Archive
NAFLD
#
1. Request:
1. lipid profile
2. liver sonography
3. BS profile
2. Treatment
1. cap vitamin E 400u bid #100
2. Tab metformin 500 mg bid #100
3. Tab atorvastatin 10 mg qd #100
3. visit the pt 6 month later with
1. PT,PTT,INR
2. LFT
3. LIVER sonography
4.
Myiasis
#
1. Treatment
1. Ivermectin: Dose: 150–200 µg/kg orally as a single dose (may repeat after 24–48 hours if needed).
1. Or Mebendazole 200 mg #6 q12h
Motion sickness
#
1. tab dimenhydrinate 50 mg #10, repeat every 4 hours for long rides
1. or tab promethazine 25mg #10
Methanol poisoning
#
1. Serum level:
1. ≥20 mg/dl in blood ⇒ symptomatic pt.
2. ≥50 mg/dl in blood ⇒ ophthalmic symptoms
3. ≥150 mg/dl ⇒ death
2. Orders:
1. folic acid 1mg/kg q4h IV
2. Keep pH >7.2
3. Ethanol
1. 1.8 cc/kg stat then 0.2 cc/kg, 43% PO
2. 8 cc/kg stat then 1.2 cc/kg/hr 10% IV
3. if use 20% PO ⇒ use double dose
4. if on H.D ⇒ use double dose
4. Fomepizole 15mg/kg stat then 10 mg/kg q12h *4
1. if not resolved after 2 days ⇒ increase dose up to 15 mg/kg q12h
5. Hemodialysis if:
1. refractory acidosis
2. ophthalmopathies
3. cns problems
4. >50 mg/dl serum level
5. >30 cc/kg intake
6. Continue dialysis till serum level <20 mg/dl or for at least 8 hours
Medial/Lateral epicondylitis
#
1. tab naproxen 250 mg bid
2. or cap celexib 100 mg bid
3. or cap indomethacin 75 mg bid
4. cap piroxicam tid #2
5. Cap omeprazole 20 mg bid
6. if not healed after 4 weeks, refer to orthopedics for:
1. Amp triamcinolone
Measles, Rubella
#
1. Measles (سرخک)
1. symptoms
1. 1-2 week of incubation period
2. low grade fever
3. photophobia
4. cough
5. koplik spots in buccal before rash
6. maculopapular rash in head and neck and descending
2. contagious from 1 week before rash up to 5 days after them
3. Treatment
1. Elixir diphenhydramine w/3 qid
2. Syrup acetaminophen w/2 qid
2. Rubella (سرخجه)
1. symptoms
1. 2-3 week of incubation
2. low grade fever
3. sore throat
4. lymphadenopathy in neck
5. pink small regular maculopapular rash in face and descending
1. in 24 hours seen in all part of body
2. resolve in 3 days
2. contagious from 1 week before till 1 week after rash
3. if pregnant pt has contact: check Rubella AB IgG
4. Treatment
1. Elixir diphenhydramine w/3 qid
2. Syrup acetaminophen w/2 qid
Mastoiditis
#
1. Seen in children post AOM
2. Treatment
1. Cap amoxicillin 250mg tds #30
1. or Tab co-amoxiclav 625mg tds #42
2. or tab co-trimoxazole 480mg #28
3. or tab azithromycin 500mg qd #10
4. or tab cefuroxime 500 mg #20
2. tab acetaminophen 325mg qid #20
3. Tab pseudoephedrine 30 mg qid #20
3. re-visit the pt after 48 hours. if not treated, refer to ENT man for hospitalization
Mastitis
#
1. Symptoms
1. fever
2. tenderness
3. congestion
2. if suspicious of abscess formation ⇒ sonography and refer for I&D
3. If no abscess:
1. Cap cefalexin 500mg #40 qid
2. tab acetaminophen 500 mg #30 qid
3. do not abrupt feeding
4. in severe cases:
1. use clindamycin 300 mg
Lacrimal Canal Obstruction
#
1. usually resolves till 1 y/o
2. Treatment
1. Eye drop Sulfacetamide 10% 1-2drop qid
1. or eye drop gentamycin 1-2 drop qid
2. massage
3. warm compress