Tasha, A 24-year-old female, presents to your clinic this mo…
Tasha, A 24-year-old female, presents to your clinic this morning with fatigue, headaches and diffuse joint pain. She says it started a couple of days ago. She says that she just returned back from a short trip to visit her boyfriend in Pennsylvania. She says they spent three days in the woods camping “under the stars in a tent.” She denies any past medical history, is a non-smoker, and denies street drugs or alcohol use. Her physical exam demonstrates the skin lesion shown below (see photo). If diagnostic tests are positive for the likely differential diagnosis, what is the most appropriate treatment for this patient?
Read DetailsA 6-year-old boy presents with a rash of 2-weeks duration on…
A 6-year-old boy presents with a rash of 2-weeks duration on his hands, arms, trunk, and genitalia. The rash is intensely pruritic, especially at night. Two older siblings have a similar rash. The child is afebrile. Examination was normal except for assorted papules, vesicles, and pustules, some in linear array (especially at the web spaces of the fingers) and some with excoriations at the web spaces of the fingers, palms, soles, flexion creases of the elbows, trunk, and genitalia. Optimal treatment consists of antiprutitics and what else?
Read DetailsYou are the nurse practitioner at a school-based primary car…
You are the nurse practitioner at a school-based primary care clinic. You have a 7th grader who comes to the clinic itching her head. She says that it is particularly itchy behind her ears. You note nits in the hair and a Wood’s lamp identifies bright white nits. The mother is very upset about this because she feels like she is not taking good care of her daughter. Which of the following would be included in your teaching plan for the mom and daughter?
Read DetailsClay is a 14-year-old male with no past medical history that…
Clay is a 14-year-old male with no past medical history that is in the primary care clinic today for a rash that occurred over the last few days. He states that he is a wrestler for his high school and that the rash started a few days after his wrestling tournament last weekend. He notes that the rash is found predominantly on his right arm and right leg and he denies any other symptoms. He is afebrile, no respiratory symptoms, GI is normal, and vital signs are within normal limits. Physical exam demonstrates a rash with yellow crusted sores and erythema. What is the treatment for his condition?
Read DetailsA 36-year-old female presents to the primary care clinic wit…
A 36-year-old female presents to the primary care clinic with vaginal burning and itching. She says that the vagina is very irritated and it burns during urination. She states she has had a white, thick discharge. Which of the following diagnostics will assist the nurse practitioner in making the diagnosis?
Read DetailsKelsey is a 17-year-old girl whose mother brings her to the…
Kelsey is a 17-year-old girl whose mother brings her to the primary care clinic worried about an eating disorder. Kelsey has lost 14 pounds since her last visit 6 months ago. Her BMI has changed from 29 to 23. She complains that she gets dizzy when she gets up and has times where “my heart feels like it’s racing.” Her last period was 2 months ago and a pregnancy test today is negative. Her mother reports that Kelsey has been avoiding going to parties, going out with friends, and refuses to be in any photos. Her mother also reports that she found chewable over-the counter-laxatives in Kelsey’s purse. Upon exam you note erosion of her dental enamel and calluses on the back of her hands. Despite explaining to Kelsey that her BMI is in the normal range she says she still needs to lose weight. Based on these findings, which of the following treatments or combinations of treatments should be considered for this patient?
Read DetailsA 55-year-old male patient presents to the family nurse prac…
A 55-year-old male patient presents to the family nurse practitioner complaining of a painful, tingling rash across the right side of the abdomen. Exam reveals vesicles with erythemous bases; some of the vesicles are draining cloudy fluid, whereas others are crusted (see photo). The patient states that the rash is very painful and first appeared about 48 hours ago following a day of pain and itching/burning of the skin over this area. What is the recommended treatment for this patient?
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