NURS 623 Leik’s Exam Tips
Medication
1) Aspirin irreversibly suppresses platelet function for up to 7 days (due to
irreversible
acetylation).
2) Discontinue ASA if patient complains of tinnitus (possible aspirin toxicity).
3) For chronic use, the recommended dose is 81 mg/day (some exceptions exist).
4) Aspirin given post-MI or after a stroke/TIA is considered tertiary prevention.
5) Avoid using in children with viral infections who are less than 16 years of age
(Reye’s
syndrome).
1) Memorize the FDA category and dose of finasteride (Proscar 5 mg PO once a
day).
2) Accutane is a potent teratogen. Reproductive-aged females must use 2 reliable
forms of
birth control and must have a negative pregnancy test 1 month before, during, and
1 month
after Accutane.
3) High-dose vitamin A is teratogenic in animal studies—avoid “mega-doses” of
vitamins in
pregnancy.
4) Avoid mixing warfarin with sulfa drugs—can increase INR and bleeding risk.
HEENT
■Treatment for otitis externa is Cortisporin Otic drops.
■ Otitis externa’s common bacterial pathogen is Pseudomonas.
■ Ruptured spleen is a catastrophic event. Avoid contact sports (i.e., 4 weeks) until
ultrasound
documents resolution.
■ Betimol (timolol) has the same contraindications as oral beta blockers.
■ Cholesteatoma, periorbital sinusitis complication.
■ Do not use amoxicillin if used in the past 3 months. Advance to second-line
antibiotics such
as Augmentin or Ceftin.
■ Penicillin-allergic patients, use macrolides, sulfas (avoid cephalosporins,
especially if had
Class I reaction or anaphylaxis from penicillins).
■ Learn to recognize a description of eye findings such as pinguecula, pterygium,
chalazion.
, ■ Rinne test result of BC greater than AC with conductive hearing loss (i.e.,
cerumenosis,
AOM).
■ Weber test result is lateralization to the “bad” or affected ear with conductive
hearing loss.
■ Weber or Rinne are testing the acoustic or CN 8.
■ Lateralization on the Weber exam is an abnormal finding.
■ Normal finding in Rinne test is air conduction that lasts longer than bone
conduction (AC
greater than BC).
■ Remember what 20/40 vision means: patient can see at 20 feet what a person
with normal
vision can see at 40 feet.
■ Carbamide peroxide (similar to hydrogen peroxide) is one of the most common
OTC treatments
for cerumenosis.
Dermatology
Differentiate between contact dermatitis and atopic dermatitis. The best clue is the
unilateral
location and the shape of the lesions in contact dermatitis.
■ Rashes that are very pruritic at night and located on the interdigital webs and/or
penis are
scabies until proven otherwise. Treat entire family. Wash linens/clothes in hot
water.
■ Preferred antibiotic is Augmentin for human, dog, and cat bites.
■ Do not confuse actinic keratosis (precursor to squamous cell cancer) with
seborrheic keratoses
(benign).
■ Diagnose hidradenitis suppurativa, psoriasis, RMSF, meningococcemia,
erythema migrans
(Lyme disease), contact dermatitis, rosacea.
■ Instead of silvery scales, may see “covered with fi ne scales” with psoriasis.
■ Psoralens (tar-derived topicals) used to treat psoriasis, antimetabolite
(methotrexate).
■ How to treat mild and moderate acne. Mild acne is treated only with topicals.
■ Accutane in females: Use two forms of reliable birth control.
■ “Herald patch” or a “Christmas tree” pattern is found in pityriasis rosea.
■ PHN (post-herpetic neuralgia) prophylaxis: Tricyclic antidepressants (TCA),
amitriptyline
Medication
1) Aspirin irreversibly suppresses platelet function for up to 7 days (due to
irreversible
acetylation).
2) Discontinue ASA if patient complains of tinnitus (possible aspirin toxicity).
3) For chronic use, the recommended dose is 81 mg/day (some exceptions exist).
4) Aspirin given post-MI or after a stroke/TIA is considered tertiary prevention.
5) Avoid using in children with viral infections who are less than 16 years of age
(Reye’s
syndrome).
1) Memorize the FDA category and dose of finasteride (Proscar 5 mg PO once a
day).
2) Accutane is a potent teratogen. Reproductive-aged females must use 2 reliable
forms of
birth control and must have a negative pregnancy test 1 month before, during, and
1 month
after Accutane.
3) High-dose vitamin A is teratogenic in animal studies—avoid “mega-doses” of
vitamins in
pregnancy.
4) Avoid mixing warfarin with sulfa drugs—can increase INR and bleeding risk.
HEENT
■Treatment for otitis externa is Cortisporin Otic drops.
■ Otitis externa’s common bacterial pathogen is Pseudomonas.
■ Ruptured spleen is a catastrophic event. Avoid contact sports (i.e., 4 weeks) until
ultrasound
documents resolution.
■ Betimol (timolol) has the same contraindications as oral beta blockers.
■ Cholesteatoma, periorbital sinusitis complication.
■ Do not use amoxicillin if used in the past 3 months. Advance to second-line
antibiotics such
as Augmentin or Ceftin.
■ Penicillin-allergic patients, use macrolides, sulfas (avoid cephalosporins,
especially if had
Class I reaction or anaphylaxis from penicillins).
■ Learn to recognize a description of eye findings such as pinguecula, pterygium,
chalazion.
, ■ Rinne test result of BC greater than AC with conductive hearing loss (i.e.,
cerumenosis,
AOM).
■ Weber test result is lateralization to the “bad” or affected ear with conductive
hearing loss.
■ Weber or Rinne are testing the acoustic or CN 8.
■ Lateralization on the Weber exam is an abnormal finding.
■ Normal finding in Rinne test is air conduction that lasts longer than bone
conduction (AC
greater than BC).
■ Remember what 20/40 vision means: patient can see at 20 feet what a person
with normal
vision can see at 40 feet.
■ Carbamide peroxide (similar to hydrogen peroxide) is one of the most common
OTC treatments
for cerumenosis.
Dermatology
Differentiate between contact dermatitis and atopic dermatitis. The best clue is the
unilateral
location and the shape of the lesions in contact dermatitis.
■ Rashes that are very pruritic at night and located on the interdigital webs and/or
penis are
scabies until proven otherwise. Treat entire family. Wash linens/clothes in hot
water.
■ Preferred antibiotic is Augmentin for human, dog, and cat bites.
■ Do not confuse actinic keratosis (precursor to squamous cell cancer) with
seborrheic keratoses
(benign).
■ Diagnose hidradenitis suppurativa, psoriasis, RMSF, meningococcemia,
erythema migrans
(Lyme disease), contact dermatitis, rosacea.
■ Instead of silvery scales, may see “covered with fi ne scales” with psoriasis.
■ Psoralens (tar-derived topicals) used to treat psoriasis, antimetabolite
(methotrexate).
■ How to treat mild and moderate acne. Mild acne is treated only with topicals.
■ Accutane in females: Use two forms of reliable birth control.
■ “Herald patch” or a “Christmas tree” pattern is found in pityriasis rosea.
■ PHN (post-herpetic neuralgia) prophylaxis: Tricyclic antidepressants (TCA),
amitriptyline
