A 31-year-old man who has worked for several years installing ...

[laurencescou]

A 31-year-old man who has worked for several years installing fiberglass insulation has developed itchy, irritating lesions on his wrists and forearms over the last several months.
 
  He has applied moisturizing creams repeatedly and has taken antihistamines but has experienced no significant improvement. He is understandably concerned about the potential effect this could have on his livelihood and has asked his care provider when treatment will resolve the problem. What is the care provider's most appropriate response?
  A)
  A steroid cream will likely help but often the skin problem lasts long after contact with the product that irritates the skin.
  B)
  You're clearly allergic to the fiberglass in your insulation, and over-the-counter allergy medications are likely to resolve the problem quite rapidly.
  C)
  The problem is that your skin is producing and sloughing off cells prematurely; this will respond well to a topical steroid.
  D)
  There are medications I can prescribe that will cure this sensitivity, but they tend to take many months to take full effect.

Question 2

A 36-year-old female who has experienced diverse symptoms for several years has finally had her health problems attributed to scleroderma (systemic sclerosis) and has committed herself to learning as much about the disease as she can.
 
  Which of her following statements would her nurse want to correct or clarify?
  A)
  I'm surprised that in this day and age, they still don't know what causes scleroderma.
  B)
  I suppose this explains why I have such terrible circulation to my hands and feet.
  C)
  I'm scared by the damage that this could cause to my heart and lungs.
  D)
  The worst part of this so far has been learning that there aren't any treatments for scleroderma.

[helenmarkerine]

Answer to Question 1

Ans:
A

Feedback:

Topical corticosteroids are often used in the treatment of irritant contact dermatitis, but symptoms can persist long after contact with the irritant ceases. The course of the man's complaint is suggestive of irritant, not allergic, contact dermatitis. Hyperkeratinization is characteristic of psoriasis, and a sensitivity can be treated but not cured.

Answer to Question 2

Ans:
D

Feedback:

While the cause of scleroderma remains unknown, supportive treatments that address symptoms do exist. Reynaud phenomenon is a very common accompaniment to the disease, and cardiac and pulmonary involvement is common.

[laurencescou]

Excellent

[Perkypinki]

TYSM