Discussion: Evaluation Of Hair Loss
Discussion: Evaluation Of Hair Loss
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Question 19
An 8-year-old girl comes with her mother for evaluation of hair loss She denies pulling or twisting her hair, and her mother has not noted this behavior at all She does not put her hair in braids On physical examination, you note a clearly demarcated, round patch of hair loss without visible scaling or inflammation There are no hair shafts visible Based on this description, what is your most likely diagnosis?
A) Alopecia areata
B) Trichotillomania
C) Tinea capitis
D) Traction alopecia
Question 20
A 19-year-old construction worker presents for evaluation of a rash He notes that it started on his back with a multitude of spots and is also on his arms, chest, and neck It itches a lot He does sweat more than before because being outdoors is part of his job On physical examination, you note dark tan patches with a reddish cast that has sharp borders and fine scales, scattered more prominently around the upper back, chest, neck, and upper arms as well as under the arms Based on this description, what is your most likely diagnosis?
A) Pityriasis rosea
B) Tinea versicolor
C) Psoriasis
D) Atopic eczema
Question 21
Which of the following booster immunizations is recommended in the older adult population?
A) Tetanus
B) Diphtheria
C) Measles
D) Mumps
Question 22
A patient presents for evaluation of a sharp, aching chest pain which increases with breathing Which anatomic area would you localize the symptom to?
A) Musculoskeletal
B) Reproductive
C) Urinary
D) Endocrine
Question 23
MsWhiting is a 68 year old who comes in for her usual follow-up visit You notice a few flat red and purple lesions, about 6 centimeters in diameter, on the ulnar aspect of her forearms but nowhere else She doesn’t mention them They are tender when you examine them What should you do?
A) Conclude that these are lesions she has had for a long time
B) Wait for her to mention them before asking further questions
C) Ask how she acquired them
D) Conduct the visit as usual for the patient
Question 24
You have recently returned from a medical missions trip to sub-Saharan Africa, where you learned a great deal about malaria You decide to use some of the same questions and maneuvers in your “routine” when examining patients in the midwestern United States You are disappointed to find that despite getting some positive answers and findings, on further workup, none of your patients has malaria except one, who recently emigrated from Ghana How should you next approach these questions and maneuvers?
A) Continue asking these questions in a more selective way
B) Stop asking these questions, because they are low yield
C) Question the validity of the questions
D) Ask these questions of all your patients
