AAFM BOARDS DERMATOLOGY WITH
ANSWERS
When should antihypertensive medication be given in acute
ischemic stroke in the elderly? ANSWER 1). should not be
given during the first 48-72 hours as long as they are not
candidates for, or recipients of, reperfusion therapy with
alteplase or thrombectomy;
2). do not have a comorbid condition requiring acute blood
pressure lowering;
3). and do not have a blood pressure >220/120 mm Hg.
However, patients with a history of hypertension can generally
resume their home blood pressure medications once they are
safely eating and drinking.
Intensive behavioral intervention has been shown to be more
effective than other treatment modalities in treating children
who have been diagnosed with ANSWER Autism
A 30-year-old male is treated with topical medications for his
papulopustular rosacea with only partial improvement. He has
no drug allergies.The preferred oral antibiotic in this situation is
ANSWER 1st line doxycycline (100-200 mg daily or 40 mg of a
modified release formulation) and minocycline (100-200 mg
daily)
2nd line for those who can't take tetracyclines are oral
metronidazole or macrolides such as azithromycin and
clarithromycin
,A 63-year-old male sees you after carotid ultrasonography at a
local health fair showed a 50% occlusion of his left proximal
internal carotid artery. He has never had a TIA or stroke and he
takes no medications. He smokes one pack of cigarettes daily.
His blood pressure today is 122/76 mm Hg.In addition to
counseling on a healthy diet, exercise, and tobacco cessation,
you should recommend ANSWER statin therapy and repeat
U/S in 1 year
A 25-year-old landscaper presents to the emergency
department with a 1-day history of pain and swelling in his left
hand. Three days ago he sustained a puncture wound from a
thorn in the palm of his hand. He has generalized achiness and
chills in addition to the hand pain. He has no significant past
medical history. patient's temperature is 37.9°C (100.2°F). His
left third finger is diffusely swollen, erythematous, and held in
flexion. There is tenderness along the third tendon in the palm.
A radiograph of the hand is negative for a fracture or foreign
body. What would be the most appropriate next step?
ANSWER Flexor tenosynovitis requires treatment with prompt
intravenous antibiotics and surgical debridement and irrigation
Which one of the following is considered most useful when
implementing shared decision-making? ANSWER Number
needed to treat
A 27-year-old soccer player presents with anterior hip pain
along with a clicking sensation in the hip when he runs or
attempts lateral movements. The flexion, adduction, and
internal rotation (FADIR) test and the flexion, abduction, and
external rotation (FABER) test both elicit pain. You suspect a
labral tear.The most accurate imaging test for the suspected
diagnosis is ANSWER MRI
labral tears usually present with anterior hip pain and may have
catching, popping, or clicking sounds associated with activities
such as gymnastics, soccer, dancing, basketball, or hockey. On
physical examination the flexion, adduction, and internal
, rotation (FADIR) test and the flexion, abduction, and external
rotation (FABER) test will elicit pain. Although initial imaging
may include radiographs of the hip, MRI is often needed for
diagnosis. MR arthrography with gadolinium injection into the
hip joint has been the standard to diagnose labral tears, but
newer MR technology (3-tesla MRI with specialized protocols)
allow for imaging of the joint without the need for intra-articular
contrast.
Psychogenic tremor ANSWER characterized by an abrupt
onset, spontaneous remission, changing characteristics, and
extinction with distraction, such as with alternating finger
tapping or mental concentration on serial 7s.
Cerebellar tremor ANSWER Neurologic testing will reveal past-
pointing on finger-to-nose testing. MRI of the brain is the
diagnostic test of choice.
Parkinsonian tremor ANSWER noted at rest and decreases
with voluntary movement. Bradykinesia, rigidity, and postural
instability may also be noted
essential tremor ANSWER symmetric tremors that may involve
the hands, wrists, head, voice, or lower extremities. May be
treated pharmacologically with propranolol, primidone
(mysoline), or topiramate.
Enhanced physiologic tremor ANSWER a postural tremor of
low amplitude exacerbated by medication. It may also be worse
with caffeine use or anxiety.
Which one of the following treatments has been shown to
improve the quality of life for a patient with tinnitus? ANSWER
Cognitive behavioral therapy, acoustic stimulation, and
educational counseling
ANSWERS
When should antihypertensive medication be given in acute
ischemic stroke in the elderly? ANSWER 1). should not be
given during the first 48-72 hours as long as they are not
candidates for, or recipients of, reperfusion therapy with
alteplase or thrombectomy;
2). do not have a comorbid condition requiring acute blood
pressure lowering;
3). and do not have a blood pressure >220/120 mm Hg.
However, patients with a history of hypertension can generally
resume their home blood pressure medications once they are
safely eating and drinking.
Intensive behavioral intervention has been shown to be more
effective than other treatment modalities in treating children
who have been diagnosed with ANSWER Autism
A 30-year-old male is treated with topical medications for his
papulopustular rosacea with only partial improvement. He has
no drug allergies.The preferred oral antibiotic in this situation is
ANSWER 1st line doxycycline (100-200 mg daily or 40 mg of a
modified release formulation) and minocycline (100-200 mg
daily)
2nd line for those who can't take tetracyclines are oral
metronidazole or macrolides such as azithromycin and
clarithromycin
,A 63-year-old male sees you after carotid ultrasonography at a
local health fair showed a 50% occlusion of his left proximal
internal carotid artery. He has never had a TIA or stroke and he
takes no medications. He smokes one pack of cigarettes daily.
His blood pressure today is 122/76 mm Hg.In addition to
counseling on a healthy diet, exercise, and tobacco cessation,
you should recommend ANSWER statin therapy and repeat
U/S in 1 year
A 25-year-old landscaper presents to the emergency
department with a 1-day history of pain and swelling in his left
hand. Three days ago he sustained a puncture wound from a
thorn in the palm of his hand. He has generalized achiness and
chills in addition to the hand pain. He has no significant past
medical history. patient's temperature is 37.9°C (100.2°F). His
left third finger is diffusely swollen, erythematous, and held in
flexion. There is tenderness along the third tendon in the palm.
A radiograph of the hand is negative for a fracture or foreign
body. What would be the most appropriate next step?
ANSWER Flexor tenosynovitis requires treatment with prompt
intravenous antibiotics and surgical debridement and irrigation
Which one of the following is considered most useful when
implementing shared decision-making? ANSWER Number
needed to treat
A 27-year-old soccer player presents with anterior hip pain
along with a clicking sensation in the hip when he runs or
attempts lateral movements. The flexion, adduction, and
internal rotation (FADIR) test and the flexion, abduction, and
external rotation (FABER) test both elicit pain. You suspect a
labral tear.The most accurate imaging test for the suspected
diagnosis is ANSWER MRI
labral tears usually present with anterior hip pain and may have
catching, popping, or clicking sounds associated with activities
such as gymnastics, soccer, dancing, basketball, or hockey. On
physical examination the flexion, adduction, and internal
, rotation (FADIR) test and the flexion, abduction, and external
rotation (FABER) test will elicit pain. Although initial imaging
may include radiographs of the hip, MRI is often needed for
diagnosis. MR arthrography with gadolinium injection into the
hip joint has been the standard to diagnose labral tears, but
newer MR technology (3-tesla MRI with specialized protocols)
allow for imaging of the joint without the need for intra-articular
contrast.
Psychogenic tremor ANSWER characterized by an abrupt
onset, spontaneous remission, changing characteristics, and
extinction with distraction, such as with alternating finger
tapping or mental concentration on serial 7s.
Cerebellar tremor ANSWER Neurologic testing will reveal past-
pointing on finger-to-nose testing. MRI of the brain is the
diagnostic test of choice.
Parkinsonian tremor ANSWER noted at rest and decreases
with voluntary movement. Bradykinesia, rigidity, and postural
instability may also be noted
essential tremor ANSWER symmetric tremors that may involve
the hands, wrists, head, voice, or lower extremities. May be
treated pharmacologically with propranolol, primidone
(mysoline), or topiramate.
Enhanced physiologic tremor ANSWER a postural tremor of
low amplitude exacerbated by medication. It may also be worse
with caffeine use or anxiety.
Which one of the following treatments has been shown to
improve the quality of life for a patient with tinnitus? ANSWER
Cognitive behavioral therapy, acoustic stimulation, and
educational counseling
