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Anna Sanchez, a 21-year-old nursing student, comes to her nurse  practitioner in

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Anna Sanchez, a 21-year-old nursing student, comes to her nurse  practitioner in December with a 5-week history of itchy eyes and nasal  congestion with watery nasal discharge. She also complains of a  “tickling” cough, especially at night, and she has had episodes of  repetitive sneezing. She gets frequent “colds” every spring and fall 

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