bpac: quiz

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Acne quiz

Name:
NZMC No.:
Practice:
Email:

1.	Which of the following statements are true
		Acne only occurs in young people
		Acne is associated with increased androgens
		Free testosterone should be measured in all women with acne
		The main aim of treatment is to stop the spread of acne
		One aim of treatment is to prevent anxiety and depression

Case scenarios

Case 1: A 15 year old female wants treatment for her acne. She has multiple open and closed comedones and a few inflammatory lesions.

2.	When taking a history, which of the following questions are not necessary?
		How long has the acne been present?
		How much junk food (i.e. chocolates, sweets) are consumed in your diet?
		Which skin care products (e.g. moisturiser, sunblock) do you use?
		Have you used over the counter acne treatments?
		Do you have sensitive or dry skin?

3.	She reports she has not tried any acne products. Which product(s) are suitable initial treatments for her?
		Doxycycline
		Oral isotretinoin
		Benzoyl peroxide
		Topical adapalene
		Topical clindamycin alone

Case 2: A 16 year old male presents requesting treatment for his acne. He informs you that he has had acne for a year and has tried benzoyl peroxide and topical tretinoin. He has moderately severe facial acne with multiple papules, pustules and comedones, and scattered inflammatory lesions on his shoulders.

You ask him to continue a topical retinoid or benzoyl peroxide.

4.	Which of the following should you also prescribe?
		A three-week course of minocycline
		Erythromycin gel
		Ethinyloestrodiol / cyproterone acetate
		Oral isotretinoin
		A three-month course of doxycycline

The acne in the previous case did not significantly improve after a 6 month course of appropriate therapy. After discussion with the patient you have decided to try isotretinoin

5.	Which baseline test(s) are appropriate for this patient
		Complete blood count
		Liver function tests
		Lipids
		Thyroid function
		Testosterone

6.	Isotretinoin is a major teratogen. Its effects on sperm continue for 6 months after treatment cessation.
		True
		False

Medicines management questions

7.	What patient advice is inappropriate for patients using benzoyl peroxide
		Apply benzoyl peroxide only to active lesions
		Use for a least 6 weeks before judging effectiveness
		Use a lower strength product (i.e. 2.5%) initially and then increase
		Benzoyl peroxide may bleach clothes, towels, bedding and hair

8.	When first prescribing oral antibiotics such as doxycycline for acne, you should tell the patient to expect significant improvement within:
		1-2 weeks
		4-6 weeks
		3-6 months
		12 months

9.	Which of the following is not an adverse effect associated with doxycycline
		Photosensitivity
		Oesophagitis
		Blue-grey pigmentation
		Candida albicans infection