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Tetracycline
Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line
treatment for hidradenitis suppurativa.
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Hidradenitis suppurativa is a disorder of the terminal follicular epithelium in
apocrine gland-bearing skin. It is a chronic, disabling disorder that progresses,
often causing keloids, contractures, and immobility. It is characterized by
comedone-like follicular occlusion, chronic and relapsing inflammation,
mucopurulent discharge, and progressive scarring.
Arthropathy associated with hidradenitis may be present. Typical presentation
includes nodules and sinus tracts (inflamed or noninflamed), abscesses, and
scarring found in the axilla, genitofemoral area, perineum, gluteal area, and
inframammary area in women.
Recommended treatments include antibiotics, steroids, retinoids, dapsone, and
anti-tumor necrosis factor agents. A dermatology con
A middle-age female patient presents to the clinic with a recurrence of mild
hidradenitis suppurativa after topical therapies failed. Which first-line treatment
is recommended?
,The "Medicine Wheel" is used by many for the purpose of health and healing
The "Medicine Wheel" is traditionally used and contains four directions; north,
south, east, and west. Traditionally each tribe has different meanings for each
direction and they may represent the season of the year or stage of life. It is
aimed at providing a holistic view of life.
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An understanding of different cultural preferences leads to cultural competence
in healthcare. Some patients may value traditional culture and preferences as it
relates to healthcare. These individual preferences should be included in the
interview and treatment plan for patients.
Traditionally, the American Indian culture values a holistic approach to health
care integrating the person, lifestyle, environment, family, and religion. Patients
adhering to these traditional cultural practices often feel that illness is due to
When providing culturally competent health care services to an American Indian
elder, the nurse practitioner understands which is traditionally true?
Cerumen, commonly called earwax, is a combination of secretions and sloughed
epithelial cells that protects the ears from infection, water, and insects. It is
normally expelled from the ear canal through natural jaw movement. When this
self-cleaning process fails, cerumen can become impacted. Cerumen impaction
occludes the ear canal and can press against the tympanic membrane, resulting in
conductive hearing loss.
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,Conductive hearing is the transition of sound from the external and middle ear to
the inner ear. Conductive hearing loss is caused by problems in the external and
middle ear that interfere with the transmission of sound and its conversion to
mechanical vibration. Causes of conductive hearing loss include obstruction of the
external auditory canal by cerumen, foreign bodies, debris from otitis externa,
and large exocytosis and osteomas.
Sensorineural hearing loss i
The nurse practitioner sees an older adult patient in the clinic with the primary
report of hearing loss and a sensation of fullness in the right ear. The nurse
practitioner suspects conductive hearing loss. Which could contribute to this?
Amoxicillin
High-dose amoxicillin (Amoxil) or doxycycline are recommended as first-line
therapy for adults without comorbidities.
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Community-acquired pneumonia (CAP) is pneumonia not acquired in a hospital or
long-term care facility. Patients with suspected CAP should receive a chest X-ray
for diagnosis. The Pneumonia Severity Index should be used to assist in decisions
regarding the need for hospitalization in patients with CAP.
According to the American Thoracic Society (ATS) and the Infectious Diseases
Society of America (IDSA) 2019 guidelines, the initial treatment of CAP for most
patients is amoxicillin or doxycycline. Macrolides are an option for treatment, but
are no longer recommended routinely as first-line treatment, given increased
, macrolide resistance. This is a change from the 2007 ATS/IDSA guidelines.
Respiratory fluoroquinolones and amoxicillin/clavulanate
An otherwise healthy adult patient presents to the clinic with a diagnosis of
community-acquired pneumonia and no recent antibiotic therapy. Which is the
best option for treatment?
A patient presents to the clinic for conception counseling. She recently stopped
taking oral contraceptives and would like to become pregnant. Which statement
about conception safety after stopping oral contraceptives is correct?
Tinel's sign
You have a 35-year-old female patient who is complaining of wrist pain. She is an
administrative assistant who does a great deal of computer work in her job. You
will test her for carpal tunnel syndrome. When you tap at the volar surface of the
wrist you are performing which of the following tests?
Zollinger-Ellison syndrome
A gastrinoma located on the pancreas or the stomach which secretes gastrin,
stimulating high levels of acid production in the stomach is which of the
following?