Author Question: A 6-year-old patient complains of a constantly itchy scalp that developed after returning home from ... (Read 173 times)

fbq8i · **on:** Jun 25, 2018

A 6-year-old patient complains of a constantly itchy scalp that developed after returning home from school today. The most common cause for this condition in a child is:

A. Seborrheic dermatitis
B. Pediculosis
C. Psoriasis
D. Basal cell carcinoma

Question 2

A solitary cold nodule on Radioactive Iodine (RAI) uptake on a thyroid scan is suspicious for:

A. Hyperthyroidism
B. Myxedema
C. Trigeminal neuralgia
D. Thyroid Cancer

jasonq · **Reply #1 on:** Jun 25, 2018

Answer to Question 1

ANS: B
It would be unusual for pruritus in the head and neck to indicate anything except a skin condition/disease or infestation. If the patient is a school-age child, pediculosis (head lice) is an obvious choice, and the child's friends and school administrators should be questioned about recent outbreaks. Nits are lice eggs that are fixed to the hair shaft and are grayish-white in appearance. Unlike the flakiness of seborrhea or psoriasis, nits cannot be easily dislodged. Basal cell carcinoma is a slow-growing, invasive type of skin cancer that occurs on sun-exposed regions of the head, such as the nose.

Answer to Question 2

ANS: D
Hyperthyroidism does not necessarily coincide with a thyroid nodule. Myxedema is a tissue swelling of the face and body due to hypothyroidism. Trigeminal neuralgia causes paroxysms of pain on one side of the face. Thyroid cancer presents as a solitary cold nodule on a thyroid ultrasound. Predisposing factors include female gender, positive family history, and history of radiation exposure to the head, face, or neck.