Legg-Calve-Perthes Disease - A 7-year-old male presents with a painless limp,
antalgic gait, muscle spasm, mildly restricted hip abduction and internal rotation,
proximal thigh atrophy, and slightly short stature.
MMR - Initial given at 12 months and second dose 4-6 years. Can give a
monovalent under 12 months if there is an outbreak.
Actinic Keratosis - Patchy, scaly, raised, irregular lesions in sun-exposed areas that
are tri-colored. Pre-malignant and 20% can develop into squamous cell carcinoma.
Seborrheic Keratoses - Chronic benign lesions that are raised, oily, flaky, waxy,
wart-like, erythematous without associated sun exposure.
Malignant Melanoma - 3rd most common type skin cancer. Originates from
pigmented mole (nevus) may be flat or raised, irregular borders, variegated color,
and highly metastatic.
Nodule on Prostate Exam - Assess PSA and hematuria for prostate CA diagnosis.
Prostate CA - Hard and non-tender prostate with exam, hematuria, elevated PSA,
and urinary retention.
Spermatocele
Symptoms/signs - Freely moveable cystic mass and nonviable sperm.
JNC 8 <60 years - Diagnose HTN with BP 140/90
JNC 8 >60 years - Diagnose HTN with BP 150/90
Dacryostenosis - Narrowing of the nasolacrimal duct preventing drainage. Massage
to help open.
, Opthalmic Infection
Signs/symptoms - Swelling, erythema, pain and purulence. With extreme swelling
treat with antibacterial-steroid combination.
Trigeminal Neuralgia - Unilateral, sudden onset stabbing, surface pain that lasts
minutes and subsides and then returns. Pain triggered by touch or temperature.
Generally affects women over 50.
Fibrocystic Breast Disease - Women should be taught to avoid methylxanthines
(coffee, tea, chocolate) to decrease breast pain. Mammography recommended once
at 35 years, then 1-2 years from 40 on and then annually at 50. Oral contraceptives
can help with reduction of cyclical pain and inflammation. Painful bilaterally.
Chlamydia Tx In Pregnancy - Single dose of Azithromycin or Erythromycin QID x
14 days. Doxycycline is contraindicated in pregnancy.
Gonorrhea Tx in Pregnancy - Ceftriaxone
Phalen's Test - Diagnose carpal tunnel. 90 degree wrist flexion for 60 seconds
reproduces symptoms.
Carpal Tunnel Syndrome - Median nerve compression at the wrist with painful
dysesthesia of the palmar surface of the thumb, index finger and third finger.
Salmeterol - Long-acting Beta Agonist. Never use during an attack. Best for
regular treatment and control of asthma symptom control.
GERD in infants
Tx - Smaller more frequent meals, thickening formula with rice cereal, frequent
burping, position at 45 degree angle to reduce gastric content volume and pressure.
Frontal Sinuses Appear
when? - 5-6 years of age, infants are born with maxillary and ethmoid sinuses.
Sphenoid Sinuses - Visible radiographically at 9 years of age.