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Author Question: A parent brings a 6-year-old child to the clinic for evaluation of a rash. The primary care NP ... (Read 59 times)

lbcchick

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on: Jul 24, 2018
A parent brings a 6-year-old child to the clinic for evaluation of a rash.
 
  The primary care NP notes three annular lesions with elevated borders and central clearing on the child's face and a similar lesion on the back of the neck that extends above the hairline. The NP should prescribe: a. fluconazole.
  b. griseofulvin.
  c. oral ketoconazole.
  d. topical ketoconazole.

Question 2

A female patient has vaginal candidiasis and has taken a single dose of fluconazole without resolution of the infection. The primary care NP obtains a culture and should order:
 
  a. oral ketoconazole.
  b. griseofulvin for 4 weeks.
  c. another dose of fluconazole.
  d. topical miconazole (Monistat).


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recede

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Reply #1 on: Jul 24, 2018
Answer to Question 1

B
Griseofulvin is used for tinea infections of the skin, hair, and nails that are not responsive to topical therapy. Topical treatment of tinea capitis is usually ineffective because the fungus invades the hair shaft. Fluconazole is not indicated for tinea infections.

Answer to Question 2

D
Topical miconazole is still recommended as the drug of first choice and should be given when oral fluconazole has failed. Fluconazole has been approved for single-dose treatment of vulvovaginal candidiasis, although the Centers for Disease Control and Prevention continues to recommend topical therapy with an imidazole derivative because of fluconazole-resistant candidiasis. Ketoconazole and griseofulvin are not recommended first-line treatments for vulvovaginal candidiasis. Another dose of fluconazole would not be effective if resistance is present.


lbcchick

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Reply #2 on: Jul 24, 2018
Both answers were spot on, thank you once again


recede

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Reply #3 on: Jul 24, 2018
Great! Please up vote :D


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