Put the Lyme in the Coconut
Which of the following is not normally seen when a person develops a skin rash from Lyme disease?
a. Single circle rash with a bull’s-eye appearance
b. The area of the rash is warm to the touch
c. The rash is not painful or itchy
d. The rash often appears as several small patches around the area of the tick bite.
CS
A 14 y/o has been coming to you for PT for his little league elbow (medial epicondylitis) from playing baseball. During one of his treatment sessions, you notice he keeps scratching his wrist intensely. After taking a closer look at his wrist, you observe redness on his skin and a pimple-like skin rash. The patient mentions that his friends at school have a similar rash. Which of the following diagnoses do you think the patient may have?
A. Lyme disease
B. Scabies
C. Psoriasis
D. Cellulitis
JC
When should you see a doctor about a concerning mole?
a. When it is a large, symmetrical mole that hasn’t grown
b. A small mole that has been there your whole life
c. An unusual looking mole that has grown
d. You have a large bundle of freckles on your arm
CH
Which of the following is a contagious bacterial infection that typically forms sores around the mouth and nose, and is most common in children
a. Contact dermatitis
b. Chickenpox
c. Impetigo
d. Scabies
MHB
Patient is an 89 y/o who was living in a nursing home until a recent fall. You are seeing them in the hospital. They report fatigue, shortness of breath, and a new onset of confusion. During your exam, you notice a small wound on their left forearm that does not match the wounds associated with the fall. The small shallow wound is red, and has a mild rash around the edges and a small amount of pus coming from it. Which of the following diagnoses are you suspecting in regard to the wound?
A. Shingles
B. Methicillin-resistant staphylococcus aureus (MRSA)
C. Contact dermatitis
D. Actinic keratosis
MC
Which of the following is true about Lyme disease?
a. The stages are very straight forward and symptoms do not overlap between stages
b. A rash will always occur as the first sign of Lyme disease
c. Stage 3 is considered early disseminated disease
d. Stage 3 involves discoloration and swelling of the back of hands and tops of feet
KAJ
Which of the following presentations is associated with contact dermatitis?
A. Skin infection which appears as a red, raised pimple which can resemble a spider bite and is often painful.
B. Swollen, painful, and discolored area which may be hot or tender to touch.
C. Raised bump with white or yellow center which may rupture and weep fluid.
D. Scaly, itchy, or raw skin area with visible borders and possible redness or color change.
MM
Which would NOT be classified as an increased risk factor for melanoma?
a. Large congenital nevi > 20 cm in diameter
b. Having > 20 moles on your body
c. Family history of melanoma
d. Regular use of tanning beds/lamps
RN
Which one is NOT the characteristic of singles?
1. A shingles rash form a stripe of blisters on one side of the body, torso, neck, and face.
2. Oozing skin and fluid filled blisters with flu like symptoms.
3. Singles is in the same viral family as herpes simplex.
4. Appears on bilateral side of the body including face and extremities.
5. None of the above
YA
A patient has a large puss filled raised bump on their armpit. The wound has a small white center, and they report that it is very painful. Which primary skin lesion is being described?
A. Wart
B. Keloids
C. Cellulitis
D. Boil
HE
A 23 y/o presents to you reporting that they went hiking along the coast of Maine a few weeks ago. This patient reports that he had gotten some pretty bad bug bites however never got a rash. Recently, however, he was having some headaches and has been pretty tired lately. 4 weeks after the original trip he is beginning to develop some pain and weakness in his hands and feet, and swelling to his R eye. You suspect that this patient may have developed Lyme disease and would like to refer him to his PCP. What stage of Lyme disease does this patient most likely have?
a) Stage 1
b) Stage 2
c) Stage 3
d) Stage 4
AM
Your patient (45 year old male) comes to PT and reports that he’s feeling “a little under the weather”. He reports that he’s been under a lot of stress at work the last few weeks and feels as though it’s taking a toll on his health. While talking to him, you notice a red patch of skin on the corner of his mouth that appears to be weeping clear fluid. You ask him if that is new and he brushes you off, stating that it’s “just eczema.” What is the most probable cause of this red patch of skin?
a. Actinic Keratosis
b. Allergic Eczema
c. Cold Sore
d. Impetigo
MM
Your 76-year-old patient comes to the clinic for his routine skin checks after being diagnosed with skin cancer 15 years ago. As of the last few visits, a mole on his back has been of concern. Which of the following changes would NOT be of concern?
a. The mole has notched edges
b. The mole has a blue color to it
c. Growth greater than 1/3 inch
d. There is itchiness near the site of the mole
SR
Your patient reports feeling ill and complaining of chills and feeling lightheaded. Upon further examination, you notice that his right lower leg is discolored, inflamed, and the skin appears tight and glossy. The area is painful and tender. What is the most likely diagnosis?
a. vasculitis
b. cellulitis
c. shingles
d. contact dermatitis
NF
A 4 y/o presents with a rash and blisters surrounding his mouth. In addition to the rash, the parent reports that their child also has golden flaky skin. Based on the patient’s presentation and the parent’s description, what is the best treatment for this skin condition?
a.) Oral fungicidal medication
b.) Antihistamine and removal of allergen from environment
c.) Antibiotics
d.) There is no treatment for this skin condition
PM
The skin condition associated with Europe’s most common type of Lyme disease presents with discoloration and swelling of the skin on the backs of the hands and tops of the feet. What is this skin condition called?
A. Acrodermatitis chronic atrophicans
B. Early disseminated disease
C. Congenital nevi
D. Late disseminated disease
CC
Which of the following describes a mite infestation with a delayed (4-6 week) symptom onset which consists of an extremely itchy rash that may be pimply and made up of tiny blisters. The most common sites for this rash include the wrist, elbow, armpit, waist, buttocks, and the area between the fingers.
a. Chicken Pox
b. Scabies
c. Shingles
d. Hives
VH
Which of the following is a trait of abnormal moles that may be a sign of melanoma?
a. Light in color
b. Symmetrical in shape
c. New symptoms such as itchiness or bleeding
d. Hair in or around the mole
MR
Which answer is correct in regard to scabies?
a. Raised bumps that are painful with a yellow or white center
b. Symptoms can take 4 to 6 weeks to appear and they can be pimply
c. Clear watery filled blisters
d. Noticeable change in coloration to the skin.
HG
A 22 y/o has complaints of round and oval wounds along the anterior aspect of their lower legs bilaterally. What condition should the PT be concerned about?
A. Pyoderma Gangrenosum
B. Sickle Cell
C. Ulcerative Necrobiosis Lipoidica
D. Necrotizing Fasciitis
RC
Each of the following is true of Lyme disease, EXCEPT?
a. The site of the tick bite typically develops into a rash which appears similar to a red bull’s-eye with a clear center.
b. A tick bite site may initially resemble a tiny bump on the skin, similar to a mosquito bite.
c. The rash that follows the tick bite is most often very painful and itchy.
d. Not all individuals experience a bulls-eye rash following a tick bite.
KD
A 42-year-old female comes to PT with a chief complaint of R lateral leg pain. During your examination you palpate the area to analyze any muscle involvement. While palpating you noticed a reddish scaly raised surface on the lateral aspect of her leg. The lesion appears thick, scaly crust and wart-like. You notify the patient about your finding, she expressed that she was unaware of the lesion. Based on the clinical presentation which of the skin lesion is most likely to be diagnosed in this patient?
a. Impetigo
b. Melanocytic nevus
c. Actinic Keratosis
d. Psoriasis
GN
Patient is a 66 Y/O Caucasian female who reports the presence of numerous moles all over her body since childhood. She reports a history of laying out in the sun for 3-4 hrs each day throughout the summer for the past 20 years. She recently noticed that one particular mole on her R arm has grown in size. The change in mole size could be indicative of which of the following:
A. Melanoma
B. Atopic dermatitis
C. Cellulitis
D. Myoma
JS
A patient comes in complaining of an itchy rash that appeared on their skin 1-2 days ago. The rash has visible borders and appears scaly. The patient also has known allergies. Which of the following options provides the best explanation?
a. Psoriasis
b. Shingles
c. Contact Dermatitis
d. Actinic Keratosis
PR
Which of the following is not a characteristic of actinic keratosis?
a. A thick, scaly, or crusty skin path
b. Located on parts of the body that receive a lot of sun exposure
c. A bright red spot that leaks a clear fluid
d. Smaller than 2 centimeters – about the size of a pencil eraser
CC