Nursing

Multiple Myeloma Patient will be elderly Complaining of back pain PE will show CRAB: hyperCalcemia, Renal insufficiency, Anemia, lytic Bone lesions/Back pain Labs will show monoclonal antibody spike X-ray will show lytic lesions Peripheral blood smear: Rouleaux formations Serum protein electrophoresis: M spike Protein electrophoresis urine analysis: Bence-Jones proteins Most commonly caused by single clone plasma cell read more…

Molluscum Contagiosum Patient will be a school-age child Presenting with “warts” PE will show multiple waxy, dome-shaped papules with umbilicated appearance Most commonly caused by poxvirus Treatment is self-limiting

Complex Regional Pain Syndrome Patient will have a history of previous extremity injury or fracture Complaining of light touch causing extreme pain and allodynia (pain felt from a nonpainful stimulus, such as clothes or bed sheets on the skin) Treatment is NSAIDs, gabapentin, sympathectomy

Bacterial Tracheitis Patient will be 3–5 years old High fever, barky cough, stridor Treat as airway emergency! Comments: Patient will look like croup but toxic appearing Sample Question: A 3-year-old boy presents in severe respiratory distress. His mother informs you that he has been ill for the last five days, initially with a low-grade fever and “barky cough.”  read more…

Absence Seizures Patient will be a 5–10 years old Sudden mental status alteration without motor activity or a blank stare EEG during an event would show symmetric 3 Hz spike and wave activity Treatment is ethosuximide Comments: There will be no aura or postictal state

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Causes: adhesions (pelvic surgery) > tumor > hernia (inguinal) Proximal: bilious vomiting  Distal: feculent vomiting High pitched bowel sounds X-ray: dilated bowel, air-fluid levels, “stack of coins” or “string of pearls” sign Modality of choice: CT NGT, surgery

Appendicitis Patient will be complaining of fever, pain that began periumbilical then moved to RLQ, nausea and anorexia PE will show Psoas sign (RLQ pain on extension of right hip), Obturator sign (RLQ pain on internal rotation of flexed right hip), Rovsing sign (right lower quadrant pain when the left lower quadrant is palpated) Diagnosis is made by ultrasound, CT Most commonly caused read more…