Topical Steroids: ABFM practice questions

4 board-style questions on topical steroids in the PulseMD family medicine question bank, written against current guidelines with the reference cited on each question. Two free samples below; the full set with answers, explanations, and spaced review is free to start.

Sample question 1

A 32-year-old man presents to the clinic with a 6-month history of intermittent solid food dysphagia and two episodes of food impaction requiring emergency department visits. He has a childhood history of asthma and eczema. Upper endoscopy reveals concentric rings and linear furrows in the esophageal mucosa. Biopsies show more than 15 eosinophils per high-power field. Which of the following is the most appropriate initial treatment?

1. Swallowed fluticasone propionate twice daily for 8 weeks
2. Oral prednisone 40 mg daily with a 6-week taper
3. Omeprazole 40 mg daily for 8 weeks
4. Nissen fundoplication

Sample question 2

A 28-year-old woman presents with a 6-week history of a papulopustular eruption around her mouth, nasolabial folds, and chin. She reports mild burning and tightness. She has been applying her roommate's triamcinolone 0.1% cream to the area for 2 weeks, which initially improved the rash but it has since worsened. There is a characteristic clear zone immediately adjacent to the vermilion border of the lips. What is the most appropriate management?

1. Add topical metronidazole on top of the triamcinolone
2. Obtain a fungal culture and start empiric topical ketoconazole
3. Switch to a higher-potency topical corticosteroid such as clobetasol
4. Discontinue the topical corticosteroid and start oral doxycycline 100 mg daily

Create a free PulseMD account to answer these, see the explanations, and practice five minutes a day.

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