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NR 602 Dermatology Question Bank
A microscopic examination of the sample taken from a skin lesion indicates hyphae. What
type of infection might this indicate? (Fungal)
Under microscopic exam, hyphae are long, thin and branching and indicate dermatophytic
infections. Hyphae are typical in tinea pedis, tinea cruris, and tinea corporis.
A child with a sandpaper-textured rash probably has: (Strep infection)
Streptococcal infections can present as a sandpaper-textured rash that initially is felt on the trunk.
Rubeola, measles, produces a blanching erythematous “brick-red” maculopapular rash that
begins on the back of the neck and spreads around the trunk and then extremities. Varicella
infection produces the classic crops of eruptions on the trunk that spread to the face. The rash is
maculopapular initially and then crusts. Roseola produces a generalized maculopapular rash
preceded by 3 days of high fever.
A 40-year-old female patient presents to the clinic with multiple, painful reddened nodules
on the anterior surface of both legs. She is concerned. These are probably associated with
her history of: (ulcerative colitis)
These nodules describe erythema nodosum. These are most common in women aged 15-40 years
old. They are typically found in pretibial locations and can be associated with infectious agents,
drugs, or systemic inflammatory disease like ulcerative colitis. They probably occur as a result of
a delayed hypersensitivity reaction to antigens. It is not unusual to find polyarthralgia, fever,
and/or malaise that precede or accompany the skin nodules.
,A patient is diagnosed with tinea pedis. A microscopic examination of the sample taken
from the infected area would likely demonstrate: (hyphae)
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.
When can a child with chickenpox return to daycare? (After all lesions have crusted)
Chickenpox is highly contagious and can be spread via respiratory secretions from an infected
person or by direct contact from the vesicle fluid from lesions on the skin or mucus membranes.
The usual incubation period is about 2 weeks but can be as long as 21 days or as short as 10
days. The greatest period of infectivity is 48 hours prior to the onset of the rash and until all the
skin lesions have crusted over.
A patient with a primary case of scabies was probably infected: (3-4 weeks ago)
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 that is worse at night, coupled with a rash that appears in new areas over time.
The nurse practitioner examines a patient who has had poison ivy for 3 days. She asks if
she can spread it to her family members. The nurse practitioner replies: (“No, transmission
does not occur from the blister’s contents”)
The skin reaction seen after exposure to poison ivy (or any other skin irritant), takes place
because of contact with the offending substance. In the case of poison ivy, the harmful exposure
occurs from contact with oil from the plant. The eruptions seen are NOT able to transmit the
,reaction to other people unless oil from the plant remains on the skin and someone touches the
oil. The fluid found in the blisters is NOT able to transmit poison ivy to anyone; only the oil
from the plant can do that. After oil has touched the skin, some time must pass for the reaction to
occur. Therefore, reaction times vary depending on skin thickness and quantity of oil contacting
the skin.
Which chronic skin disorder primarily affects hairy areas of the body? (Seborrheic
dermatitis)
Seborrheic dermatitis causes flaking of the skin, usually the scalp. In adolescents and adults,
when it affects the scalp, it is termed dandruff. When this occurs in young children or infants, it
is termed “cradle cap”. The exact cause is unknown; however it has a propensity for hairy areas
of the body such as the scalp, face, chest, and legs. It appears greasy and flaky. This may be seen
in patients with Parkinson’s 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? (Cellulitis)
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.
, The agent commonly used to treat patients with scabies is permethrin. How often should it
be applied to eradicate scabies? (Once)
A single whole-body application of permethrin is usually successful in eradicating infection with
scabies. It is applied over the entire body from the neck down. The lotion is left on and then
showered off 8-12 hours later. All contacts must be treated at the same time and all potential
fomites (bed linen, mattresses, cloth furniture, etc.) must be treated as well. Permethrin can be
sprayed on cloth fomites, or the fomite can be bagged for several days, washed and dried in a
washing machine and dryer. Ironing clothes after washing them is acceptable.
Impetigo is characterized by: (honey-colored crusts)
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 60-year-old patient is noted to have rounding of the distal phalanx of the fingers. What
might have caused this? (Hepatic cirrhosis)
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 has suspected scarlet fever. He likely has a sandpaper rash and: (a positive rapid
Strep test)
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