Exam (elaborations)
NGR6200 Endocrine_Metabolic_Thyroid_Gout Problems (Dunphy) Exam 4 questions with correct
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NGR6200 Endocrine_Metabolic_Thyroid_Gout Problems (Dunphy) Exam 4 questions with correct
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NGR6200Exam
5
Questions
with
correct
answers
Acne
Rosacea.
-
ANSWER-Persistent
erythema
with
clusters
of
tiny
superficial
blood
vessels
of
the
central
face,
involving
the
cheeks,
nose
and
chin.
Acne
like
erythematous
papules
and
pustules
in
the
central
face.
The
face
has
a
rosy
hue.
There
are
no
comedones
(black
heads
or
white
heads).
2.Diagnosis:
Acne
Rosacea.
Plan.a).
Consider
ruling
out
lupus
or
sarcoid
by
doing
ANA,
CXR
or
punch
biopsy.
b).
Metronidazole
0.75
%
gel
applied
to
face
once
daily
c).
Minocycline
100
mg
twice
daily
for
7
days
d).
Advise
patient
to
avoid
alcohol,
spicy
foods,
caffeine
and
sun
exposure
to
prevent
flare-ups
e).Return
to
office
in
2
weeks
Note:
Topical
steroids,
isotretinoin
not
helpful
Tinea
corporis
110.9
-
ANSWER-What
pertinent
questions
will
you
ask
her?
Past
medical
history
Severity~pain
When
did
it
start
What
exacerbates
the
rash
Any
associating
symptoms
Manifestation
of
rash
Alleviating
treatments
Does
it
itch?
Exposure
to
animals
Travel-r/o
Lyme
diseaseDescribe
the
lesion.
Red/pink
concentric
ring,
elevated
borders
with
sharply
demarginated
plaque,
central
scaling3.
What
is
your
diagnosis
and
plan?
Dx:
Tinea
corporis
110.9
Plan: Topical
Lotrimin
every
12
hours
to
affected
area
2-3
weeks
Keep
clean
and
dry
Note:
no
need
for
oral
antifungals.
Topical
corticosteroids
and
antihistamines
may
be
helpful.
Topical
steroids
may
diminish
effect
of
antifungal
agents
Herpes
Zoster
Ophthalmic
tract
053.20
-
ANSWER-What
additional
information
pertinent
to
the
CC
will
you
elicit?
1.
Past
medical
history-any
history
of
immune
disorders
2.
Severity~pain
3.
When
did
it
start?
4.
What
exacerbates
the
rash?
5.
Any
associating
symptoms-any
change
in
vision
6.
Manifestation
of
rash
7.
Alleviating
treatments
2.
Describe
the
rash.
Crusted
ulcerations
on
right
medial
periorbital
with
erythematous
base,
yellow
drainage,
Vesicles
on
nose.
3.
What
is
your
diagnosis
and
plan?
Dx:
Herpes
Zoster
Ophthalmic
tract
053.20
Plan:
1.
Antiviral
therapy:
Acyclovir
800
mg
PO
every
6
hours
for
7
days
2.
Immediate
referral
to
ophthalmologist
3.
NSAIDS
4.
Doxepin
10-100mg
PO
h.s.
for
itching
and
sleep
5.
Moist
dressing
with
Burrow
Solution
or
saline
to
sooth
pain
6.
Prednisone
Periorbital
Cellulitis
376.01
-
ANSWER-What
other
information
do
you
need?
Past
medical
history
Severity~pain
When
did
it
start?
What
exacerbates
the
rash?
Any
associating
symptoms
Manifestation
of
rash
Alleviating
treatments Do
you
have
any
visual
changes?What
part
of
the
physical
exam
will
be
of
particular
concern?
Cranial
nerves
III,
IV,
and
VI
Describe
your
findings.
Edema,
swelling,
erythematous
to
left
periorbital
What
is
your
assessment
and
plan?
Dx:
Periorbital
Cellulitis
376.01
Plan:
Medical
emergency.
Admission
to
hospital
for
IV
antibiotics
Nafcillin
2
grams
IV
every
4
hours
Rocephin
2
grams
IV
every
24
hours
Metronidazole
1
gram
IV
every
12
hours
Urticaria
708
-
ANSWER-What
additional
information
do
you
need?
Past
medical
history
Severity~pain
When
did
it
start
What
exacerbates
the
rash
Any
associating
symptoms
Manifestation
of
rash
Alleviating
treatments
Any
new
foods,
medication,
exposure
to
new
environment
or
chemical
Any
difficulty
breathing,
swelling
to
mouth,
lips,
throat.
Does
it
itch?
Are
you
allergic
to
anything?Describe
the
lesions
Red
raised
plaques
in
varying
sizes,
confluent3.
What
is
your
assessment
and
plan?
Dx:
Urticaria
708
Plan:
Stop
taking
or
being
exposed
to
known
allergen
Antihistamine:
Loratadine
10mg
PO
daily-non
sedating
during
the
day-sedating
at
night
Prednisone
40
mg
PO
daily
for
5
days
(2
-
20
mg
tabs)
Provide
Epi
pen
with
instruction
for
emergency
Advise
to
seek
emergency
care
if
returns,
swelling
of
throat,
or
SOB
Referral
to
allergist
Furuncle
682.9
-
ANSWER-What
additional
information
do
you
need
related
to
the
CC?
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