Head Lice – Board-Style Questions

What this deck covers

Head lice in 18 board-style clinical cases with worked explanations. Each case gives you a clinical vignette, four options, the correct answer, and an explanation of why each of the other three is wrong, with the guideline or textbook it follows named on the answer.

Board-style teaching questions for paediatricians and trainees preparing for paediatric board, MRCPCH and licensing examinations. Written from published guidelines and standard paediatric textbooks, with the source named on every answer.

The 18 cases, in order

1. Specks that will not brush out
2. How the answer is settled
3. No itch at all
4. Where they came from
5. Lumps at the back of the neck
6. A letter from the office
7. Could it make him ill
8. What to do with the house
9. Nothing found, three times over
10. Which one to start with
11. Why do it twice
12. Doing it without chemicals
13. Cleared, and back again
14. Asthma and a spirit base
15. Half a bottle for all that hair
16. Still scratching a fortnight on
17. The same bottle, four times
18. Something to stop it happening

Diagnoses and management options tested

Across the 18 cases you are asked to choose between options such as: An active problem, since the specks will not brush off, A living louse taken from the comb and seen moving, The number present is far too small to be felt at all, They fly a short distance across a crowded classroom, Nodes reacting to bacteria in the broken scalp skin, She should stay away until not one egg case can be found at all, It can cause anaemia when large numbers are present, Treat everyone in the family whether or not lice are seen, Look for another reason for the itch, and stop treating, An oral antibiotic given for a week to clear the whole scalp, Lice develop resistance unless the drug is given twice, Use a nit comb on the dry hair for ten minutes each evening, Fresh lice from a close contact nobody has examined, The same alcohol-based lotion, applied in a well ventilated room.

Clinical pearls from this deck

• Nits alone do not prove there is a living louse.
• Treat the scalp only when a living louse has been seen.
• A first infestation can itch only after some weeks.
• Head lice spread by contact, not by dirty hair.
• Neck glands over a scratched scalp: look for lice.
• No child needs to miss school because of head lice.

Work through the deck once for recognition, then again a week later to test yourself — each question gives the answer and explains why every other option fails.

More from this system: all dermatology case decks · pediatric reference values.