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NBME 22 Answers

nbme22/Block 3/Question#44

A 35-year-old man comes to the physician because of ...

Prescribe permethrin for the patient and his family

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submitted by mcl(216),

Scabies likes to burrow in the areas between the fingers and toes (FA 2019 161) and causes itching. Could also potentially be lice (groin involvement), but treatment for either overlaps -- gotta use permethrin.

kchakhabar  If only one person is there to see the doctor, why would the doctor prescribe medicine even for his family members who are not there? +  
mcl  Unfortunately, both of these are pretty contagious conditions. FA mentions that scabies spreads via skin to skin contact, and goes on to mention that you're supposed to treat close contacts. I think in this scenario it's ok to give permethrin to the family members who are not present but affected (it's also non-prescription in some cases, I believe.) Slightly related note, similar to why you would treat the sexual partner of someone with chlamydia/gonorrhea, or close contacts of someone with n. meningitides infection. +3  

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submitted by d_holles(39),

Damn I feel like NBME fucking loves scabies or some shit.