Application TBL SKIN

TBL: Application Excercise
Skin and related connective tissue

ตั้งชื่อกลุ่ม: MDxx (ตามด้วยเลขกลุ่ม)

Multiple Choice

A 18-year-old boy presented with rash as figure for 4 weeks. What is the most appropriate treatment?

• Topical steroid

• Topical mupirocin ointment

• Topical clotrimazole cream

• Oral cephalexin

• Oral itraconazole

Multiple Choice

A 50-year-old man presented with pruritic, tingling skin lesions on the chest wall, as shown in the figure, for 3 days.

  What is the most likely finding from a bedside skin smear?

Multiple Choice

A 60-year-old woman diagnosed with herpes zoster at the left T9 dermatome, confirmed by Tzancksmear, took oral acyclovir for 5 days. She comes to the clinic for follow-up. Today her skin lesions reveal as shown with severely itchy and painful sensation. Vital signs: BT 37.0°C, BP 130/80 mmHg, PR 70/min, RR 14/min.

  What is the most approriate treatment?

• AFusidic acid 2% ointment apply lesion

• Clotrimazole cream apply lesion

• Oral dicloxacillin

• Oral itraconazole

• IV acyclovir

Multiple Choice

A 70-year-old man with poorly controlled diabetes mellitus presented with fever and right leg pain for 3 days. Vital signs: BT 39°C, BP 100/70 mmHg, PR 120/min, RR 22/min. Examination of the right leg, as shown in the figure, revealed tenderness and warmth on palpation.

  What is the most appropriate treatment?

• Oral dicloxacillin

• Oral amoxycillin/clavulanic acid

• IV cefazolin

• IV ceftriaxone

• IV cephazolin + IV clindamycin

Multiple Choice

After admission, the skin lesion progressed as shown in the figure, and there was worsening pain spreading all over the right leg. Vital signs: BT 39°C, BP100/70 mmHg, PR 120/min, RR 22/min. Purulent fluid (5 cc) was aspirated, and a Gram stain showed multiple strains of Gram-positive cocci and bacilli. The doctor decided to add IV clindamycin.

 What is the most appropriate next step in management?

• Add doxycycline

• Add amphotericinB

• Switch ATB to meropenem

• Surgical debridement

• Intravenous immunoglobulin