113 terms

Medical Diagnosis

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hidradenitis suppurative
rare, long-term skin condition that features small, painful lumps under the skin. They typically develop where the skin rubs together, such as the armpits, the groin, between the buttocks and under the breasts. The lumps may break open and smell or cause tunnels under the skin.
herpes zoster (shingles)
Reactivation of varicella-zoster virus that has remained dormant within dorsal root ganglia, often for decades after patient's initial exposure t varicella (chickenpox), results in herpes zoster (shingles). complication leads to postherpectic neuralgia
tinea versicolor
fungal infection of the skin. caused by a type of yeast that naturally lives on your skin.
Tinea corporis
(ringworm) is the name used for infection of the trunk, legs or arms with a dermatophyte fungus.
candidiasis
fungal infection caused by yeasts that belong to the genus Candida. if in mouth, it is thrush, if in vagina, it is yeast infection. There are many types of candida infections
Herpes Zoster
viral infection that causes a painful rash.can occur anywhere on your body, it most often appears as a single stripe of blisters that wraps around either the left or the right side of your torso.
caused by the varicella-zoster virus
acne vulgaris
common chronic skin disease involving blockage and/or inflammation of pilosebaceous units (hair follicles and their accompanying sebaceous gland).
acne rosacea
chronic, incurable, adult acne-like skin affects the central third of the face, especially the nose, and its intensity varies over time.
contact dermatitis
allergic or irritant skin reaction caused by an external agent.
cellulitis
acute spreading infection of the skin with visually indistinct borders that principally involves the dermis and subcutaneous tissue
ichtiosis
dry, scaly skin that in some cases may resemble the scales on a fish
atopic dermatitis
inflammatory skin condition characterized by dry, pruritic skin with a chronic relapsing course.
A child who has atopic dermatitis has recurrent secondary bacterial skin infections. What will the provider recommend to help prevent these infections?
Bleach baths twice weekly
Which types of medications are associated with urticarial type rashes?
Penicillins, Erythromycin, NSAIDs
When collecting a specimen to determine a diagnosis of tinea corporis, the provider will scrape which portion of the lesion?
The active, leading border
A previously healthy patient has an area of inflammation on one leg which has well-demarcated borders and the presence of lymphangitic streaking. Based on these symptoms, what is the initial treatment for this infection?
Amoxicillin-clavulanate
When recommending an over-the-counter topical medication to treat a dermatologic condition, which instruction to the patient is important to enhance absorption of the drug?
Place an occlusive dressing over the medication
A primary care provider is performing a Tzanck test to evaluate possible herpes simplex lesions. To attain accurate results, the provider will
remove the top of the vesicles and obtain fluid from the lesions.
A female patient is diagnosed with hidradenitis suppurativa and has multiple areas of swelling, pain, and erythema, along with several abscesses in the right femoral area. When counseling the patient about this disorder, the practitioner will include which information?
It is often progressive with relapses and permanent scarring.
When evaluating scalp lesions in a patient suspected of having tinea capitis, the provider uses a Wood's lamp and is unable to elicit fluorescence. What is the significance of this finding?
The patient may have tinea capitis.
Which type of bite is generally closed by delayed primary closure?
Deep puncture wounds, bites to the hand, Wounds 8 hours old
Which is the primary symptom causing discomfort in patients with atopic dermatitis?
pruritus
A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury?
Potential septic arthritis or osteomyelitis
Which medication will the provider prescribe as first-line therapy to treat tinea capitis?
Oral griseofulvin
When examining a patient's skin, a practitioner uses dermoscopy in order to
determine whether lesion borders are regular or irregular, assess changes in pigmentation throughout various lesions,visualize skin fissures, hair follicles, and pores in lesions
A provider is prescribing a topical dermatologic medication for a patient who has open lesions on a hairy area of the body. Which vehicle type will the provider choose when prescribing this medication?
gel
Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient's nose. What will the provider do?
Refer the patient for possible electrodessication and curettage
The parent of a 10-month-old child with atopic dermatitis asks what can be done to minimize the recurrence of symptoms in the child. What will the provider recommend?
Lubricants and emollients
A child is brought to a clinic with a sudden onset of rash after taking an antibiotic for 2 days. The provider notes all over wheals with pruritis, which the parent reports seem to come and go. Which action is correct?
Admit the child to the hospital for treatment and observation
Which medications may be used as part of the treatment for a patient with hidradenitis suppurativa? (Select all that apply.)
Erythromycin
Infliximab
Isotretinoin, prednisone
A patient has been bitten by a dog and has sustained several puncture wounds near the thumb of one hand. The patient is able to move all fingers and the bleeding has stopped. What is the correct treatment for this patient?
Obtain a physician consultation for evaluation and treatment
A patient has acne and the provider notes lesions on half of the face, some nodules, and two scarred areas. Which treatment will be prescribed?
Topical benzoyl peroxide and clindamycin
When counseling a patient who has dry skin about ways to minimize exacerbations, what will the provider include?
Eat soups and stews frequently ,Take tepid-water baths ,Use fragrance-free detergents
When using Dermabond Advanced adhesive for wound closure, manually approximate the edges for ______ seconds to allow for initial polymerization and instruct the patient not to apply any _______, which might break down the adhesive.
60 seconds, ointments or creams
During the I&D procedure, packing of the wound is used to ________. Overpacking can cause __________.
Promote healing by secondary intention and avoid premature closure of the wound; ischemia or interfere with wound drainage.
The initial goal of suturing is to:
Cause apposition of the tissue edges
When examining a patient, physical exam of a subcutaneous abscess will usually show _______. If still unsure, providers can also use _____ or _____ to confirm the diagnosis.
Swelling, pain, erythema, and fluctuant nodule; needle aspiration or ultrasound
Cutaneous abscesses have been described in all areas of the body, but are most commonly found in the ________.
Axilla, buttocks, and extremities
Cryotherapy is an effective therapy for skin lesions because ice formation in cutaneous cells causes
Changes in the cell membrane
A concentration of toxic solutes
Microcirculatory failure
Toenail removals are sterile procedures that require adequate anesthesia with _______.
Complete digital block using 1%lidocaine without epinephrine
medication that blocks conversion of angiotensin 1 to angiotensin 2 which is a potent vasoconstrictor
ACE inhibitors
medication that blocks angiotensin 2 resulting in less aldosterone
ARBs or alpha receptor blocker
medications that end in pril
Ace inhibitor
cozier and avapro are what type of medication
ARBs or alpha receptor blocker
CHF and bradycardia is contraindicated in what type of medication?
Calcium channel blocker
norvasc, verapamil, nifedipine and verapamil are what type of medication?
calcium channel blocker
a potent vasoconstrictor, alpha blocker is given to patients with
hypertension with BPH
penicillin allergic patients may also be allergic to
cephalosporins such as keflex
a good alternative antibiotic for penicillin allergic patients with gram positive bacterial infections are
macrolide such as azithromycin or clarithromycin
even though clindamycin is also an alternative for penicillin allergy patients avoid it because of slightly higher risk for
C. diff
most patients with mono may break out in nonallergic maculopapular rash if they take
amoxicillin, so avoid this medication
erythromycin , clarithromycin, azithromycin, Z-Pack is what type of antibiotic?
macrolide. macrolides are bacteriostatic antibiotics with a broad spectrum of activity against many gram-positive bacteria.
what type of antibiotics should only be used to treat conditions such as sinusitis, bronchitis, and uncomplicated urinary tract infections when other, less toxic antibiotics are not appropriate
quinolones
examples of quinolone are
ciprofloxacin, levofloxacin
what medication is not effective for mycoplasma and chlamydia
Bactrim
what type of medication is the initial treatment of choice for chronic bronchitis/COPD
anticholinergic such as ipratropium bromide or atrovent
If symptoms are not better with atrovent, what is the next treatment for patient with chronic bronchitis /COPD
saba or short acting beta 2 agonist
Drug class that work by blocking the action of acetylcholine in the brain and at nerves.
anticholinergic or antispasmodic
drug class that treats medical conditions involving muscles such as overactive bladder, muscle spasms, breathing problems, diarrhea, gastrointestinal cramps, movement disorders
Anticholinergics
Are typically used as "rescue" medications to provide quick relieve of asthma symptoms.
SABA or short acting beta agonist drugs such as albuterol
class of sympathomimetic agents which act upon the beta adrenoceptor. it relax muscles of the airways, which widens the airways and results in easier breathing.
Beta adrenergic agonists or Beta agonists, example is albuterol
combivent is a combination drug of what class
anticholinergic/SABA
Pneumovax is recommended for all
COPD patients
bacteriostatic or bactericidal are the two types of
antibiotic drugs
antibiotic that kills bacteria
bactericidal
antibiotic that limit bacterial growth and replication which limits the infection, resulting in lower bacterial count allowing immune system to clear it
bacteriostatic
antibiotic used to treat acne
tetracycline
tetracycline that is used to treat first line chlamydial and atypical bacterial infection
doxycycline
first line antibiotic used to treat moderate to severe acne rosacea
tetracycline
tetracycline decreased the effectiveness of
oral contraceptive pills
first line treatment for Pelvic inflammatory disease, cervicitis, atypical pneumonia, mycoplasma ex urethritis
doxycycline
are macrolide bacteriostatic or bactericide?
bacteriostatic
examples of these include: erythromycin, azithromycin, clarithromycin
Macrolides
Azythromycin has a drug interaction with
anticoagulant such as warfarin
Treat patient with _____ if they have to use a macrolide but cannot tolerate erythromycin or biaxin
azythromycin
macrolide with a lot of drug interaction
erythromycin
pain that follows the path of the nerve into arm or leg and may be accompanied by numbness or weakness. Other terms are sciatica or radiculopathy, and can be caused by conditions such as a herniated disc or spinal stenosis, or spondylolisthesis.
radicular pain
pain that you can identify with one finger, as in 'it hurts here.
axial pain
A patient reports severe back pain located in the lumbar spine. To evaluate whether the patient has axial pain or radicular pain, which assessment is necessary?
Asking the patient to perform the Valsalva maneuver
fluid-filled sacs that act as a cushion between bones, tendons, joints, and muscles. When these sacs become inflamed it is called
bursa, bursitis
A patient has symptoms of carpal tunnel syndrome. Which diagnostic tests will help confirm this disorder?
Electromyography, Nerve conduction studies
What are included in the initial management of bursitis of the heel?
Rest, ice, compression, and elevation , Activity modification and bracing, onsteroidal anti-inflammatory medications
A patient with elbow pain without localized erythema or warmth is diagnosed with bursitis of the elbow and serum laboratory results are pending. What is the initial treatment while waiting for these results
Elbow pads, NSAIDs, rest, and ice
A patient reports elbow pain and the examiner elicits pain with resisted wrist flexion, forearm pronation, and passive wrist extension on the affected side. What is a likely cause of this pain?
Medial epicondylitis
Which maneuver during a physical examination is used to assess the anterior cruciate ligament?
Anterior drawer test
A patient has an acute onset of lower back pain associated with lifting heavy objects at work. A physical examination reveals no loss of lower extremity function or neurological symptoms. What is the initial intervention for this patient?
Treatment with a nonsteroidal anti-inflammatory drug
An emergency department provider is giving instructions for rest, ice, compression, and elevation (RICE) treatment in a patient with a sprain. What is included in teaching about this home care?
An elastic bandage is sufficient for compression, Moist heat therapy may be applied if muscle spasm occurs, Place a cloth between the ice pack and the skin
A patient with shoulder pain is seen by an orthopedic specialist who notes erythema, warmth, and fluctuance of the shoulder joint. What is the next step in treatment for this patient?
Admit to the hospital for intravenous antibiotics
A patient has pain on the plantar aspect of the heel with weight bearing after rest. The pain is worsened with dorsiflexion of the foot. What is the initial treatment for this patient?
Avoiding all high-impact activities
A patient reports a deep ache in one shoulder and the provider suspects tendonitis secondary to repetitive activity. To determine whether the pain is caused by impingement on the acromion, the provider will ask the patient to
abduct the arm.
A patient has recurrent lumbar pain which is sometimes severe. The patient reports that prescription NSAIDs are no longer effective for pain relief. What will the provider recommend
Referral to an interventional spine physician
A patient injures an ankle while playing soccer and reports rolling the foot inward while falling with immediate pain and swelling of the lateral part of the joint. The patient is able to bear weight and denies hearing an audible sound at the time of injury. What does this history indicate?
Likely ankle sprain with a possible fracture
A patient reports a recurrent sensation of spinning associated with nausea and vomiting. Which test will the provider order to confirm a diagnosis for this patient?
The Hallpike-Dix positioning maneuver
A patient who has a seizure disorder and who takes levetiracetam is brought to an emergency department with a seizure which has persisted for15 minutes and which immediately followed another 15 minute seizure. What is the priority action for this patient?
Administer lorazepam and monitor cardiorespiratory status
An elderly patient is brought to the emergency department after being found on the floor after a fall. The patient has unilateral sagging of the face, marked slurring of the speech, and paralysis on one side of the body. The patient's blood pressure is 220/190 mm Hg. What is the likely treatment for this patient?
Neurosurgical consultation
What are initial approaches when managing delirium in a hospitalized patient who is agitated and confused?
Attend to hydration and toileting needs , Discontinue any non-essential medications ,Decrease stimulation
Which tests are indicated as part of the initial evaluation for women of childbearing age who report syncope?
12-lead electrocardiogram , Complete blood count,
Electroencephalogram,
Serum glucose testing
A previously healthy 30-year-old patient is brought to the emergency department with signs of stroke. Diagnostic testing determines an ongoing ischemic cause. The patient's spouse reports that symptoms began approximately 2 hours prior to transport. What is the recommended treatment?
Tissue plasminogen activator (tPA) administration
A healthy 20-year-old patient reports having had 1 or 2 episodes of syncope without loss of consciousness. Which is the most likely type of syncope in this patient?
Reflex syncope
A patient who sustained a head injury has a Glasgow Coma score of 14. The patient's spouse reported that the patient lost consciousness for approximately 7 minutes after falling down the stairs. A head CT does not reveal brain lesions. Which treatment is indicated?
Admission to the hospital with a neurosurgical evaluation
A 35-year-old patient reports suddenly experiencing an asymmetric smile along with drooping and tearing in one eye. The patient has a history of a recent viral illness, but is otherwise healthy. During the exam, the provider notes that there is unilateral full face paralysis on the right side. What is the initial intervention for this patient?
Prescribe oral prednisolone
A patient with a seizure disorder has seizures which begin with eye twitching and occasionally visual hallucinations. Which site in the brain is the seizure focus?
Occipital
What are initial approaches when managing delirium in a hospitalized patient who is agitated and confused? (Select all that apply.)
Decrease stimulation,Attend to hydration and toileting needs ,Discontinue any non-essential medications
An 80-year-old patient becomes apathetic, with decreased alertness and a slowing of speech several days after hip replacement surgery alternating with long periods of lucidity. What is the most likely cause of these symptoms?
delirium
Which drug is used to treat patients with focal epilepsy and complex partial seizures?
carbamazepine
A previously lucid patient with early-stage Alzheimer's disease is hospitalized after a surgical procedure and exhibits distractibility and perceptual disturbances that occur only in the late afternoon. The patient has difficulty sleeping at night and instead sleeps much of the morning. What is the likely cause of these symptoms?
Sundowner syndrome
A patient exhibits visual field defect, ataxia, and dysarthria and complains of a mild headache. A family member reports that the symptoms began several hours prior. An examination reveals normal range of motion of the neck. What type of cerebrovascular event is most likely?
Ischemic stroke
What is recommended to prevent ophthalmic complications in patients with Bell's palsy?
Lubricating eye drops
A patient has sustained a human bite on his hand during a fist fight. Which is especially concerning with this type of bite injury?
Potential septic arthritis or osteomyelitis
When examining a patient's skin, a practitioner uses dermoscopy in order to
determine whether lesion borders are regular or irregular. ,assess changes in pigmentation throughout various lesions. visualize skin fissures, hair follicles, and pores in lesions.
Curing a total body skin examination for skin cancer, the provider notes a raised, shiny, slightly pigmented lesion on the patient's nose. What will the provider do?
Refer the patient for possible electrodessication and curettage
When counseling a patient who has dry skin about ways to minimize exacerbations, what will the provider include?
Eat soups and stews frequently,Take tepid-water baths,Use fragrance-free detergents
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