1. Erik presents with one golden-crusted lesion at the site of an insect bite consistent with impetigo. His parents have limited finances and request the least expensive treatment. Which medication would be the best choice for treatment? Retapamulin (Altabax)

Mupirocin (Bactroban)

Bacitracin and polymixin B (generic double antibiotic ointment)

Oral cephalexin (Keflex)

Question 2. Juakeem is a nasal MRSA carrier. Treatment to eradicate nasal MRSA is mupirocin. Patient education regarding treating nasal MRSA includes:

Alternate treating one nare in the morning and the other in the evening

Take the oral medication exactly as prescribed

Nasal MRSA eradication requires at least 4 weeks of therapy, with up to 8 weeks needed in some patients

Insert one-half of the dose in each nostril twice a day

Question 3. First-line therapy for treating topical fungal infections such as tinea corporis (ringworm) or tinea pedis (athlete's foot) would be:

Oral griseofulvin microsize

OTC topical azole (clotrimazole, miconazole)

Oral terbinafine

Nystatin cream or ointment

Question 4. Erika has been prescribed isotretinoin (Accutane) by her dermatologist and is presenting to her primary care provider with symptoms of sadness and depression. A Beck's Depression Scale indicates she has mild to moderate depression. What would be the best care for her at this point?

Reassure her that mood swings are normal and schedule follow up in a week

Prescribe an SSRI antidepressant

Refer her to a mental health therapist

Contact her dermatologist about discontinuing the isotretinoin

Question 5. Drew is a 17-year-old competitive runner who presents with complaint of pain in his hip that occurred after he fell while running. His only medical problem is severe acne for which he takes isotretinoin (Accutane). With this history what would you be concerned for?

Teen athletes are at risk for repetitive stress injuries.

He may have pulled a muscle and needs to rest to recover.

Isotretinoin interacts with ibuprofen which is the pain medication of choice.

He is at risk for bony injuries and needs to be evaluated for fracture.

Question 6. Larry is taking allopurinol to prevent gout. Monitoring of a patient who is taking allopurinol includes:

BUN, creatinine, and creatinine clearance

Complete blood count

C-reactive protein

Blood glucose

Question 7. Pong-tai is a 12-month-old who is being treated with amoxicillin for acute otitis media. His parents call the clinic and say he has developed diarrhea. The appropriate action would be to:

Recommend increased fluids and fiber in his diet

Advise the parents that some diarrhea is normal with amoxicillin and try feeding him yogurt daily

Change the antibiotic to one that is less of a gastrointestinal irritant

Order stool cultures for suspected viral pathogens not treated by the amoxicillin

Question 8. To prevent further development of antibacterial resistance it is recommended fluoroquinolones be reserved for treatment of:

Urinary tract infections in young women

Community-acquired pneumonia in patients with comorbidities

Upper respiratory infections in adults

Skin and soft tissue infections in adults

Question 9. Keng has chronic hepatitis that has led to mildly impaired liver function. He has an infection that would be best treated by the macrolide/azalide/ketolide group. Which would be the WORST choice for a patient with liver dysfunction?

Azithromycin (Zithromax)

Telithromycin

Clarithromycin (Biaxin)

Erythromycin (E-mycin)

Question 10. Jamie has glucose-6-phosphate dehydrogenase deficiency (G6PD) and requires an antibiotic. Which class of antibiotics should be avoided in this patient?

Cephalosporins

Penicillins

Sulfonamides

Macrolides

Question 11. When prescribing NSAIDS, a complete drug history should be conducted as NSAIDs interact with these drugs:

Diphenhydramine, an antihistamine

Omeprazole, a proton pump inhibitor

Warfarin, an anticoagulant

Combined oral contraceptive

Question 12. Patient education when prescribing the Vitamin D3 derivative calcipotriene for psoriasis includes:

Do not use calcipotriene in combination with their topical corticosteroids

Apply thickly to affected psoriatic areas two to three times a day

A maximum of 100 grams per week may be applied

Calcipotriene may be augmented with the use of coal tar products

Question 13. When choosing a topical corticosteroid cream to treat diaper dermatitis, the ideal medication would be:

A high potency corticosteroid cream (Diprolene AF)

Intermediate potency corticosteroid ointment (Kenalog)

A low potency corticosteroid cream applied sparingly (hydrocortisone 1%)

A combination of a corticosteroid and an antifungal (Lotrisone)

Question 14. Topical immunomodulators such as pimecrolimus (Elidel) or tacrolimus (Protopic) are used for:

Recalcitrant nodular acne

Short-term or intermittent treatment of atopic dermatitis

Chronic, inflammatory seborrheic dermatitis

Topical treatment of fungal infections (Candida)

Question 15. Josefina is a 2 year old with acute otitis media and upper respiratory infection. Along with an antibiotic she receives a recommendation to treat the ear pain with ibuprofen. What education would her parent need regarding ibuprofen?

Ibuprofen is completely safe in children with no known adverse effects

They can cut an adult ibuprofen tablet in half to give Josefina

Josefina needs to be well hydrated while taking ibuprofen

Ibuprofen dose can be doubled for severe pain