. Martin, age 13, just started taking amoxicillin for otitis media.
His mother said that he woke up this morning with a rash on his
trunk. What is your first action? . Correct Answer Stop the
amoxicillin
A 10 year old male in 5th grade presents to the pediatric office
with his mother complaining of itchy and red eyes for 1 day.
The patient complains of watery drainage in both eyes,
associated with repetitive itching. On physical exam, he has no
fever or constitutional symptoms. His vision is normal, with no
decrease in extra ocular movements. The patient has a sibling
that just started day care recently. He also has bilateral pre-
auricular lymph nodes that are inflamed. What is the patient's
diagnosis? Correct Answer Viral conjunctivitis
A 16 year old male presents to your office. He was sent by an
orthopedist. He has recently had surgical fixation on a humerus
fracture. The patient has been going to physical therapy and has
been developing a rash on his arm after therapy that disappears
shortly after returning home. He does not have the rash prior to
therapy. The patient denies fever and chills, and his incision is
well healed, with no signs of infection. Of note, the patient has
been experiencing more hand edema that the average patient and
has had edema wraps used at the end of therapy to help with
swelling. The wraps are made of synthetic plastic material. The
rash the patient gets is erythematous and blotchy, not raised; is
on the operative upper extremity. What is the most likely
diagnosis Correct Answer Contact dermatitis
,A 20 year old male presents to your primary care clinic. This
patient is a college student. He complains of fatigue, sore throat,
and low grade fever for 3 days. On physical exam, he has a
temperature of 100.7. His ear exam is normal. His nose and
throat exam shows mild erythema of the nasal mucosa and
edematous, enlarged tonsils bilaterally, with erythema of the
pharyngeal wall and tonsillar exudates. He has inflamed
posterior cervical lymph nodes. he has a nonproductive cough
and clear lung exam. What is his most likely diagnosis? Correct
Answer Mononucleosis
A 22 year old African American female presents to your family
practice office complaining of progressive discoloration. She is
adopted and has no known family history of skin problems. The
patient notes no palpable patches of skin loss and blanching of
her forehead and both hands and feet. It has developed over a
period of 6 months and appear to have stopped. It is not pruritic,
and there is no erythema or sign of infectious etiology. What is
the most likely diagnosis? Correct Answer Vitiligo
A 22 year old college student presents to your urgent care clinic
complaining of a rash. She was recently on spring break and
spent every night in the hot tub at her hotel. On physical exam,
she has multiple small areas of 1 to 2 mm erythematous pustules
that are present mostly where her bathing suit covered her
buttocks. Which is most likely pathogen causing these lesions.
Correct Answer Pseudomonas aeruginosa
A 25 year old client who plays in a band complains that he finds
it difficult to understand his fellow musicians at the end of the
night of performing that is compounded by the noisy
,environment of the club. These symptoms are more
characteristic of which of the following? Correct Answer
Sensorineural loss
A 25 year old male presents with "bleeding in my eye" for 1
day. He awoke this morning with a dark area of redness in his
eye. He has no visual loss or changes. He denies constitutional
symptoms, pruritis, drainage, or recent trauma. The redness
presents on physical exam as a dark red area in the pt. Sclera of
the right eye only and takes up less than 50% of the eye. The pt.
Remaining sclera is clear and white. he also notes he was
drinking alcohol last night and vomited afterward. What is the
best treatment? Correct Answer Reassurance that this lesion
will resolve without any treatment in 2 to 4 wk
A 27 year old female comes into your primary care office
complaining of perioral rash. The patient noticed burning around
her lips a couple days ago that quickly went away. She awoke
from sleep yesterday and noticed a group of vesicles with
erythematous bases where the burning had been before. There is
no burning today. She is a febrile and has no difficulty eating or
swallowing. What test would confirm her diagnosis Correct
Answer Tzanck smear
A 3 yr old patient presents to your pediatric office with her
mother. She has recently been started in day care. Her mother
noted slight perioral erythema on the right side of the patient's
mouth prior to bed last night. The patient awoke today with 3
small, superficial honey colored vesicles where the erythema
was last night. The patient has no surrounding erythema. She
had no difficulty eating this morning and is active and energetic
, and doesn't appear lethargic or fatigued. She is also a febrile.
How would you treat this child? Correct Answer Local
debridement and mupirocin for 5 days
A 4 year old male presents to your pediatric clinic with his
mother complaining of an itchy rash, mostly between his
fingers. This has been going on for multiple days and has been
getting worse. The patient recently started a new day care. On
physical exam, the patient is a febrile and has multiple small red
papules in sets of 3 located in the web spaces between his
fingers. He also has signs of excoriation. What is the treatment
for this problem? Correct Answer Permethrin lotion for the
patient and also his family members (scabies)
A 44-year-old banker comes to your office for evaluation of a
pulsating headache over the left temporal region, and he rates
the pain as an 8 on a scale of 1 to 10. The pain has been constant
for the past several hours and is accompanied by nausea and
sensitivity to light. He has had frequent, though less severe,
headaches for many years, and they are usually relieved by over-
the-counter medicines. He is unclear as to a precipitating event
but notes that he has had visual disturbances before each
headache and he has been under a lot of stress in his job. Based
on this description, what is the most likely diagnosis of this type
of headache?
1.Tension.
2.Migraine.
3.Cluster.
4.Temporal arteritis. Correct Answer Migraine
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