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derm finale

Total questions: 212

Worksheet time: 2hrs 8mins

Name
Class
Date
1.

what is xerosis characterized by

a)

roughness, scaling

b)

gain of flexibility

c)

inflammation and/or fissures

d)

pruritis

e)

redness

2.

what are risk factors for xerosis?

a)

physical damage such as shaving or scrubbing

b)

lack of natural skin oils

c)

hyperthyroidism

d)

cholinergic drugs

e)

exposure to additional environmental elements and chemicals

3.

when do we refer patients with xerosis and self-care is not effective?

a)

if large areas are affected

b)

if it is in any interiginous areas

c)

if there are infection

d)

if there is intense itching

e)

if they are younger than 2

4.

which is best in lesions without thickening of the skin

a)

ointments

b)

creams

c)

lotions

5.

do soap-free skin cleansers work the same way as emollients

a)

yes

b)

no

6.

patient education for emollients

a)

3-4 applications daily for most benefit

b)

can be greasy and stain clothing

c)

avoid wounds, infections, or lacerations

d)

avoid eyes, mucous membranes, and acne prone areas

e)

over-application can lead to tissue becoming too soft and wearing away

7.

true or false: the atopic march theory explains the natural history of atopic manifestations. It is characterized by some antibody responses to immunoglobulin E and clinical symptoms that may appear in childhood, and continue for years or decades and often changing with age.

a)

true

b)

false

8.

in what atopic dermatitis phase does a patient have "weepy lesions"

a)

infantile (up to 2 years old)

b)

childhood (2 years old to puberty)

c)

adult

9.

in what atopic dermatitis phase does a patient start to not have "weepy lesions" and they become more thickened?

a)

infantile (up to 2 years old)

b)

childhood (2 years old to puberty)

c)

adult

10.

in what atopic dermatitis phase do we start seeing thickened lesions and potentially chronic hand/foot lesions that may indicate a chronic course

a)

infantile (up to 2 years old)

b)

childhood (2 years old to puberty)

c)

adult

11.

two types of contact dermatitis

a)

irritant

b)

allergic

c)

atopic

12.

poison ivy is an example of what

a)

atopic dermatitis

b)

irritant contact dermatitis

c)

allergic contact dermatitis

13.

in _____ do we see a quicker reaction to exposure, often being only minutes to hours

a)

allergic contact dermatitis

b)

irritant contact dermatitis

c)

atopic dermatitis

14.

what type of dermatitis can we see anywhere

a)

irritant dermatitis

b)

allergic dermatitis

15.

what is first line in atopic dermatitis?

a)

emollients

b)

topical corticosteroids

c)

PDE-4 inhibitors

d)

systemic corticosteroids

16.

what is flare treatment for atopic dermatitis

a)

topical or oral corticosteroids first, emollients second, then PDE-4 inhibitors or calcineurin inhibitors or dupixent

b)

emollients first, PDE-4 inhibitors or calcineurin inhibitors or dupixent second, topical or oral corticosteroids last

c)

PDE-4 inhibitors or calcineurin inhibitors or dupixent, topical or oral corticosteroids second, emollients last

d)

emollients first, topical or oral corticosteroids second, then PDE-4 inhibitors or calcineurin inhibitors or dupixent

17.

true or false: you can use topical benadryl for dermatitis

a)

true

b)

false

18.

what is first line in contact dermatitis?

a)

emollients

b)

topical corticosteroids

c)

PDE-4 inhibitors

d)

systemic corticosteroids

19.

what are the MOAs of corticosteroids

a)

anti-inflammatory

b)

immunosuppressive properties

c)

antiproliferative actions to help decrease skin turnover

d)

vasoconstrictive properties to help decrease histamine production and less immune fighters to that area

20.

why do we taper steroids?

a)

exogenous steroids can lead to negative feedback in the HPA axis causing a decrease in endogenous cortisol production over time

b)

natural production of hormones decreases if abruptly stopped

c)

not a big issue for topical corticosteroids because there's not enough systemic absorption UNLESS USING HIGH POTENCY TOPICAL CORTICOSTEROIDS

d)

in derm, tapers are preferred to help reduce flares

21.

safe for infants, children, longer duration, and interiginous areas

a)

low potency

b)

medium potency

c)

high potency

d)

ultra high potency

22.

safe for short durations in infants and children; face, axillae, genitals ok in adults

a)

low potency

b)

medium potency

c)

high potency

d)

ultra high potency

23.

may be used with close supervision in children for less than two weeks

a)

low potency

b)

medium potency

c)

high potency

d)

ultra high potency

24.

no occlusion, maximum duration of 2-4 weeks. do not use in infants, children, on face, axillae, or groin

a)

low potency

b)

medium potency

c)

high potency

d)

ultra high potency

25.

for palms, soles, scalp

a)

higher potency steroids

b)

medium potency steroid

c)

low potency steroid

26.

for arms, legs, abdomen

a)

higher potency steroids

b)

medium potency steroid

c)

low potency steroid

27.

for thinner skin like eyelids, face, anogenital region

a)

higher potency steroids

b)

medium potency steroid

c)

low potency steroid

28.

topical steroid side effects include

a)

skin atrophy

b)

acne-like lesions

c)

striae

d)

folliculitis (pore clogging)

e)

periorbital dermatitis

29.

systemic steroid side effects/counseling points include

a)

take with food

b)

insomnia

c)

tapering if necessary

30.

when we we use systemic corticosteroids in contact dermatitis

a)

when the affected area is 5% BSA or more

b)

when affected area is 10% BSA or more

c)

when affected area is 20% BSA or more

d)

when affected area is 35% BSA or more

31.

which class of drugs has the black box warning: risk of serious infections, mortality, malignancy, major adverse cardiovascular events, and thrombosis (blood clots)

a)

JAK inhibitors

b)

interleukin antagonists

c)

PDE-4 inhibitors

d)

calcineurin inhibitors

32.

adverse effects: conjunctivitis, herpes simplex virus flares

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

33.

adverse effects: itching, hypersensitivity reactions

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

34.

adverse effects: burning, stinging, and immunosuppression

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

35.

which class of drugs has the black box warning: long term use has been linked to basal cell and squamous cell carcinomas as well as lymphomas

a)

JAK inhibitors

b)

interleukin antagonists

c)

PDE-4 inhibitors

d)

calcineurin inhibitors

36.

IL4 and IL13 inhibitor via inhibition of the IL4aR subunit. decreases the release of proinflammatory cytokines. 600mg once and then 300mg every other week. can be used with or without topical corticosteroids

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

37.

specifically blocks degradation of cAMP. suppresses production of pro-inflammatory cytokines. increases production of anti-inflammatory mediators.

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

38.

inhibits calcineurin from initiating T cell activation and release of inflammatory mediators, thereby decreasing itching and inflammation

a)

dupixent

b)

eucrisa

c)

tacrolimus

d)

rinvoq

39.

an alternative to long-term use of corticosteroids. no skin atrophy/striae or metabolic abnormalities. can be applied to the face and used on children older than 2. much more expensive than topical corticosteroids.

a)

JAK inhibitors

b)

interleukin antagonists

c)

PDE-4 inhibitors

d)

calcineurin inhibitors

40.

exclusions for self-treatment of poison ivy

a)

less than 2 years old

b)

dermatitis present for more than 2 weeks

c)

involvement of more than 20% BSA (need systemic corticosteroids)

d)

swelling of eyes, eyelids shut, body, or extremities

e)

failure of self-management after 7 days

41.

true or false: breastfed infants do not have lower rates of diaper dermatitis compared to bottle-fed infants

a)

true

b)

false

42.

diaper rash fungal infections are usually caused by

a)

candida albicans

b)

tinea capitis

c)

tinea manum

d)

candidal intertrigo

43.

non-pharmacologic recommendations for diaper rash

a)

keep patient dry

b)

change diaper 6 or more times a day

c)

disposable diaper decrease the rate of severe diaper dermatitis compared to cloth

d)

make sure skin is dry before re-diapering

e)

clean area with plain water or a bland soft cloth or wipe

44.

first-line diaper rash treatment

(a)  

45.

when to refer for diaper rash treatment

a)

after 7 days

b)

after 30 days

c)

if improvement is seen in 7 days can continue for another 3 days

d)

after 14 days

46.

contraindications for diaper rash self-treatment

a)

secondary infections: bacterial, fungal, or viral

b)

presence of rash outside diaper region

c)

presence of broken skin: ulcers, blisters, peeling slin

d)

oozing, blood, vesicles, or pus at lesion site

e)

lesions present for more than 7 days

47.

treatment goals for seborrheic dermatitis

a)

reduce inflammation and epidermal turnover rate of scalp or affected skin

b)

reduce malassezia levels

c)

minimize or eliminate erythema and scaling

d)

minimize itch

48.

first line for seborrheic dermatitis

a)

topical corticosteroids

b)

medicated shampoos

c)

salicylic acid and sulfur

49.

for OTC medicated shampoos

a)

daily for 1-2 weeks then 2-3 times a week for the next 4 weeks then apply once weekly

b)

2 times a week for 4 weeks then apply once weekly

c)

once weekly for 1-2 weeks then daily for 4 weeks

d)

once weekly for 4 weeks and then 2 times a week

50.

second line treatment for seborrheic dermatitis is topical corticosteroids. what is the requirements for said recommendation?

a)

can be used to manage greater levels of inflammation

b)

hydrocortisone ointment no more than BID

c)

treat up to 7 days then need to be seen by a PCP

51.

causes for rosacea

a)

immune dysregulation

b)

neurovascular dysregulation causing more blood flow to the skin

c)

genetic predisposition

d)

overgrowth of demodex (a parasite like organism)

e)

overgrowth of malassezia (a parasite like organism)

52.

rosacea triggers include

a)

UV radiation

b)

heat exposure

c)

alcohol

d)

spicy food

e)

stress

53.

what are the non-prescription therapies for rosacea

a)

gentle cleansers

b)

moisturizers

c)

sunscreen

d)

green tinted makeup

54.

treatments for rosacea include

a)

metronidazole

b)

oxymetazoline

c)

terbinafine

d)

salicylic acid

e)

brimonidine

55.

reduces oxidative stress and has been proven to reduce redness and inflammation. often start with the lotion and then go to the gel but the gel is more irritating

a)

metronidazole

b)

oxymetazoline

c)

azelaic acid

d)

brimonidine

e)

ivermectin

56.

A1 agonist, causing vasoconstriction to decrease redness. can cause rebound redness so requires regular application to be effective

a)

metronidazole

b)

oxymetazoline

c)

azelaic acid

d)

brimonidine

e)

ivermectin

57.

suspect some antimicrobial activity. inhibits production of ROS which decreases redness and inflammation. typically used as an adjunct therapy 1-2 times a week

a)

metronidazole

b)

oxymetazoline

c)

azelaic acid

d)

brimonidine

e)

ivermectin

58.

decreases inflammation and redness. has antiparasitic effects.

a)

metronidazole

b)

oxymetazoline

c)

azelaic acid

d)

brimonidine

e)

ivermectin

59.

alpha adrenergic agonist to cause vasoconstriction. little rebound redness is seen with this medication

a)

metronidazole

b)

oxymetazoline

c)

azelaic acid

d)

brimonidine

e)

ivermectin

60.

which of these has a side effect of phototoxicity

a)

sodium sulfacetamide sulfur

b)

azelaic acid

c)

metronidazole

d)

oxymetazoline

61.

what medications are recommended for severe rosacea

a)

fluconazole

b)

doxycycline

c)

isotretinoin

d)

minocycline

e)

imiquimod

62.

what treatment options can be used for warts

a)

cryotherapy

b)

salicylic acid

c)

azelaic acid

d)

imiquimod

e)

cimetidine

63.

activates immune cells through toll-like receptor 7. side effects include phototoxicity and influenza-like symptoms.

a)

metronidazole

b)

oxymetazoline

c)

imiquimod

d)

brimonidine

e)

ivermectin

64.

treatments for molluscum contagiosum

a)

retinoids

b)

imiquimod

c)

cryotherapy

d)

salicylic acid

65.

melasma

a)

must treat continuously or it will come back

b)

due to hormonal changes

c)

treatment is triple therapy fluocinolone, hydroquinone, and retinoid. or just hydroquinone or retinoids on their own

d)

no treatment during pregnancy. best to wait until post partum to begin treatment.

66.

vitiligo

a)

immune mediated skin condition resulting in a loss of pigmentation

b)

treatment includes high potency steroids (class II and III)

c)

treatment include topical calcineurin inhibitors

d)

treatment includes UVA or UVB exposure

e)

treatment includes systemic corticosteroids

67.

a (a)   % improvement in PASI score means the therapy is effective

68.

for psoriasis, a BSA of __% or more is mild, up to __% is moderate, and __ or more is severe

(a)  

69.

for mild to moderate psoriasis categorize treatment by order phototherapy, topical agents, and systemic agents in order

(a)  

70.

true or false: we do not use higher potency steroids first in psoriasis

a)

false

b)

true

71.

in corticosteroid dosing for psoriasis

a)

we can occlude with saran wrap to increase effects

b)

can have them do TID instead of BID

c)

potency can be increased by using an ointment versus a cream

d)

location of plaques dictates the vehicle

72.

vitamin D analogs

a)

also first line therapy in psoriasis

b)

calcipotriene is available in combination with betamethasone

c)

use a thin layer BID for 8 weeks

d)

can exacerbate psoriasis and can rarely cause hypercalcemia

73.

what is third line for psoriasis treatmetn

a)

topical retinoids such as tazarotene

b)

coal tar

c)

systemic corticosteroids

d)

phototherapy

74.

which third line treatment could we use in combination with phototherapy

a)

coal tar

b)

tazarotene

c)

systemic corticosteroids

75.

what systemic drugs can we use for psoriasis

a)

otezla

b)

acitretin

c)

methotrexate

d)

humira

e)

cosentyx

76.

what medication requires LFTs and CBCs done regularly and has many drug interactions. it is a treatment for psoriasis.

a)

methotrexate

b)

metronidazole

c)

remicade

d)

cimetidine

77.

a topical retinoid that has an incredibly long half life, should avoid alcohol when taking, and has it's own REMS program? a treatment for psoriasis

a)

otezla

b)

acitretin

c)

methotrexate

d)

isotretinoin

e)

metronidazole

78.

treatment success is shown with a (a)   % and above reduction in PASI score

79.

adverse effects of methotrexate

a)

GI toxicity - anorexia, nausea

b)

liver toxicity - fibrosis and/or cirrhosis

c)

neutropenia, thrombocytopenia, anemia

d)

many drug interactions

e)

psuedotumor cerebri

80.

adverse effects of acitretin

a)

hyperlipidemia

b)

liver toxicity

c)

bone/muscle pain

d)

pseudotumor cerebri

e)

eye irritation

81.

adverse effects of otezla

a)

GI upset in diarrhea and nausea

b)

headache

c)

weightloss

d)

depression and suicidal behavior

82.

dosing for otezla

a)

daily titration from 10mg daily to 30mg BID

b)

max dose is 60mg

83.

enbrel (etanercept) is

a)

TNF inhibitor

b)

T-cell activation inhibitor

c)

interleukin antagonist

d)

PDE-4 inhibitor

84.

remicade (infliximab) is

a)

TNF inhibitor

b)

T-cell activation inhibitor

c)

interleukin antagonist

d)

PDE-4 inhibitor

85.

humira (adalimumab)

a)

TNF inhibitor

b)

T-cell activation inhibitor

c)

interleukin antagonist

d)

PDE-4 inhibitor

86.

amevive (alefacept)

a)

TNF inhibitor

b)

T-cell activation inhibitor

c)

interleukin antagonist

d)

PDE-4 inhibitor

87.

which drug do you have to get a CD4 count done for

a)

enbrel (etanercept)

b)

remicade (infliximab)

c)

humira (adalimumab)

d)

amevive (alefacept)

e)

stelara (ustekinumab)

88.

non-blanchable redness with warmth or hardness. no skin breakdown

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

89.

superficial lesion with partial thickness skin loss. looks like a popped blister.

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

90.

full thickness skin loss. can see fat within the wound

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

91.

extensive tissue necrosis and damage to muscle, tendon, joint, or bone

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

92.

which type of ulcer is due to obesity, heart failure, and anything causing fluid retention

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

93.

which type of ulcer is associated with peripheral vascular disease (PVD). cholesterol buildup can prevent good blood flow

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

94.

which type of ulcer is associated with peripheral vascular disease (PVD), neuropathy, trauma, and most commonly diabetes

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

95.

because of the large fluid buildup, these have lots of exudate. not quick to heal

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

96.

a dry wound with little to no exudate. quite painful

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

97.

maintain a moist wound environment - moderately wet or moderately dry

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

98.

you can promote healing of _____ by modification of risk factors for PVD including smoking cessation and treating hyperlipidemia by putting patient on a statin.

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

99.

most common chronic wound. treatment is minimal - rotating patients positions and use of dressings

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

100.

we would use dressings that absorb fluid for ____

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

101.

we would use dressings that maintain wet or dry environment for ____

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

102.

we would use dressings that hydrate for ____

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

103.

which of these REQUIRES a secondary dressing

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

104.

which of these CAN ACT AS a secondary dressing

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

transparent films

105.

may over-dry the wound

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

transparent films

106.

non-transparent so cannot visualize the wound

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

107.

which of these should you use a transparent film as a secondary dressing

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

108.

which of these provides cushioning

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

109.

which of these melts into the wound

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

110.

which of these can you go 3-4 days without changing (good for adherence)

a)

calcium alginates

b)

hydrogel sheets

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

111.

which of these can facilitate autolytic debridement

a)

calcium alginates

b)

transparent films

c)

amorphous hydrogels

d)

hydrocolloids

e)

foams

112.

which of these is ointment-like and is usually in a tube. it does not adhere to wounds and is the best agent for getting moisture into the wound

a)

calcium alginates

b)

transparent films

c)

amorphous hydrogels

d)

hydrogel sheets

e)

foams

113.

which of these is especially useful for burns as it has a cooling effect

a)

calcium alginates

b)

transparent films

c)

amorphous hydrogels

d)

hydrogel sheets

e)

foams

114.

which of these are difficult to position at some anatomical sites

a)

calcium alginates

b)

transparent films

c)

amorphous hydrogels

d)

hydrogel sheets

e)

foams

115.

risk factor medications for chronic wounds

a)

sedative/hypnotics

b)

antihistamines

c)

diuretics

d)

beta blockers

e)

corticosteroids

116.

risk factors for chronic wounds

a)

excessive pressure can lead to immobility

b)

immunodeficiency and infection

c)

poor circulation and poor nutrition

d)

age

e)

obesity

117.

regranex gel is used for ____

a)

venous stasis ulcer

b)

aterial ulcer

c)

pressure ulcer

d)

neuropathic ulcer

118.

when to refer a patient to an outpatient clinic

a)

2 degree burn on <2% of BSA and not on the hands, feet, face, genitalia, perineum, or major joints

b)

2 or 3 degree burns on <10% BSA and not on the hands, feet, face, genitalia, perineum, or major joints

c)

1 degree burns on <2% BSA

d)

electrical and chemical burns

e)

those with preexisting medical or mental disorders that would prohibit or prolong treatment

119.

when to refer a patient to a community hospital

a)

2 degree burn on <2% of BSA and not on the hands, feet, face, genitalia, perineum, or major joints

b)

2 or 3 degree burns on <10% BSA and not on the hands, feet, face, genitalia, perineum, or major joints

c)

1 degree burns on <2% BSA

d)

electrical and chemical burns

e)

those with preexisting medical or mental disorders that would prohibit or prolong treatment

120.

when to refer self-treatment

a)

2 degree burn on <2% of BSA and not on the hands, feet, face, genitalia, perineum, or major joints

b)

2 or 3 degree burns on <10% BSA and not on the hands, feet, face, genitalia, perineum, or major joints

c)

1 degree burns on <2% BSA

d)

electrical and chemical burns

e)

those with preexisting medical or mental disorders that would prohibit or prolong treatment

121.

when to refer to a burn center

a)

TBSA burned is >10%

b)

2 or 3 degree burns on <10% BSA but on the hands, feet, face, genitalia, perineum, or major joints

c)

electrical and chemical burns

d)

those with preexisting medical or mental disorders that would prohibit or prolong treatment

e)

inhalation injury or any burn associated with accompanying trauma such as fractures

122.

what stage of frostbite is this: numb, central white plaque with edema

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

123.

what stage of frostbite is this: blisters form with edema and erythema

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

124.

what stage of frostbite is this: hemorrhage blisters turn into eschar in 14 days

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

125.

what stage of frostbite is this: complete necrosis and tissue loss

a)

stage I

b)

stage II

c)

stage III

d)

stage IV

126.

get absorbed into the skin where they absorb the radiation

a)

sunscreen

b)

sunblock

c)

chemical sunscreen

d)

physical sunscreen

127.

stay on top of the skin and reflect UV radiation

a)

sunscreen

b)

sunblock

c)

chemical sunscreen

d)

physical sunscreen

128.

first line: OTC topical such as terbinafine, miconazole, or clotrimazole. second line: RX topicals such as ketoconazole and econazole. in resistant cases, systemic antifungals such as fluconazole or terbinafine can be used

a)

tinea corpis

b)

tinea capitis

c)

onychomycosis

d)

candida intertrigo

e)

candida albicans (diaper rash)

129.

first line: systemic oral agents such as terbinafine or griseofulvin then use topical OTC selenium sulfide or RX ketoconazole to help decrease transmission

a)

tinea corpis

b)

tinea capitis

c)

onychomycosis

d)

candida intertrigo

e)

candida albicans (diaper rash)

130.

first line: topicals do not work well (take up to 48 weeks) but include ciclopirox and efinaconazole and should be used in conjunction with systemic terbinafine

a)

tinea corpis

b)

tinea capitis

c)

onychomycosis

d)

candida intertrigo

e)

candida albicans (diaper rash)

131.

the two types of candida skin infection are

(a)  

132.

true or false: the most common cause of skin and nail fungal infections is trichophyton rubrum

a)

true

b)

false

133.

general spectrum of action for mupirocin

a)

gram positive and gram negative

b)

gram positive only

c)

gram negative only

134.

general spectrum of action for bacitracin

a)

gram positive and gram negative

b)

gram positive only

c)

gram negative only

135.

general spectrum of action for retapamulin

a)

gram positive and gram negative

b)

gram positive only

c)

gram negative only

136.

what are the major roles of steroids in humans

a)

main component of membranes

b)

hormones

c)

bile acids

d)

vitamin D3 precursor

137.

what is the simplest steroid

(a)  

138.

what is the common precursor to steroids

(a)  

139.

cortisol; functions include immunosuppression

a)

glucocorticoids

b)

mineralocorticoids

c)

progestogens

d)

androgens

e)

estrogens

140.

aldosterone; helps regulate blood pressure through water and electrolyte balance

a)

glucocorticoids

b)

mineralocorticoids

c)

progestogens

d)

androgens

e)

estrogens

141.

progesterone; regulates cyclical changes in the endometrium of the uterus and maintains a pregnancy

a)

glucocorticoids

b)

mineralocorticoids

c)

progestogens

d)

androgens

e)

estrogens

142.

testosterone; contributes to the development and maintenance of male secondary sex characteristics

a)

glucocorticoids

b)

mineralocorticoids

c)

progestogens

d)

androgens

e)

estrogens

143.

estradiol; contributes to the development and maintenance of female secondary sex characteristics

a)

glucocorticoids

b)

mineralocorticoids

c)

progestogens

d)

androgens

e)

estrogens

144.

neurosteroids

a)

DHEA and allopregnanolone

b)

pancuronium bromide

c)

cholecalciferol

d)

ergocalciferol

e)

calcitriol

145.

aminosteroid neuromuscular blocking agent

a)

DHEA and allopregnanolone

b)

pancuronium bromide

c)

cholecalciferol

d)

ergocalciferol

e)

calcitriol

146.

secosteroid

a)

DHEA and allopregnanolone

b)

pancuronium bromide

c)

cholecalciferol

d)

ergocalciferol

e)

calcitriol

147.

cholesterol

a)
b)
c)
d)
e)
148.

testosterone

a)
b)
c)
d)
e)
149.

progesterone

a)
b)
c)
d)
e)
150.

corticosterone

a)
b)
c)
d)
e)
151.

11-desoxycorticosterone

a)
b)
c)
d)
e)
152.

what is an example of a common drug that is an anti-mineralocorticoid and how does it work?

a)

MCRA is an anti-mineralocorticoid. it is a diuretic drug which antagonizes the action of aldosterone at mineralocorticoid receptors.

b)

spironolactone is an antimineralocorticoid (steroidal spironolactone)

c)

finerenone is a non-steroidal antimineralocorticoid

153.

transactivation vs transrepression

a)

transactivation – homodimerization of the receptor, translocation of the receptor into the nucleus, and binding to specific DNA elements activating gene transcription.

b)

transrepression – homodimerization of the receptor, translocation of the receptor into the nucleus, and binding to specific DNA elements activating gene transcription.

c)

transrepression  – when GRs are not activated, other transcription factors can transactivate the target genes. however, activated GRs can complex with these other factors and prevent them from binding their target genes and repress the expression.

d)

transactivation  – when GRs are not activated, other transcription factors can transactivate the target genes. however, activated GRs can complex with these other factors and prevent them from binding their target genes and repress the expression.

154.

When you add something to a mineralocorticoid receptor what happens?

a)

aldosterone fufills its major physiological function of maintaining sodium and potassium balance and blood pressure control

b)

potassium secretion and sodium reabsorption increase

c)

the regulation of gene transcription for development, metabolism, and immune response

155.

When you add a steroid to a glucocorticoid receptor what happens?

a)

aldosterone fufills its major physiological function of maintaining sodium and potassium balance and blood pressure control

b)

potassium secretion and sodium reabsorption increase

c)

the regulation of gene transcription for development, metabolism, and immune response

156.

how is aldosterone produced and what does it do?

a)

produced by the zona glomerulosa of the adrenal cortex in the adrenal gland

b)

produced by your mom

c)

conserves sodium

d)

regulates BP and potassium levels

157.

In common prescription terms what steroid is cortisol most commonly known as?

(a)  

158.

how does cortisol weaken the immune system

a)

increases blood sugar through gluconeogenesis to suppress the immune system.

b)

prevents proliferation of T-cells by making the interleukin 2-producer T-cells unresponsive to interleukin I.

c)

chronic elevations can lead to the immune system becoming “resistant,” an accumulation of stress hormones, and increased production of inflammatory cytokines that further compromise the immune response

d)

unable to produce the T-cell growth factor IL-2.

159.

HMG-CoA reductase turns HMG-CoA into ___

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

160.

through a series of ATP kinases, mevalonate becomes ____

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

161.

through a series of steps, IPP becomes ____

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

162.

farnesyl diphosphate becomes ____

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

163.

denaturation of squalene epoxide gives ____

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

164.

through a series of steps, what is the precursor to cholesterol?

a)

mevalonate

b)

squalene

c)

isopentenyl diphosphate

d)

farnesyl diphosophate

e)

lanesterol

165.

cholesterol and NADPH becomes _____

a)

7-dehydrocholesterol

b)

chenocholic acid

c)

vitamin D3

d)

trioxo-cholanic acid

166.

after cholesterol becomes 7-dehydrocholesterol, what is the next step in the synthesis of vitamin D3?

a)

UV light

b)

heat

c)

vitamin D3

d)

NADPH

167.

what is the last step in the synthesis of vitamin D3 from cholesterol?

a)

UV light

b)

heat

c)

H2O

d)

NADPH

168.

what is the first step in the conversion of cholesterol to bile acids

a)

oxidation of the side chain from C27 becomes COOH at C24

b)

inversion of 3b-OH to 3a-OH

c)

reduction of a double bond to 5b-H

d)

hydroxylation on C7 and C12 become 7a-OH and 12a-OH

e)

further oxidation of 7a-OH and 12a-OH become ketones

169.

which of these steps in the conversion of cholesterol to bile acids is incorrect

a)

oxidation of the side chain from C27 becomes COOH at C24

b)

inversion of 3a-OH to 3b-OH

c)

reduction of a double bond to 5b-H

d)

hydroxylation on C7 and C12 become 7a-OH and 12a-OH

e)

further oxidation of 7a-OH and 12a-OH become ketones

170.

at which carbon(s) does hydroxylation occur in conversion of cholesterol to bile acids

a)

C7

b)

C12

c)

C19

d)

C3

171.

what is the rate limiting enzyme of cholesterol synthesis

a)

HMG-CoA reductase

b)

HMG-CoA synthase

c)

squalene epoxidase

d)

oxidosqualene lanesterol cyclase

172.

17C

a)

gonane

b)

estrane

c)

androstane

d)

pregnane

e)

cholestane

173.

19C

a)

gonane

b)

estrane

c)

androstane

d)

pregnane

e)

cholestane

174.

18C

a)

gonane

b)

estrane

c)

androstane

d)

pregnane

e)

cholestane

175.

21C

a)

gonane

b)

estrane

c)

androstane

d)

pregnane

e)

cholestane

176.

27C

a)

gonane

b)

estrane

c)

androstane

d)

pregnane

e)

cholestane

177.

the junctions between B and C

a)

are always transfused

b)

are normally transfused and can be cisfused

c)

can be cisfused or transfused

d)

are always cisfused

178.

the junctions between C an D

a)

are always transfused

b)

are normally transfused and can be cisfused

c)

can be cisfused or transfused

d)

are always cisfused

179.

the junctions between A and B

a)

are always transfused

b)

are normally transfused and can be cisfused

c)

can be cisfused or transfused

d)

are always cisfused

180.

what means below the plane

a)

alpha

b)

beta

181.

what means above the plane

a)

alpha

b)

beta

182.

disruption of enterohepatic circulation of bile acids will lower cholesterol

a)

hyperlipidemia

b)

cholestasis

c)

gallstones

d)

bile acid diarrhea

183.

structural or functional abnormalities of the biliary system results in an increase in bilirubin (jaundice) and a decrease in bile acids in the blood.

a)

hyperlipidemia

b)

cholestasis

c)

gallstones

d)

bile acid diarrhea

184.

normally treated with ursodeoxycholic acid

a)

hyperlipidemia

b)

cholestasis

c)

gallstones

d)

bile acid diarrhea

185.

may result from increased saturation of cholesterol or bilirubin or from bile stasis

a)

hyperlipidemia

b)

cholestasis

c)

gallstones

d)

bile acid diarrhea

186.

excessive concentration of bile acids in colon cause chronic ___ which is seen in ulcerative colitis and chron's disease

a)

hyperlipidemia

b)

cholestasis

c)

gallstones

d)

bile acid diarrhea

187.

nuclear receptor proteins are transcription factors able to regulate the expression of genes controlling numerous processes including

a)

reproduction

b)

development

c)

metabolism

d)

bile acid synthesis

188.

mediate biological effects of retinoids by their involvement in retinoic acid gene activation

a)

RXR

b)

LXR

c)

FXR

d)

PPARs

189.

important regulators of cholesterol, fatty acids, glucose homeostasis

a)

RXR

b)

LXR

c)

FXR

d)

PPARs

190.

expressed at increased levels in the lliver and intestines

a)

RXR

b)

LXR

c)

FXR

d)

PPARs

191.

cholesterol lowering fibrates bind to and regulate PPARy

a)

RXR

b)

LXR

c)

FXR

d)

PPARs

192.

in the inactive state, receptors for steroids reside in the ____ and then translocate to the ____ after ligand binding

a)

cytoplasm, nucleus

b)

nucleus, cytoplasm

193.

true or false: some LXRs and FXRs don't reside in the cytoplasm when inactivated and instead actually reside in the nucleus. they are activated by changes in concentration of hydrophobic lipid molecules

a)

false

b)

true

194.

adrenal steroids are synthesized by the (a)   backbone

195.

adrenal steroids are derived from the

a)

adrenal glands in the kidneys

b)

the zona reticularis layer

c)

the adrenal cortex

d)

the hypothalamus

e)

the anterior pituitary

196.

adrenocorticoids are regulated by

a)

ACTH

b)

CRH

c)

cortisol

197.

what stimulates corticosteroid synthesis

a)

ACTH

b)

CRH

c)

angiotensin II

d)

angiotensin I

198.

the ____ secretes CRH which then signals the ____ to release ACTH. this then signals the _____ to produce cortisol

a)

hypothalamus, anterior pituitary, adrenal cortex

b)

adrenal cortex, hypothalamus, anterior pituitary

c)

adrenal cortex, anterior pituitary, hypothalamus

d)

hypothalamus, adrenal cortex, anterior pituitary

199.

the hypothalamus secretes ____ which signals the anterior pituitary to secrete ____ when signals the adrenal cortex to produce ____

a)

CRH, ACTH, cortisol

b)

cortisol, CRH, ACTH

c)

CRH, cortisol, ACTH

d)

ACTH, CRH, cortisol

200.

cortisol is predominantly a _____ but possesses modest _____ activity

a)

glucocorticoid, mineralocorticoid

b)

mineralocorticoid, glucocorticoid

201.

when is cortisol released

a)

in stress

b)

in low blood glucose concentration

c)

in high blood glucose concentration

d)

when sodium is low

202.

which of these is a GR agonist

a)

dexamethasone

b)

ketoconazole

c)

nifepristone

203.

which of these is a GR antagonist

a)

dexamethasone

b)

ketoconazole

c)

nifepristone

204.

which of these are functions of cortisol

a)

increase blood sugar by stimulating gluconeogenesis

b)

suppression of the immune system

c)

metabolism of fat, protein, and carbs

d)

increase in bone formation

e)

allows for release of substances in the body the causes inflammation

205.

what are some of cortisol's other functions

a)

treats conditions resulting from overactivity of B-cell mediated antibody reponse

b)

can weaken activity of immune system by prevention of proliferation of T-cells

c)

has negative feedback effect on interleukin I

206.

in early fasting, cortisol stimulates

a)

gluconeogenesis

b)

anti-inflammatory pathway activation

c)

glycogenesis

d)

proteolysis and muscle wasting

207.

in late fasting, cortisol stimulates

a)

gluconeogenesis

b)

anti-inflammatory pathway activation

c)

glycogenesis

d)

proteolysis and muscle wasting

208.

prolonged elevated cortisol stimulates

a)

gluconeogenesis

b)

anti-inflammatory pathway activation

c)

glycogenesis

d)

proteolysis and muscle wasting

209.

what do mineralocorticoid receptors do

a)

they are ligand-activated transcription factors

b)

bind to hormone-responsive elements and activate transcription of discrete sets of genes in target tissues

c)

expressed in epithelial tissues involved in electrolyte transport

210.

cortisol causes ____ and ____ retention in the kidney

a)

salt

b)

water

c)

potassium

d)

cortisol

211.

androgens

a)

DHEA

b)

DHEA sulfate

c)

androstedione

d)

aldosterone

e)

cortisol

212.

neurosteroids

a)

DHEA

b)

DHEA sulfate

c)

androstedione

d)

aldosterone

e)

cortisol