Tick born illness from Rickettsia rickettsii. Abrupt onset of high fever (103-105F), HA, myalgias, conjunctival injection, n/v, arthralgia and petechiae on day 3 of symptoms (so will look a lot like a high fever flu until the spots come on day 3). Petechiae erupt on hands and feet and move toward trunk. Tx = Doxy, draw antibodies, and biopsy skin lesion. RMSF is most common NOT in the Rockies (60% of cases are in TN,NC,AR,MO and OK) and occur in the spring and early summer. 1) Persons who have been recently infected with TB bacteria (close contacts of a person with infectious TB disease, persons who have immigrated from areas of the world with high rates of TB, children less than 5 years of age who have a positive TB test, groups with high rates of TB transmission, such as homeless persons, injection drug users, and persons with HIV infection, persons who work or reside with people who are at high risk for TB in facilities or institutions such as hospitals, homeless shelters, correctional facilities, nursing homes, and residential homes for those with HIV) and
2) persons with medical conditions that weaken the immune system
I- Olfactory. Smell. Sensory
II- Optic. Vision. Sensory
III- Oculomotor. EOMs, open eyelids, pupillary constriction. Motor
IV- Trochlear. Down and inward eye mvmt. Motor
V- Trigeminal. Muscles of mastication, sensation of face. Both
VI- Abducens. Lateral eye movement. Motor
VII- Facial. Move face, mouth, taste, saliva secretion. Both
VIII- Acoustic. Hearing and enquilibrium. Sensory
IX- Glossopharyngeal. Phonation, gag reflex, taste. Both
X- Vagus. Talking, swalling, carotid reflex. Both
XI- Spinal Accessory. Mvmt of shoulders (shrug). Motor
XII- Hypoglossal. Mvmt of tongue. Motor
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A pulmonary consolidation is a region of (normally compressible) lung tissue that has filled with liquid, a condition marked by induration (swelling or hardening of normally soft tissue) of a normally aerated lung. It is considered a radiologic sign. Consolidation occurs through accumulation of inflammatory cellular exudate in the alveoli and adjoining ducts. Simply, it is defined as alveolar space that contains liquid instead of gas. The liquid can be pulmonary edema, inflammatory exudate, pus, inhaled water, or blood (from bronchial tree or hemorrhage from a pulmonary artery). It must be present to diagnose pneumonia: the signs of lobar pneumonia are characteristic and clinically referred to as consolidation.
Signs that consolidation may have occurred include:
-Expansion of the thorax on inspiration is reduced on the affected side
-Vocal fremitus is increased on the side with consolidation
-Percussion is dull in affected area
-Breath sounds are bronchial
-Possible medium, late, or pan-inspiratory crackles
-Vocal resonance is increased. Here, the patient's voice (or whisper, as in whispered pectoriloquy) can be heard more clearly when there is consolidation, as opposed to in the healthy lung where speech sounds muffled.
-A pleural rub may be present.
-A lower Pa02
Typically, an area of white lung is seen on a standard X-ray. Consolidated tissue is more radio-opaque than normally aerated lung parenchyma, so that it is clearly demonstrable in radiography and on CT scans. Consolidation is often a middle-to-late stage feature/complication in pulmonary infections.
Of the given choices, infection with gonorrhea is the only option that is NOT a factor for erectile dysfunction. Advanced age, BG elevation and HTN are all r/t ED.
Other risk factors: hyperlipidemia, thyroid issues, neuro issues, substance abuse, certain meds (anti-hypertensives, psych meds, neuro meds, antihistamines, illicit drugs)