Keratolytic Effects and Sulfur Use in Dermatology
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Questions and Answers

What is the main function of the basal layer or stratum germinativum in the epidermis?

  • Contain mitotically active cells (correct)
  • Produce keratin
  • Produce melanin
  • Convert cytoplasm to keratin

    • Which layer of the epidermis is referred to as the cornified layer or stratum corneum?

  • Intermediate layer
  • Middle layer
  • Basal layer
  • Outer layer (correct)

    • What is the primary composition of the dermis underlying the epidermis?

  • Largely fat
  • Mainly collagen (correct)
  • Rich in melanin
  • Primarily water

    • Which structure found in the dermis is responsible for producing sweat?

    <p>Sweat glands</p> Signup and view all the answers

    What is a major function of subcutaneous tissue?

    <p>Store fat for energy reserves</p> Signup and view all the answers

    Which type of preparation has a base of oil or petroleum jelly and little to no water?

    <p>Ointments</p> Signup and view all the answers

    Which topical retinoid is indicated for acne, fine wrinkles, and psoriasis?

    <p>Tazarotene</p> Signup and view all the answers

    What is the primary difference between trifarotene (Aklief) and other retinoids?

    <p>It hits 1 receptor site instead of 2</p> Signup and view all the answers

    Which of the following is NOT a potential adverse effect of topical retinoids?

    <p>Vaginal yeast infection</p> Signup and view all the answers

    What is the recommended approach when starting a patient on topical tretinoin?

    <p>Start slowly every other day</p> Signup and view all the answers

    Which antibiotic is considered the agent of choice for acne treatment?

    <p>Doxycycline</p> Signup and view all the answers

    Why is Sarecycline (Seysara) considered to have lower rates of gastrointestinal (GI) effects compared to other tetracyclines?

    <p>It has less activity against normal GI flora</p> Signup and view all the answers

    Which concentration range is recommended for achieving keratolytic effects?

    <p>3% to 6%</p> Signup and view all the answers

    What symptoms can indicate systemic toxicity from sulfur use?

    <p>Tinnitus, hyperpnea, and psychologic disturbances</p> Signup and view all the answers

    What is sulfur commonly combined with for additive effects in treating skin conditions?

    <p>Salicylic acid</p> Signup and view all the answers

    Which nonpharmacologic measure is recommended to minimize acne lesions?

    <p>Reducing surface oiliness with gentle soap cleansing</p> Signup and view all the answers

    What are the two principal subgroups of topical drugs for acne treatment?

    <p>Antibiotics and retinoids</p> Signup and view all the answers

    Which drug is considered the principal agent for severe acne?

    <p>Isotretinoin</p> Signup and view all the answers

    What is the presumed mechanism of action of benzoyl peroxide in treating acne?

    <p>Suppresses the growth of P.acnes</p> Signup and view all the answers

    Which topical drug can lead to resistance if used as monotherapy in acne treatment?

    <p>Clindamycin</p> Signup and view all the answers

    What is a common side effect of dapsone gel when used for acne treatment?

    <p>Oily skin and erythema</p> Signup and view all the answers

    What does azelaic acid work on to produce its anti-acne effects?

    <p>P.acnes growth and keratinocyte proliferation</p> Signup and view all the answers

    Which type of topical formulation is most suitable for oily skin?

    <p>Gel</p> Signup and view all the answers

    What is the main reason why ointments are not recommended for weeping or oozing skin conditions?

    <p>They provide an occlusive film</p> Signup and view all the answers

    Which region of the body has the lowest absorption of topical glucocorticoids?

    <p>Palms</p> Signup and view all the answers

    What is a principal concern associated with long-term use of topical glucocorticoids in children?

    <p>Growth delay</p> Signup and view all the answers

    Which type of topical formulation can greatly increase drug absorption when combined with an occlusive dressing?

    <p>Cream</p> Signup and view all the answers

    What is the main disadvantage of using lotions?

    <p>May cause a burning sensation</p> Signup and view all the answers

    In what kind of dermatologic conditions are topical glucocorticoids mainly used?

    <p>Eczema</p> Signup and view all the answers

    What effect does salicylic acid have on the skin?

    <p><strong>Promotes shedding</strong> of the stratum corneum</p> Signup and view all the answers

    What is the cost of 15 grams of Retipamulin?

    <p>$270</p> Signup and view all the answers

    Which topical antibiotic is the least expensive way to treat impetigo?

    <p>Dicloxicillin</p> Signup and view all the answers

    Which local anesthetic can be applied topically to relieve pain and itching associated with various skin disorders?

    <p>All of the above</p> Signup and view all the answers

    What is the primary factor for selecting a topical anesthetic?

    <p>Duration of action</p> Signup and view all the answers

    Which quinolone is used to treat impetigo and is very expensive at around $300 for 30 grams?

    <p>Ozenoxacin</p> Signup and view all the answers

    What is the main reason topical steroids are used to treat psoriasis?

    <p>To suppress the activity of inflammatory cells</p> Signup and view all the answers

    Which vitamin D derivative is mentioned as effective and safe for short or long-term use in psoriasis treatment?

    <p>Calcitriol</p> Signup and view all the answers

    Why are moderate to high potency steroids used in treating psoriasis instead of lower potency ones?

    <p>The lesions in psoriasis are generally steroid-resistant</p> Signup and view all the answers

    Which vitamin derivative is Tazarotene, a topical drug mentioned in psoriasis treatment?

    <p>Vitamin A</p> Signup and view all the answers

    What is the main function of glucocorticoids in psoriasis treatment?

    <p>Suppress inflammatory cell activity</p> Signup and view all the answers

    'Why is Calcipotriene recommended for use twice daily, morning and evening?'

    <p>To maintain a steady level of medication throughout the day and night</p> Signup and view all the answers

    What is the most common body part where benign lesions appear?

    <p>Hands</p> Signup and view all the answers

    Which of the following is a protein produced by the bacterium Clostridium botulinum?

    <p>OnabotulinumtoxinA (Botox)</p> Signup and view all the answers

    What is the main reason for avoiding Botox in people above 65 years of age?

    <p>Unlikely to help due to skin elasticity</p> Signup and view all the answers

    Which of the following is a side effect commonly associated with Botox injections for cosmetic treatment?

    <p>Facial Pain</p> Signup and view all the answers

    What part of the body can be affected by seborrheic dermatitis, in addition to the face and scalp?

    <p>Chest</p> Signup and view all the answers

    Which topical drug is specifically mentioned for the treatment of inflammation and scaling associated with seborrheic dermatitis?

    <p>Ketoconazole</p> Signup and view all the answers

    What microbial family does Malassezia belong to, which causes symptoms associated with seborrheic dermatitis?

    <p>Yeast</p> Signup and view all the answers

    Which toxin acts on cholinergic neurons to block the release of acetylcholine?

    <p>(Botox)</p> Signup and view all the answers

    What are the two principal forms of physical procedures used for removing common warts?

    <p>Cryotherapy and Electrodesiccation</p> Signup and view all the answers

    What is the most effective treatment for onychomycosis according to the text?

    <p>Topical terbinafine</p> Signup and view all the answers

    Which medication was originally developed for benign prostatic hyperplasia (BPH) but is now used for male-pattern baldness?

    <p>Finasteride</p> Signup and view all the answers

    What is the main concern regarding women handling crushed or broken tablets of finasteride?

    <p>Possible teratogenic effects</p> Signup and view all the answers

    Which formulation of minoxidil is specifically approved for women with hair loss?

    <p>2% solution (generic only)</p> Signup and view all the answers

    What is the primary mechanism of action of Eflornithine (Vaniqa) in treating facial hair growth in women?

    <p>Inhibiting ornithine decarboxylase</p> Signup and view all the answers

    Which tinea infection requires the use of ketoconazole as the treatment of choice?

    <p>Tinea corporis</p> Signup and view all the answers

    "Minoxidil can delay loss of hair and stimulate hair growth." What aspect of using minoxidil do patients need to be aware of?

    <p><strong>Gradual benefits over several months</strong></p> Signup and view all the answers

    "The most common reactions to Eflornithine cream are transient stinging, burning, tingling, or rash at the application site." What should users be cautious about?

    <p><strong>Temporary side effects</strong></p> Signup and view all the answers

    "Absorption of Minoxidil is low; hence systemic reactions are rare." What conclusion can be drawn from this statement?

    <p><strong>Low incidence of adverse reactions</strong></p> Signup and view all the answers

    What is the primary mechanism of action of podofilox?

    <p>Inhibition of DNA synthesis</p> Signup and view all the answers

    Which topical drug is contraindicated in HIV-infected patients and those with genital herpes infection?

    <p>Kunecatechins</p> Signup and view all the answers

    What is the dosing schedule for applying podofilox gel or solution?

    <p>Twice daily for 3 consecutive days followed by 4 days off</p> Signup and view all the answers

    Which adverse effect is common with the use of kunecatechins?

    <p>Pruritus and burning</p> Signup and view all the answers

    What distinguishes the application schedule of Aldara (imiquimod) from the standard imiquimod cream regimen?

    <p>Aldara is applied for up to 16 weeks</p> Signup and view all the answers

    Which complication can occur if solutions containing BCA or TCA are applied excessively?

    <p>Kidney damage</p> Signup and view all the answers

    What distinguishes podophyllin from other drugs mentioned in the text regarding wart treatment?

    <p>Podophyllin is primarily used for perianal and venereal warts</p> Signup and view all the answers

    What is the mechanism of action of coal tar in treating psoriasis?

    <p>Enzyme inhibition and antimycotic action</p> Signup and view all the answers

    Why are biologic agents for psoriasis only prescribed by dermatologists?

    <p>They have significant adverse effects and require expert management</p> Signup and view all the answers

    Which treatment for actinic keratosis involves using blue light?

    <p>Aminolevulinic acid plus blue light</p> Signup and view all the answers

    How do venereal warts primarily spread?

    <p>By direct sexual contact</p> Signup and view all the answers

    Why is it important to warn patients with anogenital warts about transmission to sexual partners?

    <p>To prevent the spread of the warts to other individuals</p> Signup and view all the answers

    What is a characteristic of physical measures used to remove venereal warts?

    <p>They eradicate the virus completely</p> Signup and view all the answers

    Which type of drug used to remove venereal warts must be administered by a healthcare provider?

    <p>Podophyllin</p> Signup and view all the answers

    What distinguishes ultraviolet B (UVB) therapy from tanning beds in psoriasis treatment?

    <p>Tanning beds increase the risk of skin cancer</p> Signup and view all the answers

    How are individuals with anogenital warts advised to minimize transmission to sexual partners?

    <p>By using a condom during sexual activity</p> Signup and view all the answers

    Why is it important for the partners of individuals with anogenital warts to be examined for warts?

    <p>To prevent further spread of the warts within the relationship</p> Signup and view all the answers

    What are the three factors employed by the body to regulate calcium levels?

    <p>Parathyroid hormone, vitamin D, and calcitonin</p> Signup and view all the answers

    What is the main concern associated with taking excessive supplemental calcium?

    <p>Increased risk of vascular calcification</p> Signup and view all the answers

    Which food item provides the most calcium per serving among the following options?

    <p>Dairy products like milk, yogurt, and cheese</p> Signup and view all the answers

    What is the primary concern regarding calcium intake for adolescent girls and postmenopausal women?

    <p>Possible inadequate calcium intake from diet alone</p> Signup and view all the answers

    What is the percentage of calcium stored in bones in the human body?

    <p>More than 98%</p> Signup and view all the answers

    Which of the following is NOT a good source of dietary calcium for individuals?

    <p>Processed meats</p> Signup and view all the answers

    What treatment option is specifically mentioned for hypocalcemia associated with hypoparathyroidism?

    <p>Intravenous calcium supplementation</p> Signup and view all the answers

    Which drugs inhibit the resorption of calcium from bone to help lower calcium levels?

    <p>Inorganic phosphates</p> Signup and view all the answers

    What is a common sign of Paget's disease of the bone?

    <p>Skeletal deformities</p> Signup and view all the answers

    Which group of drugs can be used to suppress PTH secretion in hypercalcemia associated with hyperparathyroidism?

    <p>Bisphosphonates</p> Signup and view all the answers

    Which disorder results from insufficient vitamin D and presents with bowing of legs and fractures?

    <p>Osteomalacia</p> Signup and view all the answers

    What is the FDA-approved drug specifically for patients with chronic kidney disease on hemodialysis?

    <p>Etelcalcetide</p> Signup and view all the answers

    What is the primary treatment for hypoparathyroidism?

    <p>Intravenous calcium supplementation</p> Signup and view all the answers

    Which agent can be used for hypercalcemia associated with hyperparathyroidism to suppress PTH secretion?

    <p>Bone mobilization inhibitors</p> Signup and view all the answers

    What is the main side effect of Abaloparatide?

    <p>Hypercalcemia</p> Signup and view all the answers

    Which drug suppresses the bone resorption of osteoclasts?

    <p>Denosumab</p> Signup and view all the answers

    What is the primary mechanism of action of Furosemide in treating hypercalcemia emergencies?

    <p>Increases renal excretion of calcium</p> Signup and view all the answers

    How is osteoporosis diagnosed?

    <p>By measuring Bone Mineral Density (BMD)</p> Signup and view all the answers

    What is the known adverse effect of Bisphosphonates?

    <p>Osteonecrosis of the jaw</p> Signup and view all the answers

    Which vitamin aids in ensuring calcium absorption and bone integrity?

    <p>Vitamin D</p> Signup and view all the answers

    What are the anticipated additional indications for Abaloparatide in the future?

    <p>Additional indications are not specified</p> Signup and view all the answers

    What is the standard technique for measuring Bone Mineral Density (BMD)?

    <p>Dual-energy X-ray absorptiometry (DEXA)</p> Signup and view all the answers

    Which drug contains both Bazedoxifene and conjugated estrogens?

    <p>Duavee</p> Signup and view all the answers

    What are the primary indications for Teriparatide?

    <p>Treatment of osteoporosis in postmenopausal women and men</p> Signup and view all the answers

    What does a T-score of -2.6 indicate in terms of bone health?

    <p>Osteoporosis</p> Signup and view all the answers

    What is the mechanism of action of Cinacalcet (Sensipar) in the treatment of primary hyperparathyroidism?

    <p>Accelerates renal excretion of calcium</p> Signup and view all the answers

    Which drug is NOT mentioned as an antiresorptive agent for preventing bone loss?

    <p>Teriparatide</p> Signup and view all the answers

    What is a common adverse effect of bisphosphonates used to manage osteoporosis and hypercalcemia?

    <p>Osteonecrosis of the jaw</p> Signup and view all the answers

    What is the 10-year probability of a hip fracture that would warrant treatment for osteoporosis in postmenopausal women?

    <p>3% or more</p> Signup and view all the answers

    Which vitamin D preparation is typically preferred due to its higher effectiveness in raising blood levels of the active form of vitamin D?

    <p>Cholecalciferol</p> Signup and view all the answers

    Which type of drugs are most effective when substantial bone loss has not yet occurred?

    <p>Antiresorptive drugs</p> Signup and view all the answers

    What is the therapeutic use of calcitonin in bone health?

    <p>Inhibit osteoclasts activity</p> Signup and view all the answers

    In men, which drug is NOT approved for the treatment of osteoporosis?

    <p>Raloxifene</p> Signup and view all the answers

    Which drug is indicated for treating secondary hyperparathyroidism caused by chronic kidney disease?

    <p>Paricalcitol</p> Signup and view all the answers

    What is the main reason behind the use of testosterone replacement therapy for osteoporosis?

    <p>To stimulate bone formation</p> Signup and view all the answers

    What is the preferred route of administration for vitamin D supplementation?

    <p>Oral intake</p> Signup and view all the answers

    Which vitamin D derivative leads to calcium deposition in soft tissues and potential heart, blood vessel, and lung damage?

    <p>Calcitriol</p> Signup and view all the answers

    What is the primary function of glucocorticoids in psoriasis treatment?

    <p>Suppressing immune response</p> Signup and view all the answers

    What is a significant concern regarding the use of Calcitonin for osteoporosis?

    <p>May cause atypical femur fractures</p> Signup and view all the answers

    Why are synthetic derivatives of natural vitamin D required, such as paricalcitol and doxercalciferol?

    <p>To avoid potential toxicity</p> Signup and view all the answers

    Which cells are responsible for depositing new bone during the continuous remodeling process?

    <p>Osteoblasts</p> Signup and view all the answers

    What percentage of total serum calcium is bound to proteins and other substances?

    <p>50%</p> Signup and view all the answers

    Which hormone works to promote calcium resorption from the bone?

    <p>Parathyroid hormone (PTH)</p> Signup and view all the answers

    What is the primary function of calcitonin when blood calcium levels are high?

    <p>Lowering calcium levels by inhibiting resorption from bone</p> Signup and view all the answers

    What symptoms can be associated with persistent and severe hypercalcemia?

    <p>Polyuria, nocturia, and proteinuria</p> Signup and view all the answers

    Which factor takes priority over preservation of calcium in bone when blood calcium levels are low?

    <p>Preservation of blood calcium levels</p> Signup and view all the answers

    What is the role of vitamin D in calcium metabolism?

    <p>Increases calcium absorption from the intestine</p> Signup and view all the answers

    Which gland releases calcitonin when blood calcium levels rise too high?

    <p>Thyroid gland</p> Signup and view all the answers

    What can be a consequence of calcium deposition in soft tissues according to the text?

    <p>Heart, blood vessel, and lung damage</p> Signup and view all the answers

    What is a common initial symptom of mild hypercalcemia?

    <p>Weakness</p> Signup and view all the answers

    What is the primary mechanism of action of cinacalcet in the treatment of secondary hyperparathyroidism?

    <p>Reducing PTH levels</p> Signup and view all the answers

    Why does the Kidney Disease Improving Global Outcomes (KDIGO) not recommend the use of cinacalcet in early or pre-dialysis stages of chronic kidney disease?

    <p>It worsens mineral homeostasis</p> Signup and view all the answers

    Which vitamin D form is primarily obtained through exposure to sunlight?

    <p>Vitamin D3</p> Signup and view all the answers

    What are the primary indications for vitamin D supplementation according to the text?

    <p>Osteoporosis</p> Signup and view all the answers

    How is vitamin D primarily measured in the body?

    <p>Serum concentration of 25-hydroxyvitamin D</p> Signup and view all the answers

    What is the target level of 25-(OH)D usually recommended in clinical practice?

    <p>30-50 ng/mL</p> Signup and view all the answers

    Why does vitamin D promote bone decalcification in certain conditions?

    <p>When serum calcium concentrations cannot be maintained</p> Signup and view all the answers

    Which source provides the highest dietary intake of vitamin D based on the text?

    <p>Oily fish like salmon</p> Signup and view all the answers

    What did the Institute of Medicine (IOM) recommend as the daily intake of vitamin D for adults aged 71 years and older?

    <p>$800 IU/day$</p> Signup and view all the answers

    What distinguishes zoledronic acid from other bisphosphonates in terms of dosing for postmenopausal osteoporosis?

    <p>Dosing is done once a year or once every 2 years</p> Signup and view all the answers

    How does estrogen replacement therapy impact osteoclast proliferation and bone resorption?

    <p>It decreases bone resorption</p> Signup and view all the answers

    Why is low-dose estrogen recommended for osteoporosis prevention?

    <p>To suppress bone resorption</p> Signup and view all the answers

    What differentiates raloxifene from estrogen in terms of its effects on breast tissue?

    <p>Raloxifene protects against breast cancer</p> Signup and view all the answers

    What is the main reason for the use of raloxifene in postmenopausal women?

    <p>To prevent bone density loss</p> Signup and view all the answers

    How does raloxifene differ from estrogen in relation to cancer risk?

    <p>Estrogen promotes breast and endometrial cancer</p> Signup and view all the answers

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