NR511 MIDTERM DIFF DIAGNOSIS
QUESTIONS AND ANSWERS WITH
SOLUTIONS 2024
The ability of a test to correctly identify those who do not have the disease
# of true negatives divided by total # of people who do not have the disease - ANSWER specificity
ability of a test to correctly identify pt has disease
true positives divided by # of people who have disease - ANSWER sensitivity
pain, tingling, stabbing, unilateral vesicular rash along dermatome - ANSWER herpes zoster
how is herpes zoster diagosed? - ANSWER history and physical, PCR assay
white macules or patches usually on sun exposed areas, premature graying of hair - ANSWER vitiligo
what labs are done for vitiligo? - ANSWER cbc, peripheral smear (detect pernicious anemia), thyroids,
ANA
mask of pregnancy
hyperpigmentation of face during pregnancy - ANSWER cholasma (melasma)
how is cholasma diagnosed? - ANSWER wood's lamp examination
diffuse, generazlied, hyperpigmentation, especially on skin creased d/t increased adrenocorticotropic
hormon - ANSWER addison's disease
what labs are done to detect addison's disease? - ANSWER NA, K, cortisol, ACTH level, ca, CBC, TSH, B12,
RH factor
,what are the characteristics of malignant melanoma? - ANSWER asymmetrical, irregular borders, color
changes, diameter >6mm, evolving, raised
health teaching for those with pruritus - ANSWER short, tepid showers, no baths, no scratching, cool
compresses, emollients
what is "soak and smear" and what does it help with? - ANSWER soak skin for 20 mins and apply
ointment to wet skin to prevent pruritus
What is urticaria?
First line treatment class and drugs?
Prevention/teaching? - ANSWER hives/wheals
2nd gen nonsedating H1 antihistamines- loratadine, fexofenadine
cool temps, no hot showers, avoid tight clothes
topical treatment for urticaria? - ANSWER pramoxine
1-2mm red papules interdigital web staples, wrists, axillary folds, and periumbilical? - ANSWER scabies
what does an intraepidermal burrow from scabies look like? - ANSWER white with black specks linear
how is an intraepidermal burrow from scabies diagnosed? - ANSWER burrow ink test- mark with ink, ink
will go into tunnel
how is scabies diagnosed? - ANSWER place drop of mineral oil, scrape off with blade, place on slide, look
under microscope
treatment and teaching for scabies - ANSWER wash all clothes and bedding in hot water and detergent
scabicide lotions
antihistamines and topical steroids for pruritus
, example of scabicides lotion - ANSWER permethrin and malathion lotion
red, small, erythematous, macules or papules, pruritus worse at night, mostly scalp - ANSWER
pediculosis (lice)
how is pediculosis diagnosed? - ANSWER wood light exam, magnifying glass
Treatment of pediculosis
first line
second line - ANSWER Topical insecticides are effective such as permethrin, pyrethrins, and malathion
are considered first line
Lindaine and ivermectin are second line
petroleum jelly or other occlusive substances can be used to suffocate lice. Reapplication in 7-10 days
recommended to kill any newly hatched lice.
what is the prevention/education for pediculosis - ANSWER avoid sharing clothes/hats, use special
combs to remove nits, pt and family to be treated, itching will continue after tx due to inflammation
differential diagnosis for scabies (5) - ANSWER dermatitis
impetigo
insect bites
liver disease
folliculitis
What treatment is used for scabies - ANSWER scabicide lotion and ivermectin systemic antiparasitic
Difference between pediculosis and dandruff? - ANSWER dandruff slides off hair shaft easily and does
not originate on hair shaf