4 board-style questions on topical steroids in the PulseMD family medicine question bank — physician-reviewed, 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.
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, and biopsies show more than 15 eosinophils per high-power field. After 8 weeks of omeprazole 20 mg twice daily, his dysphagia persists and repeat biopsies still show more than 15 eosinophils per high-power field. Which of the following is the most appropriate next treatment?
A 38-year-old woman has been applying betamethasone valerate 0.1% cream to her face twice daily for 8 months to treat what she was told was eczema. She now presents with facial skin that appears thin and shiny, visible telangiectasias on the cheeks, prominent striae on the nasolabial folds, and a papulopustular eruption around the mouth and nose. When she tries to stop the cream, the rash flares significantly within 48 hours. What is the most appropriate management approach?
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