SOLUTIONS GRADED A+
✔✔Describe benign paroxysmal positional vertigo (BPPV) - ✔✔- affects the posterior or
anterior canals
- free floating particles in the affected semicircular canals stimulate the cupula and
cause vertigo
- relocating these particles to the utricle by using the Epley maneuver works in 90-95%
of cases
✔✔Describe dysmenorrhea - ✔✔- menstrual pain and cramps
- sharp, throbbing, dull, nauseating, burning, or shooting pain
- may precede menstruation by several days or accompany
- excessively heavy blood loss
✔✔Describe otalgia - ✔✔- ear pain
may be caused by:
- impacted teeth
- sinus disease
- inflamed tonsils
- infections of the nose and pharynx
- throat cancer
- occasionally as a sensory aura that precedes a migraine
✔✔Describe otitis media - ✔✔Middle ear infection - bacterial or viral
Complications include: perforated ear drum, chronic mastoiditis, scarring and hearing
loss
✔✔Describe the treatment for otitis media - ✔✔- first line: amoxicillin
- if there's resistance or use of amoxicillin in the last 30 days then amoxicillin-
clavulanate or another penicillin derivative plus beta lactamase inhibitor is
recommended
✔✔Prescribing antibiotics longer than this will likely result is side effects -
✔✔Prescribing antibiotics more than 7 days will have less side effects
✔✔When prescribing azithromycin for otitis media, the FNP should know - ✔✔- For a
short course
- long-acting
- more likely to be successful than short-acting alternatives
- no improvement after 2-3 days of treatment, then change therapy
✔✔Describe otitis externa - ✔✔Infection of the auditory canal.
-History of trauma or moist environment.
-Itching in the ear canal.
, -Intense pain with movement of pinna such as chewing.
-Discharge may be watery at first, then purulent and thick mixed with pus and epithelial
cells. Foul smelling.
-Conductive hearing loss.
-Canal is red, edematous. Tympanic membrane obscure.
✔✔Describe the treatment for bone fractures - ✔✔- either surgical or conservative
- conservative treatment with pain management, immobilization, non-surgical
stabilization
- either open vs closed treatment
✔✔How should an open fracture be treated in primary care? - ✔✔It's a medical
emergency
✔✔What are the pain sensitive structures in the head? - ✔✔- Brain tissue isn't sensitive
to pain
- periosteum of the skull
- muscles
- nerves
- arteries
- veins
- subcutaneous tissues
- eyes
- ears
- sinuses
- mucous membranes
✔✔What is the first line treatment for a headache? - ✔✔Naproxen
✔✔Describe the symptoms of TBI - ✔✔- exchangeable with concussion
- clumsiness
- fatigue
- confusion
- nausea
- blurry vision
- headaches
✔✔describe hidradenitis suppurativa - ✔✔chronic skin disease w/ clusters of abscesses
or subcutaneous boil-like skin lesion around the apocrine glands that most commonly
affects the underarms, under the breasts, inner thighs, groin, and buttocks. Outbreaks
are painful and may persist for years with interspersed periods of inflammation, often
culminating in sudden drainage of pus. This process often forms open wounds that will
not heal and frequently leads to SIGNIFICANT SCARRING
✔✔How is hidradenitis suppurativa treated? - ✔✔- antibiotics