36 YEAR OLD ITCHY RASH CERTIFICATION
SCRIPT 2026 QUESTIONS WITH ANSWERS
GRADED A+
⩥ A 27-year-old female comes in to 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
afebrile and has no difficulty eating or swallowing. What test would
confirm her diagnosis?
a) Tzanck smear
b) potassium hydroxide (KOH) prep
c) exam under a Wood lamp
d) sterile cultures sent for aerobic and anaerobic bacteria. Answer: a)
Tzanck smear
Rationale: This would show giant cells consistent with herpes simplex
virus.
⩥ Caroline has a 13-year-old daughter who has had 2 recent infestations
of lice. She asks you what she can do to prevent this. You respond:
a) "After two days of no head lice, her bedding is lice-free."
b) "Boys are more susceptible, so watch out for her brother also."
,c) "After several infestations, she is now immune and is no longer
susceptible."
d) "Don't let her share hats, combs, or brushes with anyone.". Answer: d)
"Don't let her share hats, combs, or brushes with anyone."
⩥ Shelby, age 14, has a blister on her arm that is filled with clear fluid. It
is the result of contact with a hot iron. How do you document this?
a) Bulla
b) Wheal
c) Cyst
d) Pustule. Answer: a) Bulla
Rationale: Bulla is primary skin lesion filled w/ fluid and larger than 1
cm in diameter aka vesicle. Wheal is irregular in size, blanches and
surrounded by local edema and inflammation. Cyst is filled w/ fluid and
occurs in variety of sizes. Pustule is superficial, elevated lesion filled
with purulent fluid.
⩥ Danny, age 18, presents with a pruritic rash on his upper trunk and
shoulders. You observe flat to slightly elevated brown papule and
plaques that scale when they are rubbed. You also notice areas of
hypopigmentation. What is your initial diagnosis?
a) Lentigo syndrome
b) tinea versicolor
c) localized brown macules
,d) ochronosis. Answer: b) tinea versicolor
Rationale: Lentigines are macular tan to black lesions, 1 mm to 1 cm in
size, do not increase in color with sun exposure. Localized brown
macules are freckles. Ochronosis has poorly circumscribed blue-black
macules.
⩥ You are teaching Harvey, age 55, about the warts on his hands. What
is included in your teaching?
a) Treatment is usually effective, and most warts will not recur
afterward.
b) Because warts have roots, it is difficult to remove them surgically.
c) Warts are caused by the human papillomavirus.
d) Shaving the wart may prevent its recurrence.. Answer: c) Warts are
caused by the human papillomavirus.
Rationale: Most warts recur despite treatment. Warts do not have roots.
Abrading the skin can spread the virus.
⩥ Ashley, age 6 months, has a Candida infection in the diaper area.
What do you suggest to the parent?
a) "Use rubber or plastic pants to contain the infection and prevent it
from getting to the thighs."
b) "Keep the area as dry as possible."
, c) "Use baby powder with cornstarch."
d) "Keep Ashley away from other babies until the infection is cleared
up.". Answer: b) "Keep the area as dry as possible."
Rationale: Candida can utilize cornstarch as food.
⩥ Lee brings her 13-year-old son to your clinic. He has been
complaining of a rash on the buttocks, anterior thighs, and postlatedral
aspects of his upper arms. He tells you it is mildly pruritic and looks like
"gooseflesh." On examination, the rash appears as small, pinpoint,
follicular papule on a mildly erythematous base. You explain to Lee that
the benign condition is likely to resolve by the time her son reaches
adulthood, and it is known as:
a) comedones of acne
b) Molluscum contagiosum
c) keratosis pilaris
d) atopic dermatitis. Answer: c) keratosis pilaris
Rationale: Comedones of acne involve face, chest, and upper back.
Molluscum contagiosum involves waxy-appearing lesions. Atopic
dermatitis is usually located on extensor surfaces, cheeks, and hands.
⩥ A 22-year-old African American female presents to your family
practice office complaining of progressive skin discoloration. She is
adopted and has no known family history of skin problems. The patient
SCRIPT 2026 QUESTIONS WITH ANSWERS
GRADED A+
⩥ A 27-year-old female comes in to 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
afebrile and has no difficulty eating or swallowing. What test would
confirm her diagnosis?
a) Tzanck smear
b) potassium hydroxide (KOH) prep
c) exam under a Wood lamp
d) sterile cultures sent for aerobic and anaerobic bacteria. Answer: a)
Tzanck smear
Rationale: This would show giant cells consistent with herpes simplex
virus.
⩥ Caroline has a 13-year-old daughter who has had 2 recent infestations
of lice. She asks you what she can do to prevent this. You respond:
a) "After two days of no head lice, her bedding is lice-free."
b) "Boys are more susceptible, so watch out for her brother also."
,c) "After several infestations, she is now immune and is no longer
susceptible."
d) "Don't let her share hats, combs, or brushes with anyone.". Answer: d)
"Don't let her share hats, combs, or brushes with anyone."
⩥ Shelby, age 14, has a blister on her arm that is filled with clear fluid. It
is the result of contact with a hot iron. How do you document this?
a) Bulla
b) Wheal
c) Cyst
d) Pustule. Answer: a) Bulla
Rationale: Bulla is primary skin lesion filled w/ fluid and larger than 1
cm in diameter aka vesicle. Wheal is irregular in size, blanches and
surrounded by local edema and inflammation. Cyst is filled w/ fluid and
occurs in variety of sizes. Pustule is superficial, elevated lesion filled
with purulent fluid.
⩥ Danny, age 18, presents with a pruritic rash on his upper trunk and
shoulders. You observe flat to slightly elevated brown papule and
plaques that scale when they are rubbed. You also notice areas of
hypopigmentation. What is your initial diagnosis?
a) Lentigo syndrome
b) tinea versicolor
c) localized brown macules
,d) ochronosis. Answer: b) tinea versicolor
Rationale: Lentigines are macular tan to black lesions, 1 mm to 1 cm in
size, do not increase in color with sun exposure. Localized brown
macules are freckles. Ochronosis has poorly circumscribed blue-black
macules.
⩥ You are teaching Harvey, age 55, about the warts on his hands. What
is included in your teaching?
a) Treatment is usually effective, and most warts will not recur
afterward.
b) Because warts have roots, it is difficult to remove them surgically.
c) Warts are caused by the human papillomavirus.
d) Shaving the wart may prevent its recurrence.. Answer: c) Warts are
caused by the human papillomavirus.
Rationale: Most warts recur despite treatment. Warts do not have roots.
Abrading the skin can spread the virus.
⩥ Ashley, age 6 months, has a Candida infection in the diaper area.
What do you suggest to the parent?
a) "Use rubber or plastic pants to contain the infection and prevent it
from getting to the thighs."
b) "Keep the area as dry as possible."
, c) "Use baby powder with cornstarch."
d) "Keep Ashley away from other babies until the infection is cleared
up.". Answer: b) "Keep the area as dry as possible."
Rationale: Candida can utilize cornstarch as food.
⩥ Lee brings her 13-year-old son to your clinic. He has been
complaining of a rash on the buttocks, anterior thighs, and postlatedral
aspects of his upper arms. He tells you it is mildly pruritic and looks like
"gooseflesh." On examination, the rash appears as small, pinpoint,
follicular papule on a mildly erythematous base. You explain to Lee that
the benign condition is likely to resolve by the time her son reaches
adulthood, and it is known as:
a) comedones of acne
b) Molluscum contagiosum
c) keratosis pilaris
d) atopic dermatitis. Answer: c) keratosis pilaris
Rationale: Comedones of acne involve face, chest, and upper back.
Molluscum contagiosum involves waxy-appearing lesions. Atopic
dermatitis is usually located on extensor surfaces, cheeks, and hands.
⩥ A 22-year-old African American female presents to your family
practice office complaining of progressive skin discoloration. She is
adopted and has no known family history of skin problems. The patient
