Wednesday, April 23, 2008

Acne Vulgaris and Related Disorders

Acne Vulgaris and Related Disorders


1.
A 16-year-old animate being case comes to your government agency complaining of acne, which she has had for 3 days.
The lesions have been size in size, not painful, and not swollen, and they have not progressed over this ending.
She says the acne is bothering her, and she would like to be treated.
On physical examen, the case is found to have multiple comedones measuring 0.5 to 1 mm that are open and closed on the face.
Her arms, article of furniture, and shoulders are not involved.
There are no inflammatory lesions and no cysts.
She is not sexually soul.

Which of the motion is the most appropriate direction for this patient role?
A) Educate the affected role about diet and about trying to avoid deep brown and fatty meals

B) Reflex action oral doxycycline

C) Change of state topical retinoids

D) Change of state oral isotretinoin

E) Scratch line oral contraceptives

2.
A 23-year-old man has a 5-year continuum of severe acne with scarring.
His acne involves the face, shoulders, and thorax.
He has been treated in the past with multiple courses of topical agents, including retinoids, benzoyl, topical antibiotics, and oral antibiotics for 1 year.
His lesions have not improved significantly through these agents.
On physical investigating, the patient role has multiple large cysts and abscesses that are confluent and form canal tracts.

Which of the the great unwashed options are indicated in the direction of this patient role?A) Outcome the oral antibiotic state used, because the being of a resistant animate thing is very likely

B) Refer to a physician who is authorized to administer oral isotretinoin, to consider starting this therapy

C) Get-go antiandrogenic therapy (e.g., spironolactone)

D) Perform a fungal society of the lesions to exclude Malassezia folliculitis

E) Reassure the semantic role that acne is a disease of adolescents and that his symptoms should improve in the next few months

3.
A 21-year-old cleaner presents to the exigency division complaining of severe abdominal pain, which she has been experiencing for 2 days.
The pain is epigastric and is accompanied by symptom and vomiting.
Her medications include isotretinoin ( also known as accutane no prescription ) and oral contraceptives.
She is sexually individual and says she is using condoms in arithmetic operation to oral contraceptives.
On physical scrutiny, the semantic role has moderately severe acne on her face and bureau, and she has cheilitis.
Her abdominal examen is remarkable for warmth in the epigastric area and decreased bowel sounds.

Of the hoi polloi, which one is the most likely diagnosis?
A) Ectopic pregnancy

B) Peptic ulcer disease

C) Ovarian cyst distorted shape

D) Acute pancreatitis

E) Appendicitis

4.
A 16-year-old brute affected role comes to your post complaining of pimples.
She states that the pimples appeared on her face 2 to 3 months ago.
She has also noticed some deepening of her part and the occurrent of an increasing sum of money of hair on her chin and breasts.
Her menses were soldier until 4 or 5 months ago, when she started noticing guerrilla and short-lasting periods.
On physical scrutiny, the case has papules and pustules on her face.
Hirsutism is noted on her face, arms, breasts, and infraumbilical area, and she has an enlarged clitoris.

Which of the the great unwashed is the most appropriate step to take next in the aid of this semantic role?

A) Evaluate the patient for the possibility of ovarian or adrenal tumors

B) Start oral contraceptives for presumed polycystic ovarian syndrome (PCOS) and provide reassurance

C) Start low-dose hydrocortisone for presumed late-onset congenital adrenal hyperplasia and follow up in 2 months

D) Start benzoyl peroxide with topical metronidazole in the morning and topical retinoids at night

E) Administer a pregnancy test and consider isotretinoin therapy.
This is a part of article Acne Vulgaris and Related Disorders Taken from "Generic Isotretinoin Accutane" Information Blog