A 76 year old female presents to the emergency department after being found down in her home by a family member. The family member reported that there were burned muffins in the oven. EMS reported the patient was somnolent upon arrival to the scene. Vital signs were stable other than oxygen saturation of 85%. A non-rebreather was placed on the scene, and the patient was brought to the nearest emergency department. Paramedics report the patient’s somnolence improved to lethargy during the ambulance ride. Initial ED evaluation the patient remain lethargic though is oriented to herself and month. Family member reports a medical history of only hypertension. Denies that the patient smokes. When asked about living situation, the family remember reports the patient lives in a home built in the 1920s, and cooks on a gas stove/oven. 1 hour after arrival the patient is awake, confused to the situation, complains of a headache with blurry vision and nausea.  Base on the information given, what is the most likely cause of this patient’s symptoms? 

Primary prevention is defined as health promotion that precedes disease or onset of symptoms.

You are discharging a patient from the emergency department whom you diagnosed with herpes zoster. Which prescription should be sent to the patient’s pharmacy? 

Primary prevention occurs after patient has had a stroke and needs rehabilitation.

*BONUS Question* Answer this question correctly, and 2 points will be added to your final exam grade. There is no penalty for answering incorrectly.  A 19 year old male presents to the emergency department with burns after being at a bond fire party with his friends. His accompanying friend states the fire was burning out so he and the patient add more logs to the fire, then the patient threw a bottle of gasoline on the fire which caused an explosion.  Upon exam you note significant erythema and blisters to the patient’s face, chest, and abdomen. You note black charred skin of his entire right arm, and blisters to the front of his right leg. The skin of his front left arm and leg are dry, without blisters, but are erythematous and painful. No burns present to his genitals or back.  What percentage of this patient’s total body surface area is injured?   

A 62 year old male presents to the urgent care clinic with complaints of worsening nodules to his neck that have now appeared to his face. He states this started a year ago, but has gotten worse. On exam you note he is a white male with fair complected skin. When you ask about medical and social history, he reports he has hypertension and GERD. States he works as a landscaper.  On physical exam you note nodules to the neck that are waxy and pearly in appearance.  You refer the patient to an outpatient dermatology clinic for biopsy, because you are concern for which condition? 

Select all of the indications for prophylactic intubation in patients who present with burns. 

Match the lesion to its associated description. 

Which physical exam findings represent chronic obstructive pulmonary disease (COPD)? Select all that apply. 

All of the following classifications of medications are used to prevent or suppress organ transplant rejection, except: