- Most common in elderly
- Telangiectasias and crusting
- Rough, scaly patch from UV-B exposure
- Precancerous routinely removed
Removed by 5PU cream, cryotherapy, punch biopsy, excisional
Give this one a go later!
Actinic keratosis
>GERD
- Reflux of stomach acid
- Mild to moderate (1-2 episodes a week follow)
- Start with lifestyle modifications (decrease weight, exercise, smoking cessation, avoid
initiating foods).
,- Step up to H2 receptor blockers (blockers and PPI as needed).
> Erosive esophagitis
- Symptoms 2 or more times a week or severe impairment of quality of life
- Continue PPI therapy in patients with severe erosive esophagitis or Barrett's esophagus.
- Start with PPI once daily for eight weeks
- Lifestyle and dietary modifications, then move down to H2 receptor blockers
Give this one a go later!
GERD
> Anemia of chronic disease
- Immune-mediated dysregulation of iron homeostasis
- Iron studies: ferritin increased, serum iron decreased, TIBV decreased
- Causes
- Inflammatory disease (SLE, IBD, Vasculitis, systemic sclerosis).
- Malignancy
- Infections
- Chronic disorders such as COPD or CHF
- Symptoms
- Fatigue, exercise intolerance, SOB, pallor.
- Treatment
- Treat underlying cause
> Acute blood loss
- Circulating RBCs are normal size (MCV 81-99)
- Circulating RBCs are normal red color (MCHC 33-37).
- Symptoms: dizziness, SOB, Chest pain, black stools, hematemesis, orthostatic dizziness
- Causes: trauma, ruptured aneurysm, massive upper or lower GI bleed, ruptured ectopic
pregnancy, DIC, hemorrhage.
- Diagnosis: H&P, CBC, peripheral smear, retic count.
- Treatment: identify source of bleed and correct.
,Give this one a go later!
Normocytic anemias
> Lymphoma
- Hodgkin's (most curable) and non-Hodgkin's
- First identified by painless swelling of neck, groin, axilla. May also include night sweats,
unexplained weight loss, drenching sweats at night.
- Risk factors include heredity, exposure to herbicides, radiation, AIDs.
- Identification usually by lymph node biopsy, PET scan, serology.
- Treatment: Stage 1-2: radiation. Stage 3-4: radiation and/or chemotherapy.
>Rheumatoid arthritis
- Autoimmune
- Symmetrical on both sides of the body
- Identified by serum rheumatoid factor.
- Physical exam consistent with ulnar deviation and redness, swelling, decreased ROM,
and warmth to the joints.
- Treatment: steroids early and in extremists, DMARDs, methotrexate, gold salts.
> Herpes Zoster
- Chicken pox now, shingles later.
- Common in children prior to widespread vaccination
- Varicella zoster ameliorated by vaccination.
- Treatment remains mainly supportive care. Oatmeal baths, minimizing itching/eruption
for risk of scaring.
- Zoster stays in nerve roots, can reactivate after years of dormancy.
- Pain and hypersensitivity preceding dermal eruption.
Treatment: valacyclovir or acyclovir, topical steroids, NSAIDs
Give this one a go later!
, Immune
- Macule: flat, non-palpable (freckles)
- Papule: solid (mole)
- Plaque: flattened, elevated (psoriasis)
- Vesicles (herpes simplex)
- Bulla (impetigo, burn, blister)
- Pustule (acne)
Give this one a go later!
primary skin lesions
- Primary prevention intervention
-Herd immunity
-Active immunity
- Immunization, onset within 2-4 weeks, protection lasts years to lifelong.
- Passive immunity
- Immunoglobulin, onset within hours, protection duration limited, often only several
months.
Give this one a go later!
Immunizations
- Telangiectasias and crusting
- Rough, scaly patch from UV-B exposure
- Precancerous routinely removed
Removed by 5PU cream, cryotherapy, punch biopsy, excisional
Give this one a go later!
Actinic keratosis
>GERD
- Reflux of stomach acid
- Mild to moderate (1-2 episodes a week follow)
- Start with lifestyle modifications (decrease weight, exercise, smoking cessation, avoid
initiating foods).
,- Step up to H2 receptor blockers (blockers and PPI as needed).
> Erosive esophagitis
- Symptoms 2 or more times a week or severe impairment of quality of life
- Continue PPI therapy in patients with severe erosive esophagitis or Barrett's esophagus.
- Start with PPI once daily for eight weeks
- Lifestyle and dietary modifications, then move down to H2 receptor blockers
Give this one a go later!
GERD
> Anemia of chronic disease
- Immune-mediated dysregulation of iron homeostasis
- Iron studies: ferritin increased, serum iron decreased, TIBV decreased
- Causes
- Inflammatory disease (SLE, IBD, Vasculitis, systemic sclerosis).
- Malignancy
- Infections
- Chronic disorders such as COPD or CHF
- Symptoms
- Fatigue, exercise intolerance, SOB, pallor.
- Treatment
- Treat underlying cause
> Acute blood loss
- Circulating RBCs are normal size (MCV 81-99)
- Circulating RBCs are normal red color (MCHC 33-37).
- Symptoms: dizziness, SOB, Chest pain, black stools, hematemesis, orthostatic dizziness
- Causes: trauma, ruptured aneurysm, massive upper or lower GI bleed, ruptured ectopic
pregnancy, DIC, hemorrhage.
- Diagnosis: H&P, CBC, peripheral smear, retic count.
- Treatment: identify source of bleed and correct.
,Give this one a go later!
Normocytic anemias
> Lymphoma
- Hodgkin's (most curable) and non-Hodgkin's
- First identified by painless swelling of neck, groin, axilla. May also include night sweats,
unexplained weight loss, drenching sweats at night.
- Risk factors include heredity, exposure to herbicides, radiation, AIDs.
- Identification usually by lymph node biopsy, PET scan, serology.
- Treatment: Stage 1-2: radiation. Stage 3-4: radiation and/or chemotherapy.
>Rheumatoid arthritis
- Autoimmune
- Symmetrical on both sides of the body
- Identified by serum rheumatoid factor.
- Physical exam consistent with ulnar deviation and redness, swelling, decreased ROM,
and warmth to the joints.
- Treatment: steroids early and in extremists, DMARDs, methotrexate, gold salts.
> Herpes Zoster
- Chicken pox now, shingles later.
- Common in children prior to widespread vaccination
- Varicella zoster ameliorated by vaccination.
- Treatment remains mainly supportive care. Oatmeal baths, minimizing itching/eruption
for risk of scaring.
- Zoster stays in nerve roots, can reactivate after years of dormancy.
- Pain and hypersensitivity preceding dermal eruption.
Treatment: valacyclovir or acyclovir, topical steroids, NSAIDs
Give this one a go later!
, Immune
- Macule: flat, non-palpable (freckles)
- Papule: solid (mole)
- Plaque: flattened, elevated (psoriasis)
- Vesicles (herpes simplex)
- Bulla (impetigo, burn, blister)
- Pustule (acne)
Give this one a go later!
primary skin lesions
- Primary prevention intervention
-Herd immunity
-Active immunity
- Immunization, onset within 2-4 weeks, protection lasts years to lifelong.
- Passive immunity
- Immunoglobulin, onset within hours, protection duration limited, often only several
months.
Give this one a go later!
Immunizations
