AND CORRECT SOLUTIONS
◉ Squamous cell carcinoma common locations. Answer: rims of
ears, lips, nose, face and top of hands
◉ precursor lesion to squamous cell cancer. Answer: actinic
keratosis
◉ squamous cell carcinoma diagnosis by. Answer: biopsy gold
standard. if biopsy is not an option, refer to dermatology .
◉ Risk factors for skin cancer(melanoma and both non-melanoma).
Answer: Blistering sunburn as a child, history of sunburns, light skin,
chronic exposure to UV light (sunlight/tanning beds), moles, family
hx for skin cancer
◉ Melanoma symptoms (ABCDE). Answer: asymmetry
(shape/uneven texture)
border (irregular/notched/blurred)
color (variegated colors from black, blue, dark to light brown)
diameter (size >6mm size of pencil eraser or larger)
evolving (changes in color/size/shape)
,may be itchy
◉ Acral lengtiginous melanoma. Answer: Most common type of
melanoma in dark skinned individuals (blacks & asians)
--> look for longitudinal brown to black bands under the nailbed. a
changing spot or mole in the palms, or the soles of the feet
◉ seborrheic keratosis. Answer: soft, round, wart-like growth that is
light tan to black and looks pasted on
asymptomatic &benign
◉ Bacterial Meningitis Bacteria. Answer: Streptococcus
pneumoniae- most common strain
Haemophilus influenzae
Neisseria meningitidis
Escherichia coli
*others
◉ Bacterial meningitis symptoms (Classic Triad). Answer: High fever
Nuchal rigidity
rapid change in mental status w/ headache
Triad=neck up
,erythematous spot-like rash (petechiae) ecchymosis to purple-
colored lesions (purpura) which are non-blanchable
◉ Is bacterial meningitis a reportable disease. Answer: yes!
◉ Treatment for Bacterial meningitis-patient. Answer: IV Abx ASAP,
resp/droplet iso for first 24-48 hrs, hydrate (low maintenance after
initial fluid correction), Maintain ventilation and reduce increased
intra cranial pressure if present (dexamethosone(to reduce
inflammation, mannitol to diurese the brain), low stim environment,
tx complications that may arrive and support family
◉ Treatment for bacterial meningitis-close encounter. Answer: Close
contacts should be treated w/ rifampin 600 mg q 12 hours x 2 days
**Rifampin changes urine color to reddish orange and can stain
contacts
**AVOID RIFAMPIN IN PREGNANCY
◉ Brudzinkski sign (meningeal irritation). Answer: Tests for
meningeal irritation
Patient supine, raise BACK of head and flex chin towards chest
+ result if pt automatically beds both hips
--Brudzinski and back of head start with B as well as bends--
, ◉ Kernig's sign. Answer: Tests for meningeal irritation
patient supine. flex patients hips and knees in a right angle, then
slowly straighten/extend the legs up
+ result if when the patient complains of pain during extension of leg
◉ MCV4 (meningococcal vaccine) Age 11-19. Answer: Give one dose
of menactra or menveo
primary dose given age 12 or younger give a booster at age 16-18
◉ MCV4 (meningococcal vaccine) Age 19-21. Answer: Give one dose
of menactra or menveo if never had either
◉ Rocky mountain spotted fever (RMSF) symptoms. Answer: Fever
chills
N/V
myalgia
arthralgia
2-5 days later develop petechial rash on forearms, ankles, and wrists
that spreads towards trunk and becomes generalised. sometimes
rash develops on palms and soles
**RASH DEVELOPS INWARDS**