vitamins & herbs Flashcards

1
Q

vitamins are required in what amount for growth and maintenance of health?

a. minute
b. major
c. four cups
d. massive

A

a. minute

a person does not need excessive amounts of vitamins to have a healthy lifesyle or maintain proper body function.

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2
Q

vitamins are not a source of energy. true or false.

A

True.

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3
Q

vitamins are essential for which of the following processes? select all that apply.

a. regulation of blood throughout the body
b. energy transformation
c. synapse of the neuronal transmitters
d. regulation of metabolic processes

A

b. energy transformation
d. regulation of the metabolic processes

vitamins do not actually provide the body with energy. they rather aid functions of the body.
ex: they help enzymes within the body function better.
ex: they help carbohydrates metabolize better.

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4
Q

who sets the guidlines for vitamin intake so people can gage their vitamin intake and not reach toxic levels.

A

the national academy of medicine

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5
Q

RDA

A

recommended daily allowence

specificly, the overall amount of one vitamin that a person can consume per day

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6
Q

AI

A

adequate intake

just enough to perform bodily functions. cells are at working capacity, but its not really the optimal intake. anything below would result in vitamin defficiency.

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7
Q

UL

A

tolerable upper intake level

the point in which the person has had to much of a vitamin.
can cause overdose toxicity

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8
Q

EAR

A

estimated average requirement

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9
Q

what are the two subclasses of vitamins?

a. vitamins & minerals
b. carbohydrate & protein
c. fat & water
d. oil & fat

A

c. fat & water

fat soluble vitamins and water soluble vitamins

fat soluble vitamins
- vitamin A
- vitamin D
- vitamin E
- vitamin K

water soluble vitamins
- vitamin c
- vitamin B complex - thiamin, riboflavin, niacin, pyridoxine, pantothenic acid, biotin, folic acid, cyanocoblamin

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10
Q

The patient ask the nurse to list types of fat soluble vitamins. The nurse replies with which of the following:

a. vitamin A
b. vitamin C
c. vitamin B complex
d. vitamin D
e. vitamin E
f. vitamin K

A

a. vitamin A
d. vitamin D
e. vitamin E
f. vitamin K

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11
Q

The patient ask the nurse to list types of water soluble vitamins. The nurse replies with which of the following:

a. vitamin A
b. vitamin C
c. vitamin B complex
d. vitamin D
e. vitamin E
f. vitamin K

A

b. vitamin C
c. vitamin B complex

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12
Q

fat soluble vitamins are more prone to producing overdose toxicity. true or false.

A

true.

when fat soluble vitamins (A, D, E, K) are consumed they are stored in the body, the fat cells and other tissues and steadily leak out over time causing an abundance of the vitamin(s)

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13
Q

what happens to water soluble vitamins after they are consumed?

a. they are stored in the tissues
b. they are stored in the kindney
c. they are excreted out though the urine
d. they enter the blood stream

A

c. they are excreted out through the urine

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14
Q

the nurse knows that there are two main forms of vitamin A; vitamin A (retinol) and provitamin A carotenoids (beta - carotene) . true or false.

A

true.

provitamin a carotenoids such as beta - carotene are converted to retinol.

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15
Q

foods that contain vitamin a (retinol)

A
  • milk
  • cheese
  • butter
  • egg
  • organ meats

animal products, fortified foods, vitamin supplements

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16
Q

foods that contain vitamin a carotenoids (beta - carotene)

A
  • carrots
  • sweet potatoes
  • mangoes
  • papaya
  • cantelope
  • red peppers
  • spinach
  • lettuce

foods that are rich in beta - carotene often have a bright orange color

plant foods that are orange or dark leafy greens.

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17
Q

A mother wants to know what vitamin should she begin taking as she is grwowing a fetus. The nurse responds with…

a. vitamin A
b. vitamin B
c. vitamin K
d. vitamin D

A

a. vitamin A

vitamin a is essential for embryogenesis, the development of a fetus.

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18
Q

A mother brings her child into the ER and complains that her child is turning an orange color. The nurse knows what could be the cause?

a. the child has been consuming to much beta - carotene
b. the child has been consuming to much vitamin B complex
c. the child is having an allergic reaction
d. the child is pranking the mother

A

a. the child has been consuming to much beta - carotene

vitamin a carotenoid (beta - carotene) is critical for skin function but can also affect the skin. a diet high in beta - carotene can cause the storage of vitamin a and beta - carotene in the skin causing it to turn orange.

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19
Q

a patient experiencing night blindess is showing deficiency in what vitamin?

a. vitamin A
b. vitamin B
c. vitamin C

A

a. vitamin A

critical in sight

the patient may also be experiencing corneal dryness and ulceration, skin lesions, dysfunction of mucous membranes.

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20
Q

the nurse knows that consuming to much vitamin a can cause:

A
  • a teratogenic effect
  • liver damage
  • hypervitaminosis A

teratogenic effect - can cause abnormalities or bith defects in a developing fetus.

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21
Q

hypervitaminosis A is the clinical name for a vitamin A overdose and is charecterized by:

A
  • hair loss
  • peeling skin
  • GI upset
  • lethargy
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22
Q

The function of Vitamin D

A

regulates calcium and phosphorus to benefit bone health

specifically in their uptake of bone processing and building

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23
Q

a vitamin D deficiency has the same diagnosis in children as it does adults. True or false.

A

false.

A vitamin D deficiency is diagnosed differently in adults versus children. It is the same deficiency, and causes spongey bone and boing of the bone but it has a different name depending on if it is an adult or child patient.

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24
Q

A nurse has a patient with vitamin D deficiency and is diagnosed with rickets. The nurse can assume the patient is a:

a. a 12 year old male
b. a 34 year old female
c. a 36 year old male
d. a 42 year old male

A

a. a 12 year old male

a vitamin D deficiency causes rickets in children.

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25
A nurse has a patient with vitamin D deficiency and is diagnosed with osteomalacia. The nurse can assume the patient is a: a. a 12 year old male b. a 13 year old female c. a 16 year old male d. a 42 year old male
d. a 42 year old male ## Footnote a vitamin D deficiency causes osteomalacia in adults.
26
what is rickets and osteomalacia?
rickets occurs in children while osteomalacia occurs in adults and both are a result of vitamin D deficiency. causing the inability of the bone to reserve calcium and phosphorus and maintain its strength. ## Footnote if it happenes early on in children, where there is bone growth, its probably going to have more severe deficiencies and is reffered to as rickets
27
A patient labs result show hypercalcemia. What can the nurse infer may be the problem? a. the patient is overdosing on vitamin a b. the patient is overdosing on vitamin c c. the patient is overdosing on vitamin d
c. the patient is overdosing on vitamin d ## Footnote the patient may also be experiencing **hypervitaminosis D,** secondary to hypercalcemia.
28
A patient is experiencing hypervitaminosis D secondary to hypercalcemia and is showing s/s of:
- nausea - vomiting - anorexia
29
vitamin E is an antioxidant and is critical for what bodily function?
red blood cell function ## Footnote Vitamin E protects RBCs from hemolysis, (the destruction of RBCs)
30
A patient with a deficiency of RBCs may experience what?
Hemolysis ## Footnote breakdown / destruction of RBCs
31
A nurse knows that a patient overdosed on vitamin E is at risk for what? a. increased ICP b. increased urine output c. increased risk for bleeding d. decreased risk for saliva production
c. increased risk for bleeding
32
Vitamin K is required for what function?
it is required for synthesis of prothrombin and other clotting factors VII, IX, X ## Footnote Prothrombine time, aka PT, evaluates blood clotting; measures the time it takes for blood plasma portion of the blood to clot. normal range: 11 to 13.5 seconds
33
Vitamin K is the antidote for what drug? a. digoxin b. warfarin c. lovenox d. diphenhydramine
b. warfarin
34
A nurse knows that because infants are born deficient in what vitamin they usually recive a shot this at birth?
vitamin K ## Footnote vitamin k deficiency produces bleeding and infants are born vitamin k deicient which can lead to serious bleeding problems.
35
Toxicity of vitamin K in infants presents as hyperbilirubinemia, hemolytic anemia, and jaundice in newborns. True or false.
True.
36
Oral vitamin K1 (phytonadione) can cause shock, respiratory arrest, and cardiac arrest im adults. True or false.
False. ## Footnote **IV vitamin K1** (phytonadione) can cause schock, respiratory arrest, and cardiac arrest
37
The nurse knows that what route of vitamin k1 is nontoxic in adults? a. IV b. Oral c. Parental d. Intranasal
b. oral
38
what water soluble vitamin is required for the production of collagen, synthesis of adrenal steroids, absorption of iron? a. vitamin a b. vitamin b c. vitamin c d.vitamin d
c. vitamin c ## Footnote vitamin a and d are fat soluble vitamins
39
sources of vitamin C
citrus fruits/juices, tomatoes, potatoes, strawberries, melons, spinach, broccoli ## Footnote excessive doses of vitamin c cause GI irritation - abd cramps, nausea, diarrhea
40
a deficiency in vitamin c can lead to what disease?
scurvy ## Footnote smokers are also deficient
41
Vitamin B complex includes what
B1, B2, B3, B5, B6, B7, B9, B12 ## Footnote Think; This Really Nice Pet Played By Frisbee Catching This - Thiamine Really - Riboflavin Nice - Niacin Pet - Pantothenic Acid Played - Pyridoxine By - Biotin Frisbee - Folic Acid Catching - Cobalamin
42
B1 | This
thiamine
43
B1 (Thiamine) is essential for which of the following mechanisms? a. essential for carbohydrate metabolism b. essential for enzymatic rxns c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
a. essential for carbohydrate metabolism
44
What is the term for the deficency in Vitamin B1 Thiamine that can lead to **cardiac problems and edema**?
**Wet Betiberi** ## Footnote think wet = fluid problems
45
What is the term for vitamin B1 thiamine deficency that can lead to **neurologic disorders, ataxia, diplopia, and recent memory loss**?
**Dry beriberi** ## Footnote think = dehydration
46
What is **Dry beriberi** reffered to in alcoholics?
**Wernicke - Korsakoff syndrome** ## Footnote they are more predisposed to having a B1 deficiency
47
B2 (Riboflavin) is essential for which of the following mechanisms? a. essential for carbohydrate metabolism b. essential for enzymatic rxns c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
b. essential for enzymatic rxns ## Footnote - scaly dermatitis, skin cracks at corners of mouth, skin and tongue inflammation
48
B6 (pyridoxine) is essential for which of the following mechanisms? a. essential for carbohydrate metabolism b. essential for enzymatic rxns c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
c. essential for metabolism of amino acids and proteins ## Footnote - neuritis, seizure, anemia, depression, confusion, seborrheic dermatitis
49
B3 (niacin) is essential for which of the following mechanisms? a. essential for carbohydrate metabolism b. essential for enzymatic rxns c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
d. coenzyme for cellular respiration ## Footnote Pellagra: dermatitis characterized by scaling and cracking of the skin in areas exposed to the sun CNS: irritability, insomnia, memory loss, anxiety, and dementia - reduces high cholesterol in large doses and causes vasodilation
50
B12 (cyanocobalamin) is essential for which of the following mechanisms? a. involved in carbohydrate and fat metabolism, protein synthesis, DNA synthesis, and formation of blood cells b. essential in DNA synthesis c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
a. involved in carbohydrate and fat metabolism, protein synthesis, DNA synthesis, and formation of blood cells ## Footnote a deficiency can cause anemia, neurologic damage, mental status changes
51
B9 (Folate/Folic Acid) is essential for which of the following mechanisms? a. involved in carbohydrate and fat metabolism, protein synthesis, DNA synthesis, and formation of blood cells b. essential in DNA synthesis c. essential for metabolism of amino acids and proteins d. coenzyme for cellular respiration
b. essential in DNA synthesis ## Footnote a deficiency can cause impaired development of the CNS during pregnancy therefore they are encouraged in ALL women of childbearing age
52
B5 (Panthothenic acid)
genetic deficiency in pantothenate kinase - associated neurodegeneration 2
53
B7 (Biotin)
extremely rare
54
What companies are trustworthy when looking at the quality of Herbal supplements?
- U.S. Pharmacopeia - Consumer Lab - Natural Product Association - National Sanitation Foundation (NSF – International)
55
What herbal supplement's therapeutic use is to tx **congestive heart failure (CHF) and myopathies due to HMG-CoA reductase inhibitors** (statins) ? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
a. CoQ10
56
What herbal supplement's therapeutic use is to tx **osteoarthritis** of the knee, hip, and wrist? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
b. Glucosamine and Chondroitin
57
A patient states that they have a shellfish allergy. What herbal supplement should the nurse question? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
b. Glucosamine and Chondroitin
58
What herbal supplement's therapeutic use is to relieve urinary symptoms of **BPH**? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
c. Saw palmetto ## Footnote - may have antiplatelet effects - may have anti-androgenic effects **- likey not safe in pregnancy**
59
A patient states that they are pregnant. What herbal supplement should the nurse question? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
c. Saw Palmetto
60
What herbal supplement's therapeutic use is to tx **depression**? a. CoQ10 b. Glucosamine and Chondroitin c. Saw Palmetto d. St. John's Wort
d. St. John's Wort ## Footnote - Hyperforin and hypericin decrease reuptake of serotonin, norepinephrine, and dopamine
61
What herbal supplement should the nurse be concerned with interacting with many drugs?
St. John's Worth ## Footnote - Induction of cytochrome P450 enzymes - Induction of P-glycoprotein - Intensification of serotonin effects
62
Harmful Supplements
- Comfrey - Kava - Ma huang
63
What harmful supplement contains pyrrolizidine alkaloids that are associated with veno-occlusive disease? a. Comfrey b. Kava c. Ma huang
a. Comfrey
64
What harmful substance can elevate blood pressure and stimulate the heart and CNS? a. Comfrey b. Kava c. Ma huang
c. Ma huang
65
What harmful supplement can result in severe **hepatic damage**? a. Comfrey b. Kava c. Ma huang
b. Kava
66
What harmful supplements can elevate blood pressure and stimulate the heart and CNS? a. Comfrey b. Kava c. Ma huang
c. Ma huang
67
Glaucoma
Visual field loss secondary to optic nerve damage Forms: - Primary open-angle glaucoma (POAG) *most common* - Acute angle-closure glaucoma | s/s: tunnel vision ## Footnote - leading cause of preventable blindness in the US - abt 50% dx - 90% couldve saved their sight with timely tx
68
What form of Glaucoma is **progressive** optic nerve damage, with eventful vision impairment and flow of the **aqueous humor is slow** increasing intaocular pressure? a. Primary open-angle glaucoma (POAG) b. Acute angle-closure glaucoma
a. primary open-angle glaucoma | (POAG)
69
Tx of POAG
To **lower intraocular pressure** by targeting the production and the drainage of aqueous humor to slow or stop dz progression. ## Footnote Surgical tx: - Laser trabeculoplasty - Trabeculectomy
70
What form of Glaucoma is **precipitated** event where displacement of the iris covers the trabecular meshwork (drainage) and flow of the aqueous humor is severely blocked? It occurs suddenly with a lot of pain and causes irreverible vision loss in 1-2 days
Angle-Closure Glaucoma | narrow-angle
71
Tx of Angle-Closure Glaucome
To **lower intraocular pressure** by targeting the production and the drainage of aqueous humor to slow or stop dz progression. ## Footnote tx is rapid and acute before corrective surgery Surgical tx: - Laser iridotomy - Iridectomy
72
**Topical** Drugs for Glacoma lower IOP by:
- **Facilitating** aqueous humor **outflow** - **Reducing** aqueous humor **production** ## Footnote These topical drugs can cause **eye irritation & blurred vision** - combined therapy is more effective than monotherapy
73
What two *first line agents* are used for the tx of Glaucoma that reduce IOP **by reducing production of aqueous humor**? a. Betaxolol & Timolol b. Brimonidine & Apraclonidine c. Iatanoprost & Pilocarpine d. Echothiopate & Metoprolol
A. Betaxolol & Timolol | Beta Blockers ## Footnote - used primarily for open-angle glaucoma -* Betaxolol good for asthma patients*
74
# Alpha2 - Adrenergic Agonists What agent is used for the **short-term** therapy of Glaucoma that reduces IOP **by reducing production of aqueous humor**, but does not cross the blood-brain barrier? a. Timolol b. Apraclonidine c. Pilocarpine d. Brimonidine ## Footnote therefore it does not promote hypotension
b. Apraclonidine ## Footnote - used primarily for open-angle glaucoma
75
# Alpha2 - Adrenergic Agonists What agent is used for the **long-term** therapy of Glaucoma that reduces IOP **by reducing production of aqueous humor**, but DOES cross the blood-brain barrier? a. Timolol b. Apraclonidine c. Pilocarpine d. Brimonidine ## Footnote useful in ocular hypotension
d. Brimonidine ## Footnote AE: drowsiness, fatigue, and hypotension
76
# Prostaglandin Analog What first-line agent is used for the tx of Glaucoma that reduces IOP **by facilitating aqueous humor outflow**? a. Timolol b. Apraclonidine c. Lanoprost d. Metoprolol ## Footnote As affective as beta blocker, with fewer side effects
c. Lanoprost
77
A patient states that they are noticing a **brown pigmentation on their iris**. The nurse can assume the patient is on what **prostaglandin Analog**? a. Bumethasine b. Apraclonidine c. Lanoprost d. Labetalol
c. Lanoprost ## Footnote - increased lash ang length/thickness
78
# Cholinomimetics What second-line agent is used for the tx of Glaucoma that reduces IOP **by facilitating aqueous humor outflow** causing miosis and contraction of the ciliary muscle? a. Metrodolol b. Apraclonidine c. Lanoprost d. Pilocarpine ## Footnote Used for EMERGENCY tx of acute angle-closure glaucoma
d. Pilocarpine ## Footnote Adverse effects - Retinal detachment - Decreased visual acuity - Local irritation, brow pain, and eye pain - Systemic effects
79
Age-Related Macular Degeneration (ARMD)
painless, progressive dz that blurs central vision and limits perception of fine detail Forms: - **Dry** AMRD - **Wet** AMRD
80
Dry AMRD tx | drusen (yellow deposits under the retina)
antioxidants and zinc, multiple vitamins
81
Wet ARMD (neovascular) tx | growth of new fragile and leaky blood vessels (angiogenesis)
- Laser therapy - Photodynamic therapy - Angiogenesis inhibitor injection: **bevacizumab**
82
anatomy of the skin
Epidermis --> Dermis --> Subcutaneous ## Footnote epidermis is lipophilic so for something to penetrate it has to be a lipid
83
Acne
increased production of androgens, sebum production, and **turnover of epithelial skin cells which clogs pores and then the growth of propionibacterium acnes**
84
What **topical antibiotic** is given to reduce inflammation from *P. acnes*?
Clindamycin
85
What **retinoid** normalizes epithelial cell proliferation and thins the stratum corneum to reduce acne? a. erythromycin b. tretinoin c. flagyl
b. tretinoin ## Footnote AE: drying, burning, blistering, **sun sensitivity** bc the med thins the skin
86
What is the drug of choice for **oral antibiotic** that can cause *teeth discoloration*?
Doxycycline
87
What oral retinoid is used to tx severe nondulocystic acne vulgaris?
Isotretinoin
88
Which of the following does the nurse know is not an adverse effect of Isotretinoin used to tx acne? a. it is teratogenic b. nose bleeds c. inflammation of the lips and eyes d. intense dryness e. itchy feet f. increased sweating g. depression and suicidal ideation
e. and f. are incorrect ## Footnote Isotretinoin AE: a. it is teratogenic b. nose bleeds c. inflammation of the lips and eyes d. intense dryness g. **depression and suicidal ideation**
89
A women tells the nurse she is on isotretinoin. The nurse knows it is a highly **teratogenic** drug and will need to do which of the following? a. take pregnancy test monthly b. not give blood c. be on two forms of birth control d. exercise 20 minutes a day
a. take pregnancy test monthly b. not give blood c. be on two forms of birth control ## Footnote Isotretinoin iPLEDGE system
90
Psoriasis
common, chronic inflammatory disorder that follows an eratic course Symptoms result from: **- Accelerated maturation of epidermal cells** **- Excessive activity of inflammatory cells** ## Footnote therapy controls symptoms, there is no cure
91
What drug tx the symptoms of psoriasis by suppressing activation of inflammatory cells? a. Glucocorticoids b. Altepase c. Niamycin
a. Glucocorticoids
92
# conventional agents What chemotherapeutic drug can be used to inhibit epidermal proliferation? a. cyclosporine b. neusborine c. methotrexate d. marlicumab
c. methotrexate
93
# Biologic agents tx moderate to severe psoriasis by blocking inflammation All biologic agents for psoriasis suppress immune function, so which drug blocks **TNFα Blocking Antibodies**? a. Ustekinumab b. Adalimumab c. Methotrexate d. Marlicumab
b. Adalimumab
94
# Biologic agents tx moderate to severe psoriasis by blocking inflammation All biologic agents for psoriasis suppress immune function, so which drug blocks **Interleukin 12/23 Blocking Antibodies**? a. Ustekinumab b. Adalimumab c. Methotrexate d. Marlicumab
a. Ustekinumab
95
Pain medication to tx acute otitis media
- acetaminophen - ibuprofen - codeine - anesthetic ear drops
96
when are anitbiotics of acute otitis media given?
- pt is 6m or younger - severe or extremely inflammed - well est. bacterial infection
97
What is the drug that txs antibiotic-resistant otitis media? ## Footnote factors increase resistance: day care attendance, recent antibiotic exposure (1-2 m), winter and spring months, age <2yo
HIGH-dose AMOXICILLIN - **CLAVULANATE**
98
How to tx Acute otitis Eterna (swimmers ear)?
- 2% solution of acetic acid + alcohol as ear drops - Ciprofloxacin plus hydrocortisone
99
When **AOE progresses** to the outside of the ear, oral antibiotics become indicated. The nurse knows that the **adults** rx should include which drug? a. Cephalexin b. Barbitunide c. Longastrone d. Ciprofloxacin
d. Ciprofloxacin ## Footnote a floroquinone that can cause tendon rupture
100
When **AOE progresses** to the outside of the ear, oral antibiotics become indicated. The nurse knows that the **child's** rx should include which drug? a. Cephalexin b. Barbitunide c. Longastrone d. Ciprofloxacin
a. Cephalexin
101
A patient has **fungal** otitis externa and acidifying drops are not being effective, What can the nurse assume the HCP will perscribe next? a. Amoxicillin-Clavulanate b. Ciprofloxacin c. Cephalexin d. Clotrimazole
d. clotrimazole | antifungal