NSG554 2026 CERTIFICATION
EVALUATION QUESTIONS AND ANSWERS
◉ Herpetic whitlow. Answer: -self-limited viral infection of the area
between the fascial planes of the distal finger, usually surrounding
the nail
-herpetiform vesicles or blisters erupt on the distal phalanx;
throbbing, tingling, numbness, or pruritis in area of eruption are
common
-painful vesicles, can be singular or coalescent
◉ herpetic whitlow. Answer: which nail disorder is most commonly
associated with gingivostomatitis, genital herpes and in healthcare
workers?
◉ treatment for herpetic whitlow. Answer: cool compresses, cover
them with gauze, keep them dry, analgesics, and oral antivirals
◉ paronychial infections. Answer: -these infections can be acute or
chronic inflammation of the tissue surrounding the nail and most
common in women
-symptoms are usually localized to one finger, throbbing pain
,-affected nail may display distal onycholysis, discoloration,
distortion, and ridging; the affected nail folds have erythema and
edema; may have purulent discharge
◉ Treatment of paronychial infections. Answer: topical neomycin,
oral Abx, oral antifungals for chronic type. Consider incision and
drainage (I&D) if abscess is suspected or infection is not responding
to noninvasive care
◉ onychomycosis. Answer: any infection of the nails caused by a
dermatophyte, yeast, or sometimes mold; most common nail
condition and usually found in toes; classified by nail bed location or
infection
◉ onychomycosis. Answer: this infection causes nails to be white or
yellowed, with a powdery or thickened nail texture; surface typically
has a greenish tinge with bacterial infections. Ensure you look for
onycholysis with these infections
◉ Treatment of onychomycosis. Answer: -apply ciclopirox (nail
lacquer)
-terbinafine (Lamisil) orally and daily for 12 weeks for toenails, 6
weeks for fingernails
-check LFTs before tx and 6 weeks after starting treatment
-removal of nailbed is the most permanent elimination of infection
,-phototherapy
-apply topical antifungal agent after clinical response to oral agent to
prevent nail reinfection
◉ check LFTs before tx and 6 weeks after starting tx. Answer: A
patient comes in to the clinic with onychomycosis on the fifth digit
nail of his left hand. The patient asks about Lamisil because his mom
was prescribed this for the same problem. What is important to
check when prescribing a patient with Lamisil?
◉ Seborrheic Dermatitis. Answer: This appears as a greasy, slightly
erythematous scaling that occurs in areas with the highest
concentration of sweat glands or sebaceous glands, including the
scalp, face, and postauricular and intertriginous areas
◉ populations affected by seborrheic dermatitis. Answer: affects
more men than women
-infants: yellow or brown scaling lesions on the scalp
-adolescents and adults: dandruff-dry, flaky scales on the scalp
◉ Treatment of seborrheic dermatitis. Answer: treatment is targeted
at controlling acute flares and maintaining remission
-first-line therapy: topical antifungals or topical corticosteroids
, -anti-seborrheic shampoos like ketoconazole 2%, selenium sulfide
2.5%, ciclopirox 1% used 1-2 times a week for 4 weeks to treat flare
ups and prevent relapses
◉ psoriasis. Answer: -inflammatory papulosquamous eruption;
appears as well-circumscribed erythematous macular and papular
lesions with loosely adherent silvery white scales
-chronic with remissions and exacerbations
-common sites include the elbows, knees, scalp, genitals, and
interfluteal cleft
◉ labs to get with psoriasis. Answer: biopsy (pustular cases), nail
cultures (fungal disease), uric acid levels (gout)
◉ treatment of psoriasis. Answer: topical corticosteroids, oral
retinoids, methotrexate, cyclosporine, biologic agents
◉ pityriasis rosacea. Answer: caused by the herpes virus and
medications; starts with "herald patch" and then has widespread
eruption for 1-2 weeks
◉ treatment for pityriasis rosacea. Answer: calamine lotion,
antihistamines. Might consider acyclovir for 1 week if rash does not
resolve
EVALUATION QUESTIONS AND ANSWERS
◉ Herpetic whitlow. Answer: -self-limited viral infection of the area
between the fascial planes of the distal finger, usually surrounding
the nail
-herpetiform vesicles or blisters erupt on the distal phalanx;
throbbing, tingling, numbness, or pruritis in area of eruption are
common
-painful vesicles, can be singular or coalescent
◉ herpetic whitlow. Answer: which nail disorder is most commonly
associated with gingivostomatitis, genital herpes and in healthcare
workers?
◉ treatment for herpetic whitlow. Answer: cool compresses, cover
them with gauze, keep them dry, analgesics, and oral antivirals
◉ paronychial infections. Answer: -these infections can be acute or
chronic inflammation of the tissue surrounding the nail and most
common in women
-symptoms are usually localized to one finger, throbbing pain
,-affected nail may display distal onycholysis, discoloration,
distortion, and ridging; the affected nail folds have erythema and
edema; may have purulent discharge
◉ Treatment of paronychial infections. Answer: topical neomycin,
oral Abx, oral antifungals for chronic type. Consider incision and
drainage (I&D) if abscess is suspected or infection is not responding
to noninvasive care
◉ onychomycosis. Answer: any infection of the nails caused by a
dermatophyte, yeast, or sometimes mold; most common nail
condition and usually found in toes; classified by nail bed location or
infection
◉ onychomycosis. Answer: this infection causes nails to be white or
yellowed, with a powdery or thickened nail texture; surface typically
has a greenish tinge with bacterial infections. Ensure you look for
onycholysis with these infections
◉ Treatment of onychomycosis. Answer: -apply ciclopirox (nail
lacquer)
-terbinafine (Lamisil) orally and daily for 12 weeks for toenails, 6
weeks for fingernails
-check LFTs before tx and 6 weeks after starting treatment
-removal of nailbed is the most permanent elimination of infection
,-phototherapy
-apply topical antifungal agent after clinical response to oral agent to
prevent nail reinfection
◉ check LFTs before tx and 6 weeks after starting tx. Answer: A
patient comes in to the clinic with onychomycosis on the fifth digit
nail of his left hand. The patient asks about Lamisil because his mom
was prescribed this for the same problem. What is important to
check when prescribing a patient with Lamisil?
◉ Seborrheic Dermatitis. Answer: This appears as a greasy, slightly
erythematous scaling that occurs in areas with the highest
concentration of sweat glands or sebaceous glands, including the
scalp, face, and postauricular and intertriginous areas
◉ populations affected by seborrheic dermatitis. Answer: affects
more men than women
-infants: yellow or brown scaling lesions on the scalp
-adolescents and adults: dandruff-dry, flaky scales on the scalp
◉ Treatment of seborrheic dermatitis. Answer: treatment is targeted
at controlling acute flares and maintaining remission
-first-line therapy: topical antifungals or topical corticosteroids
, -anti-seborrheic shampoos like ketoconazole 2%, selenium sulfide
2.5%, ciclopirox 1% used 1-2 times a week for 4 weeks to treat flare
ups and prevent relapses
◉ psoriasis. Answer: -inflammatory papulosquamous eruption;
appears as well-circumscribed erythematous macular and papular
lesions with loosely adherent silvery white scales
-chronic with remissions and exacerbations
-common sites include the elbows, knees, scalp, genitals, and
interfluteal cleft
◉ labs to get with psoriasis. Answer: biopsy (pustular cases), nail
cultures (fungal disease), uric acid levels (gout)
◉ treatment of psoriasis. Answer: topical corticosteroids, oral
retinoids, methotrexate, cyclosporine, biologic agents
◉ pityriasis rosacea. Answer: caused by the herpes virus and
medications; starts with "herald patch" and then has widespread
eruption for 1-2 weeks
◉ treatment for pityriasis rosacea. Answer: calamine lotion,
antihistamines. Might consider acyclovir for 1 week if rash does not
resolve
