contraceptives, monthly prego testing, only prescribe 1 month supply.
Acne Rosacea-
chronic small acne like papules/pustules around nose mouth chin.
TREATMENT- Metrogel, Azelex. Low dose tetracycline.
EXAM
Impetigo-
Gram positive. Itchy pink-red lesions, evolve into vesiculopustules that rupture. If bullous-
large blisters. Severe- Keflex, dicloxacillin. PCN Allergic-Azithro, clinda. If NO BULLAE- Bactroban. EXAM
Scarlet fever (Scarlantina)-
“sandpaper textured-pink rash with sore throat” strawberry tongue,
rash starts on head and neck, spreads to trunk. The skin THEN desquamates.
EXAM
LICHEN PLANUS:
SMALL FLAT TOPPED, RED TO PURPLE BUMPS THAT MAY HAVE
WHITE SCALES/FLAKES.. WHISPY GREY WHITE STREAKS CALLED WICHHAMS STRIAE.
INNER WRISTS FOREARMS, AND ANKLES. IF ON SCALP CAUSE HAIR LOSS. Causes
hep C, medications, contact with chemicals.
EXAM
Spider bite: fever chills, n/v, located arms, upper legs, or the trunk. Biten area
becomes swollen, red, and tender, and blisters appear within 24-48 hours. Necrotic
in center, which kills the tissue. Ice packs to wound and cold inactivates the toxin, tx
like cellulitis of the skin, abx ointment at first, watch etc.
Exam
Pityoris rosea itchy, herald patch, xmas tree pattern, rash hands soles/feet
think to test for secondary syphilis RPR then VDRL are screening, then dx
FTA-ABS. EXAM
HEAD/EARS/EYES/NOSE/THROAT
Herpes keratitis-
fluorescein dye “fern like” CN V.
Abrupt onset of pain.
Corneal Abrasions- Round/Irregular.
Was on EXAM.
Acute Angle-closure
glaucoma
-
acute/severe halos, cupping optic nerve,
cloudy cornea, mid-dilated oval pupil. ER STAT.
EXAM
Primary
Open
Angle Glaucoma-
CN2 gradual changes in peripheral vision LOST FIRST, then
second central vision.
Cataracts is on EXAM in elderly night vision issues. Opaque
EXAM
Age-Related Macular Degeneration – Painless loss of “central vision” reports straight
lines appear curved. Periphery is preserved. Give asmler grid.
Retinal Detachment- Floaters, curtain, flashes of light. Painless.
EXAM
Cholesteatoma-
cauliflower, foul-smell, hearing loss. If erodes bones in face afects CN VII. SURGERY
Canker sores-
Aphthous stomatitis: painful shallow ulcers heal 7-10 days. Magic
mouthwash.
Papilledema-
optic disc swollen w/ blurred edges due to increased ICP.
EXAM
Hypertensive Retinopathy-
Copper/silver wire arterioles. AV nicking(mild retinopathy). Retinal
Hemorrhages.
EXAM
Diabetic Retinopathy-Cotton wool spots (moderate retinopathy), micro-aneurysms.
ALSO RETINAL HEMORRHAGES ON CENTER OF EYE APPEAR ORANGE RED
Koplik Spots- “clusters sm. Size red papules w/ white centers in the buccal mucosa by lower molars”.
Rubeolla. Fever, conjunctivitis, coryza, cough (3c). Morbiliform rash.
EXAM
Sensorineural:
Lateralization to good ear.
Rinne- AC > BC.
Conductive:
Lateralization to bad ear. Rinne- BC > AC.
Rinne (1
st
mastoid, 2 front of ear, time each area).
Weber: Tunning fork midline. CN 8 (acoustic).
EXAM
Hordeolum-
painful
swollen red warm abscess TREAT hot compress
erythromycin, dicloxacillin.
Acute Otitis Media- middle ear. Usually
S. pneumo. (others: h influ, mor catarrhalis).
Popping, muffled, afebrile or low-grade, TM can rupture blood and pus on pillow on
awakening with relief of ear pain. “erythematous TM” bulging or retracting.
