SARAH MICHELLE CRASH UPDATED EXAMS SCRIPT
QUESTIONS AND ANSWERS SURE A+
✔✔Rosacea - ✔✔-erythematous facial rash
-does not spare the nasabial folds
-Treatment: behavior modifications, sun protection, metronidazole gel/cream
(inflammatory= papules and pustules).
✔✔Malar rash (Butterfly rash) - ✔✔-rash across nose and cheekbones
-spares the nasolabial folds
-commonly associated with lupus
-also seen with Sjogren's syndrome= dry mouth and eyes
✔✔Superficial cellulitis (Erysipeias) - ✔✔-Sharpley defined borders
-superficial and red
-Treatment: PCN or cephalexin.
✔✔Purulent and non-purulent cellulitis - ✔✔-incredibly erythematous
-swollen
-non purulent treatment: PCN, cephalexin
-Purulent (Poss MRSA) Treatment: BCD (Bactrim, clindamycin, Doxycycline).
✔✔Acne - ✔✔-topical applications= benzoyl peroxide
-topical antibiotics= tretinoin (keep pores from clogging up)
-PO ABX: Doxycycline. Topical: Clindamycin.
-wear sunscreen
-Derm, Accutane. Black box warning: do not become pregnant (2 forms of birth control).
✔✔Geographical tongue - ✔✔-spicy or hot foods
-benign
✔✔Leukoplakia vs. Oral candidiasis - ✔✔- scrapes off? = yeast
- leukoplakia= refer to dentist
-mostly seen in HIV= detrimental to enamel.
✔✔fifth disease - ✔✔-slapped cheek rash
-fever > rash, lacy net-like
-when rash appears, no longer contagious
-Treatment: self-limiting
-stay away from pregnant women and not immune= miscarriage.
✔✔Ring worm - ✔✔-annular rash
-capitis= head
-bulbae= beard
-crurs=groin
,-pedis= foot
-versicolor= all over body= AFC for treatment
-Treatment: AFC
✔✔Enterobiasis (pinworms) - ✔✔-genital are pruritic at night
-diagnosed by scotch tape test early in AM
-Treatment: mebendazole or bendazole.
✔✔Cat or dog bite - ✔✔-Augmentin
-wounds not sutured or dermabound (skin glue)
✔✔Eyes - ✔✔any eye concern, always check visual acuity with Snellen chart.
Emergent= may overlook.
Emergent referral: papilledema, acute angle-closure glaucoma, retinal detachment.
-20/40 vision= a person can see at 20 feet what a person with norma vision can see at
40 feet.
-20/200= legally blind
✔✔Amylopia - ✔✔-common
-lazy eye- affects visual acuity
-typically develops in a child due to strabismus
✔✔color blindness test - ✔✔Ishihara chart
✔✔Cranial nerves related to the eyes - ✔✔CN II (Optic)- visual acuity
CN III (oculomotor)- movement follows eyes to focus
CN IV (trochlear)- movement downward/inward movement
CN VI (abducens)- movement outward movement.
✔✔Fundoscopic exam: Normal exam - ✔✔- retinal arteries should be thinner and lighter
in color than the veins.
-no hemorrhages or cotton wool spots
-optic disc should have sharp margins and no swelling (swelling present is called
papilledema, refer immediately).
-no arteries crossing over a vein
-red reflex should be present
✔✔Hypertension eye - ✔✔-copper wire arterioles
-AV nicking (artery crossing a vein, causes a bulge).
-these can be reversible with adequate BP control
-flame hemorrhages (little hemorrhages that look like a flame).
✔✔Diabetic eye - ✔✔-cotton wool spots (white fluffy spots) (ischemia to eyes),
Increased CBG.
-neurovasculization (formulation of new arteries)
,-microaneurysms
✔✔Acute angle-closure glaucoma - ✔✔-sudden onset of severe eye pain
-blurry vision
-eye firm to touch
-tonometry, increased IOP
-refer immediately to ER/urgent ophthalmologist
-massive IOP= permanent vision loss.
✔✔Retinal detachment - ✔✔-feels like a curtain coming down
-sudden appearance of floaters (painless), flashes of light
-blurred vision
-emergency referral
✔✔Xanthelasma - ✔✔-arcus senilis (gray halo in eye)
-cholesterol deposits in the eyes
-increase in cholesterol levels
-in younger adults, typically related to familial hyperlipidemia, increase dose statins.
-in older adults, typically do not require treatment.
✔✔Pterygium vs. pinguecula - ✔✔-benign non-cancerous overgrowth of conjunctiva
-may have minor eye redness
-encroaches on the actual cornea
-pinguecula will not go over the cornea
✔✔Hordeolum (stye) vs. chalazion - ✔✔-sudden onset of localized inflamed eyelid
-stye= usually caused by infection (staph aureus)
-chalazion- blockage of a duct
-warm compresses
✔✔Conjunctivitis - ✔✔-bacterial, viral, allergic
-bilaterally= allergic
-starts unilaterally than spreads to other eye= viral
-allergic drainage- stringy and ropey
-viral conjunctivitis- preauricular or submandibular enlarged lymph nodes.
-allergic= cervical enlarged lymph nodes.
-bacterial- no lymphadenopathy
-medical term for pink eye= adenoviral conjunctivitis.
✔✔Cataracts - ✔✔- symptoms driving at night
-bilateral leukocoria noted on exam (white reflex)
✔✔Macular degeneration - ✔✔-central vision loss
-put things in larger print to read
, ✔✔Presbyopia - ✔✔-middle age range
-arms "too short", short arm syndrome
-reading glasses
✔✔corneal abrasion - ✔✔-eye irritation after bell's palsy episode
-keep eyes lubricated
-Diagnostic tool: fluorescein staining
-tonometry when to measure IOP.
✔✔Keratitis (caused by bacterial infection) - ✔✔-wears contacts
-inflamed and reddened cornea
-inability to hold eye open
-cloudiness and blurred vision
-no recent trauma/injury
-refer to ophthalmologist immediately
✔✔Iritis - ✔✔-eye pain
-sensitivity to light
-not able to see normal
-entire eye red, swelling of the iris
-refer to ophthalmology
✔✔Subconjunctivae hemorrhage - ✔✔-broken blood vessels on sclera
-typically, asymptomatic
-may use eye drops for lubrication
✔✔Brain tumor headache - ✔✔-behavioral changes
-vision changes
-nausea/vomiting
-dull, always in the same spot
-diagnostic tests: CT scan (rule out CVA)
-worse headache of their life
✔✔Ischemic vs hemorrhagic stroke - ✔✔-unilateral weakness
-facial drooping
-slurred speech
-Afib= increased risk of ischemic stroke
-HTN=increased risk of hemorrhagic CVA
-TIA- symptoms resolved within 1-24 hours
-BE FAST (balance, eyes, face, arm, speech, time).
✔✔Aphasia - ✔✔-pt's inability to understand or produce speech
-boils down to residual effects r/t Wernicke's or Broca's area.
QUESTIONS AND ANSWERS SURE A+
✔✔Rosacea - ✔✔-erythematous facial rash
-does not spare the nasabial folds
-Treatment: behavior modifications, sun protection, metronidazole gel/cream
(inflammatory= papules and pustules).
✔✔Malar rash (Butterfly rash) - ✔✔-rash across nose and cheekbones
-spares the nasolabial folds
-commonly associated with lupus
-also seen with Sjogren's syndrome= dry mouth and eyes
✔✔Superficial cellulitis (Erysipeias) - ✔✔-Sharpley defined borders
-superficial and red
-Treatment: PCN or cephalexin.
✔✔Purulent and non-purulent cellulitis - ✔✔-incredibly erythematous
-swollen
-non purulent treatment: PCN, cephalexin
-Purulent (Poss MRSA) Treatment: BCD (Bactrim, clindamycin, Doxycycline).
✔✔Acne - ✔✔-topical applications= benzoyl peroxide
-topical antibiotics= tretinoin (keep pores from clogging up)
-PO ABX: Doxycycline. Topical: Clindamycin.
-wear sunscreen
-Derm, Accutane. Black box warning: do not become pregnant (2 forms of birth control).
✔✔Geographical tongue - ✔✔-spicy or hot foods
-benign
✔✔Leukoplakia vs. Oral candidiasis - ✔✔- scrapes off? = yeast
- leukoplakia= refer to dentist
-mostly seen in HIV= detrimental to enamel.
✔✔fifth disease - ✔✔-slapped cheek rash
-fever > rash, lacy net-like
-when rash appears, no longer contagious
-Treatment: self-limiting
-stay away from pregnant women and not immune= miscarriage.
✔✔Ring worm - ✔✔-annular rash
-capitis= head
-bulbae= beard
-crurs=groin
,-pedis= foot
-versicolor= all over body= AFC for treatment
-Treatment: AFC
✔✔Enterobiasis (pinworms) - ✔✔-genital are pruritic at night
-diagnosed by scotch tape test early in AM
-Treatment: mebendazole or bendazole.
✔✔Cat or dog bite - ✔✔-Augmentin
-wounds not sutured or dermabound (skin glue)
✔✔Eyes - ✔✔any eye concern, always check visual acuity with Snellen chart.
Emergent= may overlook.
Emergent referral: papilledema, acute angle-closure glaucoma, retinal detachment.
-20/40 vision= a person can see at 20 feet what a person with norma vision can see at
40 feet.
-20/200= legally blind
✔✔Amylopia - ✔✔-common
-lazy eye- affects visual acuity
-typically develops in a child due to strabismus
✔✔color blindness test - ✔✔Ishihara chart
✔✔Cranial nerves related to the eyes - ✔✔CN II (Optic)- visual acuity
CN III (oculomotor)- movement follows eyes to focus
CN IV (trochlear)- movement downward/inward movement
CN VI (abducens)- movement outward movement.
✔✔Fundoscopic exam: Normal exam - ✔✔- retinal arteries should be thinner and lighter
in color than the veins.
-no hemorrhages or cotton wool spots
-optic disc should have sharp margins and no swelling (swelling present is called
papilledema, refer immediately).
-no arteries crossing over a vein
-red reflex should be present
✔✔Hypertension eye - ✔✔-copper wire arterioles
-AV nicking (artery crossing a vein, causes a bulge).
-these can be reversible with adequate BP control
-flame hemorrhages (little hemorrhages that look like a flame).
✔✔Diabetic eye - ✔✔-cotton wool spots (white fluffy spots) (ischemia to eyes),
Increased CBG.
-neurovasculization (formulation of new arteries)
,-microaneurysms
✔✔Acute angle-closure glaucoma - ✔✔-sudden onset of severe eye pain
-blurry vision
-eye firm to touch
-tonometry, increased IOP
-refer immediately to ER/urgent ophthalmologist
-massive IOP= permanent vision loss.
✔✔Retinal detachment - ✔✔-feels like a curtain coming down
-sudden appearance of floaters (painless), flashes of light
-blurred vision
-emergency referral
✔✔Xanthelasma - ✔✔-arcus senilis (gray halo in eye)
-cholesterol deposits in the eyes
-increase in cholesterol levels
-in younger adults, typically related to familial hyperlipidemia, increase dose statins.
-in older adults, typically do not require treatment.
✔✔Pterygium vs. pinguecula - ✔✔-benign non-cancerous overgrowth of conjunctiva
-may have minor eye redness
-encroaches on the actual cornea
-pinguecula will not go over the cornea
✔✔Hordeolum (stye) vs. chalazion - ✔✔-sudden onset of localized inflamed eyelid
-stye= usually caused by infection (staph aureus)
-chalazion- blockage of a duct
-warm compresses
✔✔Conjunctivitis - ✔✔-bacterial, viral, allergic
-bilaterally= allergic
-starts unilaterally than spreads to other eye= viral
-allergic drainage- stringy and ropey
-viral conjunctivitis- preauricular or submandibular enlarged lymph nodes.
-allergic= cervical enlarged lymph nodes.
-bacterial- no lymphadenopathy
-medical term for pink eye= adenoviral conjunctivitis.
✔✔Cataracts - ✔✔- symptoms driving at night
-bilateral leukocoria noted on exam (white reflex)
✔✔Macular degeneration - ✔✔-central vision loss
-put things in larger print to read
, ✔✔Presbyopia - ✔✔-middle age range
-arms "too short", short arm syndrome
-reading glasses
✔✔corneal abrasion - ✔✔-eye irritation after bell's palsy episode
-keep eyes lubricated
-Diagnostic tool: fluorescein staining
-tonometry when to measure IOP.
✔✔Keratitis (caused by bacterial infection) - ✔✔-wears contacts
-inflamed and reddened cornea
-inability to hold eye open
-cloudiness and blurred vision
-no recent trauma/injury
-refer to ophthalmologist immediately
✔✔Iritis - ✔✔-eye pain
-sensitivity to light
-not able to see normal
-entire eye red, swelling of the iris
-refer to ophthalmology
✔✔Subconjunctivae hemorrhage - ✔✔-broken blood vessels on sclera
-typically, asymptomatic
-may use eye drops for lubrication
✔✔Brain tumor headache - ✔✔-behavioral changes
-vision changes
-nausea/vomiting
-dull, always in the same spot
-diagnostic tests: CT scan (rule out CVA)
-worse headache of their life
✔✔Ischemic vs hemorrhagic stroke - ✔✔-unilateral weakness
-facial drooping
-slurred speech
-Afib= increased risk of ischemic stroke
-HTN=increased risk of hemorrhagic CVA
-TIA- symptoms resolved within 1-24 hours
-BE FAST (balance, eyes, face, arm, speech, time).
✔✔Aphasia - ✔✔-pt's inability to understand or produce speech
-boils down to residual effects r/t Wernicke's or Broca's area.
