MVU NURS 629 LATEST COMPREHENSIVE
QUESTIONS AND ANSWERS SURE A+
✔✔Psoriasis - ✔✔o Red, scaling papules that coalesce to forum round-oval plaques
o Silvery white and adherent scales, bleed when removed (Auspitz sign), scratch test
leaves a white mark
o Most commonly found on extensor surfaces (knees, elbows, scalp)
✔✔psoriasis TX - ✔✔o Sun exposure, emollient creams, topical corticosteroids,
Dovonex ointment, tar shampoos (T-gel), UV light B
o Dermatology referral
✔✔Kawasaki disease - ✔✔· At least 4 of the following 5 features
o 1. Changes in extremities (edema, erythema, desquamation)
o 2. Polymorphous exanthem, usually truncal
o 3. Conjunctival injection
o 4. Erythema and/or fissuring of lips & oral cavity
o 5. Cervical lymphadenopathy
--· If untreated, can develop coronary artery aneurysms, ischemic heart disease or
sudden death
✔✔Kawasaki TX - ✔✔o IV immunoglobulin
o Aspirin
o ECHO with cardiology consult
✔✔Bullous Myringitis - ✔✔Small vesicles containing blood on the drum; accompany
mycoplasma pneumonia and virus infections
--treat with macrolide
✔✔tympanostomy tubes - ✔✔o >3 confirmed ear infection in 6 months or 4+ episodes
in 12 months
o TM rupture
· Existing tubes and AOM
, o Topical medications
o Floxin Otic (Ofloxacine)—1-12yr—5 gtts BID x10 days
o Ciprodex (Ciprofloxacin)—6mo+--4 gtts BID x7 days
· Fluoroquinolones are safe with perforated TM—do not use neomycin with perforated
TM
✔✔Otitis Media with Effusion - ✔✔· with no signs/sx of AOM
· Air fluid levels, dullness of TM, decreased mvt of TM
· Treatment
o Observation; up to 90% will resolve within 3 monthsrefer to ENT if still present at 12
weeks
✔✔visual acuity - ✔✔o B-2 months—20/400
o 4 mo—20/200
o 6 mo—20/150
o 12 mo—20/50
o 18 mo+--20/25 or 20/20
✔✔Strabismus - ✔✔· Misalignment of eyes—"lazy eye" or cross-eyed
· Loss of depth perception and double vision
Findings
o Intermittent exotropia; Squinting; Nystagmus
✔✔sinusitis - ✔✔· URI sx >10 days without improvement; Severe sx with high fever and
purulent drainage at onset lasting 3-4 days
· Symptoms worse on day 6 or 7 of URI
-o Augmentin, Azithromycin or Bactrim DS x10 days
o Decongestant, antihistamines, saline rinses, nasal steroids
✔✔pharyngitis - ✔✔Amoxicillin 50-80 mg/kg/day x10 days
Cephalosporin or Macrolide if allergy
Warm water gargle
Tylenol/NSAIDs
✔✔Infectious Mononucleosis - ✔✔· Viral syndrome—Fever, Exudative pharyngitis,
Adenopathy (posterior cervical)
· Epstein-Barr virus; Spread via saliva; Incubation 2-5 weeks
Symptomatic unless severe
Corticosteroids
Treat with Erythromycin if strep to avoid rash d/t Amox or PCN
No contact sports for 1 mo
F/U 1-2 weeks
QUESTIONS AND ANSWERS SURE A+
✔✔Psoriasis - ✔✔o Red, scaling papules that coalesce to forum round-oval plaques
o Silvery white and adherent scales, bleed when removed (Auspitz sign), scratch test
leaves a white mark
o Most commonly found on extensor surfaces (knees, elbows, scalp)
✔✔psoriasis TX - ✔✔o Sun exposure, emollient creams, topical corticosteroids,
Dovonex ointment, tar shampoos (T-gel), UV light B
o Dermatology referral
✔✔Kawasaki disease - ✔✔· At least 4 of the following 5 features
o 1. Changes in extremities (edema, erythema, desquamation)
o 2. Polymorphous exanthem, usually truncal
o 3. Conjunctival injection
o 4. Erythema and/or fissuring of lips & oral cavity
o 5. Cervical lymphadenopathy
--· If untreated, can develop coronary artery aneurysms, ischemic heart disease or
sudden death
✔✔Kawasaki TX - ✔✔o IV immunoglobulin
o Aspirin
o ECHO with cardiology consult
✔✔Bullous Myringitis - ✔✔Small vesicles containing blood on the drum; accompany
mycoplasma pneumonia and virus infections
--treat with macrolide
✔✔tympanostomy tubes - ✔✔o >3 confirmed ear infection in 6 months or 4+ episodes
in 12 months
o TM rupture
· Existing tubes and AOM
, o Topical medications
o Floxin Otic (Ofloxacine)—1-12yr—5 gtts BID x10 days
o Ciprodex (Ciprofloxacin)—6mo+--4 gtts BID x7 days
· Fluoroquinolones are safe with perforated TM—do not use neomycin with perforated
TM
✔✔Otitis Media with Effusion - ✔✔· with no signs/sx of AOM
· Air fluid levels, dullness of TM, decreased mvt of TM
· Treatment
o Observation; up to 90% will resolve within 3 monthsrefer to ENT if still present at 12
weeks
✔✔visual acuity - ✔✔o B-2 months—20/400
o 4 mo—20/200
o 6 mo—20/150
o 12 mo—20/50
o 18 mo+--20/25 or 20/20
✔✔Strabismus - ✔✔· Misalignment of eyes—"lazy eye" or cross-eyed
· Loss of depth perception and double vision
Findings
o Intermittent exotropia; Squinting; Nystagmus
✔✔sinusitis - ✔✔· URI sx >10 days without improvement; Severe sx with high fever and
purulent drainage at onset lasting 3-4 days
· Symptoms worse on day 6 or 7 of URI
-o Augmentin, Azithromycin or Bactrim DS x10 days
o Decongestant, antihistamines, saline rinses, nasal steroids
✔✔pharyngitis - ✔✔Amoxicillin 50-80 mg/kg/day x10 days
Cephalosporin or Macrolide if allergy
Warm water gargle
Tylenol/NSAIDs
✔✔Infectious Mononucleosis - ✔✔· Viral syndrome—Fever, Exudative pharyngitis,
Adenopathy (posterior cervical)
· Epstein-Barr virus; Spread via saliva; Incubation 2-5 weeks
Symptomatic unless severe
Corticosteroids
Treat with Erythromycin if strep to avoid rash d/t Amox or PCN
No contact sports for 1 mo
F/U 1-2 weeks
