A 30-Year-Old Man Comes to the Office Due to a Rash

question 399

Multiple Choice

A 30-year-old man comes to the office due to a rash.  For the last 3 weeks, he has had a slowly enlarging, pruritic rash at the left groin.  The patient had a similar rash 2 months ago that resolved after topical treatment with miconazole; he has since been careful to dry his skin thoroughly after bathing.  Medical history is unremarkable.  The patient has 1 long-term sexual partner and does not use tobacco, alcohol, or illicit drugs.  Vital signs are normal.  BMI is 24 kg/m².  Examination shows an annular plaque with a scaly border in the left groin; scrotal skin is normal.  Potassium hydroxide microscopy of skin scrapings from the lesion reveals segmented hyphae.  Which of the following is the most appropriate next step in management of this patient?

• A)Examine interdigital skin of toes
• B)Obtain fungal blood cultures
• C)Order serum immunoglobulin level
• D)Prescribe hydrocortisone cream
• E)Prescribe topical selenium sulfide

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Definitions:

Double Jeopardy Clause

A provision of the Fifth Amendment to the U.S. Constitution that protects individuals from being tried twice for the same offense in the same jurisdiction.

Gideon's Rule

A legal principle stemming from Gideon v. Wainwright (1963) that guarantees the right to free legal representation for defendants in criminal cases who cannot afford an attorney.

Fourteenth Amendment

An amendment to the U.S. Constitution, ratified in 1868, that guarantees equal protection under the law to all citizens.

Constitutional Limit

Restrictions and boundaries set by a constitution that determine the scope of powers and authority of government bodies and officials.