New Urgent Care Module for EM Residency Programs -

Announcing the New Urgent Care Module for Emergency Medicine Residency Programs

December 14, 2017
Today we released the first Urgent Care Module for Emergency Medicine Residencies. This module is best suited as an adjunct to your core Emergency Medicine curriculum.

Topics range from cutaneous disorders (e.g., Pityriasis rosea) through minor wounds and trauma (e.g., dog bites)

Here is an example:

Tinea versicolor for question

A 34-year-old woman presents with a rash on her back for three months. She states that the rash gets worse in the summer. The patient’s back is seen above. Which of the following managements is most likely indicated?

A. Cephalexin for seven days
B. Permethrin topical
C. Selenium sulfide topical
D. Topical corticosteroids

Answer C

This patient presents with tinea versicolor requiring treatment with selenium sulfide topical. Tinea versicolor is a superficial fungal infection caused by Malassezia furfur (formerly Pityrosporum ovale). Typically, patients will present with scaly patches on the chest and trunk but occasionally, the rash will spread to the limbs. There may be mild pruritus associated with the rash. Patients often seek care after sun exposure because the affected areas do not tan and will appear hypopigmented. The diagnosis is made based on clinical presentation but can be confirmed by a KOH preparation of scraping of the patches. The treatment for tinea versicolor is with 2.5% selenium sulfide shampoo, imidazole cream or oral fluconazole. Recurrence is common (15–50%). 

Tinea versicolor

Cephalexin (A) is a first-generation cephalosporin with activity against many Streptococcus and Staphylococcus species but no antifungal activity. Permethrin topical (B) is not effective in treating tinea versicolor but is effective in the treatment of scabies. Topical corticosteroids (D) may reduce itching but will not treat the underlying disease.

One Step Further question:
What treatment can be given for prophylaxis against repeat episodes of tinea versicolor?

Monthly application of propylene glycol, selenium shampoo, or azole creams can be used for prophylaxis.

Since these categories and tasks are integrated into our improved performance and feedback page, you have access to robust data to help you fine-tune your studying.

If you have not been introduced yet to Nachi Gupta and Jeff Nusbaum from @Roshcast I encourage you to see what they’ve been up to. Check out a list of their podcast episodes here.

Keep an eye out for more upcoming releases.

A bolus of confidence. A lifetime of knowledge.

By Adam Rosh

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