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PHAR 501 Final Exam ADVANCED
PATHOPHYSIOLOGY EXAM 2025
QUESTIONS AND ANSWERS FOR
NURSING.
Def need to know:
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Atopic dermatitis is driven by (external/genetic) factors while contact dermatitis is driven by (external/genetic) factors.
Atopic: genetic
Contact: external
Contact dermatitis develops on what location of the body?
A) all over the body
B) skin folds and exposed skin surfaces
C) site of of physical contact with irritant or allergen
C
Where does atopic dermatitis (AD) develop on the body?
all over, but especially in skin folds and exposed skin surfaces
When does atopic dermatitis usually start presenting?
Infancy or early childhood
What are the 3 components of the Atopic Triad, aka the Atopic March?
- Eczema (atopic dermatitis)
- Asthma
- Hay fever
In atopic dermatitis, what layer of the skin is less moisturized?
stratum corneum
What stage of AD is more scaly?
subacute
In what stage of AD would you find thickened plaques of skin and accentuated skin markings?
chronic
Which level/s of AD is/are appropriate for self-care?
A) mild AD with dry skin and infrequent itching
B) moderate AD with dry skin and frequent itching
C) severe AD with bleeding, oozing, or extreme itching
A only
Refer the others
What class of medication is the first-line treatment for mild AD?
topical corticosteroids
Nonpharmacologic treatments for AD
- moisturize frequently
- lukewarm baths
- moisturize right after bathing
- soft cotton clothing (no polyester)
- avoid overheating and irritants
What type of moisturizer would you want a patient with AD to use first and why?
A) Humectant
B) Emollient
C) Occlusive
B) Emollient
fills in and smooths the skin
When should you avoid ointments to treat dermatitis?
- weeping or inflamed skin
- hairy areas
When should you refer a PT with mild AD to their PCP after recommending hydrocortisone?
if no improvement in 2-3 days
[T/F] Hydrocortisone can only be applied to the affected area after moisturizers.
false
apply before
What is the age exclusion for treating AD?
less than 1 yo
Common signs and symptoms of contact dermatitis
- inflammation
- redness
- itching
- burning
- stinging
- vesicle and pustule formation on localized area
What are the 2 main types of contact dermatitis?
- irritant (ICD)
- allergic (ACD)
Where on the body is ICD commonly seen?
- face
- dorsal parts of hands/forearms
Presentation of ICD
- dry/macerated skin
- painful
- cracked skin
- inflamed skin
- involves face/neck/scalp
- extreme itching/irritation
- involves mucous membranes
- Sx of chronic derm
- lots of large bullae
- infection Si/Sx
What is the age exclusion for self-treating contact dermatitis?
less than 2 yo
A patient with contact dermatitis without lesions and lasting for the past 3 days comes in looking to reduce her inflammation. What would you recommend?
Astringents like:
- aluminum acetate (Burow's sln)
- aluminum sulfate/calcium acetate (Domeboro)
- witch hazel
use with a wet dressing
Side effects of astringents
- temporary burning/stinging
- itching
- skin inflammation
- skin dryness
- rarely, rash
A patient with contact dermatitis without lesions and lasting for the past 3 days comes in looking for something nonsteroidal to reduce her itching. What would you recommend?
colloidal oatmeal (Aveeno Soothing Bath Treatment)
soak for 15-30 min and pat dry to keep a thin layer on skin
Side effects of colloidal oatmeal
What is Caladryl (calamine 8% + pramoxine HCl 1%) used for and how should a patient use it?
Dermatitis:
anti-itch (calamine) and topical analgesic (pramoxine)
What are the first-line treatments for ICD?
- cleanse area in lukewarm water and mild cleansers
- emollients
- barrier creams
What is the 5A's approach to smoking cessation?
Ask, Assess, Advise, Assist, Arrange
How do you calculate the number of pack years that a PT has been smoking for?
Pack yrs = N * T
N: # ppd
T: # yrs of smoking
The most effective treatment for smoking cessation is a combination of pharmacotherapy and _______ ________.
behavioral counseling
2 non-pharmacological techniques for behavioral counseling
- CBT
- motivational interviewing (more PT-centered and goal-oriented)
What are the 5 D's of smoking cessation?
delay
distract
drink water
deep breathing
discuss
What is the only OTC med for smoking cessation and what dosage forms are available OTC?
Nicotine replacement therapy (NRT)
patches, gum, lozenges
Directions for the NRT patch
apply new patch to non-hairy, clean, dry skin on upper body or upper outer arm qd
C) 24
What strength NRT gum/lozenge would you give to a PT who has their first cig within the first 30 min of waking up?
After the first 30 min?
4 mg for super smoker
2 mg for after
Directions for NRT gum
chew slowly until peppery flavor appears, then park b/w cheek and gum, and chew until taste fades (~ min)
Common side effects of NRT gum
- mouth soreness/irritation
- unpleasant taste
- hiccups
- dyspepsia (stomach pain)
- nausea
What is the max # of NRT lozenges you can have in a day?
A) 10
B) 20
C) 25
D) 30
B
5 lozenges q6h, up to 20 lozenges/day
Side effects for NRT lozenge
- mouth/throat irritation
- hiccups
- flatulence
- heartburn
- N
What is the first-line Rx agent for smoking cessation and how is it dosed?
Varenicline (Chantix)
Start with 0.5 mg QD, then 0.5 mg BID, then 1 mg BID (12 wks total if desired)
Chantix side effects
- N
- insomnia, abnormal dreams
- HA
Buproprion SR (Wellbutrin) is available (OTC/Rx), and its side effects include...
Rx only
In which PTs should you avoid using buproprion for smoking cessation?
- HISTORY OF SEIZURE
- eating D/O
- maoi use in the last 2 wks
Non-pharmacological prevention of tooth caries
- brush and floss regularly
- avoid cariogenic foods (sticky, <15% sugar, etc.)
Which toothbrush bristles are preferred and how often should you replace them?
A) soft
B) medium
C) firm
A) soft
replace q3months
[T/F] Oral irrigating devices can substitute flossing.
False
