PEDIATRICS IN PRIMARY CARE: FINAL EXAM

PEDIATRICS IN PRIMARY CARE: FINAL EXAM

WITH REAL EXAM QUESTIONS AND WELL-

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Traumatic Alopecia: Presentation (TRACTION) - ANSWER-1. Erythema &

pustules (traction)

• Thinning & breaking in certain areas (traction)

Traumatic Alopecia: Presentation (Trichotillomania/TTM) - ANSWER-1.

Circumscribed hair loss with irregular borders and broken hairs of varied length (TTM)

• Eyelashes, parietal and temporal areas, eyebrows (TTM)

Traumatic Alopecia: Management (Traction) - ANSWER-1. Antibiotics if pustules

present

• Avoid tight hairstyles
• Mild shampoos

Traumatic Alopecia: Management (TTM) - ANSWER-1. Behavioral therapy

• Medication
• Hypnosis
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Traumatic Alopecia: Hair growth expected in what time frame after treatment? -

ANSWER-3-6 months

Cellulitis (H&P/Presentation) - ANSWER-Erythematous swelling, induration, tenderness, malaise, fever; Always ask about occupation etc (e.g. Nursing home higher risk for MRSA)

Cellulitis (Management) - ANSWER-1. I&D as needed; Culture

• In peds always assume MRSA (Treat with Bactrim or Clindamycin)

Candidiasis (Etiology) - ANSWER-1. Environment

• Immunocompromised
• Antibiotic use
• Oral steroid use

Candidiasis (H&P/Presentation) - ANSWER-1. Satellite lesion present

• Beefy, erythematous, shiny, painful/burning lesion; May peel
• White plaques present on oral mucosa

Candidiasis (Management) - ANSWER-1. Topical Antifungals (Nystatin, Lotrimin, ketoconazole, spectazole; apply a thin layer to rash and 1 inch beyond margins)

• If recalcitrant- Oral Antifungal (fluconazole)
• If bottle feeding (Dishwash or Boil nipples); If breastfeeding swab nystatin on

nipple (advise the mother to see PCP if infection begins to develop on breast e.g.peeling)

• Don't use wipes (they burn), warm water on cloth; Baby oil
• Zinc oxide-based cream (e.g. destin) 2 / 3

Tinea (What is it?) - ANSWER-A dermatophyte fungal infection

Tinea (H&P/Presentation) - ANSWER-1. Pruritis

• Annular exanthem with central clearing and erythematous border
• Present on head, body, feet, and groin
• If on scalp hair breaks off at the base leaving a "black dot look" (hair does

return)

Tinea (Management) - ANSWER-1. Culture

• Antifungal agent
• Soak combs in bleach if scalp involved

Tinea (Head, Body, Groin, Feet) - ANSWER-1. Capitis

• Corporis
• Cruris
• Pedis

Tinea Management (1. Corporis 2. Capitis) --med and course of treatment - ANSWER-1. Antifungal cream (clotrimazole/Lotrimin) 2-3 x/day

• Griseofulvin qday x 4-8 weeks

Alopecia Areata (1. What is it? 2. Etiology? 3. Affects what pediatric population?)

• ANSWER-1. Complete/Partial hair loss (frontal or parietal areas; "bald patches"
• Unknown etiology (can occur in mono, stress)
• Usually occurs in children older than 2 years old (24-65% of children have 1st

episode prior to 16 yr.)

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