A 13 y.o. pt has a throat culture that is positive for strep throat. She
reports that her younger brother was recently diagnosed with strep and
was treated. The pt has a severe allergy to penicillin and reports
erythromycin makes her very nauseated. Which of the following ABX is
the best choice?
A. Azythromycin
B Cephalexin (keflex)
C. Cefuroxime axetil (Ceftin)
D. Levofloxacin (Levaquin) - ✔ ✔ A. Azythromycin: Don't use
Levaquin in kids, 10% cross reactivity between penicillin and Keflex,
Erythromycin commonly has nausea as side effect but not allergy,
azythromycin better tolerated.
A 62 y.o. male with COPD complains to his NP that his ipratropium
bromide (Atrovent) is not working. He reports he still feels SOB after
using it 4X per day for 3 months. Which of the following actions is the
next step for the NP?
A. Increase pt's dose to 3 inhalations QID
B. Continue the atrovent and start the pt on O2 via NC
C. Continue the atrovent and add albuterol 2 inhalations QID
,D. Start the pt on O2 at night time abd PRN during the day - ✔ ✔ C:
COntinue atrovent and add albuterol. The plan of care is always start
with an anticholinergic (Atrovent) and then add short acting beta
agonist
What structure of the eye is responsible for 20/20 vision?
A. Rods
B. Cones
C. Optic disc
D. Fovea and macula - ✔ ✔ D. Fovea and Macula
A new patient is being interviewed by an NP, and states she had a
gastrectomy procedure 5 years ago. The NP knows that this patient is at
risk for which of the following?
A. Folate deficiency anemia
B. b12 deficiency anemia
C. Iron deficiency anemia
D. Normocytic anemia - ✔ ✔ B. B12 deficiency anemia: intrinsic
factor is made by parietal cells in fundus of the stomach. IF is needed to
sufficiently absorb B12. Gastrectomy pts have damaged fundus usually
so they are at risk.
What bacteria most commonly causes otitis externa?
, A. Pseudomonas aeroginosa
B. Strep pyogens
C. Haemophilis influenza
D. Maraxella catarrhalis - ✔ ✔ A. Pseudomonas aeroginosa is the
most common. Staphylococcus is the second most common seen in
otitis externa. Treat with neomycin ear drops of Ofloxacin ear drops
The mother of a 12 m.o baby reports to the NP that her baby had a high
fever for several days that resolved spontaneously. A few days later she
broke out into a maculopapular rash. Which of the following is the most
likely DX?
A. Fifths disease (erythema infectiosum)
B. Roseola infantum (exanthema subitum)
C. Varicella
D. Infantile maculopapular rashes - ✔ ✔ B. Roseola Infantum
(exanthum subitum) is a common viral rash that is caused by the
human herpes virus. The most common ages of onset is 6months -2 yrs
old. The rashes are maculopapular (round and pink) and appear first on
the trunk and then spread to the extremities
An 8 y.o. boy is seen by the NP and the mother reports he has had a
fever X2 days, not eating well due to painful sores inside pt's mouth.
Temp is 101F, Pulse is 88 BPM, and respirations are 14. Np notices