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
Chicken pox
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1. Course
1. Low grade fever
2. Papules ⇒ vesicles ⇒ pustules ⇒ crust formation
3. lasting about 1 week
2. No use of
1. Aspirin ⇒ Ray syndrome
2. Ibuprofen ⇒ Toxic shock syndrome
3. Treatment
1. Elixir diphenhydramine 12.5mg/5cc #1 2.5cc tds
2. Syrup hydroxyzine 10mg/5cc #1 5cc bid
3. Susp acetaminophen 120mg/5cc w/2cc qid #1
4. Daily bath
5. If:
1. Age >12y/o
2. immunodeficiency
3. corticosteroids use
4. pulmocutaneous lesions
5. Long-term salicylate use
1. Tab acyclovir 400 mg 2 tab q6h (20mg/kg/day, max dose 800 mg q6h for 5 days)
1. or tab valacyclovir 1000 mg tds (20mg/kg/day)
Chalazion
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1. Ex: Meibomian glands obstruction
2. Symptoms:
1. Pain
2. bulging
3. redness
3. treatment
1. warm compress
2. baby shampoo #1 tds
3. oint erythromycin 0.5% #1 qid
4. drop tear opht artificial 0.5% #1 qid
Cervicitis
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1. symptoms
1. pain while intercourse
2. Abnormal bleeding
3. discharge
4. hypogastric pain
2. Etiology
1. Neisseria
2. Chlamydial
3. Treat both the pt and her partner
1. Cap metronidazole 500 mg #28 bid
2. Tab azithromycin 500mg #4 each one 1 gr stat (can be prescribed in pregnancy with erythromycin)
3. other option:
1. Cap cefixime 400mg #2 each one 400 mg
2. Tab doxycycline 100mg #28 for both
Cellulitis, erysipelas
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1. Erysipelas
1. sharp border
2. painful
3. strep
2. Cellulitis
1. dermis and subcutaneous are involved
2. vague border
3. staph
4. mostly in DM, malnutrition, immunodeficiency, trauma, fly bite
3. Treatment: if high risk, start IV treatment then change into PO treatment
1. Cold compress
2. Cap mefenamic acid tds
3. Vial ceftriaxone 1gr (50-75mg/kg) qd
1. or Vial cefazolin 1gr q8h (100mg/kg/day)
4. Vial vancomycin 1gr q12h (15mg/kg/day)
1. or cap cefalexin 500 mg qid
2. or susp cefalexin 250, 125mg/5ml
3. or tab erythromycin 400 mg
4. or tab penicillin 500 mg qid
5. treat for 7 days, start with IV then change to Po
6. always consider necrotizing fasciitis
4. Prophylaxis for recurrent cellulitis
1. Cap penicillin v 500 mg q12h #30
5. for septal cellulitis, always admit and use IV antibiotics
1. diplopia
2. proptosis
3. vision loss
Candidiasis
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1. Whitish lesion on newborns’ tongue
2. Check these if recurrent
1. CBC, diff
2. ESR
3. HIV Ab
3. Treatment
1. Drop nystatin qid #4 (each container = 15 cc) for 7 days
1. 1 cc for <1m/o
2. 2 cc for , 12 m/o
3. 4cc for >1 y/o
2. use both for infant and nipple
3. do not use milk bottle
4. if no response, repeat for a week