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)

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

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

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

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.

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

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

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

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)

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

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

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

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)

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)

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