Ancc Fnp Board Questions And Answers With Rationales

ANCC FNP BOARD QUESTIONS AND ANSWERS WITH RATIONALES 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? - ANSWER- Tetracycline Twelve weeks of oral tetracycline (Sumycin) is the recommended first-line treatment for hidradenitis suppurativa. __________________________________________________ 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 ornoninflamed), 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 consultation should also be considered. First-line treatment is a 12week course of an oral tetracycline (Sumycin) such as doxycycline. For patients who do not respond to doxycycline, the next recommended step is a combination of twice-daily clindamycin (Cleocin) and rifampicin (Rifadin) for 10-12 weeks. If treatment fails, acitretin (Soriatane, for males and nonfertile females) or dapsone (Aczone) may be