Practice Questions NURS 5433 Module 3-4 Questions with Correct Solutions Rated A+

1. What testing is needed to confirm TB?: sputum culture and chest x-ray 2. What are the first line drugs for TB: Isoniazid, rifampin, pyrazinamide and ethambutol 3. A patients 33 year old mother brings her 4 year old son into the office with complaints of a rash on the cheeks and abdomen, she is concerned about potential food allergies. Upon exam, you ask about any recent illness. She said he had a fever about a week ago with a cough and runny nose. With the provided information, what is your top diagnosis? What is the causative agent? 3 differentials? Diagnostics needed? What additional information or questions would you have for the parent?: Top diagnosis: 5th disease causative agent: human parvovirus b-19 Differentials: Roseola, rubella, rubeola, kawasaki disease Diagnostics: None needed Additional info: patient is not contagious, can return to school. Inquire if mom could potentially be pregnant, and if so, needs an immediate referral to OBGYN. 4. A 43 year old man is seen in office with complaints of a rash that has appeared on his left lower leg, along with fever and myalgia. He recently was camping in minnesota 2 weeks ago with family and noticed this rash appear in the last few days. Upon exam, it has grown to be about 8cm, round with central clearing. What is your top diagnosis? Causative agent? Diagnostics needed? Treatment? Follow ups needed? What are possible complications?: Diagnosis: Lyme disease Causative agent: Borrelia burgdoferi Diagnostics needed: Either EIA or IFA.. if positive, confirm with western blot test Treatment: Doxycycline 100mg BID for 14-21 days is first line hrerapy. Can use amoxicillin as alternative. Follow up: after end of abx treatment... if still having symptoms, continue treatment for 28 more days. Possible complications: AV heart blocks, recurrent arthritis, meningitis 5. A parent brings her 3 year old child in and states he has had a fever for a week, that is not resolving. He has had cough, rhinorrhea and now is showing conjunctivitis, peeling on his palms, generalized rash over his body, and cracking of the lips. What is your initial diagnosis? Causative agent? Treatment? How do you make this diagnosis? Follow ups, treatment: Aspirin, IVIG and possibly steroids Diagnostics: Must have 4/5 of diagnostic criteria along with fever for more than 5 days to be complete Kawasaki disease Follow ups: regularly in first 2 months... need urgent referral to cardiologist. 2D echo now and in 6-8 weeks when most other s/s resolve Complications: carditis (aneurysms, regurgitation, MI), facial palsy, hydrops of gallbladder