mm over the trunk and
extremities. After completing a dermascopic exam, the nurse practitioner diagnoses
Bowen's disease. Which treatment will the nurse practitioner recommend?
A. Moh's surgery
B. Radiation therapy
C. Curettage and electrodessication
D. Standard excision
Correct Answer: C - Curettage and electrodessication
Rationale: The patient has Bowen’s disease, a squamous cell cancer (SCC) of the epidermis
that has not invaded the dermis yet. Curettage and electrodessication is an efficient, cost-
effective method with low complication rates. Surgical treatments such as a standard excision
(95% removal) and Moh’s surgery (100% removal) are more invasive, and there is a greater
risk for complications, especially in the elderly. Radiation therapy is not indicated for low-risk
lesions.
6. The nurse practitioner is conducting a health history on a 39-year-old male patient with
necrotic ulcers on his arms, face, and neck. The patient reveals that he is a livestock
farmer. The nurse practitioner will:
A. Isolate the patient in an examination room
B. Administer the anthrax vaccine adsorbed (AVA)
C. Prescribe ciprofloxacin (Cipro)
D. Send a blood sample to the state lab and Centers for Disease Control and Prevention
(CDC)
Correct Answer: D - Send a blood sample to the state lab and Centers for Disease
Rationale: Control and Prevention (CDC) A patient with suspected cutaneous anthrax
requires a blood test to confirm Bacillus anthracis (grampositive rods). The blood sample
should be sent to the state lab and the CDC for confirmation. Because anthrax is not
contagious, there is no need to isolate the patient in an examination room. The anthrax
vaccine is administered to specifi c populations (18 to 65 years), such as military personnel,
veterinarians, and people who work with specific animals or in slaughterhouses. Once the
diagnosis is confirmed and course of antibiotics completed, the vaccine can be administered.
,7. Your female patient of 10 years is concerned about her most recent diagnosis. She
was told by her dermatologist that she has an advanced case of actinic keratosis. Which
of the following is the best explanation for this patient?
A. It is a benign condition
B. It is a precancerous lesion and needs to be followed up with her dermatologist
C. It will diminish with application of hydrocortisone cream 1% BID for 2 weeks
D. It is important for her to follow up with an oncologist
Correct Answer: B - It is a precancerous lesion and needs to be followed up with
Rationale: her dermatologist Actinic keratoses are small, raised skin lesions that result from
extended sun exposure. Some actinic keratoses may develop into skin cancer; therefore,
further evaluation is needed to determine if removal is required.
8. Acanthosis nigricans is associated with all of the following disorders, except:
A. Obesity
B. Diabetes
C. Colon cancer
D. Tinea versicolor
Correct Answer: D - Tinea versicolor
Rationale: Acanthosis nigricans is a benign skin condition that is a sign of insulin resistance.
It appears as hyperpigmented velvety areas that are usually located on the neck and the
axillae. It is rarely associated with some types of adenocarcinoma of the gastrointestinal tract.
Tinea versicolor is a superficial infection of the skin (stratum corneum layer) that is caused by
dermatophytes (fungi) of the tinea family. Another name for it is sunspots.
,9. The parent of a 5-year-old states, "My child has had a rash for the past week and
cannot stop scratching it." Physical assessment reveals 1-mm papules and pustules,
grayishwhite burrows on the child's palms and soles of the feet, and excoriated skin with
honeycolored crusting on the face and neck. The nurse practitioner will prescribe:
A. Topical nystatin
B. Oral griseofulvin
C. Oral ketoconazole (Nizoral)
D. Topical permethrin (Elimite)
Correct Answer: D - Topical permethrin (Elimite)
Rationale: The assessment findings are consistent with scabies and require the application
of a scabicide such as topical permethrin (Elimite). Topical nystatin is used to treat candidal
infections. Oral griseofulvin is used to treat different fungal infections. Oral ketoconazole
(Nizoral) is reserved for severe fungal infections.
10. A nurse practitioner sees a fair-skinned patient who is experiencing recurrent small
acne-like pustules and papules on the cheeks, nose, and chin, as well as chronic dry
eyes. Which diagnosis is most likely?
A. Rocky Mountain spotted fever (RMSF)
B. Herpes zoster ophthalmicus
C. Acne rosacea
D. Actinic keratosis
Correct Answer: C - Acne rosacea
Rationale: The patient is presenting with acne rosacea, a chronic inflammatory disease of
the cheeks, chin, and nose, with dry, reddened eyes. First-line treatment is to determine
triggers such as spicy foods and alcohol. Herpes zoster ophthalmicus affects one side of the
head with sudden vesicular lesions on the scalp, nose, and forehead. The patient may also
report photophobia, eye pain, and blurred vision. RMSF causes a rash, an abrupt onset of a
high fever, chills, severe headache, photophobia, and nausea and vomiting. A petechial rash
starts on the wrists, forearms, and feet and then moves up to the trunk. RMSF is caused by
the bite of a dog tick that is infected with the parasite Rickettsia ricksettsii . Actinic keratosis is
more common in older to elderly adults. Numerous dry, round, and red-colored lesions do not
heal and mostly occur in sun-exposed areas. They may be precancerous lesions to
squamous cell carcinoma.
,11. The nurse practitioner is screening a patient for melanoma using the ABCD acronym.
Which lesion size is an abnormal finding?
A. Diameter <2 mm B Diameter <3 mm
C. Diameter >6 mm
D. Diameter <4 mm
Correct Answer: C - Diameter >6 mm
Rationale: In the ABCDE acronym for melanoma screening, the “D” is for the diameter of a
lesion. If the lesion is larger than 6 mm (1/4) with asymmetry, border irregularity, color variety,
and enlargement over time, the patient should be referred to a dermatologist.
12. A 7-year-old is brought to the clinic by his mother, who is concerned about "bumps"
on his trunk and armpits lasting for several weeks. There are no complaints of pain or
itching, and the child is afebrile. Upon examination, the nurse practitioner notes a cluster
of 2-mm papules that are fleshcolored, dome-shaped, and smooth with a central
umbilication. Which diagnosis is most likely?
A. Secondary milia
B. Verruca vulgaris
C. Molluscum contagiosum
D. Folliculitis
Correct Answer: C - Molluscum contagiosum
Rationale: Molluscum contagiosum is a viral condition common in children spread by direct
contact. The condition is self-limiting, does not produce pain or itching, and resolves over
several months. Milia are keratin-filled cysts that usually occur around the nose and eyes.
Verruca vulgaris (warts) are viral and appear as irregular, raised, flesh-colored growths that
feel rough to the touch. Folliculitis is an inflammation of the hair follicles, which can become
pus-filled sores.
,13. The mother of an 8-year-old boy reports the presence of a round red rash on the
child's left lower leg. It appeared 1 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 a round target. Which
condition is most likely?
A. Erythema migrans
B. Rocky Mountain spotted fever
C. Meningococcemia
D. Larva migrans
Correct Answer: A - Erythema migrans
Rationale: Erythema migrans is a symptom of early Lyme disease. It is an annular lesion that
slowly enlarges with time (days to weeks) and has central clearing. It is caused by a bite from
an infected ( Borrelia burgdorferi ) blacklegged tick. If untreated, infection will spread to the
joints, nervous system, and heart. Most cases of Lyme disease occur in the Northeast, mid-
Atlantic states, Wisconsin, Minnesota, and northern California.
,14. The nurse practitioner sees a 58-year-old female patient with complaints of abscesses
and pustules in the axilla and groin and under the breasts, which burst and drain
purulent green discharge. She has a history of smoking and a body mass index (BMI) of
37.1. Which diagnosis is most likely?
A. Impetigo
B. Carbuncles
C. Shingles
D. Hidradenitis suppurativa
Correct Answer: D - Hidradenitis suppurativa.
Rationale: Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity
are significant risk factors. Lesions are treated with topical antibiotics (or oral antibiotics,
warm compresses, and pain medications). Institute diet changes to reduce high glycemic and
dairy food intake. Refer to a dermatologist for additional treatment options. Impetigo is
caused by Group B streptococcus or Staphylococcus aureus and is more common in
children. Lesions form under the nose and around the mouth, and it is very contagious. Dried
lesions are honey colored. Carbuncles are a collection of multiple furuncles that are treated
with systemic antibiotics. The lesions of shingles present as groups of vesicles and papules
with a red base, which rupture and form dermatomal, crusted lesions on one side of the body.
15. A new patient who is a 40-year-old female postal worker is being evaluated for
complaints of a 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 levothyroxine (Synthroid) 1.25 mg daily. Which of the following
conditions is most likely?
A. Atopic dermatitis
B. Thyroid disease
C. Lupus erythematosus
D. Rosacea
Correct Answer: C - Lupus erythematosus
Rationale: Classic symptoms of lupus erythematosus are butterfly rash across both cheeks
and the bridge of the nose and fatigue. Risk factors include being female and 40 years old.
Rosacea also has a similar rash but usually not associated with fatigue.
, 16. Which of the following is recommended treatment for erythema migrans or early
Lyme disease?
A. Doxycycline (Vibramycin) 100 mg PO BID × 21 days
B. Ciprofloxacin (Cipro) 250 mg PO BID × 14 days
C. Erythromycin (E-mycin) 333 mg PO TID × 10 days
D. Dicloxacillin (Dynapen) 500 mg PO BID × 10 days
Correct Answer: A - Doxycycline (Vibramycin) 100 mg PO BID × 21 days
Rationale: Erythema migrans is the rash characteristic of Lyme disease, and it usually
appears 7 to 10 days after a tick bite. Lyme disease is caused by Borrelia burgdorferi , a
spirochete. The rash appears either as a single expanding red patch or as a central spot
surrounded by clear skin that is in turn ringed by an expanded red rash (bull’s-eye). The
choice of antibiotic depends on bacterial sensitivity. Doxycycline 100 mg BID for 14 to 21
days is the recommended treatment of adults.
17. Which of the following conditions is associated with a positive Auspitz sign?
A. Contact dermatitis
B. Seborrheic dermatitis
C. Systemic lupus erythematosus
D. Psoriasis
Correct Answer: D - Psoriasis
Rationale: The Auspitz sign is simply bleeding that occurs after psoriasis scales have been
removed. It occurs because the capillaries run very close to the surface of the skin under a
psoriasis lesion, and removing the scale essentially pulls the tops off the capillaries, causing
bleeding. Auspitz sign is also found in other scaling disorders such as actinic keratoses.
Board-Prep Qs & Review Terms
900+ Prep Qs & Review Terms
Board-Exam Preparation
Main Features:
• Focused ANCC FNP board-exam review
• Board-Prep Questions and Review Terms
• Extensive collection of practice questions
• Helpful for identifying knowledge gaps
• Covers high-yield concepts
• Supports structured study and final revision
,1. An older adult reports waking up that morning with one side of his face paralyzed.
Complains of difficulty chewing and swallowing food on the same side. Unable to fully
close eyelid on affected side.
Answer: Bell’s Palsy
2. An 18-year-old female patient is being followed up for acne by the nurse practitioner.
During the facial exam, papules and pustules are noted mostly on the forehead and the
chin areas. The patient has been using over-the-counter topical antibiotic gels and
medicated soap daily for 6 months without much improvement. The nurse practitioner
will recommend:
A. Isotretinoin (Accutane)
B. Tetracycline (Sumycin)
C. Clindamycin topical solution (Cleocin T)
D. Minoxidil (Rogaine)
Correct Answer: B - Tetracycline (Sumycin)
Rationale: First-line treatment for acne vulgaris includes over-the-counter medicated soap
and water with topical antibiotic gels. The next step in treatment would be the initiation of oral
tetracycline.
,3. Which diagnosis describes a chronic disease of the apocrine follicles and glands,
characterized by clusters of abscesses and pustules in the axilla, groin, and perianal
area?
A. Mulloscum contagiosum
B. Hidradenitis suppurativa
C. Folliculitis
D. Furuncle
Correct Answer: B - Hidradenitis suppurativa
Rationale: Hidradenitis suppurativa is a chronic disease and recurrent inflammatory disorder
of the apocrine glands that results in painful pustules, nodules, and abscesses in areas such
as the axilla, groin, perianal, and mammary areas. It is more common in women; risk factors
include obesity and a history of smoking. Mulloscum contagiosum is a relatively common viral
infection of the skin that results in round, firm, painless bumps ranging in size from a pinhead
to a pencil eraser. Folliculitis is a common skin condition in which hair follicles become
inflamed. It is usually caused by a bacterial or fungal infection. At first, it may look like small
red bumps or white headed pimples around hair follicles. It is not a chronic condition. A
furuncle, also known as a boil, is a painful infection that forms around a hair follicle and
contains pus. It is not a chronic condition.
4. A child diagnosed with eczema was treated with over-the-counter 1% hydrocortisone
ointment. During a follow-up visit, the mother reports that the rash does not seem to be
improving. What level steroid should the nurse practitioner prescribe next?
A. Group 6
B. Group 5
C. Group 4
D. Group 3
Correct Answer: A - Group 6
Rationale: The patient is currently using a potency Group 7 (over-thecounter topical
hydrocortisone, 0.5%–1.0%) for eczema. The nurse practitioner should prescribe the next
level of topical steroids, a Group 6, such as desonide cream or lotion (0.05%) and then
reevaluate for effectiveness. The topical steroid strengths range from 7 (least potent) to 1
(very potent). For example, a Group 5 is fluticasone propionate cream (0.05%), a Group 4 is
triamcinolone acetonide cream (0.1%), and a Group 3 is amcinonide (0.1%). Children should
not be prescribed topical steroids for more than 2 weeks.
,5. A patient has several well-defined, primary lesions <20 mm over the trunk and
extremities. After completing a dermascopic exam, the nurse practitioner diagnoses
Bowen's disease. Which treatment will the nurse practitioner recommend?
A. Moh's surgery
B. Radiation therapy
C. Curettage and electrodessication
D. Standard excision
Correct Answer: C - Curettage and electrodessication
Rationale: The patient has Bowen’s disease, a squamous cell cancer (SCC) of the epidermis
that has not invaded the dermis yet. Curettage and electrodessication is an efficient, cost-
effective method with low complication rates. Surgical treatments such as a standard excision
(95% removal) and Moh’s surgery (100% removal) are more invasive, and there is a greater
risk for complications, especially in the elderly. Radiation therapy is not indicated for low-risk
lesions.
6. The nurse practitioner is conducting a health history on a 39-year-old male patient with
necrotic ulcers on his arms, face, and neck. The patient reveals that he is a livestock
farmer. The nurse practitioner will:
A. Isolate the patient in an examination room
B. Administer the anthrax vaccine adsorbed (AVA)
C. Prescribe ciprofloxacin (Cipro)
D. Send a blood sample to the state lab and Centers for Disease Control and Prevention
(CDC)
Correct Answer: D - Send a blood sample to the state lab and Centers for Disease
Rationale: Control and Prevention (CDC) A patient with suspected cutaneous anthrax
requires a blood test to confirm Bacillus anthracis (grampositive rods). The blood sample
should be sent to the state lab and the CDC for confirmation. Because anthrax is not
contagious, there is no need to isolate the patient in an examination room. The anthrax
vaccine is administered to specifi c populations (18 to 65 years), such as military personnel,
veterinarians, and people who work with specific animals or in slaughterhouses. Once the
diagnosis is confirmed and course of antibiotics completed, the vaccine can be administered.
,7. Your female patient of 10 years is concerned about her most recent diagnosis. She
was told by her dermatologist that she has an advanced case of actinic keratosis. Which
of the following is the best explanation for this patient?
A. It is a benign condition
B. It is a precancerous lesion and needs to be followed up with her dermatologist
C. It will diminish with application of hydrocortisone cream 1% BID for 2 weeks
D. It is important for her to follow up with an oncologist
Correct Answer: B - It is a precancerous lesion and needs to be followed up with
Rationale: her dermatologist Actinic keratoses are small, raised skin lesions that result from
extended sun exposure. Some actinic keratoses may develop into skin cancer; therefore,
further evaluation is needed to determine if removal is required.
8. Acanthosis nigricans is associated with all of the following disorders, except:
A. Obesity
B. Diabetes
C. Colon cancer
D. Tinea versicolor
Correct Answer: D - Tinea versicolor
Rationale: Acanthosis nigricans is a benign skin condition that is a sign of insulin resistance.
It appears as hyperpigmented velvety areas that are usually located on the neck and the
axillae. It is rarely associated with some types of adenocarcinoma of the gastrointestinal tract.
Tinea versicolor is a superficial infection of the skin (stratum corneum layer) that is caused by
dermatophytes (fungi) of the tinea family. Another name for it is sunspots.
,9. The parent of a 5-year-old states, "My child has had a rash for the past week and
cannot stop scratching it." Physical assessment reveals 1-mm papules and pustules,
grayishwhite burrows on the child's palms and soles of the feet, and excoriated skin with
honeycolored crusting on the face and neck. The nurse practitioner will prescribe:
A. Topical nystatin
B. Oral griseofulvin
C. Oral ketoconazole (Nizoral)
D. Topical permethrin (Elimite)
Correct Answer: D - Topical permethrin (Elimite)
Rationale: The assessment findings are consistent with scabies and require the application
of a scabicide such as topical permethrin (Elimite). Topical nystatin is used to treat candidal
infections. Oral griseofulvin is used to treat different fungal infections. Oral ketoconazole
(Nizoral) is reserved for severe fungal infections.
10. A nurse practitioner sees a fair-skinned patient who is experiencing recurrent small
acne-like pustules and papules on the cheeks, nose, and chin, as well as chronic dry
eyes. Which diagnosis is most likely?
A. Rocky Mountain spotted fever (RMSF)
B. Herpes zoster ophthalmicus
C. Acne rosacea
D. Actinic keratosis
Correct Answer: C - Acne rosacea
Rationale: The patient is presenting with acne rosacea, a chronic inflammatory disease of
the cheeks, chin, and nose, with dry, reddened eyes. First-line treatment is to determine
triggers such as spicy foods and alcohol. Herpes zoster ophthalmicus affects one side of the
head with sudden vesicular lesions on the scalp, nose, and forehead. The patient may also
report photophobia, eye pain, and blurred vision. RMSF causes a rash, an abrupt onset of a
high fever, chills, severe headache, photophobia, and nausea and vomiting. A petechial rash
starts on the wrists, forearms, and feet and then moves up to the trunk. RMSF is caused by
the bite of a dog tick that is infected with the parasite Rickettsia ricksettsii . Actinic keratosis is
more common in older to elderly adults. Numerous dry, round, and red-colored lesions do not
heal and mostly occur in sun-exposed areas. They may be precancerous lesions to
squamous cell carcinoma.
,11. The nurse practitioner is screening a patient for melanoma using the ABCD acronym.
Which lesion size is an abnormal finding?
A. Diameter <2 mm B Diameter <3 mm
C. Diameter >6 mm
D. Diameter <4 mm
Correct Answer: C - Diameter >6 mm
Rationale: In the ABCDE acronym for melanoma screening, the “D” is for the diameter of a
lesion. If the lesion is larger than 6 mm (1/4) with asymmetry, border irregularity, color variety,
and enlargement over time, the patient should be referred to a dermatologist.
12. A 7-year-old is brought to the clinic by his mother, who is concerned about "bumps"
on his trunk and armpits lasting for several weeks. There are no complaints of pain or
itching, and the child is afebrile. Upon examination, the nurse practitioner notes a cluster
of 2-mm papules that are fleshcolored, dome-shaped, and smooth with a central
umbilication. Which diagnosis is most likely?
A. Secondary milia
B. Verruca vulgaris
C. Molluscum contagiosum
D. Folliculitis
Correct Answer: C - Molluscum contagiosum
Rationale: Molluscum contagiosum is a viral condition common in children spread by direct
contact. The condition is self-limiting, does not produce pain or itching, and resolves over
several months. Milia are keratin-filled cysts that usually occur around the nose and eyes.
Verruca vulgaris (warts) are viral and appear as irregular, raised, flesh-colored growths that
feel rough to the touch. Folliculitis is an inflammation of the hair follicles, which can become
pus-filled sores.
,13. The mother of an 8-year-old boy reports the presence of a round red rash on the
child's left lower leg. It appeared 1 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 a round target. Which
condition is most likely?
A. Erythema migrans
B. Rocky Mountain spotted fever
C. Meningococcemia
D. Larva migrans
Correct Answer: A - Erythema migrans
Rationale: Erythema migrans is a symptom of early Lyme disease. It is an annular lesion that
slowly enlarges with time (days to weeks) and has central clearing. It is caused by a bite from
an infected ( Borrelia burgdorferi ) blacklegged tick. If untreated, infection will spread to the
joints, nervous system, and heart. Most cases of Lyme disease occur in the Northeast, mid-
Atlantic states, Wisconsin, Minnesota, and northern California.
,14. The nurse practitioner sees a 58-year-old female patient with complaints of abscesses
and pustules in the axilla and groin and under the breasts, which burst and drain
purulent green discharge. She has a history of smoking and a body mass index (BMI) of
37.1. Which diagnosis is most likely?
A. Impetigo
B. Carbuncles
C. Shingles
D. Hidradenitis suppurativa
Correct Answer: D - Hidradenitis suppurativa.
Rationale: Hidradenitis suppurativa is most common in women (3:1). Smoking and obesity
are significant risk factors. Lesions are treated with topical antibiotics (or oral antibiotics,
warm compresses, and pain medications). Institute diet changes to reduce high glycemic and
dairy food intake. Refer to a dermatologist for additional treatment options. Impetigo is
caused by Group B streptococcus or Staphylococcus aureus and is more common in
children. Lesions form under the nose and around the mouth, and it is very contagious. Dried
lesions are honey colored. Carbuncles are a collection of multiple furuncles that are treated
with systemic antibiotics. The lesions of shingles present as groups of vesicles and papules
with a red base, which rupture and form dermatomal, crusted lesions on one side of the body.
15. A new patient who is a 40-year-old female postal worker is being evaluated for
complaints of a 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 levothyroxine (Synthroid) 1.25 mg daily. Which of the following
conditions is most likely?
A. Atopic dermatitis
B. Thyroid disease
C. Lupus erythematosus
D. Rosacea
Correct Answer: C - Lupus erythematosus
Rationale: Classic symptoms of lupus erythematosus are butterfly rash across both cheeks
and the bridge of the nose and fatigue. Risk factors include being female and 40 years old.
Rosacea also has a similar rash but usually not associated with fatigue.
, 16. Which of the following is recommended treatment for erythema migrans or early
Lyme disease?
A. Doxycycline (Vibramycin) 100 mg PO BID × 21 days
B. Ciprofloxacin (Cipro) 250 mg PO BID × 14 days
C. Erythromycin (E-mycin) 333 mg PO TID × 10 days
D. Dicloxacillin (Dynapen) 500 mg PO BID × 10 days
Correct Answer: A - Doxycycline (Vibramycin) 100 mg PO BID × 21 days
Rationale: Erythema migrans is the rash characteristic of Lyme disease, and it usually
appears 7 to 10 days after a tick bite. Lyme disease is caused by Borrelia burgdorferi , a
spirochete. The rash appears either as a single expanding red patch or as a central spot
surrounded by clear skin that is in turn ringed by an expanded red rash (bull’s-eye). The
choice of antibiotic depends on bacterial sensitivity. Doxycycline 100 mg BID for 14 to 21
days is the recommended treatment of adults.
17. Which of the following conditions is associated with a positive Auspitz sign?
A. Contact dermatitis
B. Seborrheic dermatitis
C. Systemic lupus erythematosus
D. Psoriasis
Correct Answer: D - Psoriasis
Rationale: The Auspitz sign is simply bleeding that occurs after psoriasis scales have been
removed. It occurs because the capillaries run very close to the surface of the skin under a
psoriasis lesion, and removing the scale essentially pulls the tops off the capillaries, causing
bleeding. Auspitz sign is also found in other scaling disorders such as actinic keratoses.
