Dental abscess in pediatric
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– Treatment
– Co-amoxi 643 1/3 wt cc q8h
– Susp metronidazole 125mg/5cc, 15-50mg/kg/3 q8h
Archive
Dacryocyctitis in adults
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1. Treatment
2. Massage with warm compress
3. Drop opht sulfacetamide 10% #1 qid 2 drops
Cystitis
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1. Symptoms:
1. Dysuria
2. frequency
3. hypogastric pain
4. more seen in women
2. Treatment
1. Tab TMP-SMX 800-160mg bid for 3 days
1. or tab ciprofloxacin 500mg bid
2. or tab nitrofurantoin 100mg tds
2. for dysuria:
1. Tab phenazopyridine #10 qid
1. causes urine color change
2. do not use for more than 3 days
3. in pregnancy
1. Cap cefalexin 500mg qid for 7 days
1. or Tab nitrofurantoin 100mg tds
4. in men, always take U/A, U/C
3. In Old person with frequency but without any sign/symptoms of BPH and NL lab data
1. Tab oxybutynin 5mg #10 tds
1. or tab tolterodine 1mg #10 bid
2. or Tab solifenacin 5mg #10 bid
Croup
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1. Etiology:
1. parainfluenza virus
2. Symptoms
1. in <6y/o
2. most common in 6m/o-3y/o
3. low grade fever
4. barking cough
5. Hx of common cold from 2-3 days prior to visit
3. Orders:
1. observe for 3 hours, discharge if stridor resolved and Family is alert
2. Neck x-ray AP and Lateral (for steeple sign)
3. Nep epinephrine 1:1000 2.5 cc in 3 ml N/S
1. >5y/o 5 cc & <5y/o 2.5 cc
4. Amp dexamethasone 0.6mg/kg IM
4. Other treatments:
1. tab prednisolone 2mg/kg/day 2-3 times/day
5.
Cradle cap
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1. characteristics:
1. a form of seborrheic dermatitis
2. yellowish dandruff
2. Treatment
1. Olive oil at night, wash at morning
2. for refractory cases:
1. Shampoo ketoconazole 2 times/week for 2 weeks
CPR in children
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1. Chest compression
1. 100-120/min
2. respiration 2 ::: 15 compression
2. Defibrillation:
1. unsynchronized start with 2j ⇒ 4 ⇒ 6 ⇒ 8 ⇒ 10j
3. Doses:
1. Amp Epinephrine
1. IV: 0.1 cc/kg or 0.01 mg/kg (max 1 mg) from 1/1000
2. Intra thecal: 0.1 cc/kg or 0.1 mg/kg (max 10 mg) from 1/10,000
2. Amp Amiodarone in VT with Pulse
1. IV: 5 mg/kg infused in 30-60 min *3times
3. Amp Lidocaine 1 mg/kg
4. Amp Adenosine in PSVT
1. start with 0.1mg/kg (max 6mg)
2. repeat with 0.2 mg/kg (max 12mg)
5. Amp procainamide in VT with Pulse with LOW BP (about 70-90 in different ages) 15 mg/kg
4. Hydration with 20 cc/kg crystalloids or N/S
5. Intubation
1. size <2 y/o ⇒ small finger, adult: 7-8
2. fixation: youth 12+(age/2), adult male 23, female 21
6.
CPR in Adults
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1. chest compression and respiration:
1. 100-120/min, 1/3 of chest wall diameter, for 2 minutes
2. 30 compression ::: 2 respiration
2. course:
1. cc + resp ⇒ shock ⇒ cc + resp ⇒ shock + epi ⇒ cc + resp ⇒ shock + epi + amiodarone
3. Doses:
1. Amp epinephrine 1mg/kg IV repeat every 3-5 minutes
2. Amp amiodarone 150 mg/3ml IV
1. first dose 300 mg
2. 2nd dose 150 mg
3. do not use in PEA
4. Defibrillation
1. unsynchronized in PEA
2. 200 j
Contraceptive pills
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1. PO drugs:
1. LD
2. HD
3. Yasmin
4. Yaz
5. Cyproterone compound
6. Rokin
2. Start from firs day of menstruations qd for 21 days
then rest for 7 days
then start the next cycle
3. if one night missed, double next dose
if 2 nights missed, triple the dose
if more than 2 nights missed, start a new cycle and use another contraceptive way
4. IV drugs:
1. Amp Depo-Provera (DMPA) #1 IM
1. in the 5 days of menstruations
2. repeat every 3 months
5. In breast feeding period
1. Tab contraceptive LD #21
1. or Amp DMPA #1 q3m
2. Tab minipill #30 qd
6. For emergency:
1. Tab levonorgestrel 1.5mg #1 stat
1. or Tab HD #4 2 tab q1h
2. or Tab LD #8 4tabs q12h
3. or Tab Ulipristal 30mg SD #1 available for 120hrs post sex
2. can be used in 72hrs post intercourse
3. if have N/V in 3 hrs post taking the pills, repeat the dose
4. IUD in 7 days
7. For weddings or Mecca
1. Start contraceptive 3-4 days after finishing the menstruations till when she wants
2. high risk of stroke
Contact dermatitis
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1. Moisturizing agents:
1. Cream Moringa #1
2. Cream Doctor Jilan #1
3. Cream Face Doux #1
4. Cream QV #1
2. Corticosteroids
1. Oint hydrocortisone 1% bid for 2 weeks #1 ⇒ use for sensitive and thin skin
1. or Oint Tacrolimus 0.03% for >18 y/o #1
2. Or oint tacrolimus 0.1% for >2y/o #1
2. Oint betamethasone bid for 2 weeks #1
Constipation in Pediatrics
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1. Treatment
1. behavioral treatment
2. night bells
3. continue treatment for 6 months
4. Syrup lactulose 1-3cc/w bid
1. or syrup glycerin
2. or syrup MOM 1-2cc/w bid
2. if refractory, check
1. Total Alb, anti TTG Ab, serum IgA
2. TSH, T3, T4
3. CBC
4. K, Ca
5. U/A
3. infants can have low defecation up to 1 time/ week