NR511 Midterm diff diagnosis

The ability of a test to correctly identify those who do not have the disease # of true negatives divided by total # of people who do not have the disease specificity ability of a test to correctly identify pt has disease true positives divided by # of people who have disease sensitivity pain, tingling, stabbing, unilateral vesicular rash along dermatome herpes zoster how is herpes zoster diagosed? history and physical, PCR assay white macules or patches usually on sun exposed areas, premature graying of hair vitiligo what labs are done for vitiligo? cbc, peripheral smear (detect pernicious anemia), thyroids, ANA mask of pregnancy hyperpigmentation of face during pregnancy cholasma (melasma) how is cholasma diagnosed? wood's lamp examination diffuse, generazlied, hyperpigmentation, especially on skin creased d/t increased adrenocorticotropic hormon addison's disease what labs are done to detect addison's disease? NA, K, cortisol, ACTH level, ca, CBC, TSH, B12, RH factor what are the characteristics of malignant melanoma? asymmetrical, irregular borders, color changes, diameter 6mm, evolving, raised health teaching for those with pruritus short, tepid showers, no baths, no scratching, cool compresses, emollients what is "soak and smear" and what does it help with? soak skin for 20 mins and apply ointment to wet skin to prevent pruritus What is urticaria? First line treatment class and drugs? Prevention/teaching? hives/wheals 2nd gen nonsedating H1 antihistamines- loratadine, fexofenadine cool temps, no hot showers, avoid tight clothes topical treatment for urticaria? pramoxine 1-2mm red papules interdigital web staples, wrists, axillary folds, and periumbilical? scabies what does an intraepidermal burrow from scabies look like? white with black specks linear how is an intraepidermal burrow from scabies diagnosed? burrow ink test- mark with ink, ink will go into tunnel how is scabies diagnosed? place drop of mineral oil, scrape off with blade, place on slide, look under microscope treatment and teaching for scabies wash all clothes and bedding in hot water and detergent scabicide lotions antihistamines and topical steroids for pruritus example of scabicides lotion permethrin and malathion lotion red, small, erythematous, macules or papules, pruritus worse at night, mostly scalp pediculosis (lice) how is pediculosis diagnosed? wood light exam, magnifying glass Treatment of pediculosis first line second line Topical insecticides are effective such as permethrin, pyrethrins, and malathion are considered first line Lindaine and ivermectin are second line petroleum jelly or other occlusive substances can be used to suffocate lice. Reapplication in 7-10 days recommended to kill any newly hatched lice. what is the prevention/education for pediculosis avoid sharing clothes/hats, use special combs to remove nits, pt and family to be treated, itching will continue after tx due to inflammation differential diagnosis for scabies (5) dermatitis impetigo insect bites liver disease folliculitis What treatment is used for scabies scabicide lotion and ivermectin systemic antiparasitic Difference between pediculosis and dandruff? dandruff slides off hair shaft easily and does not originate on hair shaf 3 risk factors for developing fungal skin infection hot, moist areas, immunocompromised pts, pts on abx Treatment of oral candidiasis (thrush) (3) clotrimazole troches (dossolve), miconazole buccal tabs, nystatin swish and swallow White vaginal discharge (cottage cheese), burning, itching, dysuria vaginal candidiasis Sexually active male with small erythematous eroded patches tender to touch, rash, and itching of glans penis balanitis An obese female with red, itchy, weepy rash with maceration in the perianal, groin and interdigital areas intertriginous candidiasis treatment of intertriginous candidiasis? nystatin powder a male who works as a dishwasher in Olive Garden presents with a painful abscess on the 1st finger of the right hand which looks red, hot, swollen? what is it? candidal paronychia what is the treatment and prevention of candidal paronychia? incision and drainage warm compresses A female bartender presents with yellow fingernails for months. She denies any pain or itching at site. What is the diagnosis subungual candida what is the treatment of onychomycosis? 2 class and examples of drugs topical antifungals- terbinafine, nystatin, miconazole, ciclopirox