Blog

A 21-year-old female presented to the clinic today stating t…

A 21-year-old female presented to the clinic today stating that she has a sore throat and “lumps” in her neck. She had some nausea and vomiting last evening. The patient states that she has been running a fever, and that she “just feels really bad.” She denies a cough, any shortness of breath, difficulty breathing, chest pain, lightheadedness, or dizziness. She says that she has had “strep throat” two times in the last year. Physical exam as follows: BP 121/92, pulse 121, temp. 101.1. HEENT: TMs are dull and immobile. Sinuses are nontender. Nares are normal. Throat is very red. Tonsillar exudates present. Neck is supple with tender anterior cervical lymph nodes on the right. Cardiac: Regular rate and rhythm, no murmurs. Lungs: CTA. The patient is positive for strep on rapid antigen testing (rapid strep test). After checking for drug allergies (patient is negative), which treatment plan will you prescribe?

A 17-year-old girl presents to the primary care clinic for a…

A 17-year-old girl presents to the primary care clinic for a 2-week history of ear pain and pruritis. On further questioning, she reports ear fullness and trouble hearing. She says she has also noticed a little “whitish” discharge. She is on the high school swim team. She has had these episodes in the past but not to this extent.  On physical exam, her tympanic membrane is difficult to visualize, but it is mobile without any inflammation. No perforation is noted. You note pustules in the outer 1/3 of the ear with crusting. There is pain on palpation of the tragus. Pain is also elicited with traction of the pinna. Which of the following treatments should be prescribed for this patient?

The nurse practitioner is performing an assessment of Daniel…

The nurse practitioner is performing an assessment of Daniel, a 49-year-old male patient who is in the clinic today. He reports fatigue, malaise, and myalgia for about 4 weeks. He says he is having headaches, muscle pain, low grade temperatures and pain to the upper right quadrant of his abdomen. He reports three sexual partners this year with no use of condoms. He denies current drug use but states he used to be an IV drug user 5 years ago. He reports 3-4 alcoholic drinks a week and has a negative CAGE exam. He states he used to drink heavier but has cut back in the last 6 months. The nurse practitioner receives the following serology report: HBsAg= positive anti-Hbc= positive IgM= positive anti-HBs=negative What does the nurse appropriately recognize as the accurate interpretation of this serology report?    

A 23 year old male patient presents to the urgent care clini…

A 23 year old male patient presents to the urgent care clinic with a complaint of right eye pain. This patient states he was mowing the lawn and a small piece of debris flew up and hit him in the eye. He states it “feels like there is something still in there”. Since the incident the vision in his right eye has been blurred and he is sensitive to light. This patient’s vital signs are all WNL. This patient denies any previous medical history including problems with the eye.  He does not wear contacts or glasses and believes his normal vision to be near 20/20.On exam you find this patient’s right eye appears erythematous.  He keeps his eye closed in the exam room and when you instruct him to open the eye it appears to be painful. He also exhibits signs of photosensitivity. He has tearing from the right eye but no purulent discharge. Visual acuity in the left eye is 20/25, acuity in the right eye is 20/30. The upper and lower lids are retracted. Inversion of the eyelids reveals no foreign body under the lids. No foreign body is still present. Upon examination with fluorescein stain and a Wood’s lamp, you note a small abrasion to the cornea. Which of the following would be part of your treatment plan?