PHM 6165 - Health Assessment

Session 10 – HEENT and Dermatology

Application Facilitator Guide

Application
Case 1:
William Hill is a 50 year old man who approaches your consultation window. “I have this itchy rash. Can you
recommend something for it?” (Just list questions, Answers will be provided when we meet back as a group)

1. What are some questions that you would ask to elicit additional information from the patient? (Patient
answers will be disclosed during the discussion.)

2. What do you think is causing his itchy rash? (Will not be able to answer until information above is provided)
A. Allergic Contact Dermatitis
B. Irritant Contact Dermatitis
C. Atopic Dermatitis
D. Impetigo
E. Candidiasis
PHM 6165 - Health Assessment
Session 10 – HEENT and Dermatology
Application Facilitator Guide
Case 2:
Kevin is a 28 year old white male. He approaches your consultation window to ask what he should get for this rash he
has on his abdomen. He wants the best thing to get rid of the rash because he has a date tonight. (Just list questions,
Answers will be provided when we meet back as a group)

3. What are some questions that you would ask Kevin? (Patient answers will be disclosed during the discussion.)

4. What type of rash do you think this is? Just based on appearance. (Will not be able to answer until information
above is provided)
A. Allergic Contact Dermatitis
B. Irritant Contact Dermatitis
C. Atopic Dermatitis
D. Impetigo
E. Candidiasis
PHM 6165 - Health Assessment
Session 10 – HEENT and Dermatology
Application Facilitator Guide
Case 3:
A 10-month-old boy is brought to urgent care for a rash on his cheeks. His mother reports that he has been dealing with
this rash for the past few weeks, though it has gotten much worse in the past few days. She has wrapped his hands in
socks to prevent scratching, especially during sleep. Family history includes childhood asthma and eczema. On physical
exam, his bilateral cheeks are erythematous with plaques and scrapes.

5. What kind of rash do you think this is?

A. Allergic Contact Dermatitis
B. Irritant Contact Dermatitis
C. Atopic Dermatitis
D. Impetigo
E. Candidiasis

6. What are some reasons why you made this conclusion?

PHM 6165 - Health Assessment
Session 10 – HEENT and Dermatology
Application Facilitator Guide
Case 4:

Kate is a 38 year old white female. She tentatively approaches your consultation window. She asks if there is a private
area available so that you can discuss a rash that she has.

Though your appropriate interview she tell you the following…

 The rash is located under her breast.

 The rash started around a week ago.
 Rash is red and itchy. There are a few pustules present.
 Nothing makes it worse or better
 It is very uncomfortable.
 She was recently diagnosed with type 2 DM, started on Metformin. Her diabetes is not currently controlled.
 She has no drug allergies.

7. What kind of rash do you think this is?

A. Allergic Contact Dermatitis
B. Irritant Contact Dermatitis
C. Atopic Dermatitis
D. Impetigo
E. Candidiasis

Case 5:

A father brings in his 6 year-old son for a “cold”. He complains of clear and watery nasal discharge, sneezing,
and itchy, burning, and watery eyes for the last 2 weeks. He also has a sore throat upon awakening that gets
better during the day. His symptoms seem to worsen in spring and fall. There are no smokers at home, 1 dog
and no roaches/excess dust/obvious sites of mold. Physical exam shows dark circles under the eyes and pale,
bluish, edematous nasal turbinates. The throat shows a mildly inflamed posterior pharynx with clear nasal
mucous drainage. His eyes have a watery discharge and are mildly inflamed, with redness of the conjunctiva.

8. What is the likely cause of his runny nose?

a. Cold
b. Allergic Rhinitis
c. Non-allergic Rhinitis
d. Sinusitis

9. What subjective and objective information helped you come to this conclusion?
PHM 6165 - Health Assessment
Session 10 – HEENT and Dermatology
Application Facilitator Guide

Case 6:

ZF is a 30 year old white male. He presents to your pharmacy with a severe and constant pain centered unilaterally
behind the right eye. He states that he has never had a headache this bad before and is feeling nauseous. You notice his
right eyelid is drooping slightly and he is holding up his hand to block the light.

10. What kind of headache is ZF suffering from

a. Migraine headache
b. Tension headache
c. Cluster headache
d. Sinusitis

11. What subjective and objective information supports your diagnosis

12. What are the different types of otitis media and what are the distinguishing factors of each?

13. D.H. is a 4 year old boy and has the following symptoms. Ear pain, irritability, fever. What is the most likely
cause of his ear pain?
a. Acute otitis media
b. Otitis media with effusion
c. Chronic suppurative otitis media
d. Otitis externa

14. What would you expect to see upon physical examination?

PHM 6165 - Health Assessment
Session 10 – HEENT and Dermatology
Application Facilitator Guide

Case 7:

AD is a 25 year old white female. She presents to your pharmacy with the complaint of an itchy ear. She has also
noticed some pain when she touches her ear.

Medical history: She is a healthy 25 year old. She has recently begun an exercise program at the YMCA, and has been
using the treadmill there almost daily. She states that she is usually dripping in sweat by the end.

Physical exam: When you attempt to look into her ear with an otoscope, she cries out in pain. You do notice that the
external ear canal is red and swollen. Pulling on the earlobe also elicits pain. You are not able to complete an
evaluation of the tympanic membrane due to the patient's discomfort.

15. What do you think is causing the patient’s ear pain?

a. Acute Otitis Media
b. Otitis Media with Effusion
c. Chronic purulent Otitis Media
d. Otitis Externa

16. What signs and symptoms cause you to come to this conclusion?

Case 8:
John Smith is a 60 year old man presenting to his PCP for a mole he never noticed before. His wife told him to get it
checked and thankfully his PCP told him there are no abnormal signs, but to keep an eye on his mole.

17. What are the signs and symptoms that John should look for?

18. John comes back a few weeks later, this time complaining of a painful rash that is very itchy and presents in a
line along his ribcage. What is the most likely cause of johns new found dermatologic issue?
a. Impetigo
b. Shingles
c. Chicken pox
d. Measles