Download APEA 3P EXAM PREP- DERMATOLOGY|2025-2026|QUESTIONS WITH ANSWERS AND RATIONALES|RATED A+ and more Exams Dermatology in PDF only on Docsity!
APEA 3P EXAM PREP- DERMATOLOGY| 2025 - 2026|QUESTIONS
WITH ANSWERS AND RATIONALES|RATED A+
Impetigo is characterized by: honey-colored crusts. silvery scales. marble-like lesions. wheals with pus. A. Impetigo is a superficial bacterial infection of the skin characterized by honey- colored crusts. Another form of impetigo is characterized by the presence of bullae. These infections are treated with topical antibiotics, good hygiene, and frequent hand washing. It is usually caused by Staphylococcus or Group A Streptococcus. A patient was burned with hot water. He has several 2-3 cm fluid-filled lesions. What are these termed? Vesicle s Bullae Cysts Wheal s B. Bullae are fluid-filled lesions that are greater than 6 mm in diameter. These are common in patients who have a superficial partial-thickness burn. Vesicles are also fluid filled, but they are smaller than 5 mm in diameter. A cyst is enclosed in a sac that can contain fluid or gelatinous material. Wheals are erythematous, irregular raised areas on the skin. All of these are termed primary lesions.
The best way to evaluate jaundice associated with liver disease is to observe: blanching of the hands, feet, and nails. the sclera, skin, and lips. the lips, oral mucosa, and tongue. tympanic membrane and skin only. B. Looking at the sclera allows the examiner to see jaundice most easily and reliably. Jaundice may also appear in the palpebral conjunctiva, lips, hard palate, undersurface of the tongue, tympanic membrane, and skin. Jaundice in adults usually is a result of liver disease, but it can be due to excessive hemolysis of red blood cells. In infants, the usual cause is hemolysis of red blood cells, as is seen in physiologic jaundice. The most common place for a basal cell carcinoma to be found is the: scalp. Face
. Ear. Anterior shin. B. The most common presentation of basal cell carcinoma (BCC) is on the face. This is probably because BCC occurs secondary to sun damage. The most common sun exposure occurs on the face. In fact, 70% of BCC occurs on the face; 15% occurs on the trunk. A topical treatment for basal cell carcinoma is: sulfacetamide lotion. 5 - fluorouracil.
dermatitis Dyshidrotic dermatitis Herpes zoster Varicella zoster B. This dermatitis is intensely pruritic and involves the palms and soles and lateral aspects of the fingers. Over a couple of weeks, the vesicles desquamate. Recurrences are common. Seborrheic dermatitis affects only hairy areas of the body. The vesicles might raise suspicion of a viral infection, but this is not present in this case. A 71 - year-old female presents with a vesicular rash that burns and itches. Shingles is diagnosed. An oral antiviral: should be started within 72 hours of the onset of symptoms. must be started within 96 hours of the onset of the rash. can be started at any time after the appearance of the rash. will nearly eliminate the risk of postherpetic neuralgia. A. This patient has been diagnosed with shingles. This can produce painful neuritis. Shingles is treated with an oral antiviral agent, preferably within 72 hours of onset of the symptoms. Treating shingles with an oral antiviral agent shortens the severity and duration of shingles. It may also
help decrease the incidence of post-herpetic neuralgia. A patient presents with plaques on the extensor surface of the elbows, knees, and back. The plaques are erythematous and thick, silvery scales are present. This is likely: plaque psoriasis. guttate psoriasis. atopic dermatitis. Staph cellulitis. A. Plaque psoriasis is seen initially in young adults and is characterized as described above. The thick, silvery scale is pathognomic and is usually asymptomatic, but some patients will complain of pruritus. A clinical finding that will help establish a diagnosis is the pitting of fingernails. This occurs in about 50% of patients with psoriasis. The plaques are commonly distributed on the scalp, and extensor surface of the elbows, knees, and back. This is a chronic skin disorder. An example of a premalignant lesion that develops on sun-damaged skin is: actinic keratosis. basal cell carcinoid. squamous cell carcinoma. molluscum contagiosum. A. Actinic keratoses (AK) are a result of solar damage to the skin. They are most common on the face, bald scalp, and forearms. Patients who present with AK usually have multiple of them. A characteristic that helps
3 - 4 weeks ago. D. The incubation period for scabies is about 3 - 4 weeks after primary infection. Patients with subsequent infections with scabies will develop symptoms in 1 - 3 days. The classic symptom is itching which is worse at night, coupled with a rash that appears in new areas over time. A patient presents to the minor care area of the emergency department after being bitten by a dog. The patient states that the dog had a tag around his neck and had been seen roaming around the neighborhood for days before the patient was bitten. The dog did not exhibit any odd behavior. How should this be managed? If the bites are only minor, do not mention rabies prophylaxis to the patient. Give the patient tetanus immunization only. Don’t call animal control. Clean the wounds, provide tetanus and rabies prophylaxis. Report the bite to animal control and administer appropriate medical care. D. All 50 states require reporting of animal bites to animal control or the state’s appropriate authority for reporting animal bites. It sounds unlikely that the dog could be infected with rabies, but rabies prophylaxis must be considered after all history and information has been gathered. A wound has the following characteristics; partial thickness loss of dermis, a shallow open ulcer with red/pink bed, and no evidence of sloughing. What stage of pressure ulcer does this describe?
Stage I Stage II Stage III Stage IV B. Stage I is characterized by intact skin and non-blanchable redness of a localized area (usually over a bony prominence). Compared to adjacent tissue, the area may be painful, firm, soft, warmer or cooler. Stage II is characterized by partial-thickness loss of dermis presenting as a shallow open ulcer or a red-pink wound bed, absent sloughing. It may also present as an intact or open/ruptured serum-filled blister. Stage III is characterized by full-thickness tissue loss with or without visible subcutaneous fat; bone, tendon, and muscle are not exposed. Sloughing may be present but does not obscure the depth of tissue loss. The depth varies by anatomical location. Stage IV is characterized by full-thickness tissue loss with exposed bone, tendon, or muscle. Sloughing or eschar may be present on some parts of the wound bed. The depth varies by anatomical location. The nurse practitioner examines a patient who has had poison ivy (hiedra venenosa) for 3 days. She asks if she can spread it to her family members. The nurse practitioner replies: “Yes, but only before crusting has occurred.” “Yes, the fluid in the blister can transmit it.” “No, the transmission does not occur from the blister’s
An oral antiviral agent plus an oral steroid An oral antiviral agent plus a topical steroid A topical steroid only A. An oral antiviral agent such as acyclovir, famciclovir or valacyclovir 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 benefits. Adverse events to therapy are more commonly reported in patients receiving oral corticosteroids. There is no evidence that corticosteroid therapy decreases the incidence or duration of postherpetic neuralgia or improves the quality of life. Corticosteroids should be limited to use in patients with acute neuritis who have not derived benefits from opioid analgesics. An example of a first-generation cephalosporin used to treat a skin infection is: cephalexin. cefuroxime. cefdinir. cefaclor.
A.
Two common first-generation cephalosporins used to treat skin and skin structure infections are cephalexin and cefadroxil. These are taken two to four times daily and are generally well tolerated. These antibiotics provide coverage against Staphylococcus and Streptococcus, common skin pathogens. A patient is diagnosed with tinea pedis. A microscopic examination of the sample taken from the infected area would likely demonstrate: hyphae. yeasts. rods or cocci. a combination of hyphae and spores. A. Under microscopic exam, hyphae are long, thin and branching, and indicate dermatophytic infections. Hyphae are typical in tinea pedis, tinea cruris, and tinea corporis. Yeasts are usually seen in candidal infections. Cocci and rods are specific to bacterial infections. A patient has been diagnosed with MRSA. She is allergic to sulfa. Which medication could be used to treat her? Augmentin
Amoxicillin- clavulanate Trimethoprim- sulfamethoxazole Cephalexin A. Doxycycline is frequently chosen first-line to treat Lyme disease. However, numerous studies have demonstrated that amoxicillin and cefuroxime have equal efficacy as doxycycline in the treatment of early Lyme disease. These drugs are recommended in patients who exhibit erythema migrans. Doxycycline is not recommended in children younger than 9 years of age. Which test is NOT suitable to diagnose shingles if the clinical presentation is questionable? Tzanck preparation Polymerase chain reaction (PCR) Direct fluorescent antibody (DFA) Complete blood count (CBC) D. Herpes viruses are the causative agents in shingles, chickenpox, genital herpes, and oral fever blisters. Diagnosis is usually made on clinical presentation. However, in questionable cases, lab tests may be employed. A Tzanck preparation is a rapid test used to diagnose infections due to herpes viruses. Cells taken from a blister’s fluid are smeared on a slide and stained with a Wright’s stain, or the fluid can be used for other methods of testing. DFA is the most common test employed for shingles diagnosis because it can be rapidly performed and offers results in about 90 minutes. PCR may be performed on skin scrapings, serum or blood for herpetic diagnosis. CBC may indicate a patient with a viral infection, but it
is nonspecific for herpetic infections. A 23-year-old male appears in clinic with the following nonpruritic lesion on his trunk. He first noticed this about 3 days ago. The lesion is probably: scabies . eczema . a herald patch. psoriasis. C. Pityriasis rosea is a viral rash that is common in older children and young adults. It typically begins with a herald patch, a single round pink or salmon-colored, nonpruritic plaque on the chest, neck, or back. It is often mistaken for ringworm prior to the eruption of the Christmas tree pattern rash. The rash occurs within 1- 2 weeks after the appearance of the herald patch. Scabies typically presents as a pruritic eruption characterized by small, erythematous, nondescript papules. Its prominent clinical feature is pruritus. Most cases of eczema initially occur by the age of five years, but can manifest in adults as an area of pruritic, thickened (lichenified), and excoriated skin in the flexural areas. Psoriasis may present as silvery scales or plaques. A skin lesion that is a solid mass is described as a: macule
A 68 - year-old female adult with pendulous breasts complains of “burning” under her right breast. The nurse practitioner observes a malodorous discharge with mild maceration under both breasts. What is this? Intertrigo Impetigo Tinea corporis Shingles A. This is not unusual in adults with pendulous breasts. Intertrigo is common in areas between skin folds, under the breasts, between the scrotum and inner thigh, or between the toes. These are moist lesions that can be easily treated if the skin can be separated from touching the adjoining skin and the area can be kept dry. A topical powder with an antifungal would likely resolve this if used twice daily for 7- 14 days. A diagnosis of diabetes should be considered if this is resistant to treatment or if it recurs. A 70 - year-old is diagnosed with multiple cherry angiomas. The nurse practitioner knows that: this is a mature capillary proliferation more common in young adults. an angioma occurs as a single lesion. these may bleed profusely if ruptured. these are precursors of skin malignancies. C.
Cherry angiomas are mature capillary proliferations that are more common in middle-aged and older adults. They blanch with pressure and are usually 0.1-0.4 cm in diameter. They are commonly found on the trunk as multiple lesions. Because they are a proliferation of capillaries, they will bleed significantly if they rupture. The bleed is not life threatening, but in older adults who take aspirin, the bleeding will be worse. Pressure should be held over the ruptured area until bleeding stops. These are not precursors of skin malignancies.
Folliculitis is a superficial infection of the hair follicles. It presents as clusters of small, raised, erythematous lesions, not as a singular lesion as demonstrated in this image. Diabetes may be associated with acanthosis nigricans, a condition characterized by areas of velvety, hyperpigmented skin most commonly on the body folds and skin creases such as the neck and axillae. Hypothyroidism is not associated with this lesion. A 60 - year-old patient is noted to have rounding of the distal phalanx of the fingers. What might have caused this? Coronary artery disease Hepatic cirrhosis Lead toxicity Iron deficiency anemia B. Rounding of the distal phalanx describes clubbing. Clubbing of fingers is most often associated with chronic hypoxia as seen in cigarette smokers and patients with COPD or lung cancer. Other causes are cirrhosis, cystic fibrosis, pulmonary fibrosis and cyanotic heart disease. A patient with diabetes has right anterior shin edema, erythema, warmth, and tenderness to touch. This developed over the past 3 days. There is no visible pus. What is the most likely diagnosis to consider? Deep vein thrombosis (DVT) Buerger’s disease Cellulitis Venous disease C. This description is one of cellulitis. Cellulitis involves an infection of the subcutaneous layers of the skin. It must be treated with an oral
antibiotic. In a patient with diabetes, it is particularly important to identify, and aggressively treat cellulitis early, because elevated blood sugar levels will make eradication more difficult. Buerger’s disease involves inflammation of the medium-sized arteries and does not present on the anterior shin only. DVT seldom presents on the anterior shin, so this is not likely. Venous disease does not present acutely, as in this situation. A patient is found to have koilonychia. What laboratory test would be prudent to perform? Liver function tests Complete blood count Hepatitis B surface antigen Arterial blood gases B. Koilonychia is the term that describes spoon-shaped nails. Spoon- shaped nails may be present in patients who have longstanding iron deficiency anemia. A CBC should be performed to assess for anemia. The most common symptoms of iron deficiency anemia are weakness, headache, irritability, fatigue, and exercise intolerance. Which of the following antibiotics may increase the likelihood of photosensitivity? Amoxicillin Cephalexin Ciprofloxa cin Azithromy cin C.
