String (Floss) Method for Ring Removal #String #Floss #Ring #Removal #procedure #clinical #video #finger

Blood Gas Analysis and Interpretation STEPS TO ANALYSIS 1. Look at PH. Alkalotic or acidotic? - If alkalotic, then it is an alkalosis. - If acidotic, then it is an acidosis. 2. Look at components. - pCO2 (respiratory component) - alkalotic or acidotic? - Bicarb/BE/BD (metabolic component) - alkalotic or acidotic? 3. Which component agrees with pH? - Whichever agrees with pH (respiratory or metabolic) is "Primary". - If the other component is in the other direction, it is "Secondary". - If they both agree, then it is "Combined". #BloodGas #ABG #VBG #Analysis #Interpretation #diagnosis

Common Dermatological Conditions - Distribution and Morphology • Acne vulgaris - Face, upper back, chest - Open and closed comedones, erythematous papules, pustules, cysts • Rosacea - Blush area of cheeks, nose, forehead, chin - Erythema, telangiectases, papules, pustules • Seborrheic dermatitis - Scalp, eyebrows, perinasal areas - Erythema with greasy yellow-brown scale • Atopic dermatitis - Antecubital and popliteal fossae; may be widespread - Patches and plaques of erythema, scaling, and lichenification; pruritus • Stasis dermatitis - Ankles, lower legs over medial malleoli - Patches of erythema and scaling on background of hyperpigmentation associated with signs of venous insufficiency • Dyshidrotic eczema - Palms, soles, sides of fingers and toes - Deep vesicles • Allergic contact dermatitis - Anywhere - Localized erythema, vesicles, scale, and pruritus (e.g., fingers, earlobes-nickel; dorsal aspect of foot-shoe; exposed ivy) • Psoriasis - Elbows, knees, scalp, lower back, fingernails (may be generalized) - Papules and plaques covered with silvery scale; nails have pits • Lichen planus - Wrists, ankles, mouth (may be widespread) - Violaceous flat-topped papules and plaques • Keratosis pilaris - Extensor surfaces of arms and thighs, buttocks - Keratotic follicular papules with surrounding erythema • Melasma - Forehead, cheeks, temples, upper lip - Tan to brown patches • Vitiligo - Periorificial, trunk, extensor surfaces of extremities, flexor wrists, axillae - Chalk-white macules • Actinic keratosis - Sun-exposed areas - Skin-colored or red-brown macule or papule with dry, rough, adherent scale • Basal cell carcinoma - Face - Papule with pearly, telangiectatic border on sun-damaged skin • Squamous cell carcinoma - Face, especially lower lip, ears - Indurated and possibly hyperkeratotic lesions often showing ulceration and/or crusting • Seborrheic keratosis - Trunk, face - Brown plaques with adherent, greasy scale; "stuck on" appearance • Folliculitis - Any hair-bearing area - Follicular pustules • Impetigo - Anywhere - Papules, vesicles, pustules, often with honey-colored crusts • Herpes simplex - Lips, genitalia - Grouped vesicles progressing to crusted erosions • Herpes zoster - Dermatomal, usually trunk but may be anywhere - Vesicles limited to a dermatome (often painful) • Varicella - Face, trunk, relative sparing of extremities - Lesions arise in crops and quickly progress from erythematous macules, to papules, to vesicles, to pustules, to crusted sites. • Pityriasis rosea - Trunk (Christmas tree pattern); herald patch followed by multiple smaller lesions - Symmetric erythematous patches with a collarette of scale • Tinea versicolor - Chest, back, abdomen, proximal extremities - Scaly hyper- or hypopigmented macules • Candidiasis - Groin, beneath breasts, vagina, oral cavity - Erythematous macerated areas with satellite pustules; white, friable patches on mucous membranes • Dermatophytosis - Feet, groin, beard, or scalp - Varies with site, (e.g„ tinea corporis-scaly annular plaque) • Scabies - Groin, axillae, between fingers and toes, beneath breasts - Excoriated papules, burrows, pruritus • Insect bites - Anywhere - Erythematous papules with central puncta • Cherry angioma - Trunk - Red, blood-filled papules • Keloid - Anywhere (site of previous injury) - Firm tumor, pink, purple, or brown • Dermatofibroma - Anywhere - Firm red to brown nodule that shows dimpling of overlying skin with lateral compression • Acrochordons (skin tags) - Groin, axilla, neck - Fleshy papules • Urticaria - Anywhere - Wheals, sometimes with surrounding flare; pruritus • Transient acantholytic dermatosis - Trunk, especially anterior chest - Erythematous papules • Xerosis - Extensor extremities, especially legs - Dry, erythematous scaling patches; pruritis #dermatology #rash #differential #diagnosis #skin #common #distribution #primarycare

Trastronos del parpado (atencion primaria) #differential #chalazion #clinical #medstudent #CEM

There are several screening questionnaires for OSA, although the accuracy of many of them is limited.4,6,7,24 The STOP-Bang questionnaire is a validated screening tool, particularly in obese and surgical patients (Figure 1).27 Its sensitivity has consistently been shown to be greater than 85%, with a specificity ranging between 25% and 85%, and a higher specificity in obese men.27–29 The STOP-Bang questionnaire can be easily administered in the primary care setting. Am Fam Physician. 2016 Sep 1;94(5):355-360. #Diagnosis #PrimaryCare #OSA #ObstructiveSleepApnea #Screening #STOPBANG #Questionnaire

Pharmacologic Treatments of Chronic Hypertension in Pregnancy Central alpha-agonists - Methyldopa - Clonidine Combined alpha- and beta-blocker - Labetalol - B-blockers Beta-blockers - Metoprolol - Atenolol Non-dihydropyridine Calcium Channel Blockers - Verapamil Dihydropyridine Calcium Channel Blockers - Nifedipine (long-acting preparation) - Amlodipine Other vasodilators - Hydralazine - Diuretics - Hydrochlorothiazide #Hypertension #Pregnancy #Management #Treatment #Pharmacology #HTN #Table #Drugs

American College of Critical Care Medicine algorithm for time-sensitive, goal-directed stepwise management of hemodynamic support in infants and children. Proceed to next step if shock persists. 1) Firsthour goals—restore and maintain heart rate thresholds, capillary refill ≤ 2s, and normal blood pressure in the first hour/emergency department. 2) Subsequent ICU goals—if shock not reversed proceed to restore and maintain normal perfusion pressure (MAP – CVP) for age, Scvo2 > 70% (* except congenital heart patients with mixing lesions), and cardiac index > 3.3 < 6.0L/min/m2 in PICU. #Shock #Algorithm #CriticalCare #Peds #Pediatrics #Sepsis #Management #StepWise

Glasgow Coma Scale - Adult and Pediatrics Check on the health of a newborn baby using the APGAR rating scale. APGAR is a scoring system best employed within the first 5 minutes of birth. Remember, APGAR is a general indication of overall health only. Manage the newborn based on the signs and symptoms present. #Glasgow #Coma #Scale #Adult #Pediatrics #Diagnosis #Score #GCS

The preterm infant compared with the term infant. #Preterm #Premature #Term #Comparison #PhysicalExam #Features #Peds #Pediatrics

Important Respiratory Distress Pearls #diagnosis #respiratory #distress #NRDS #RDS #TTN #MAS #neonatal #pediatric #adult #respiratory #adverse #effects #pulmonary #ventilation #algorithm #causes