1. An 18-year-old female of Southeast Asian ancestry is distraught over the recent appearance of white patches on her forearms and upper arms, which subsequently have been confirmed to be vitiligo. Which of the following statements by the woman expresses an accurate understanding of her condition?
A) “I suppose it’s some comfort that my patches are small and will always stay out of sight in the future.”
B) “I’m thankful that there are medications to cure this, but I’m nervous about the side effects.”
C) “I suppose this shouldn’t come as too much of a surprise, since this tends to run in my family.”
D) “I’m surprised that I ended up contracting the fungus that caused this problem for me.”

2. An 11-year-old boy with skin lesions characteristic of ringworm on his trunk has been brought to the family’s primary care provider by his mother. Which of the following aspects of the clinician’s assessment relates most directly to the suspected diagnosis?
A) Previous infection with other parasitic worms
B) Potential contact with the fungus from pets or other children
C) Allergic reactions to drugs and environmental substances
D) The child’s infanthood immunization history

3. The father of an 18-month-old girl noticed a small vesicle on her face several days ago. The lesion ruptured and left a straw-colored crust that remained on the girl’s face. The eruption of new vesicles has prompted him to bring the child to the emergency department. Which of the following treatments for the child’s skin problem is most likely?
A) A topical antifungal ointment
B) An oral corticosteroid
C) An antiviral ointment
D) A topical antibiotic

4. Which of the following teaching points is most appropriate for a teenager who has sought care for the treatment of his acne?
A) “Avoiding high-fat foods and chocolate won’t cure your acne, but it will likely improve it a lot.”
B) “All the creams and ointments that you can buy have been shown to be no real help for acne.”
C) “It’s important for you to vigorously wash your face several times a day.”
D) “You might need antibiotic pills in addition to a cream for your face.”

5. A 31-year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months. He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his care provider when treatment will resolve the problem. What is the care provider’s most appropriate response?
A) “A steroid cream will likely help, but often the skin problem lasts long after contact with the product that irritates the skin.”
B) “You’re clearly allergic to the fiberglass in your insulation, and over-the-counter allergy medications are likely to resolve the problem quite rapidly.”
C) “The problem is that your skin is producing and sloughing off cells prematurely; this will respond well to a topical steroid.”
D) “There are medications I can prescribe that will cure this sensitivity, but they tend to take many months to take full effect.”

6. A 44-year-old man has been diagnosed with chronic urticaria, the exact cause of which cannot be determined. What is the pharmacologic treatment that is most likely to be of most use to the man?
A) Topical retinoids
B) Epinephrine
C) Antihistamines
D) Benzoyl peroxide

7. A female patient is suspected of having psoriasis. Which of the following aspects of the woman’s history and her care provider’s assessment would be potential contributors to her health problem? Select all that apply.
A) The woman takes an angiotensin-converting enzyme inhibitor for the treatment of hypertension.
B) She has been diagnosed with arthritis.
C) The woman has a family history of diabetes.
D) Skin trauma of any kind often precedes an outbreak.
E) The woman has dark skin.

8. A 13-year-old girl has presented to a clinic with her mother, who explains that the girl had an oval-shaped red patch on her chest a week ago, but that more of the lesions are now appearing on her back. On examination, the lesions on her back are in a “Christmas tree” pattern. What is the girl’s most likely diagnosis?
A) Lichen planus
B) Pityriasis rosea
C) Rosacea
D) Melasma

9. A 22-year-old male who has been backpacking around Southeast Asia for several months has responded well to treatment for scabies that he acquired while on his trip. What follow-up measures should be taken?
A) Continuing his antibiotics until the full course is completed
B) Treatment of individuals whom he has been in close contact with
C) Applying corticosteroid creams for at least 8 weeks to prevent recurrence
D) Avoiding potentially irritating products such as dyes and perfumes

10. A 17-year-old male experienced third-degree, full-thickness burns to his lower limbs after a fire at his workplace 2 days ago. Which of the following complications should his care team foresee and regularly assess for? Select all that apply.
A) Systemic infection
B) Fluid volume deficit
C) Respiratory dysfunction
D) Hypermetabolic response
E) Constipation and bowel obstruction

11. A care aide who works in a long-term care facility recognizes the high incidence and prevalence of pressure ulcers in immobile older adults. Which of the following protocols in the facility would the care aide advocate changing?
A) Residents with persistently low food intake are identified.
B) Immobilized residents are turned every 2 hours during both day and night.
C) Residents are frequently encouraged to increase their fluid intake.
D) Wound dressings are applied promptly to all identified or potential pressure ulcers.

12. Which of the following patients of an oncologist is likely to have the poorest prognosis?
A) A 69-year-old man who has been diagnosed with stage IV malignant melanoma
B) A 70-year-old whose skin cancer has been identified as nodular ulcerative basal cell carcinoma
C) A 51-year-old woman whose biopsy has revealed intraepidermal squamous cell carcinoma (SCC)
D) A 59-year-old woman who has invasive squamous cell carcinoma

13. Which of the following changes in an 86-year-old male’s skin would necessitate further examination and possible medical treatment?
A) A decrease in general sebaceous gland activity
B) Appearance of new skin tags on his chest
C) A new molelike growth on his forearm
D) Appearance of a keratosis on the man’s trunk

14. A 30-year-old woman who just found out that she is pregnant seeks a treatment for her severe acne. What is the most appropriate treatment for her skin condition?
A) Accutane
B) Low-dose tetracycline
C) Retin-A
D) A benzoyl peroxide agent