08-14-2014, 06:19 PM
1.A 25-year-old white woman, gravida 1, para 1, comes to the office for an initial visit because of dark patches of skin that appeared on her cheeks and above her upper lip. She says that she had similar symptoms when she was pregnant. She notes that only her facial skin is affected. She has unsuccessfully tried to fade the darkened areas with hydroquinone cream. At this time, specific additional history should be obtained regarding which of the following?
A) Joint pain
B) History of diabetes mellitus
C) History of thyroid disorders
D) Method of contraception
E) Sun exposure
2.A 15-year-old high school wresler is brought to the office by his mother because of a 1-week history of multiple “boils” on his back and upper arms. The sores began as small pimples and then became larger and painful. He reports that severalof his wrestling teammates have similar lesions. He has not had fever, vomiting, or diarrhea . He has not used any new skin care products. Medical history otherwise is unremarkable and the patient takes no medications . Vaccinations are up-to-date. Vital signs are temperature 36.s•c (97.7.F), pulse 60/min, respirations 18/min, and blood pressure 110/70 mm Hg. Numerous firm, erythemato us pustules are present over the patient's back and upper extremities. Several of the lesions are draining purulent material, and a 3-cm ring of erythema surrounds one of the lesions. All of the lesions are tender to palpation . Which of the following is the most appropriate treatment?
A) Cleansing of the affected areas with a non-soap cleanser
B) Intravenous cefazolin
C) Oralclindamycin
D) Topicalbacitracin
E) No treatment is indicated
What is the Dx?
3. A 31-year-old Mexican American woman comes to the office because of an itchy rash. The patient mentions that a similar rash developed in her 10-year-old son 2 days ago. She denies cough, fever or headache. She does not recall having had measles, mumps, rubella, chickenpox or other childhood exanthems. Vital signs are; T 37.2 C, pulse 88/min, respiration 24/min and unlabored, and BP 110/70 mm Hg. Weight is 61 kg and heightis 165 cm; BMI is 22 kg/m2. PE shows an alert and pleasant woman who appears comfortable at rest. There is a vesicular rash on the upper part of her cheek, which is shown. She has similar lesions scattered widely over her body. Lungs are clear to auscultation and the remainder of her physical examination is normal. The nurse tells you that there was a pregnant patient in the waiting room when this patient arrived. The nurse asks if the pregnant patient is at risk for the development of a similar rash during the pregnancy. Which of the following is the most appropriate response?
A) It depends on the patient’s stage of pregnancy.
B) No, because of the advanced state of the patient’s infection.
C) No, because there was no physical contact between the patients.
D) Yes, even if she has had a similar infection in the past.
E) Yes, if she has not had a similar infection in the past.
Thanks!
A) Joint pain
B) History of diabetes mellitus
C) History of thyroid disorders
D) Method of contraception
E) Sun exposure
2.A 15-year-old high school wresler is brought to the office by his mother because of a 1-week history of multiple “boils” on his back and upper arms. The sores began as small pimples and then became larger and painful. He reports that severalof his wrestling teammates have similar lesions. He has not had fever, vomiting, or diarrhea . He has not used any new skin care products. Medical history otherwise is unremarkable and the patient takes no medications . Vaccinations are up-to-date. Vital signs are temperature 36.s•c (97.7.F), pulse 60/min, respirations 18/min, and blood pressure 110/70 mm Hg. Numerous firm, erythemato us pustules are present over the patient's back and upper extremities. Several of the lesions are draining purulent material, and a 3-cm ring of erythema surrounds one of the lesions. All of the lesions are tender to palpation . Which of the following is the most appropriate treatment?
A) Cleansing of the affected areas with a non-soap cleanser
B) Intravenous cefazolin
C) Oralclindamycin
D) Topicalbacitracin
E) No treatment is indicated
What is the Dx?
3. A 31-year-old Mexican American woman comes to the office because of an itchy rash. The patient mentions that a similar rash developed in her 10-year-old son 2 days ago. She denies cough, fever or headache. She does not recall having had measles, mumps, rubella, chickenpox or other childhood exanthems. Vital signs are; T 37.2 C, pulse 88/min, respiration 24/min and unlabored, and BP 110/70 mm Hg. Weight is 61 kg and heightis 165 cm; BMI is 22 kg/m2. PE shows an alert and pleasant woman who appears comfortable at rest. There is a vesicular rash on the upper part of her cheek, which is shown. She has similar lesions scattered widely over her body. Lungs are clear to auscultation and the remainder of her physical examination is normal. The nurse tells you that there was a pregnant patient in the waiting room when this patient arrived. The nurse asks if the pregnant patient is at risk for the development of a similar rash during the pregnancy. Which of the following is the most appropriate response?
A) It depends on the patient’s stage of pregnancy.
B) No, because of the advanced state of the patient’s infection.
C) No, because there was no physical contact between the patients.
D) Yes, even if she has had a similar infection in the past.
E) Yes, if she has not had a similar infection in the past.
Thanks!