Archive

Bacterial vaginitis

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1. symptoms:

1. malodor, whitish or grayish with fish odor discharges

2. mostly may be treated along with another type of vaginitis

3. R/O cystitis

2. treatment:

1. Tab metronidazole 500mg #14 bid

1. or vaginal gel metronidazole 0.75% #1 qhs for 5 nights

2. or cream vaginal clindamycin 2% #1 qhs for 7 nights

2. if relapsed:

1. Tab metronidazole 500 mg #28 bid

Bacterial conjunctivitis

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1. usually unilaterally affected with pussy discharges

2. Treatment

1. Oint opht erythromycin 0.5% #1 qid

1. or drop opht ciprofloxacin qd

2. drop tear opht artificial 0.5% #1 qid

3. drop opht sulfacetamide 10% #1 qid 2drops

Back pain

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1. Tab Naproxen 250 mg bid #20

2. or Tab celexib 100 mg Bid #20

3. Tab omeprazole 20 mg bid #20

4. Tab metoclopramide 500 mg bid #20

5. or Tab Tizanidine 4 mg 1/2 tab bid #10

6. Cap gabapentin 300 mg qhs #20

AUB

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1. Treatment

1. make the pt stable

2. use IV estrogen to stop bleeding

1. for those who can not receive estrogen, use IV or PO progestron

2. do not use progestron with tranexamic acid (X interaction)

3. Tab mefenamic acid #30 tds

1. or Tab naproxen 500mg #30

2. or tab tranexamic acid 500mg #40 2tabs tds

4. Amp tranexamic acid 500 mg

5. treat for 5 days

Atrophic vaginitis

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1. symptoms:

1. in menopause women due to low estrogen

2. pruritic, dyspareunia, pussy discharge

2. Treatment

1. vaginal cream conjugated estrogen 0.625 qhs for 1 week then 2times/week for 2 months

Asymptomatic bacteriuria in pregnancy

1. treatment

1. cap amoxicillin 500mg #12 qid

1. or tab cefixime 200mg #7 qd

2. repeat U/A and U/C after 2 weeks

3. if relapsed:

1. Tab nitrofurantoin 100mg #100 qd till end of pregnancy

Asthma

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1. Use this:

1. Mild disease:

1. Spray salbutamol PRN

2. Moderate disease

1. Spray salbutamol PRN

2. Spray salmeterol BID

3. Moderate to severe disease

1. Spray salbutamol PRN

2. Spray salmeterol BID

3. spray beclomethasone QD

4. very severe case

1. Spray salbutamol PRN

2. Spray salmeterol BID

3. spray beclomethasone QD

4. tab prednisolone 5-50 mg qd

2. D/C inhaled corticosteroids after well evaluating the pt after 3 months

3. Influenza vaccination

4. Do not use theophylline in children

5. use Montelukast in children

Ascaris, Pinworm (Enterobius vermicularis)

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1. Ascaris

1. Dx: ova in feces

2. treatment:

1. Tab albendazole 400 mg #2 single dose

1. or tab mebendazole 100 mg #5 single dose

2. in children or pregnancy use:

1. Syrup pyrantel 250mg/5ml #1 11mg/kg for adults single dose, w/4 cc single dose for child

3. repeat treatment 2 weeks later

2. Enterobius vermicularis

1. Dx: itching in anal

2. Treatment

1. tab mebendazole 100 mg 2 tab SD

1. or tab albendazole 400 mg 2 tab SD

2. repeat treatment 2 weeks later

Aphthous ulcer

1. How it looks:

1. single ulcer

2. superficial

3. peripheral redness

2. DDx:

1. herpes zoster

2. Trauma

3. Iron, folate, B12 deficiency

4. poor hygiene

3. Cocktail tds for 2 minutes mouth washing then spit out

1. Elixir diphenhydramine 12.5mg/5cc #1

2. Cap tetracycline 250 mg #8

1. or cap cefalexin 500 mg #8

3. Amp lidocaine 2% 1cc #1

4. Amp dexamethasone 1cc #1

4. Oral/gingival infections:

1. Tab Penicillin 800 mg qd for 4 days

2. or Metronidazole + azithromycin tds