Common Skin Conditions

Front 1

Which of the following steroid topical formulations are available over-the-counter? (Select ALL that apply.)

Back 1

Hydrocortisone 0.5%

Hydrocortisone 1%

OTC steroids are low potency: hydrocortisone 0.5% (infants, sensitive skin, groin area) and 1% for mild conditions. Hydrocortisone 2.5% is Rx.

Front 2

Which of the following statements concerning sun exposure and sunscreens are correct? (Select ALL that apply.)

Back 2

-It is advisable to stay out of the sun when it is strongest: between 10AM-4PM. Sun-protective clothing is also helpful.

-Agents that block UVA include avobenzone and ecamsule (and others); the American Academy of Dermatology states that a sunscreen with a recommended UVA-blocking agent should be chosen.

-"Broad-spectrum" sunscreens protect against both UVA and UVB.

Some dermatologists recommend SPF of 15 and some recommend an SPF of 30; higher ratings than this are not useful. Infants should stay out of the sun.

Front 3

Zoe Brown is a fifteen year old girl who was hiking in the woods near her home in California. She picked up a rash that is itchy and spreading. The pharmacist suspects the rash is from contact with poison oak. The pharmacist should offer the following advice to Ms. Brown: (Select ALL that apply.)

Back 3

-Use a product such as Aveeno or Caladryl that may provide relief. Cold compresses may help.

-The skin should be washed with soap and water; it is best to try and remove the toxin.

-If the rash worsens she can ask her physician for stronger medicine, such as an oral steroid.

Do not touch the rash and then touch the face, especially around the eyes. Ivy Block (bentoquatam) or other barrier blocks may have been helpful if applied prior to the hike. Clothing should cover legs that may come into contact with poison ivy (east coast), sumac or oak.

Front 4

Which of the following topical steroids is considered a very high potency agent?

Back 4

Clobetasol propionate 0.05%

Front 5

What are the ingredients in the OTC “Triple Antibiotic” products?

Back 5

Polymyxin, bacitracin, neomycin

Front 6

Which OTC acne product is considered the first-line recommendation due to higher efficacy for acne than the others?

Back 6

Benzoyl peroxide

Front 7

Correct application instructions for topical steroid products should include the following points except:

Back 7

Lower potency steroids (OTC strengths) are usually applied three or four times daily.

Front 8

Counseling instructions for the use of a topical antifungal for athlete’s foot (tinea pedis) should include all of the following except:

Back 8

Apply the medicine directly on the rash; do not extend the application beyond the visible rash.

Front 9

Which of the following agents is used for alopecia?

Back 9

Minoxidil

Front 10

Which medications cannot be used if a patient is taking oral isotretinoin? (Select ALL that apply.)

Back 10

Vitamin A supplements

Tetracyclines

Steroids

St John's wort

Front 11

A patient asks for help choosing an over-the-counter acne product. She is also asking what causes acne. She had a friend who used the product Duac and asks if she can have it. Which of the following statements are correct? (Select ALL that apply.)

Back 11

-Some women find benefit in treating acne using birth control pills.

-Common times to get acne are during puberty, in infants, and women around the time of the menstrual cycle.

-Benzoyl peroxide comes in combinations with the antibiotics clindamycin or erythromycin; these require a prescription.

Front 12

A patient asks the pharmacist to recommend a sunscreen that is "broad spectrum". What is the correct meaning of the term "broad spectrum" when used for a sunscreen? (Select ALL that apply.)

Back 12

-It protects against UVA, which causes aging.

-It protects against UVB, which causes burning.

Front 13

Counseling for a parent treating lice in a child should include all of the following except:

Back 13

Check all family members and treat anyone with an infestation except those over the age of 70 years old.

Front 14

A 29 year-old male patient uses the local gym daily. He was not careful to use sandals in the shower and his feet are itchy, particularly between the toes. Choose appropriate OTC medications that will eradicate the infection and are recommended for this purpose: (Select ALL that apply.)

Back 14

Lamisil AT

Lotrimin AF

Front 15

Select the correct statement concerning oral isotretinoin:

Back 15

If female, only patients who can remember to use two effective forms of birth control can use the drugs similar to Accutane.

Front 16

Choose the correct application instructions/safety information for a topical retinoid:

Back 16

Limit sun exposure; skin will burn more easily.

Front 17

If one squeezes out enough steroid cream to stretch the length from the fingertip to the first joint, what approximate area of skin would this amount of medication treat?

Back 17

About the area of the hand

Front 18

What does SPF indicate on a sunscreen product?

Back 18

The degree of protection from UVB.

Front 19

Which of the following statements concerning mupirocin is correct?

Back 19

It is a topical product that provides very good staph and strep coverage.

Front 20

Rank the following topical steroids in order from highest to lowest potency. (Left-click the mouse to highlight, drag, and order the answer options; ALL options must be used.)

Answer

- Fluocinonide 0.05%

- Mometasone (cream) 0.1%

- Hydrocortisone 1%

- Halobetasol 0.05%

Back 20

1. Halobetasol 0.05%

2. Fluocinonide 0.05%

3. Mometasone 1%

4. Hydrocortisone 1%

Refer to the 2016 RxPrep Course Book, pages 1070 - 1071.

Front 21

Which of the following medications are first-line treatments for lice? (Select ALL that apply.)

Back 21

Nix

RID

Permethrin

Front 22

Which of the following prescription agents may be prescribed to a teenager with acne?

Back 22

solodyn

Front 23

Which acne products are available over-the-counter?

Back 23

Salicylic acid, benzoyl peroxide

Front 24

A patient approaches the pharmacy counter to ask if she should purchase a steroid cream, ointment or lotion. She wants to treat an itchy rash on her palm. She reports that she sometimes gets topical reactions to things that she touches, which appear similar to the current reaction and it generally dissipates on its own. The skin appears thick and calloused. Which formulation would be most appropriate?

Back 24

An ointment

Front 25

Occasionally antifungal agents such as ketoconazole are given as intermittent “pulse” therapy when being used long-term. What is the purpose of pulse therapy?

Back 25

Less side effects and less costly

Front 26

Which of the following agents used to treat lice is flammable?

Back 26

ovide

Front 27

Which natural product is used in a topical formulation for a soothing effect after sunburn?

Back 27

aloe

Front 28

The topical retinoids such as tretinoin (Avita, Retin-A), adapalene (Differin) and tazarotene (Tazorac, Avage) are first line prescription agents for treating most cases of acne. Choose the correct statements concerning these agents: (Select ALL that apply.)

Back 28

-They are derivatives of vitamin A.

-They are applied in a pea sized amount, which is divided into 4 equal parts and applied.

Front 29

A patient is purchasing Lamisil AT cream for a fungal foot infection. What is the active ingredient?

Back 29

Terbinafine

Front 30

Choose the correct statements concerning benzoyl peroxide-antibiotic combination products (Benzamycin, BenzaClin): (Select ALL that apply.)

Back 30

- Benzamycin is stored by the patient in the refrigerator. BenzaClin is stored at room temperature.

- Benzamycin is mixed with 70% ethyl alcohol and shaken prior to dispensing.

- Benzamycin contains benzoyl peroxide and erythromycin.

Front 31

Jennifer Wong, a 44 year-old Asian female, has struggled with eczema patches since she was a child. She typically uses Aveeno colloidal oatmeal bath. She has never used anything else and found that this product provided moderate relief. She is at her annual physical and the physician has written a prescription for Elidel. Choose the correct statement:

Back 31

Elidel is not indicated currently.

Front 32

A father is picking up a prescription of Elidel for his child. Counseling statements should include the following: (Select ALL that apply.)

Back 32

-Use the smallest amount needed to control symptoms. Continue as long as signs and symptoms persist; discontinue if resolution occurs.

- Wash hands after application. Keep the skin well hydrated by using a good moisturizer.

-Limit sun and ultraviolet ray exposure if using this medication.

-This drug may add to the child's chance of getting lymphoma or other cancers.

Front 33

Which of the following brand-generic matches are correct? (Select ALL that apply.)

Back 33

ATerbinafine-Lamisil AT

BButenafine-Lotrimin Ultra

CTolnaftate-Tinactin

DClotrimazole-Lotrimin

EUndecylenic acid-Desenex

Front 34

Which of the following agents is not used first line for scabies (mites), due to neurotoxicity/seizures, and requires a Medication Guide if dispensed?

Back 34

Lindane

Front 35

Which of the following statements concerning athlete's foot are correct? (Select ALL that apply.)

Back 35

-It is usually treatable with topical OTC agents.

- Symptoms include itching, peeling and redness.

-Patients should be careful to wear sandals or other foot coverings in public showers and locker rooms in order to avoid infection (and avoid spreading it).

Front 36

A patient has suspected onychomycosis and the physician is considering systemic terbinafine therapy. Choose the correct statement:

Back 36

If starting terbinafine, monitor for hepatotoxicity.

Front 37

A father will apply Neosporin on a scrape on the outer surface of his ten-year old son's hand. He asks if he should cover it with a Band-Aid. How should the pharmacist respond?

Back 37

Yes, use a bandage during the day since his hand is likely to get dirty.

Front 38

A pharmacist is discussing oral isotretinoin with a prescriber. Which statements are correct? (Select ALL that apply.)

Back 38

-ADue to the birth defect risk, this is a REMS drug. It can only be dispensed by a pharmacy registered with the pregnancy risk management iPLEDGE program.

-BThe progestin-only "mini pill" is not adequate as a form of birth control in females using oral isotretinoin.

-CThis medication is Pregnancy Category X; use causes severe birth defects if pregnancy occurs while using this medication.

-DPatients should be instructed that they will have dry skin; use a lip moisturizer and carry a water bottle to keep well-hydrated.

Front 39

Jennifer Lewis comes to the pharmacy and asks to speak to a pharmacist. She states that she has uncomfortable symptoms of vaginal itching and burning on urination. She states that she has never had this before and just wants it to go away quickly. Which of the following would be the best recommendation for Ms. Lewis?

Back 39

Refer patient to see a physician for diagnosis; recommend OTC antifungal

Front 40

A patient asks the pharmacist if Duac topical gel is a useful product for acne. Choose the correct statement concerning Duac:

Back 40

Duac can be stored at room temperature for up to two months.

Front 41

Choose the correct statement concerning ketoconazole shampoo (Nizoral AD):

Back 41

This product should not be applied to open sores or irritated skin.

Front 42

Taclonex is a popular dermatological drug. Taclonex is used for this condition:

Back 42

Psoriasis

Front 43

Which of the following statements concerning pimecrolimus is correct?

Back 43

Use is associated with lymphomas and skin malignancies.

Front 44

A patient asks the pharmacist what to do about a circular patch on her forearm that has raised, red edges. The inner part of the circle is clear. The circle edges have small bumps that look like blisters. The patch is ¾" in diameter. Which product should the pharmacist recommend?

Back 44

Terbinafine

Front 45

Megan MacDonald will begin therapy with Retin-A Micro. Which of the following are correct counseling statements? (Select ALL that apply.)

Back 45

-ABegin with a reduced frequency of application (every second or third day) and shorter duration of contact (washing off the application after a period of time), to improve tolerance.

-BA pea-sized amount is sufficient (for facial application); it should be divided into 4 equal parts and smoothed over the entire surface of the face. This medication should not be used as "spot" therapy.

-CIt will take 1-3 months to see the full response. Initially, the acne may actually worsen.

Front 46

Which of the following statements concerning sunscreens are correct? (Select ALL that apply.)

Back 46

-If a patient would normally burn in 10 minutes, if they used a sunscreen with an SPF of 5 they would burn in 50 minutes (5 * 10 = 50).

-All sunscreens should be reapplied at least every two hours and after going in the water; no sunscreens are truly "waterproof."

-UVA and UVB exposure increases the risk of skin cancer.

-Water-resistant means the sunscreen is resistant for somewhere between 40-80 minutes.

Front 47

Choose the correct statement concerning Nizoral A-D:

Back 47

Rub shampoo in well and leave in for 5 minutes, then rinse out, use twice weekly

Front 48

If systemic ketoconazole is used to treat onychomycosis, which of the following medications must be stopped during the ketoconazole therapy?

Back 48

Rabeprazole

Front 49

What is the brand name for imiquimod cream (used primarily for genital/perianal warts)?

Back 49

Aldara