WN is a 54 year old female who complains of symptoms of a “c…
WN is a 54 year old female who complains of symptoms of a “cold” at your clinic today. She’s the local YMCA swim coach and she’s hoping to feel better for next weekend’s swim meet. She has allergic rhinitis chronically, though lately she’s had nasal congestion with purulent nasal/postnasal discharge (yellow in color) and a cough. She complains of pressure in her face and her ears feel like they need to “pop.” She’s had symptoms for 12 days now with little to no improvement and a fever (102.1° F) for the last 24 hours. WN has an allergy to sulfa drugs, cats, and environmental allergies. Her PMH is significant for asthma, hypertension and multiple dental infections / procedures. Her medications include Fluticasone / Salmeterol (Advair Diskus) 250mcg/50mcg one inhalation twice daily, albuterol (Ventolin) HFA 2 puffs as needed for shortness of breath and lisinopril (Zestril) 20 mg by mouth daily. She reports an allergy to sulfa medications. Which of following regimens would be the best choice to treat her ABRS?
Read DetailsA 45-year-old female presents to the clinic with complaints…
A 45-year-old female presents to the clinic with complaints of severe pain in her lower back, radiating down her left leg. She describes the pain as burning and shooting, with occasional numbness and tingling. Physical examination reveals decreased sensation in the left L5 dermatome and diminished reflexes in the left lower extremity. Based on these findings, the nurse practitioner suspects lumbar radiculopathy. Which of the following medications would be the most effective for managing the patient’s neuropathic pain?
Read DetailsA 55-year-old male presents to the emergency department with…
A 55-year-old male presents to the emergency department with a productive cough, fever, and chest pain. A chest X-ray confirms the diagnosis of community-acquired pneumonia (CAP). He is started on antibiotic therapy with levofloxacin. After 48 hours of treatment, the patient’s fever resolves, and his vital signs stabilize. He is afebrile with a heart rate of 90 beats/min, respiratory rate of 22 breaths/min, blood pressure of 120/80 mm Hg, and oxygen saturation of 95% on room air. He is tolerating oral intake well and has normal mental status. What is the appropriate course of action regarding antibiotic therapy for this patient?
Read DetailsA 58-year-old male with a history of gout presents to the cl…
A 58-year-old male with a history of gout presents to the clinic complaining of sudden-onset severe pain, redness, and swelling in his left big toe. He reports similar episodes in the past and suspects another gout flare. Based on the ACR guideline recommendation for early management of acute gout flares, which of the following medications would NOT be included in the “medication-in-pocket” strategy for this patient?
Read DetailsA 45-year-old female presents to the clinic with complaints…
A 45-year-old female presents to the clinic with complaints of persistent joint pain and swelling in her hands consistent with rheumatoid arthritis. She has a history of intermittent use of over-the-counter ibuprofen for pain relief but reports inadequate symptom control. Based on the information provided, what is the minimal duration that should be considered an adequate trial of oral NSAID therapy for this patient?
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