A female patient who is 8 weeks pregnant is seen by a primary ...

[joblessjake]

A female patient who is 8 weeks pregnant is seen by a primary care nurse practitioner (NP) after a routine prenatal screen was positive for human immunodeficiency virus (HIV). A CD4 cell count is 750 cells/mm. The NP should:
 
  a. begin immediate therapy with zidovudine and lamivudine.
  b. begin therapy with zidovudine when she is in her second trimester.
  c. delay treatment with antiretroviral medications until after her pregnancy.
  d. initiate therapy with zidovudine if her CD4 cell count decreases to 500 cells/mm.

Question 2

A patient has been taking griseofulvin for 4 weeks to treat a tineal capitis infection. The primary care NP notes improvement but not complete cure. The NP should:
 
  a. obtain a culture and change to ketoconazole.
  b. add a topical antifungal cream and refill the griseofulvin prescription for 2 weeks.
  c. renew the prescription after obtaining renal, liver, and hematopoietic tests.
  d. prescribe griseofulvin for 4 more weeks and then re-evaluate the infection.

[mcomstock09]

Answer to Question 1

B
Patients who are HIV positive and who are pregnant should be treated with antiretroviral medications, but treatment should be avoided during the first trimester if possible. Zidovudine is recommended and has been shown to reduce the risk of transmission to the fetus from 25 to 8.

Answer to Question 2

C
Tineal infections may take 6 weeks to respond to griseofulvin. Patients taking griseofulvin longer than 4 weeks should have renal, hepatic, and hematopoietic functions monitored periodically. Topical antifungals typically are not effective for tinea capitis. Ketoconazole is usually not effective for tinea capitis.

[joblessjake]

Excellent

[bbburns21]

TYSM