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Primary Care I > Module 2 > Flashcards

Module 2 Flashcards

1
Q

Alopecia

A

baldness, considered autoimmune disease, may be genetic with environment trigger
Can occur anywhere where hair is present

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2
Q

alopecia areata

A

hair loss occuring in patches

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3
Q

androgenetic alopecia (AGA)

A

or male-pattern baldness
most common cause of permanent hair loss
inherited from both parents

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4
Q

four cycles of scalp hair growth

A

anagen- growth phase
latent or involution- catagen
resting- telogen
hair shed- exogen

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5
Q

meds that cause hair loss

A

hormones
anticonvulsants
anticoagulants
oral contraceptive
beta blocker
antithyroid
excessive vitamin A

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6
Q

trichotillomania

A

hair pulling
more common in teens/kids
usually same side as dominant hand

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7
Q

alopecia treatment (greater than 50%)

A

oral corticosteroids, topical immunotherapy and immunomodulators

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8
Q

finasteride

A

tx alopecia
approved for men only
use with caution in liver dx
SE: decreased libido, ED

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9
Q

minoxidil

A

Topical, available OTC
aka rogaine
Best works for patients with recent onset of alopecia (less than 5 years)
SE: irritation, itching, dryness

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10
Q

the larger the melanosome

A

darker the skin color

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11
Q

Vitiligo

A

, or the total loss of skin color in patchy areas of the body (rarely over the entire body), is recognized clinically as white macules or patches that are usually located on sun-exposed areas, such as the face, lips, arm, hands, and feet.
most often in mid 20s
thought to be autoimmune

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12
Q

tx vitiligo

A

topical corticosteroids, light therapy, psoralen with UVA therapy

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13
Q

chloasma

A

“the mask of pregnancy”
caused by increased levels of estrogen, progesterone, melanocyte stimulating hormone
affect face, nipples, genitals, linea nigra
worsened by sunlight

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14
Q

tx chloasma

A

retinoic acid, hydroquinone cream, tretinoin, corticosteroid

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15
Q

melasma

A

more general term for hyperpigmentation of certain areas of skin regardless of pregnancy status
tx with hydroquinone and sun avoidance

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16
Q

Addison’s disease

A

can cause diffuse generalized hyper-pigmentation, especially in skin crease
other symptoms: weakness, fatigue, weight loss, amenorrhea, n/v, diarrhea

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17
Q

very dark color on one nail is suscpicious for

A

melanoma

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18
Q

pruritus causes

A

insects, contact dermatitis, medications, detergents, alternative meds/ herbs, recreational drugs

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19
Q

xerosis

A

dry skin

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20
Q

pruritus management

A

eliminate strong soaps, shorter showers, use effective emoillents
use of mild soap- dove, basis, purpose, cetaphil, neutrogena
apply emollient immediately after shower
rx- h1 histamine- hydroxyzine or benadryl (watch for drowsiness)

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21
Q

exanthem

A

rash
red/pink colored skin eruption

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22
Q

Paget’s disease

A

rash that looks like eczema dermatitis of nipple/areola
onset is gradual
typically on one nipple

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23
Q

toxic shock syndrome

A

risk factors- tampon use, greater than 30 hours
may have fever, vomiting, weakness, confusion
also may have bright red, fine maculopapular rash
remove tampon immediately!

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24
Q

urticaria

A

hives/wheals
a sudden generalized eruption of pale, evanescent wheals or papules associated with severe itching

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25
Q

Cholinergic urticaria

A

trigger- exercise, anxiety, elevated body temp, hot bath
lesions resolve within 30 mins
hives small, on trunk and arms

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26
Q

pruritic urticarial paules and plaques of pregnancy

A

PUPPP
papules and plaques that start on abdomen and spread to thighs, buttocks
normally during last 2 weeks of pregnancy
resolves after delivery
tx: corticosteroid

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27
Q

Scabies

A

is a highly contagious mite infestation that occurs mainly in children, young adults, health-care workers, and institutionalized persons of all ages. It is characterized by generalized intractable pruritus, often with minimal cutaneous manifestations

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28
Q

mode of transmission for scabies

A

close personal contact

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29
Q

crusted scabies

A

characterized by scaly lesions at the sites of invasion that soon become warty and encrusted, creating a protective barrier for these mites
more common in immune compromised

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30
Q

scabies clinical presentation

A

intense itching, worse at night- does not respond to treatment
changes in feeding pattern with kids
1-2 mm red papules in interdigital web space, wrist, axillary, pelvis, ankles, penis
burrows- white color with black specks

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31
Q

scabies diagnosis

A

burrow ink test
drop mineral oil over burrow, scrape off burrow with scalpel and ID

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32
Q

scabies tx

A

clean environment, close contacts
Kill all live mites- scabicides (permethrin)- first line tx
Some may require corticosteroids if severe

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33
Q

scabies follow up

A

1 week after treatment

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34
Q

Pediculosis

A

Infestation by lice
3 species- crab louse, head louse, body louse
Common in school aged kids

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35
Q

Pediculosis clinical presentation

A

Itching, more severe at night
Feeding pattern change
2-3 mm red erythematous macules or papules, often pruritic
excoriations often present
fresh nits closest to scalp

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36
Q

Diagnosis of pediculosis

A

itching and finding white nits or lice on hair shaft

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37
Q

pediculosis tx

A

Kill/remove lice and their nits- shampoo, cream rinse, lotion
manual delousing

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38
Q

pediculosis follow up

A

if uncomplicated, not needed
if needed, f/u in one week if symptoms persist

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39
Q

Candida is part of the normal flora of both the

A

oropharynx and gastrointestinal (GI) tract

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40
Q

two most important factors contributing to candidal infections

A

Favorable environmental factors and a weakened immune system are the

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41
Q

In women with AIDS, one of the earliest and most frequent opportunistic infection is

A

vaginal candidiasis.

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42
Q

thrush clinical presentation

A

severe sore throat, pain with swallowing
white creamy patches on ant/post pharynx and tongue

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43
Q

vaginal candidiasis clinical presentation

A

burning, itching, irritation of vulva/vagina
white cottage cheese discharge

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44
Q

balanitis clinical presentation

A

red rash and itching on penis
may have female sex partner being tx for yeast infection

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45
Q

intertriginous candidiasis

A

obese patient with red itchy rash, sometimes is weepy and moist
typically occurs where there is skin rubbing against skin

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46
Q

candidal paronychia

A

painful fingertip that is red hot and swollen
frequent water immersion of the hands common

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47
Q

subungual candida

A

no pain or itching
several discolored yellow fingernails for weeks/months
excessive contact from water immersion

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48
Q

topical antifungals

A

nystatin, clotrimazole, miconazole, naftifine, terbinafine, ciclopirox
applied twice daily x2-4 weeks
apply cream sparingly, may cause maceration

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49
Q

first line treatment for mild oral candidiasis

A

clotrimazole troches 10mg five times daily
or nystatin

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50
Q

candida infection follow up

A

2 weeks

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51
Q

dermatophytoses

A

aka tinea
superficial skin infections

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52
Q

tinea capitus

A

ringworm of scalp

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53
Q

tinea corporis

A

ringworm of the body

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54
Q

tinea cruris

A

ringworm of the groin

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55
Q

tinea pedis

A

athlete’s foot

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56
Q

tinea manuum

A

tinea of the hands

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57
Q

tinea infections more common in

A

warmer climates

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58
Q

most common fungal infection in USA

A

athelete’s foot

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59
Q

tinea capitus clinical presentation

A

typically toddler or school age kid
painless bald spot
may have 3 apprearances- black dot, gray patch, kerion (large bright red boggy bump)

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60
Q

tinea corporis clinical presentation

A

erythematous round and elevated pruritic lesion that grows in size and starts to clear in center
classic shape of ringworm

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61
Q

tinea cruris clinical presentation

A

typically obese man with pruritic rash on groin that spreads to medial upper thigh
“jocks itch”

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62
Q

tinea pedis clinical presentation

A

strong foot odor
macerated soft whitened skin between toes

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63
Q

tinea versicolor

A

hypopigmented spots, mild pruritus
normally on back

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64
Q

fungal culture recommended for

A

onychomycosis and tinea capitis

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65
Q

tinea infection treatment (not capitis or onchomycosis)

A

2-4 week topical treatment with azole class meds
continue at least 1 week after lesion has cleared

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66
Q

tinea capitis treatment

A

oral systemic antifungal along with topical
treatment of choice: griseofulvin po bid for 2-4 months

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67
Q

tinea versicolor treatment

A

topical selenium sulfide lotion applied daily x7 days from neck to waist
repeated once weekly x1 month, then once month for maintenance
hypopigmented spots may take longer to resolve

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68
Q

tinea follow up

A

2 weeks

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69
Q

onychomycosis

A

benign superficial infection of the toenails and fingernails
young/middle aged bothered more by appearance
nail discoloration
first or fifth most likely to be affected

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70
Q

onychomycosis treatment

A

itraconazole
terbinafine
monitor liver function tests

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71
Q

onychomycosis follow up

A

check liver function test q4 weeks, follow up first on fourth week and then q 4-6 weeks

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72
Q

impetigo

A

contagious, superficial vesiculopustular infection of skin commonly seen infants/children
spread through direct contact among people
typically includes staph aureus and strep together

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73
Q

impetigo risk factors

A

insect bite
warm weather

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74
Q

impetigo clinical presentation

A

pruritus from lesions, red crusty rash spreading, normally on face or extremities

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75
Q

diagnostic testing for impetigo

A

bacterial culture and sensitivity
gram positive cocci

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76
Q

impetigo management

A

plain tap water 3-4x/day for 10-20 min to debride lesions
topical and oral abx-mupirocin topical bid x5 days
if fever/toxicity- cephalexin x7 days

77
Q

impetigo follow up

A

10-14 days after initiation of therapy

78
Q

folliculitis

A

superficial to deep skin infection of hair follicles
often caused by staphylococcus
most common in middle aged and children
risk factor- immunocompromised

79
Q

folliculitis clinical presentation

A

“bumpy rash” anywhere on body
typically no itching
small pustules, no involvement of surrounding skin

80
Q

barber’s itch

A

folliculitis of hair follicles on beard area of men
usually upper lip
aggravated by shaving, most common in black men

81
Q

folliculitis diagnostic test

A

gram stain and culture by rupturing a pustule and taking sample of exudate
positive for gram positive cocci

82
Q

folliculitis management

A

gentle cleansing by washing twice daily with antibacterial soap

83
Q

furuncle

A

boil
deep bacterial infection of hair follicle with abscess formation
caused by gram positive s. aureus
most common- scalp, neck, axilla, buttocks, groin, thighs

84
Q

carbuncle

A

large, multiloculated abscess with multiple furuncles
less common
large, red painful lumps on skin

85
Q

furuncle clinical presentation

A

hot, tender bright red bump
may develop yellow central plug

86
Q

furuncle diagnosis

A

gram stain and culture for s. aureus

87
Q

furuncle treatment

A

must be drained to heal, typically occurs spontaneously within 2 weeks
can use treatment with topical abx like mupirocin twice daily
if on face, refer to physician

88
Q

carbuncle treatment

A

systemic antibiotics and physician referral
cephalexin, doxycycline

89
Q

furuncle follow up

A

1 week

90
Q

cellulitis

A

bacterial infection of skin involving both dermis and subcut tissue
most caused by group a betahemolytic streptococcus or by s. aureus

91
Q

cellulitis clinical presentation

A

tender warm erythematous area of skin, normally on face, neck, extremities
may have precipitating condition- insect bite, small cute
red borders are flat and diffuse

92
Q

cellulitis treatment

A

depends on culture and gram stain results
penicillin, dicloxacillin, clindamycin, cephalexin

93
Q

cellulitis follow up

A

improvement normally within 2-3 days

94
Q

Erysipelas

A

it can be fatal if it is not treated promptly
only involves superficial level of skin, not subcut
face, lower legs
high fever, chills, malaise
bright red lesion by nares that spread rapidly, becomes enlarging plaque that is warm to touch and has sharp, distinct borders

95
Q

necrotizing fasciitis

A

rapid progression of tissue destruction
bright red lesion with edema, severe pain at affected site

96
Q

periorbital cellulitis

A

life-threatening, emergent
pain with certain eye movements, fever, tachycardia, lethargy

97
Q

warts

A

contagious skin lesions formed by infected keratinocytes, caused by HPV
can be transmitted by touch
risk factor= handle raw meat, bite nails, walk barefoot

98
Q

wart clinical presentation

A

small bump present for several weeks- months
become dome shaped with black dot on surface

99
Q

wart management

A

1/2 resolve without treatment within 1 year, 2/3 within 2 years
salicyclic acid plaster
may also treat with cryosurgery/liquid nitrogen

100
Q

HSV infection

A

2 types- genital and oral.
2 phases- primary and secondary or recurrent infection. symptoms occur 2-21 days after exposure

101
Q

hsv infection clinical presentation

A

“cold sore”
fever, sore throat- oral
genital- fever, headache, muscle ache, painful urination

102
Q

herpes simplex diagnostic testing

A

viral culture, dna study- sample must be done in first 72 hours of outbreak

103
Q

herpes simplex management

A

acetaminophen to control fever and pain
blistex- oral
genital- oral antiviral like valacyclovir and famciclovir

104
Q

atopic dermatitis

A

eczema
not distinct disease, descriptive term for group of skin disorders characterized by pruritus and inflammation
inherited skin reaction that usually begins in infancy

105
Q

atopic dermatitis clinical presentation

A

the itch that rashes
cardinal sign-itching
history of episodic exacerbation
infants- lesions affect cheeks, face, upper extremities- excoriated, maculopaular, inflamed

106
Q

RAST test

A

radioallergosorbent test
identifies antigen specific mast cell activation to quantify levels of allergen specific igE

107
Q

atopic dermatitis management

A

control signs/symptoms, no cure
eliminate precipating factors, wet lesions should dry, dry lesion should hydrate, inflammation treat with steroids

108
Q

nonpharm atopic dermatitis treatment

A

mild emollients (cetaphil)
soak baths preferred, followed by moisturizer
no fragrance soap

109
Q

pharmacologic management atopic dermatitis

A

antihistamines not effective
doxepin
singulair
corticosteroids

110
Q

contact dermatitis

A

can be either irritant dermatitis or allergic dermatitis

111
Q

allergic contact dermatitis

A

immunologically mediated

112
Q

irritant contact dermatitis

A

result of repeated insults to atopic skin from caustic, irritant, detergent substance

113
Q

contact dermatitis clinical presentation

A

pruritic erythematous rash
weeping lesions with numerous tiny vesicles
rough, reddened patches, but without skin thickening of psoriasis

114
Q

contact dermatitis management

A

symptom relief while trying to ID underlying precipitant and eliminating it
drying agents (calamine lotion) twice daily

115
Q

seborrheic dermatitis

A

chronic condition that is characterized by remissions and exacerbations and may be a sign of more serious underlying pathology, such as immune suppression. The rash of seborrheic dermatitis is seen on skin that is rich in sebaceous glands, such as the scalp, forehead, eyebrows, and the area surrounding the nose and ears

116
Q

seborrheic dermatitis clinical presentation

A

scaly patches that are slightly papular, surrounded by erythema
most frequently on scalp

117
Q

seborrheic dermatitis management

A

OTC antidandruff shampoo- 5-7 minutes
may require prescription shampoo (2.5% selenium sulfide)
topical steroid

118
Q

psoriasis

A

chronic relapsing disorder of keratin synthesis that is characterized by well-circumscribed, raised, erythematous papules and plaques, covered with silvery-white scales, usually involving extensor areas in adults such as the elbows and knees, the scalp, and, in some forms, the flexural surfaces of the body. The phrase “heartbreak of psoriasis” was coined because of the physically and emotionally disabling effects of the disease.
strong genetic influence, environmental factors trigger

119
Q

psoriasis clinical presentation

A

gradual symptoms confined to one area mostly
itchy red inflamed dry scaly plaques
preceding strep throat infection
lesions usually over bony prominences on elbows knees

120
Q

psoriasis management

A

systemic only for moderate-severe– methotrexate, otezla, gengraf
topical- emoillient, kertolytic agents twice daily
topical corticosteroids

121
Q

psoriasis follow up

A

every 2 months by specialist if severe

122
Q

dry eye syndrome

A

discomfort, visual disturbance, tear film instability- quantity/quality of tears fails to keep surface of eye adequately lubricated
“sand in eye”

123
Q

3 layers to tears

A
  1. outer oily layer- lipids
  2. middle aqueous layer- watery portion of eyes, with proteins
  3. inner mucin layer- binds water from aqueous layer to ensure that eye remains wet
124
Q

risk factors for dry eye

A

advanced age, female, computer usage, seasonal allergy, autoimmune disease
meds- antihistamine, decongestants, anti depressants, birth control

125
Q

epiphora

A

excessive tearing
overflow of tears from one or both eyes
may be from dry eye, exposure to irritant, obstruction of lacrimal duct

126
Q

red eye

A

nonuniform redness of the conjunctiva
most common cause- pink eye

127
Q

cause of floaters in vision

A

contraction of vitreous humor
if gradual and become less noticeable, usually benign
if sudden, especially bilateral, may need eval

128
Q

photopsia

A

flashing lights
should be evaluated immediately for retinal tear or detachment

129
Q

blepharitis

A

inflammation of eyelids and margins

130
Q

two forms of blepharitis

A

nonulcerative form- associated with seborrhea of face and greasy scaling at eyelid margin
ulcerative form- may involve eyelash follicles and meibomian glands of eyelid

131
Q

blepharitis clinical presentation

A

itching, burning, foreign body sensation in eye
sensitivity to bright light
lid margins edematous and erythematous

132
Q

Nonulcerative blepharitis management

A

Eyelid cleaning with a diluted 1:1 mixture of no-tears shampoo (baby shampoo) and water, using a soft washcloth or cotton balls.

133
Q

Staphylococcal blepharitis/ulcerated lesions management

A

bacitracin or erythromycin 0.5% ointment can be prescribed and applied on the eyelids one or more times daily or at bedtime after gentle cleansing and using warm compresses

134
Q

blepharitis follow up

A

2 weeks, then re-eval in 2 months

135
Q

hordeolum

A

, also known as a stye, is an acute, erythematous, tender lump within the eyelid. This condition is caused by inflammation or infection of the eyelid margin affecting the hair follicles of the eyelashes (external hordeolum) or the Meibomian glands

136
Q

chalazion

A

is a granulomatous infection of a Meibomian gland that presents as a a painless swelling on the eyelid. Initially, a chalazion may be tender and erythematous before evolving into a nontender lump.

137
Q

hordeolum treatment

A

warm compress
scrub eyelids with baby shampoo and warm water 2-4x daily
do not squeeze
d/c eye makeup
no contacts

138
Q

otalgia

A

ear pain
could be pain that originates in ear or outside of ear

139
Q

primary otalgia

A

cause: external otitis, otitis media, mastoiditis, auricular infection

140
Q

tinnitus

A

subjective ringing/buzzing
intermittent, continuous, pulsatile
may be unilateral or bilateral

141
Q

sore throat causes

A

most common- streptococcal or viral infection

142
Q

aging and hearing

A

degeneration of inner ear structure over time cause hearing loss
men more likely to experience than women

143
Q

risk factors for hearing loss

A

chronic middle ear infection
ruptured tympanic membrane
acoustic trauma
exposure to loud noises
allergies

144
Q

sensorineural hearing loss

A

a lesion in the organ of Corti or in the central neural pathways of the ear, including the cranial nerve (CN) VIII and auditory cortex

145
Q

presbycusis

A

age related hearing loss
form of sensorineural hearing lsos

146
Q

Conductive hearing loss

A

results when the passage of sound waves through the tympanic membrane and inner ear is impaired.
may occur at any age
often reversible

147
Q

Hearing loss associated with Meniere’s disease

A

fluctuating hearing loss, usually unilateral, associated with tinnitus and vertigo

148
Q

acoustic neuroma hearing loss

A

rare tumor of CN VIII, causes unilateral constant or progressive hearing loss, possibly associated with headache

149
Q

objective finding with sensorineural hearing loss

A

Weber- When sensorineural, sound in unaffected ear is louder
Rinne-  When sensorineural, ratio remains 2:1
Schwabach-  When sensorineural, bone conduction is present for shorter time than examiner’s

150
Q

objective finding with conductive hearing loss

A

Weber-  When conductive, sound in affected ear is louder
Rinne- ratio closer to 1:1
Schwabach- bone conduction present for longer than examiner

151
Q

Cerumen disimpaction-

A
  • place 1:1 mixture of 3% hydrogen peroxide and warm mineral oil in external ear canal and for 1 hour, followed by lavage with warm saline, directed toward canal wall and not toward eardrum
    o Debrox (Cerumenolytic) also effective, do not use with perforated tympanic membrane or infection
    o If trauma with cerumen disimpaction occurs, use corticosteroid/antibiotic otic solution
152
Q

Sudden sensorineural hearing loss-

A

referral to otorhinolargyngologist

153
Q

Perforation to tympanic membrane, suspicious for Meniere’s disease

A
  • referral to ENT
154
Q

Acoustic neuroma

A
    • refer for surgical eval
155
Q

Tinnitus

A
  • Subjective perception of noise when no environmental noise is present
  • Can be intermittent, continuous, pulsatile
  • Strongly associated with aging
  • Risk factors: hearing loss, labyrinthitis, Meniere’s dx, OM or OE, hypo or hypertension, anemia, hypo or hyperthyroidism, allergies
156
Q

tinnitus physical exam

A
  • Orthostatic BP
  • Gross hearing tests
  • Auscultation of upper part of neck proximate to affected ear
  • Neuro exam
157
Q

Meniere’s Disease

A
  • Peripheral sensory disorder of labyrinth and cochlea of inner ear
  • Endolymphatic volume and inner ear pressure increased, results in auditory and vestibular dysfunction
  • Recurrent attacks of tinnitus, vertigo, progressive hearing loss
  • Risk factors: allergies, high salt, caffeine, etoh, hormonal change, change in barometric pressure, exposure to high noise levels
  • Patho- possible inflammatory disease?
158
Q

diagnosis of meniere’s criteria

A
  • Two distinct episodes of vertigo (lasting 20 mins), along with sensorineural hearing loss, and tinnitus or aural fullness
159
Q

Meniere’s treatment

A
  • Rule out all other causes of symptoms
  • No proven cure, therapy is mainly palliative
  • Tx acute attack- rest with eyes closed, protection from falling
  • Dietary modification, vestibular rehab
160
Q

Otitis Externa (Swimmer’s Ear)

A
  • Inflammation of membranous lining of auditory canal
  • Invasive OE is life threatening
  • 10-20x more likely to occur in warmer summer months than in cooler seasons
  • Immune compromised at greater risk for infectious OE
  • Likely d/t pseudomonas infection, or staph aureus
  • Risk factors: skin maceration, traumatic injury, excessive cleaning, excessive moisture
161
Q

Necrotizing OE

A
    • most severe, moves from skin of auditory canal into soft tissues, cartilage and bone, may involve multiple cranial nerves
162
Q

objective findings otitis externa

A
  • Tenderness on traction of pina
  • Instill several drops of benzocaine/antipyrine otic solutions before exam, but not with ruptured membrane
  • Auditory canal- edematous, erythematous
  • Fluid- green, yellow, white (fungal)
163
Q

otitis externa treatment

A
  • Comfort is primary focus of care
  • Apply heat to outer ear, or ice
  • ASA, acetaminophen, ibuprofen prn
  • If pain extreme, Tylenol #3 or Vicodin
  • Avoid swimming or submersion of ear under water for 4-6 weeks
  • If bacterial OE, tx with topical antibiotic
  • If ear is edematous, cotton plug soaked in otic prep should be inserted
164
Q

otitis externa follow up

A
  • Normally cured after 7-10 days, follow up in 1 week if uncomplicated
  • If ear wick placed, return in 2 days for removal and cleaning
165
Q

otitis media

A
  • Inflammation of structure of middle ear
  • Risk control for infants/young kids: stop tobacco exposure, exclusive breastfeeding for first 6 months of life, annual flu vaccine, Prevnar, pneumovax
  • Incidence increases in winter months
  • Most common in young children
  • Risk factors: allergies, sinusitis, rhinitis, pharyngitis, influenza A, RSV, URI, trauma
  • Strep pneumoniae is most frequent pathogen, up to ½ from viral infections
166
Q

OME (otitis media with effusion)-

A
  • transudation of plasma fluid from middle ear blood vessels, leads to chronic effusion without signs of acute infections
167
Q

physical exam otitis media

A
  • OME- Mucous membrane infected/edematous, eardrum dull
  • Acute OM- tympanic membrane amber or yellow orange, full/bulging
  • Discharge may be present
  • Chronic OM- perforated, draining tympanic membrane
168
Q

OME treatment

A

“watchful waiting”, monthly exams, 10 day course ABX if unresponsive

169
Q

AOM treatment

A

Antibiotics, some watch for 2-3 days before starting therapy and start analgesic only

170
Q

AOM follow up

A

2-3 days if symptoms don’t resolve

171
Q

Rhinitis

A

(coryza) is an inflammation of the nasal mucosa characterized by nasal congestion, rhinorrhea, sneezing, pruritus, and/or postnasal drainage

172
Q

allergic rhinitis

A

occurs in all age groups, most commonly in adults between 30-40

173
Q

meds that causes rhinitis

A

antihypertensive most common
oral contraceptive

174
Q

rhinitis exam

A

nasal mucosa erythematous, pharyngitis

175
Q

rhinitis treatment

A

intranasal ipratropium- two sprays in each nostril 2-4x daily to relieve runny nose

176
Q

rhinitis follow up

A

2-3 weeks

177
Q

rhinosinusitis

A

inflammation of sinuses
risk factor- smoking, exposure to pollution, sneezing, cold/damp weather, sudden change in temp

178
Q

rhinosinusitis clinical presentation

A

a gradual onset of symptoms, including recurrent or chronic dull, constant pain over the affected sinuses

179
Q

rhinosinusitis treatment

A

oral analgesics
expectorants- guaifensin

180
Q

rhinosinusitis follow up

A

10-14 days from assessment

181
Q

Stomatitis

A

is a generalized inflammation of the oral mucous membranes characterized by erythema and/or vesicular or ulcerative lesions

182
Q

Glossitis

A

is an acute or chronic inflammation of the tongue that shares many of the same etiologies as stomatitis

183
Q

types of stomatitis

A

herpetic
recurrent aphtous stomatitis
vincent’s stomatitis (trench mouth)
nicotinic stomatitis

184
Q

stomatitis risk factors

A

chronic mouth breathing
hot foods
spicy acidic salty foods
infection
long term steroid use
tobacco smoking, chewing
HSV

185
Q

stomatitis clinical presentation

A

dryness of mouth, halitosis, pain, bleeding, fever, malaise, headache
mouth and tongue bright red and swollen

186
Q

stomatitis management

A

d/c behavior contributing to cause
baking soda rinse tid
liquid antacid
oral lidocaine 2%

187
Q

epistaxis

A

is a hemorrhage of the nasal mucosa resulting from the traumatic or spontaneous rupture of superficial veins and/or arteries, located most often on the anterosuperior portion of the nasal septum known as Little’s are

188
Q

epistaxis treatment

A

continuous pressure 10-15 min
pledget soaked in vasoconstricting agent
cauterization

Primary Care I (7 decks)

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