Exam Questions with Rationale
Section 1: Skin and Vaginal Fungal Infections
1. Which of the following tinea infections requires referral to an
acute or primary care provider?
a) Tinea corporis
b) Tinea cruris
c) Tinea pedis
d) Tinea capitis
Answer: d) Tinea capitis
Rationale: Tinea capitis and tinea unguium always require referral as they
cannot be managed with over-the-counter treatments and require systemic
antifungal therapy.
2. Which of the following antifungal agents can be used for both
treatment and prevention of tinea infections?
a) Clotrimazole
b) Miconazole
c) Tolnaftate
d) Terbinafine
Answer: c) Tolnaftate
Rationale: Tolnaftate is approved for both the treatment and prevention of
skin fungal infections.
3. Which population is NOT advised to self-treat vulvovaginal
candidiasis (VVC) with over-the-counter antifungals?
a) Women who experience recurrent VVC (four or more episodes per
year)
b) Women with their first suspected episode of VVC
c) Pregnant women
d) All of the above
Answer: d) All of the above
Rationale: Women who have not been previously diagnosed with VVC,
those experiencing recurrent infections, and pregnant women should seek
medical evaluation before self-treatment.
4. Which of the following statements is true regarding terbinafine
in treating tinea infections?
a) It is applied twice daily for four weeks for all types of tinea
infections
, b) It has known drug interactions with warfarin
c) It is a squalene epoxidase inhibitor that weakens fungal cell
membranes
d) It is only available as an oral medication
Answer: c) It is a squalene epoxidase inhibitor that weakens fungal cell
membranes
Rationale: Terbinafine works by inhibiting squalene epoxidase, disrupting
fungal cell membranes. It has no known drug interactions and is available in
both topical and oral forms.
Section 2: Drugs for Warts
5. Which of the following treatments is considered first-line for
common and plantar warts?
a) Zinc oxide
b) Cryotherapy and salicylic acid
c) Duct tape therapy
d) Cantharidin
Answer: b) Cryotherapy and salicylic acid
Rationale: Salicylic acid and cryotherapy have the most evidence
supporting their efficacy and are considered first-line treatments.
6. What is the main mechanism of action of salicylic acid in wart
treatment?
a) Directly kills the human papillomavirus (HPV)
b) Induces an immune response by damaging infected epithelium
c) Blocks viral DNA replication
d) Forms a protective barrier over the wart
Answer: b) Induces an immune response by damaging infected epithelium
Rationale: Salicylic acid damages the infected skin layers, stimulating an
immune response to clear the virus.
7. Why is cryotherapy generally considered more effective for
smaller or newer warts?
a) It has a stronger immune-stimulating effect on fresh infections
b) It is less painful for newer warts
c) Older warts have developed resistance to cryotherapy
d) None of the above
Section 1: Skin and Vaginal Fungal Infections
1. Which of the following tinea infections requires referral to an
acute or primary care provider?
a) Tinea corporis
b) Tinea cruris
c) Tinea pedis
d) Tinea capitis
Answer: d) Tinea capitis
Rationale: Tinea capitis and tinea unguium always require referral as they
cannot be managed with over-the-counter treatments and require systemic
antifungal therapy.
2. Which of the following antifungal agents can be used for both
treatment and prevention of tinea infections?
a) Clotrimazole
b) Miconazole
c) Tolnaftate
d) Terbinafine
Answer: c) Tolnaftate
Rationale: Tolnaftate is approved for both the treatment and prevention of
skin fungal infections.
3. Which population is NOT advised to self-treat vulvovaginal
candidiasis (VVC) with over-the-counter antifungals?
a) Women who experience recurrent VVC (four or more episodes per
year)
b) Women with their first suspected episode of VVC
c) Pregnant women
d) All of the above
Answer: d) All of the above
Rationale: Women who have not been previously diagnosed with VVC,
those experiencing recurrent infections, and pregnant women should seek
medical evaluation before self-treatment.
4. Which of the following statements is true regarding terbinafine
in treating tinea infections?
a) It is applied twice daily for four weeks for all types of tinea
infections
, b) It has known drug interactions with warfarin
c) It is a squalene epoxidase inhibitor that weakens fungal cell
membranes
d) It is only available as an oral medication
Answer: c) It is a squalene epoxidase inhibitor that weakens fungal cell
membranes
Rationale: Terbinafine works by inhibiting squalene epoxidase, disrupting
fungal cell membranes. It has no known drug interactions and is available in
both topical and oral forms.
Section 2: Drugs for Warts
5. Which of the following treatments is considered first-line for
common and plantar warts?
a) Zinc oxide
b) Cryotherapy and salicylic acid
c) Duct tape therapy
d) Cantharidin
Answer: b) Cryotherapy and salicylic acid
Rationale: Salicylic acid and cryotherapy have the most evidence
supporting their efficacy and are considered first-line treatments.
6. What is the main mechanism of action of salicylic acid in wart
treatment?
a) Directly kills the human papillomavirus (HPV)
b) Induces an immune response by damaging infected epithelium
c) Blocks viral DNA replication
d) Forms a protective barrier over the wart
Answer: b) Induces an immune response by damaging infected epithelium
Rationale: Salicylic acid damages the infected skin layers, stimulating an
immune response to clear the virus.
7. Why is cryotherapy generally considered more effective for
smaller or newer warts?
a) It has a stronger immune-stimulating effect on fresh infections
b) It is less painful for newer warts
c) Older warts have developed resistance to cryotherapy
d) None of the above
