A 15 years old high school student with a mild sore throat and low-grade fever that has persisted for about 3 weeks. She reports general malaise, fatigue, and loss of appetite. The NP suspects mononucleosis. Which of the following is the LEAST appropriate intervention?
Palpate the lymph nodes and...
A 15 years old high school student with a mild sore throat and low-grade
fever that has persisted for about 3 weeks. She reports general malaise,
fatigue, and loss of appetite. The NP suspects mononucleosis. Which of
the following is the LEAST appropriate intervention?
Palpate the lymph nodes and spleen
Examine the posterior oropharynx for petechiae Obtain a CBC, throat
culture, and heterophil antibody test.
Obtain an urinalyses and serum for LFTs and amylase - ACCURATE
ANSWERS✔✔ Obtain an urinalyses and serum for LFTs and amylase
Explanation: mononucleosis is a symptomatic infection caused by the
Epstein-Bar virus. Common is people 15-24 years of age. Common
signs and symptoms following incubation period (1-2 months) include
fatigue, chills, malaise, anorexia, white tonsillar exudates and
lymphadenopathy or posterior cervical region. Splenomegaly can be
present. A maculopapular or occasionally a petechial rash occurs in less
than 15% of patients. A diagnosis is usually made using the Monospot.
In addition, neutropenia and lymphocytosis are usually detected in the
CBC
,A 32 years old male patient complaint of urinary frequency and burning
on urination for 3 days. Urinalyses reveals bacteriuria and positive
nitrites. He denies any past hx. Of urinary tract infections. The initial
treatment should be:
a. trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim) for 7-10 day
b. ciprofloxacin (Cipro) for 3-5 days
c. Trimethoprim-Sulfamethoxazole for 3 days
d. 750 mg ciprofloxacin as a one-time dose - ACCURATE
ANSWERS✔✔ . trimethoprim-sulfamethoxazole (Bactrim, Sulfatrim)
for 7-10 day
Explanation: trimethoprim-sulfamethoxazole (TMPS) is usually n
appropriate medication to treat urinary tract infections in most patients.
In the case of community resistance to TMPS >20%^, another
medication should be substituted. In men, the appropriate length of time
is 7 10 days. Women may be treated for 3 days for uncomplicated UTI
Which agent is most effective for the treatment of nodulocystic acne?
Benzoyl peroxide (Benzac)
Retinoic acid (Retin A)
Topical tetracycline
Isotretinoin - ACCURATE ANSWERS✔✔ Isotretinoin
, Explanation: Isotretinoin (Accutane) is a systemic agent indicated for
treatment with severe inflammatory acne. Guidelines for its use must be
clearly understood by the patient. A woman of childbearing age must use
an effective method of contraception because isotretinoin is 1 There are
many restrictions in prescribing this medication because of the
teratogenic effects is given during pregnancy. Therefore, it is a
pregnancy category X.
An 18 y/o woman is taking a combined hormonal oral contraceptive.
She should be instructed to use a backup method for the prevention of
pregnancy
a. Throughout the week of placebo pills
If prescribed topiramate (Topamax) for the treatment of migraines.
If prescribed amoxicillin/clavulanate (Augmentin) for a sinus infection
if she forgets to take a single dose of the contraceptive - ACCURATE
ANSWERS✔✔ If prescribed topiramate (Topamax) for the treatment of
migraines.
Explanation: Anticonvulsant including phenytoin (Dilantin),
carbamazepine (Tegretol), primidone (Mysoline), topiramate (Topamax)
and oxcarbazepine (Trileptal) reduce the effectiveness of contraceptives.
Depo-medroxyprogesterone acetate injections or levonorgestrel-
releasing intrauterine devices would be a better method of contraceptive
for patients taking anticonvulsants. Most commonly used antibiotics
have not been proven to reduce the effectiveness of contraceptives.
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