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Erythema Nodosum
-Drugs associated w/ it (5)
- tender red nodules, typically on anterior legs
- -Associated drugs
- 1. halogens
- 2. oral contraceptives
- 3. penicillin
- 4. sulfonamides
- 5. tetracycline
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Drug Hypersensitivity Syndrome
-Frequently caused by (2)
- severe adverse drugs rxn that gives fever, rash, hepatitis, arthralgias, lymphadenopathy
- -Frequently caused by
- 1. antiepileptic drugs
- 2. sulfonamides
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BEDSORES acronym
- Bowel/bladder incontinence
- Edema/obesity
- Diabetic
- Sepsis/fever
- Occlusion of vessels
- Restrictive movement
- Elderly
- Systemic factors
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Non-malignant Tumors of old people (4)
- 1. seborrheic keratosis
- 2. epidermal tag
- 3. capillary (cherry) hemangioma
- 4. benign venous angioma (venous lake)
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Malignant neoplasms of old people (4)
- 1. actinic keratoses (precancerous)
- 2. basal cell carcinoma
- 3. squamos cell carcinoma (can arise from actinic keratoses)
- 4. malignant melanoma
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When to use Mohs survery (4)
- 1. tumor in critical location (cosmetic or functional)
- 2. tumor is recurrent
- 3. tumor has ill-defined margins
- 4. tumor is large (> 2cm) or aggressive
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6 exanthematous diseases
- 1. measles
- 2. scarlet fever
- 3. rubella
- 4. duke's disease
- 5. erythema infectiosum
- 6. exanthem subitum
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3 C's of Measles
- 1. cough
- 2. coryza (symptoms of cold)
- 3. conjunctivitis
- 4* Koplik spots (white dots in buccal mucosa opposite molars)
- These are seen during prodromal stage
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Rubella characteristics (4)
- 1. Forchheimer spots - rose colored spots on soft palate that coalesce into red blush
- 2. Rash begins on face and spreads quickly covering body in 24 hrs
- 3. during 2nd day, rash becomes pinpoint like scarlet fever on trunk
- 4. clears by 3rd day
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Measles rash characteristics (4)
- 1. Temeprature rises as rash appears; it start on neck, behind ears, on hairline and cheeks
- 2. spreads over entire upper anterior body within 24 hrs
- 3. spreads to back of body and abdomen next 24 hrs
- 4. 2nd-3rd day rash reaches feet, and begins to fade in face in same order
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Varicella (chicken pox) rash characteristics (3)
- 1. lesions start pruritic macules
- 2. evolves to papules
- 3. in 24-48 hrs, becomes vesicles and crusting develops
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Erythema Infectiosum characteristics (3)
- 1. "slapped cheek" appearance
- 2. central clearing leaving "lacy" appearance
- 3. palm and soles not affected
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Roseola (exanthem subitum) characteristics (2)
- 1. very high fever (101-106)
- 2. rash occurs after fever
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Scarlet Fever characteristics (
- 1. Pastia lines - more intense in creases of elbows, axillae, and groin
- 2. skin has "goose pimple" appearance and rough "sandpaper" texture
- 3. cheek red w/ circumoral pallor
- 4. strawberry tongue
Tx w/ penicillin; erythromyc for PCN allergies
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Kawasaki Disease characteristics (4)
-phases (3)
- 1. erythema and edema of hands and feet
- 2. strawberry tongue
- 3. rash in groin area
- 4. desquamation of finger and toes spreads to whole hand and foot
- -Phases
- 1. acute febrile phse - lasts 1-2 weeks; fever
- 2. subacute phase - desquamation, coronary aneurysm; highest risk of death; last til 4th week of illness
- 3. convalescent phase - all signs of illness gone (6-8 weeks after onset)
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Kawasaki diagnostic criteria
- Fever lasting for at least 5 days
- PLUS
- Presence of at least 4 of the following 5:
- 1. bilateral bulbar conjuntiva
- 2. changes in mucosa of oropharynx (dry fissured lips, strawberry tongue)
- 3. edema/erythma of hands and feet; desquamation in subacute phase
- 4. rash
- 5. cervical lymphadopathy; usually unilateral
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Kawasaki disease tx
- Acute stage
- 1. IVIG (intravenous immune globulin)
- 2. high dose aspirin
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Staphlococcal Scalded Skin Syndrome cause
-S.aureus that produces exfoliative toxin
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