NRNP 6635 WEEK 6 MIDTERM EXAM Q&A
2026 STUDY GUIDE WITH VERIFIED SOLUTIONS
◉ m/c cause of urticaria and maculopapular allergic skin reaction.
Answer: penicillin-based medicaiton and trimethoprim-
sulfamethoxazole
◉ penicillin-sensitive patients. Answer: cephalosporins are
assocaited with reaction in 5-15%
carbapenems 15-30%
◉ red man syndrome. Answer: not an allergic reaction, associated
with vanc often responds to slowing of infusion rate and
administration of antihistamine
◉ ACE-I. Answer: chronic cough and angioedema
◉ Beta Blockers. Answer: precipitate asthma and should not be
given to patients at high risk of anaphylaxis, BB may block the action
of epi
◉ anticonvulsants and sulfonamines. Answer: m/c cause of toxic
epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS)
,◉ radiocontrast media and opiois. Answer: stimulate mast cell
histamine release through a non-IgE-mediated mechanism
◉ lab and diagnostic for drug eruption. Answer: LFT as a baseline
skin bx
allergy skin test
patch and photo test
challenge dosing
◉ Management of drug eruption. Answer: withdrawal of drug
epi
antihistamines
◉ when does SJS or TEN usually occur. Answer: during first 8 weeks
of starting a new medicaiton
◉ m/c medications to cause SJS or TEN. Answer: allopurinol,
lamotrigine, sulfonamines, sulfasalazine, nevirapine, and oxicams
◉ SCORTEN score. Answer: prognosis of SJS/TEN
seven variables with max score of 7
, age 40 or greater = 1 pt
malignancy = 1 pt
body surface area detached greater than or equal to 10% = 1 pt
tachycardia greater or equal to 120 = 1 pt
serum urea >10 = 1 pt
serum glucose >14 = 1 pt
serum bicarb <20 = 1 pt
◉ Treatment of SJS/TEN. Answer: discontinue agent asap
treat them as a burn patient - thermoregulation and electrolyte
management
immunomodulation: cyclosporine, ATN agent, IVIG, plasmapheresis
◉ long term affects of SJS/TEN. Answer: eye disorders
vulvovaginal and urinary sequelae
◉ causative agent of cellulitis. Answer: gram + cocci
group A B-hemolytic streptococci and staphylcococcus aureus
◉ risk factors for cellulitis. Answer: prior trauma, underlying skin
lesion, DM, pedal edema, venous and lymphatic compromise, IV drug
use
2026 STUDY GUIDE WITH VERIFIED SOLUTIONS
◉ m/c cause of urticaria and maculopapular allergic skin reaction.
Answer: penicillin-based medicaiton and trimethoprim-
sulfamethoxazole
◉ penicillin-sensitive patients. Answer: cephalosporins are
assocaited with reaction in 5-15%
carbapenems 15-30%
◉ red man syndrome. Answer: not an allergic reaction, associated
with vanc often responds to slowing of infusion rate and
administration of antihistamine
◉ ACE-I. Answer: chronic cough and angioedema
◉ Beta Blockers. Answer: precipitate asthma and should not be
given to patients at high risk of anaphylaxis, BB may block the action
of epi
◉ anticonvulsants and sulfonamines. Answer: m/c cause of toxic
epidermal necrolysis (TEN) and Stevens-Johnson syndrome (SJS)
,◉ radiocontrast media and opiois. Answer: stimulate mast cell
histamine release through a non-IgE-mediated mechanism
◉ lab and diagnostic for drug eruption. Answer: LFT as a baseline
skin bx
allergy skin test
patch and photo test
challenge dosing
◉ Management of drug eruption. Answer: withdrawal of drug
epi
antihistamines
◉ when does SJS or TEN usually occur. Answer: during first 8 weeks
of starting a new medicaiton
◉ m/c medications to cause SJS or TEN. Answer: allopurinol,
lamotrigine, sulfonamines, sulfasalazine, nevirapine, and oxicams
◉ SCORTEN score. Answer: prognosis of SJS/TEN
seven variables with max score of 7
, age 40 or greater = 1 pt
malignancy = 1 pt
body surface area detached greater than or equal to 10% = 1 pt
tachycardia greater or equal to 120 = 1 pt
serum urea >10 = 1 pt
serum glucose >14 = 1 pt
serum bicarb <20 = 1 pt
◉ Treatment of SJS/TEN. Answer: discontinue agent asap
treat them as a burn patient - thermoregulation and electrolyte
management
immunomodulation: cyclosporine, ATN agent, IVIG, plasmapheresis
◉ long term affects of SJS/TEN. Answer: eye disorders
vulvovaginal and urinary sequelae
◉ causative agent of cellulitis. Answer: gram + cocci
group A B-hemolytic streptococci and staphylcococcus aureus
◉ risk factors for cellulitis. Answer: prior trauma, underlying skin
lesion, DM, pedal edema, venous and lymphatic compromise, IV drug
use
