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A 50 year old male patient presents to your urgent care clinic with a bloody nose.  He tells you that he has gotten bloody noses before occasionally, especially when his allergies are bad, but that he can always get them to stop by applying pressure.  He has not been able to get this one to stop, so he is asking for your help.  What should you try first?

Which of the following adults should receive a Recombinant Zoster Vaccine (RZV) (Shingrix) vaccine?

Which of the following is indicated in the treatment of Meniere’s disease? 

A 45-year-old man with a PMH of Crohn’s presents with a recurring rash that has lasted several years. He states that the rash consists of lesions that are scaly and silvery in color. The skin lesions occur on his elbows, knees, and gluteal cleft frequently and come and go over several months with no apparent trigger. He denies fever, chills, nausea, and sweating. The patient’s temperature = 98.5°F, HR = 80, RR = 18, and BP = 110/70. Physical exam reveals a silver, scaly plaque over his elbows and knees (picture shown below). He has punctate bleeding when the outer scale is removed from a portion of the lesion. What is the most likely diagnosis? derm3.jpg

A 49-year-old male patient presents to the emergency room after escaping from a fire at the local food store. He comes in with extensive burns to both feet and covering approximately 25% of the remainder of his body. The patient is stabilized and flown to the nearest burn center. The burns on his feet are described as including the subcutaneous tissue. There is no muscle, tendon, or bone exposed. What is the correct classification of the severity of this burn?

An 18 year old male presents with acne vulgaris.  What would be a good starting treatment option for this condition?

A 20 year hold male was seen for a physical exam by the NP. He complains of a pruritic macerated areas in his groin for the past 2 weeks. Which of the following is the mostly likely diagnosis?

An elderly retired farmer presents with a dome shaped, pearly, firm nodule with telangiectasia on the nose. In making a diagnosis, the nurse practitioner recognizes this most likely to be:

You see a patient who complains of reduced hearing in the right ear over the past 6 months, but seems to be getting worse. On inspection with the otoscope you find a hard plug of black cerumen with what appears to be cotton stuck to the surface. You recognize this as a cerumen impaction and discuss which of the following:

A 31 year-old female presents to the clinic requesting treatment for her red eyes.  She reports a burning, gritty sensation in both eyes and that her eyes have been “crusted shut” in the mornings.  She reports some mild cold symptoms as well.  She does not wear contact lenses. She notes that her children have both had this recently and that they were prescribed an antibiotic ointment that seemed to work after a few days of use.  What treatment do you recommend?