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

What is a major function of subcutaneous tissue?

<p>Store fat for energy reserves (C)</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 (D)</p> Signup and view all the answers

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

<p>Tazarotene (B)</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 (C)</p> Signup and view all the answers

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

<p>Vaginal yeast infection (B)</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 (A)</p> Signup and view all the answers

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

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

Which concentration range is recommended for achieving keratolytic effects?

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

What symptoms can indicate systemic toxicity from sulfur use?

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

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

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

Which nonpharmacologic measure is recommended to minimize acne lesions?

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

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

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

Which drug is considered the principal agent for severe acne?

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

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

<p>Clindamycin (D)</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 (A)</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 (A)</p> Signup and view all the answers

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

<p>Gel (A)</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 (C)</p> Signup and view all the answers

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

<p>Palms (D)</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 (C)</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 (D)</p> Signup and view all the answers

What is the main disadvantage of using lotions?

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

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

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

What is the cost of 15 grams of Retipamulin?

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

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

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

What is the primary factor for selecting a topical anesthetic?

<p>Duration of action (A)</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 (D)</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 (D)</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 (B)</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 (D)</p> Signup and view all the answers

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

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

What is the main function of glucocorticoids in psoriasis treatment?

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

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

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

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

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

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

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

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

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

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

<p>Topical terbinafine (C)</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 (C)</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 (B)</p> Signup and view all the answers

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

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

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

<p>Tinea corporis (A)</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> (B)</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> (C)</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> (A)</p> Signup and view all the answers

What is the primary mechanism of action of podofilox?

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

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

<p>Kunecatechins (B)</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 (C)</p> Signup and view all the answers

Which adverse effect is common with the use of kunecatechins?

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

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

<p>Kidney damage (B)</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 (D)</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 (B)</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 (D)</p> Signup and view all the answers

Which treatment for actinic keratosis involves using blue light?

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

How do venereal warts primarily spread?

<p>By direct sexual contact (B)</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 (D)</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 (B)</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 (C)</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 (D)</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 (C)</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 (A)</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 (D)</p> Signup and view all the answers

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

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

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

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

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

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

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

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

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

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

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

<p>Skeletal deformities (D)</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 (C)</p> Signup and view all the answers

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

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

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

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

What is the primary treatment for hypoparathyroidism?

<p>Intravenous calcium supplementation (A)</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 (D)</p> Signup and view all the answers

What is the main side effect of Abaloparatide?

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

Which drug suppresses the bone resorption of osteoclasts?

<p>Denosumab (B)</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 (C)</p> Signup and view all the answers

How is osteoporosis diagnosed?

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

What is the known adverse effect of Bisphosphonates?

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

Which vitamin aids in ensuring calcium absorption and bone integrity?

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

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

<p>Additional indications are not specified (A)</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) (C)</p> Signup and view all the answers

Which drug contains both Bazedoxifene and conjugated estrogens?

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

What are the primary indications for Teriparatide?

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

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

<p>Osteoporosis (B)</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 (C)</p> Signup and view all the answers

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

<p>Teriparatide (D)</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 (A)</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 (B)</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 (D)</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 (C)</p> Signup and view all the answers

What is the therapeutic use of calcitonin in bone health?

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

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

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

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

<p>Paricalcitol (D)</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 (B)</p> Signup and view all the answers

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

<p>Oral intake (A)</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 (D)</p> Signup and view all the answers

What is the primary function of glucocorticoids in psoriasis treatment?

<p>Suppressing immune response (C)</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 (A)</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 (C)</p> Signup and view all the answers

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

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

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

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

Which hormone works to promote calcium resorption from the bone?

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

What symptoms can be associated with persistent and severe hypercalcemia?

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

What is the role of vitamin D in calcium metabolism?

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

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

<p>Thyroid gland (B)</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 (D)</p> Signup and view all the answers

What is a common initial symptom of mild hypercalcemia?

<p>Weakness (A)</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 (B)</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 (A)</p> Signup and view all the answers

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

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

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

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

How is vitamin D primarily measured in the body?

<p>Serum concentration of 25-hydroxyvitamin D (A)</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 (B)</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 (C)</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 (D)</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>$800 IU/day$ (A)</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 (D)</p> Signup and view all the answers

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

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

Why is low-dose estrogen recommended for osteoporosis prevention?

<p>To suppress bone resorption (B)</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 (B)</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 (D)</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 (A)</p> Signup and view all the answers

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