I'd TAC That
Creepy Crawlies
Biologic-al Warfare
Rats, I Have Cancer
Pls Make Me Pretty
100
What is the imaging test of choice to diagnosis osteonecrosis due to corticosteroids?
MRI
100
MOA for the treatment of choice in the below disease:
Inhibits squalene epoxidase (terbinafine)
100
MOA of ustekinumab (be specific)
IgG1 antibody against the p40 subunit of IL-12 and IL-23
100
What are the 3 most common side effects of vismodegib? (in order)
Muscle spasms, alopecia, dysguesia (MAD)
Bonus: What creepy crawly medication also inhibits this pathway?
100
Which component of Jessner's can cause ochronosis?
Resorcinol
BONUS = name all components :)
200
Cardiac arrhthymias have been reported with rapid pulse methylprednisolone. Infusion of what can help prevent this?
Potassium
200
A patient was hospitalized for sepsis and received numerous IV medications. He later developed the following rash. What is the suspected offending agent?
Vancomycin
200
What biologic is preferred in pregnant patients with the below rash?
Certolizumab pegol (Cimzia)
200
A patient was recently started on Vemurafenib to treat his inoperable melanoma. He subsequently developed numerous SCCs. What can be done to decrease his risk of this?
Addition of a MEK inhibitor (trametinib, cobimetinib, binimetinib)
200
A patient who is prescribed minocycline for acne develops drug-induced lupus. In contrast to other forms of drug-induced lupus, what antibodies are most likely to develop?
ANCA
300
Every other day dosing of corticosteroid systemic therapy decreases nearly all of the major complications associated with greater than four weeks of steroid therapy EXCEPT (2)?
osteoporosis and cataracts
300
Administration of what creepy crawly medication likely contributed to the following?
Voriconazole
300
A patient in the hospital was started on IVIG for SJS. After the initial infusion, he developed anaphylaxis. Why?
He has an IgA deficiency
300
What class of chemotherapeutics causes painful and hemorrhagic onycholysis with dorsal acral erythema?
Taxanes (paclitaxel, docetaxel)
300
What is the MOA of tranexamic acid?
Competitively inhibits the activation of plasminogen
400
What enzyme in the liver converts steroids to active forms?
11-beta-hydroxysteroid dehydrogenase
400
A patient presents with the following itchy rash. She is allergic to sunflowers. What is the MOA for the treatment that should be avoided in this patient?
Disables sodium transport channels on the cell membranes of arthropods leading to paralysis (Permethrin)
400
A patient who was recently started on Etanercept for HS develops the following lesion. Name 3 other medications that can cause similar findings.
Isotretinoin, cyclosporine, erlotinib (EGFR inhibitors), rituximab, vemurafenib (BRAF inhibitors), OCPs, indinavir...... etc [among others]
400
A patient is on oral Bexarotene for CTCL. What lab abnormalities are commonly seen on this medication?
Hyperlipidemia and central hypothyroidism (low TSH and free T4)
BONUS = which cholesterol lowering medication should be avoided in patients on bexarotene?
400
A patient who has been on an oral medication for acne presents with the following findings. What is the MOA of the medication she was likely receiving for acne management?
Inhibition of RNA-dependent protein synthesis by binding to bacterial 30S ribosomal subunit (minocycline)
Bonus: what subtype of minocycline hyperpigmentation does this represent?
500
Rank the following from most potent to least potent:
A. Triamcinolone acetonide ointment 0.1%
B. Clobetasol 0.05% solution
C. Betamethasone valerate cream 0.1%
D. Halobetasol proprionate ointment 0.05%
E. Desoximetasone cream 0.05%
Halobetasol > clobetasol > triamcinolone > desoximetasone > betamethasone
500
Name the components of Neosporin.
Bacitracin, Neomycin, and Polymyxin B
500
A patient with psoriasis was recently started on a new medication. He subsequently presented to the ED with the following skin findings and pancytopenia. What is the next best step?
Leucovorin
500
A patient on chemotherapy for Hodgkin's lymphoma develops the following skin findings. What is the most likely offending agent?
Bleomycin (flagellate erythema)
Bonus: consumption of what can lead to a similar eruption?
500
Which retinoid has the following receptor specificity profile?
RAR-alpha, beta & gamma POSITIVE
RXR-alpha, beta & gamma NEGATIVE
Tretinoin