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by: Garth Dach


Garth Dach
Texas State
GPA 3.64

M. Haynes

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M. Haynes
Class Notes
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This 13 page Class Notes was uploaded by Garth Dach on Wednesday September 23, 2015. The Class Notes belongs to AT 3226 at Texas State University taught by M. Haynes in Fall. Since its upload, it has received 19 views. For similar materials see /class/212761/at-3226-texas-state-university in Athletic Training at Texas State University.

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Date Created: 09/23/15
AT 3236 ENT Lab STATION 1 VITAL SIGNS STATION These are considered quotgrab bagquot tests meaning that they may be included in a practical as an extra test to perform In some cases though taking vital signs will be absolutely required as part of your practical examination For example taking a temperature is required as part of the physical examination procedures for an ear related illness Practice taking the following vital signs on a partner Temperature Temperature can be measured is several different ways Oral with a glass paper or electronic thermometer normal 986F37C Axillary with a glass or electronic thermometer normal 976F363C Rectal or quotcorequot with a glass or electronic thermometer normal 996F377C Aural the ear with an electronic thermometer normal 996F377C Of these axillary is the least and rectal is the most accurate Respiration Best done immediately after taking the patient39s pulse Do not announce that you are measuring respirations Without letting go of the patients wrist begin to observe the patient39s breathing Is it normal or labored Count breaths for 30 seconds and multiply this number by 2 to yield the breaths per minute In adults normal resting respiratory rate is between 1420 breathsminute Rapid respiration is called tachypnea Sit or stand facing your patient Grasp the patient39s wrist with your free hand Compress the radial artery with your index and middle fingers Note whether the pulse is regular or irregular D Regular evenly spaced beats may vary slightly with respiration D Regularly Irregular regular pattern overall with quotskippedquot beats D Irregularly Irregular chaotic no real pattern very difficult to measure rate accurately Count the pulse for 15 seconds and multiply by 4 Count for a full minute if the pulse is irregular Record the rate and rhythm Blood Pressure Position the patient39s arm so the antecubital fold is level with the heart Support the patient39s arm with your arm or a bedside table Center the bladder of the cuff over the brachial artery approximately 2 cm above the antecubital fold Proper cuff size is essential to obtain an accurate reading Be sure the index line falls between the size marks when you apply the cuff Position the patient39s arm so it is slightly flexed at the elbow Place the stetescope over the brachial artery Inflate the cuff to 30 mmHg above the estimated systolic pressure Release the pressure slowly no greater than 5 mmHg per second The level at which you consistently hear beats is the systolic pressure Korotkoff sounds Continue to lower the pressure until the sounds muffle and disappear This is the diastolic pressure Record the blood pressure as systolic over diastolic quot12070quot for example STATION 2 EYE EXAMINATION STATION The following eye examination is completed in the order that it should be completed during your practical examination Please be sure to complete all of the following examination H amp P procedures History know all of these history questions What happened MOI Where is your pain 0 Describe painlocation 0 Rate pain 0 What makes it betterworse Associated Symptoms photophobia diplopia halo photopsia itching discharge tearing Any history of similar problems Known medications or allergies Direct trauma Fever InspectionObservation Be able to verbalize the structures that you are observing and normal findings In all cases be sure to write down verbalize that you are looking for edema deformity discoloration redness In addition know the following Eye remark on discharge amp color eye structures Normal External Findings conjunctiva is normal pink sclera is white and free of marks iris and pupil are round Normal Internal Findings red reflex blood vessels round amp slightly yellow optic disc and dark red macula 0 Observe the patient for ptosis exophthalmos lesions deformities or asymmetry 0 Ask the patient to look up and pull down both lower eyelids to inspect the conjunctiva and sclera 0 Next spread each eye open with your thumb and index finger while wearing gloves Ask the patient to look to each side and downward to expose the entire bulbar surface 0 Note any discoloration redness discharge or lesions Note any deformity of the iris or lesion cornea Palpation Be able to verbalize the structures that you are palpating and normal findings Palpate the bony structure around the eye noting tenderness p deformity quotSpecial Testsquot a Visual Acuity Allow the patient to use their glasses or contact lens if available You are interested in the patient39s best corrected vision Position the patient 20 feet in front of the Snellen eye chart Have the patient cover one eye at a time with a card Ask the patient to read progressively smaller letters until they can go no further Record the smallest line the patient read successfully 2020 2030 etc Repeat with the other eye b Extraocular Movement Stand or sit 3 to 6 feet in front of the patient Ask the patient to follow your finger with their eyes without moving their head Check gaze in the six cardinal directions using a cross or quotHquot pattern Check convergence by moving your finger toward the bridge of the patient39s nose c Pupil Reaction Dim the room lights as necessary Ask the patient to look into the distance Shine a bright light obliquely into each pupil in turn Look for both the direct same eye and consensual other eye reactions Record pupil size in mm and any asymmetry or irregularity d Opthalmascopic Examination Darken the room as much as possible Adjust the ophthalmoscope so that the light is no brighter than necessary Adjust the aperture to a plain white circle Set the diopter dial to zero unless you have determined a better setting for your eyes Use your left hand and left eye to examine the patient39s left eye Use your right hand and right eye to examine the patient39s right eye Ask the patient to stare at a point on the wall or corner of the room Look through the ophthalmoscope and shine the light into the patient39s eye from about two feet away You should see the retina as a quotred reflexquot Follow the red color to move within a few inches of the patient39s eye Adjust the diopter dial to bring the retina into focus Find a blood vessel and follow it to the optic disk Use this as a point of reference Inspect outward from the optic disk in at least four quadrants and note any abnormalities Move nasally from the disk to observe the macula STATION 3 EAR EXAMINATION The following ear examination is completed in the order that it should be completed during your practical examination Please be sure to complete all of the following examination H amp P procedures History know all of these history questions What happened MOI Where is your pain 0 Describe painlocation 0 Rate pain 0 What makes it betterworse Associated Symptoms pain at night stuffy ears trouble hearing balance problems tinnitus dizziness itching pressure changes Any history of similar problems Known medications or allergies Direct trauma Fever Observation Be able to verbalize the structures that you are observing and normal findings In all cases be sure to write down verbalize that you are looking for edema deformity discoloration redness In addition know the following Ear remark on discharge cerumen ear structures Normal External Findings auricle tragus external auditory meatus are all intact and normal flesh tone Normal Internal Findings Internal auditory canal normal flesh color amp tympanic membrane is pearly gray with light reflex Palpation Be able to verbalize the structures that you are palpating and normal findings Palpate the bony structure around the ear noting tenderness p deformity May find p wmoving the tragus with otitis externa quotSpecial Testsquot a Hearing Stand behind the patient or in front of the pt with the eyes closed Rub the fingers together to produce a sound Ask the patient to motion when a sound is produced and to locate the ear where the sound is located In addition ask if there is a difference in the quality or level of sound from side to side Do the same while snapping the fingers Test both sides documenting any change b Otoscope Findings Hold the otoscope with your thumb and fingers so that the ulnar aspect of your hand makes contact with the patient Pull the ear upwards and backwards to straighten the canal Insert the otoscope to a point just beyond the protective hairs in the ear canal Use the largest speculum that will fit comfortably Inspect the ear canal and middle ear structures noting any redness drainage or deformity c Lymph Node Palpation Inspect the neck for asymmetry scars or other lesions Palpate the neck to detect areas of tenderness deformity or masses Use the pads of the fingers to lightly palpate the lymph nodes in a circular motion I Preauricular In front of the ear I Tonsillar At the angle of the jaw I Submandibular Under the jaw on the side Submental Under the jaw in the midline I Superficial Anterior Cervical Over and in front of the SCMmuscle I Supraclavicular In the angle of the sternomastoid and the clavicle I Posterior Cervical behind SCM muscle NOSE FACIAL EXAMINATION The following nosefacial examination is completed in the order that it should be completed during your practical examination Please be sure to complete all of the following examination H amp P procedures History know all of these history questions What happened MOI Where is your pain 0 Describe painlocation 0 Rate pain 0 What makes it betterworse Associated Symptoms trouble breathing snoring at night runny nose stuffiness post nasal drip impaired smelling bleeding tooth pain positional pain Any history of similar problems Known medications or allergies Direct trauma Fever Observation Be able to verbalize the structures that you are observing and normal findings In all cases be sure to write down verbalize that you are looking for edema deformity discoloration redness In addition know the following Nose remark on discharge and nasal structures Normal External Findings skin intact straight nasal alignment normal opening of nostril Normal Internal Findings meatus is normal flesh color equal opening of nostrils cartilage intact turbinates Palpation Be able to verbalize the structures that you are palpating and normal findings Palpate nasal bonenasal cartilage and nostril for p tenderness and deformity quotSpecial Testsquot a Otoscope Tilt the patient39s head back slightly Ask them to hold their breath for the next few seconds Insert the otoscope into the nostril avoiding contact with the septum Inspect the visible nasal structures and note any swelling redness drainage or deformity b Sinus tapping sinusitis Palpate over the sinus area Tap the frontal ethmoid and maxillary sinus c Forward bend test sinusitis Have the pt bend over to test for p with increased pressure as pt moves from standing to bent over position d Tansillumination sinusitis Transilluminate sinus to check for fluid by placing pt in a darkened room Place the otoscope over the maxillary sinus Have the pt open hisher mouth and check for illumination in the mouth A lack of illumination suggests fluid blockage in sinus cavity THROAT EXAMINATION The following throat examination is completed in the order that it should be completed during your practical examination Please be sure to complete all of the following examination H amp P procedures History know all of these history questions What happened MOI Where is your pain 0 Describe painlocation 0 Rate pain 0 What makes it betterworse Associated Symptoms odynophagia dysphagia horseness cough Any history of similar problems Known medications or allergies Direct trauma Fever Observation Be able to verbalize the structures that you are observing and normal findings In all cases be sure to write down verbalize that you are looking for edema deformity discoloration redness In addition know the following Throat exudate and throat structures Normal Internal Structures uvula tonsils pharynx all flesh colored intact and free of exudates redness or enlargement Ask the patient to open their mouth Inspect the posterior oropharynx by depressing the tongue and asking the patient to say quotAhquot Note any tonsilar enlargement redness or discharge quotSpecial Testsquot a Temperature see above b Lymph Node Palpation see above AT 3226 Physical Exam Steps You ve gotten the history and have developed a differential diagnosisnow what Grab bag tests Temperature Respiration Pulse Blood Pressure If it s an eye illnessiniurv these tests should help you to rule in or rule out a problem Visual acuity Inspection Extraocular movement Pupillary reaction Opthalmascope If it s an ear illnessiniurv these tests should help you to rule in or rule out a problem Temperature for middle ear infection Inspection Palpation Hearing Otoscope Lymph node palpation all chains If it s a nosefacial illnessiniurv these tests should help you to rule in or rule out a problem Observation Palpation Otoscope Sinus tapping sinusitis Forward bend test sinusitis Tansillumination sinusitis If it s a throat iniurvillness these tests should help you to rule in or rule out a problem Observation external and internal with pen light or otoscope into throat to visualize tonsils Lymph node palpation Temperature strep throat THE EYE Condition Etiology Signs amp Symptoms Management Return to Play 0 Pain Redness Warm compress 1015 minutes 34 Clogging and infection ofoil gland Excess tearing timeS day Styes do not prevent participation Stye Caused by staphylococcal bacteria 0 Blurred vision I Most will resolve within a few days unless theyhave to be surgically Can occur on edge oflid or inside lid Granular sensation in the eye 0 Do NOT 39pop39 sty Oozing pus which can spread to other 0 Allow to come to head on its own areas around the eyes 0 Viral 9 infectious Somewhat dependent on the cause 0 Refer for antibiotic drops 0 Typically begins in one eye and then 0 edness Wear gloves when inspecting eye or c spreads to the other eye 0 Pain administering drops 0 Does not prevent participation onlunCtIVItls Bacterial 9 infectious 0 Discharge Instruct athlete to not rub eyes Precautions should be taken to In ammation of the conjunctiva o Maybegin in one eye or both Allergic 9 commonly occurs with hay fever and allergic rhinitis and occurs in both eyes 0 Thick and colored bacterial 0 Thin and clear viral or allergic Possible swelling of eyeli Feeling ofsand in the eye Instruct athlete to wash hands frequently Athlete should wear glasses instead ofcontacts until condition is resolved prevent spread of infection 0 No sharing oftowels THE NOSE Condition Etiology Signs amp Symptoms Management Septal Abruise or bleeding in the septum Pressure causes ischemia to cartilage and necrosis Hematoma Can cause saddle nose deformity Coughing Headache Causes by an allergic reaction to an allergen Itching ofthe nose mouth eyes throat skin or any Allergic Why 9 Allergens trigger an antibodyproduction area I Antihistamines Benadryl Rhinitis these antibodies bind to cells that contain histamine Runny nose rhinitis bluish tint to nasal structure Corticosteroids Flonase amp NasoneX Hay Fever 0 Can be seasonal only comes during certain seasons 0 Frequent sneezing stuffy nose nasal congestion and Decongestants Sudafed orperennial canhappen at anytime during the year impaired smel Increased tearing Sore throat and wheezing In ammation ofparanasal sinuses Canbe viral or bacterial 9 most are bacterial 39 causes I I I I I I I Antibiotics forbacterial infections for 1014 days 0 can beIcomphcatlon Of InomnfeICtlous rhmlItls Dull pain in early stages that later becomes throbbing Nasal decongestant Sudafed allerg195139p01yps39 fore gquot bOd es39 anamm cal Coughing Afrin 9 DO NOT USE MORE THAN 3 DAYS obstructlon ofsmus dralna e S1nu51tls Antlhlstamlnes Warning signs to return for further care 0 Nontender swelling around eyes with normal vision due to swelling ofvessels around eyes 0 Tender swelling around eyes may indicate soft tissue infection 0 If no improvement after 35 days ofantibiotics Bending over increases pain Pain with percussion Tooth pain with maxillary infection Ocean 9 salt or saline spray team 9 especially god after saline Pain relief Advil Aleve THE EAR Condition Etiology Signs amp Symptoms Management Hemorrhaging and uid accumulation To prevent wear proper earprotection Aurlcular Occurs either from compression or shear injury to o If unattended coagulation organization and fibrosis 0 Cold application will minimize hemorrhaging Hematoma the ear Single or repeated occurs IfsweIIing occurs Measures must be taken to Cauliflower Ear Causes subcutaneous bleeding 0 Appears as elevated white rounded nodular formation that is firm and resembled a cauliflower prevent fluid solidification 0 Physician aspirationpackingpressure Rupture of the Fall of slap to the unprotected ear ofsudden Complaint ofloud pop followed bypain in ear 39 i ess Small to moderate perforations usuallyheal spontaneously in 12 weeks 39 39t39 d d Tympanlc Uderwater varlatlon can FESUIt 1quot rupture nausea voml an In H Infectlon can occur and must be cont1nually Membrane IIear1nglossv151ble rupture seen through otoscope monltored gnkn jwnff t 1 d f 1 C 0 Periodic episodes of rotaryvertigo or dizziness o In some patients symptoms ease while in others Men1ere39s qua ye ec Hg ma es an ema 8539 aucaSlan39 Fluctuating progressive lowfrequencyhearing loss they can continue through life Afr1canAmer1cans and those from A51an descent Dlsease T1nn1tus Meclaz1ne amp Lorazepan drugs ofcholce to stop 0 Most common 1n those 1n the1r 40 s and 50 s but o A sensatlon of fullness or pressure 1n the ear vert1gosp1nn1ngetc noted 1n chlldren Prevent by drying earwith a soft towel use ear drops with boric acid and alcohol before and after 0 Infection ofthe ear canal caused by a gramnegative Pain and dizziness SWlewg I Avold t1ngs that mlght cause 1nfectlon Sw1mmer 5 Ear baCl us ltChlng overexposure to cold w1nd or st1ck1ng fore1gn Otltls Externa 0 Water becomes trapped by a cyst bone growth Dlscharge Objects into the ear earwaX plug or swelling caused by allergies 0 Sometimes partial hearing loss Physical referral will be necessary for antibiotics acidification of the environment to kill bacteria and to rule out tympanic membrane rupture Accumulation offluid in the middle ear caused by local and systemic infection and inflammation Intense pain in the ear fluid drainage from the ear Fluid withdrawal may be necessary to determine Middle Ear th 39 t t39b39 t39 n 6 Ion o Eustachean tube becomes blocked allowing Systemic infection may also cause a fever headaches g p 39 Otitis Media I Generally resolves 1n 24 hourswh11e paln maylast dra1nage to collect w1th1n the 1nner ear 1rr1tab111ty loss of appetlte and nausea for 72 hours 0 Bacterla forms 1nfectlon develops Initial attempts shouldbe made to irrigate the 0 Degree of muffled hearing or hearing loss canal with warm water Impacted Excesswe wax may accumulateclogg1ng the ear Generallyllttle or no paln because no 1nfectlon ls DO NOT tryto remove w1th cotton swab as 1t may Cerumen canal involved increase the degree of impaction May require physician removal with a curette THE THROAT Condition Description Causes Management 0 Viral the most common cause is the common 0 Usually selflimited In ammation of mucosa oflarynx producing cold which is spread by droplets from saliva and 0 Limitation of voice use 39hoarseness39 nose secretions Humidify air Laryngitis Most common during epidemics ofviruses in late Irritants ammonia chlorine cough overuse Avoid cigarette smoke fall winter and early spring smo ing 0 Increase uid intake 0 Maybe acute or chronic Allergies Cough suppressants Esophageal re ux vomiting 0 Can try antiin ammatories 4th most common symptom seen in the medical 0 Sore throat Throat culture rapid strep to ro strep practice Enlarged tonsils Salt water gar les 0 Can be bacterial or viral with no one problem 0 Red throat Acetaminophen ibuprofen 9 pain amp fever control Pharyngitis being more common than the other Enlarged lymph nodes 0 Co d mist humidi ier 0 Biggest issue is to rule out or treat Fever gt 102 suggests strep Avoid spicy hot acidy food drink especially orange streptococcal infections 0 Absence of cough hoarseness or lower respiratory 39Uicel 13 or more ofthe cases have no pathogens found symptoms Antibiotic ifpositive for strep Untreated o Typicallylasts 10 days 222211 Ofpharynx due to Strams Of Strep o Contagious during actual illness and an additional I wee IHCUbatlIonI Of 2393 da 5 I I sore throat 0 Increased risk of complications Transmlssmn through droplets 1n sallva and nasal 39 Pharyngeal erythema IFSdHSSSl arid Swenmg Treats Secretlons I I I I EXUdate puslon tonslls o Contagious period shortened to 24 hours after StrepI I 0 Presence of runny nose cough or conunct1v1tls 0 Enlarged tonSllIS I Startng meds also reduces severity of symptoms Pharyngltls suggest IIO strep Enlarged anterlor front ofthroat on out51de O Reduces duration of Symptoms by about a day Strep Throat Diagn051s o No single element inpatienthistory or physical exam is sensitive enough to exclude or diagnose strep o Clinician prediction rules can help place patient in low mod orhigh risk categories lymph n des Swelling of uvula thing hanging down in back of th roat Fever 0 Significantly reduces chance of complications Antibiotics 9 Penicillin is still the drug ofchoice Push uids and things with nutritional value Fever control 9 Acetaminophen amp Ibuprofen Saline gargles Humidification of air Voice rest Tonsillitis In ammation of the tonsils most serious infection one needs to consider is strep Can be either viral or bacterial Tonsils will often have exudate pus DERMATOLOGY nndi nn Etiology Signs amp Symptoms Treatment 0 Open or closed nodule Drain abscess Redness Antibiotics S 11 Acavitythat contains pus and is surrounded by we 1 Head impress Abscess in amed tissue Tenderness o Preventlon Warmt 0 Watch for bacterial infections Fever 0 Keep wounds clean Chills 0 Treat promptly MRSA Resistant to many forms ofantibiotics h I o Methicillin oxacillin penicillin and amoXicillin Redness Culture taken to find MRSA MEt39 ltCl ltn MUSt use contaCt iSOIation Swellin Often misdia nosed as a s iderbite r8515 an 0 Used to be found in hospitals in persons with g g p Staphylococcus compromised immune system Tenderness IV and oral antlblotlcs aureus Presents as cellulitis o Igtslfiillsut deep staph infection that comes from hair Peasized to golf ballsized lesion d Furuncle begins at hair follicle but becomes deeper Svevollen Ant1blot1cs Carbuncle into dermis and subcutaneous tissue Turns to a deep White or enow centers 0 Warm compress Fumncle seated firm tender nodu e Tender y 0 Lance performed by physician Carbuncle deeper and widerlesions with P f 1 0 Prevention good hygiene interconnecting subcutaneous abscesses arising from Pam u infection of several neighboringhair follicles ever Minimize friction Shallow superficial infection 0 No shaving Folliculitis Infection of one or more hair follicles Rash Keep clean Smaller than a boil and usually numerous Pustules Topical antibiotics Itching Compresses Prevention good hygiene ESidnness Antibiotics oral or IV Cellulitis 0 A diffuse infection within solid underlying tissue 0 Borders alghSEmS k 0 Tight glossy appearance watc or Strea mg 0 Prevention take care ofwounds Fever Lesions that weep Oral and topical antibiotics o A contagious skin infection characterized by crusting Clusmrs Ofthters KEEP area Clean amp Impetlgo Prevalent in gun er so 18 and Children IIoney colored Atleast 5 days before return to play y g p p 0 Itchy Prevention contagious and do not share towels Rash avoid contact wash hands after touching lesion Most common skin cancer 70 800 Raisedtranslucent lesions that may crust bleed or 39 O Bcc Locations nose cheek forehead and ears Ulcerate surglcal removal 39 39 39 0 Have rolled borders w1th 1ndented center 0 1619 of all cancers SCC Locations face neckbald scalp ears andlowerlip Raisedpink opaque nodules or patches that ulcerate Surgery Usually a mo re painful and quicker progression 5 of all skin cancers Brownblack multicolored patches or nodules with Determine depth excision and possible MM Occurs most often in women 2529 years old irregular borders immunochemo therapy Soothing baths Creams Chronic skin disorder genetic of the epidermis sc ly39 ltChy raSh Topical steroids or topical immunomodulators Eczema Commonl an aller ic reaction MmUte papmes and vesmles Antihistamines y g Oozing and crusting Preventlon d1etary restr1ctlons and avold allergens 0 Focus on treating symptoms via topical creams Psoriasis ai rjorzggecsfgignSk 32J332WS39 knees39 scalp 0 Discrete red patches with scaling redness and itching and lotions vitamin D and steroids y g y 0 Prevention possiblyhereditary ItChing Cortisone creams and lotions 0 Generic term to describe an inflammation ofthe skin Redness Dermatltls o Prevent1on avo1d contact w1th 1rr1tat1ng 0 There are a var1ety of causes 0 Crust1ng substance 0 Heat Antihistamines Urticaria An allergic skin eruption with transient wheals and Sllghtly Elevamd patChes comcosmmlds I 0 Red 0 Cool com ress Hlves welldef1ned marg1ns 0 Itchy Preventlon avold contact w1th 1rr1tat1ng substance Painful Apurulent infection ofthe skin surrounding the nail REdn ss soaks Paronychla Swelllng Top1cal and oral ant1blot1cs A nall bed 1nfectlon lS onych1a 0 Open wound Preventlon cover and clean open wounds Purulent material o Most likely to be transmitted in closecontact sports Scaxrrence presents llke u 1quot mcuhatlon perlod 539 0 Oral famcyclovir acyclovir ZoviraX valicyclovir like rugby and wrestling Valtrex Viral infection that targets epithelial cells 2 E rr39vrensaie hllgs ear Topical Abreva Herpes Type 1 non genitals face and lips pp 0 Can stop breakout if medications are taken within o V1rus hangs out In neural gangl1a Slmplex o Grouped clear ve51cles 2nd occurrence 6 hours season long prophylaX1s Virus 1amp1 Type II genitals 0 Present with tingling Stay hydrated I I I O GrouPeFl VSSl les orpaleles14Wm on r d base 0 Triggeredby stress sickness UV light dehydration Return to la uldehneS no newleslon for 72 o w sk1n to sk1nfom1ted1rty cloth1ng and injury hours oral meds for 5 days all eX1st1ngleSIons bench mats we1ghts e c Total healing time is about 23 weeks should have crust 24mm diameter vesicles and papules on a red base same treatment as HSV HEFPES Var1cella v1rus ch1ckenpoX1n chlldren Cortlcosterolds 0 Many clusters that follow a dermatome Zoster Characterlzed by 12 daypa1n severe 1n dermatomal 0 Ana ges1cs Ves1cles erode and cruse over shingles area Ma have a secondar bacterial infection Herpes Zoster1s contaglous to those that have not y y had chickenpox Virus Asymptomatic Laser ablation MOHUSCllm Characterized by discrete white to skin colored 1 Electrodesiccation c 1 3 5 th t 39 1 39 K0 prep HO M tb db f t39t39 39 t t ontaglosum 13313Ll esf mm a are 591mg 0553 us e remove e ore compe 1 lon1n con ac Common in swimmers gymnasts and wrestlers Non just an STD sport Ve rrucae Epithelial tumors caused by human pap illoma virus Named by the area that they infect Visual inspection 0 Mechanical freezing electrocautery excision or aser Chemical salicylic acid arts 0 Usually a cauli ower shape or have a at appearance 0 Will have 1015 pinpoint black spots Immunologic meds induce immune response 0 Transmission low infectivity but are spread by direct Warts should remain covered for participation in contact and fo mites sport Mild antifungal sprays or powders towel sharing can also tran39smit 39 Seen In m1dfoot w1th ves1cles and blisters on foot Topirjalsland Graig 72 hours 01013101 topical Caused b Trice hymn Seen39on plantar surface as hype39rker39atotlc scales medlcatlon requued Tinea Pezlis aFfects feet 39 Physmallpl esentatlon and Prurltls ltChl 0 Treatment included oral meds Ketoconazole Tinea Corpo s aka Gladiammm Plagnoslls made by KOll prep 14 days oftreatment requlred Tinea o Commonly called ringworm lransmltted by dlmt coma 39 Treated With topical creams 0 Common in wrestlers Scaly red pruritic plaques with red ringshaped 0 Return to play Tinea Capitis affects head and hair shaft herders O Minimum Of 72 hours Oftopical therapy for o Scaly redpruritic plaques with red ringshaped magnOSES made by KOH prep sklnlesmns borders D1agnos1s made by KOll prep 0 Mlnlmum of 2 weeks of oral therapy for scalp Tinea Cruis aka iockitch Looklike half moon plaques with scaly borders eslons I I I I I 0 occur in mural folds Looks brown in light skinned and mayhave vesicles 0 Dls39quallflcatlon OfWFSStleFS Wlth aCtIVS leSIons Discolored nail that39s thick distorted and will look Onychomycosis 0 Chronic tinea pedis leads to nail bed infection brittle over time o Topical and oral meds KOll fungal culture or biopsy


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