Module 4a

• Brudzinski’s sign

  Severe neck stiffness causes a patient’s hips and

  knees to flex when the neck is flexed
• Kernig’s sign


  Severe stiffness of the hamstrings causes an inability to straighten the leg when the hip is flexed to 90 degrees
• Cerebrospinal fluid (CSF) culture

  is the gold standard for the diagnosis of acute bacterial meningitis.
• Lumbar puncture


  It is performed to facilitate cerebrospinal fluid (CSF) analysis, which involves cell count, Gram stain and culture.
• LMX (4% lidocaine) or EMLA cream


  A eutectic mixture of lidocaine and prilocaine used for topical anesthetics to reduce pain before lumbar puncture
• Pneumococcal conjugate vaccine

  Meningococcal vaccine for types A, C, Y, and W-135

  Haemophilus influenzae type b vaccine


  Vaccines to prevent meningitis
• Otitis media


  The presence of fluid in the middle ear along with acute signs of illness and symptoms of middle ear inflammation
• Vaccine to prevent meningitis

  Meningococcal vaccine for types A, C, Y, and W-135
• Vaccine to prevent meningitis

  Haemophilus influenzae type b vaccine
• Meningococcal vaccine be given to children 2 months to 10 years of age if they are considered high risk
• Respiratory syncytial virus & Influenza


  Viruses that most likely precipitate OM
• Pneumatic otoscope


  It is essential to differentiate AOM from OME
• Acoustic reflectometry


  measures the level of sound transmitted and reflected from the middle ear to a microphone located in a probe tip placed against the ear canal opening and directed toward the tympanic membrane.
• One of the diagnostic tests for OM

  Tympanometry
• The diagnosis of AOM through the tests

  Severe bulging of the tympanic membrane
• Myringotomy


  An incision is made on the eardrum
• Tympanostomy


  These are tubes are pressure equalization devices

  (grommets) that facilitate drainage and ventilation of the middle ear.
• When is the tympanostomy tube usually pushed out?

  8-18 months
• What causes Scabies?

  Sarcoptes scabiei
• How is Scabies primarily transmitted?

  Prolonged close personal contact
• What should you look for when there are chances that the patient has Scabies?

  Discrete papules, burrows, or vesicles
• What is the drug choice for infants older 2 months for Scabies?

  Permethrin 5% cream (Elimite)
• Oral antibiotics and topicals for Impetigo?

  mupirocin (Bactroban)
• What is given if the lesions of Impetigo is near the mouth or in the event of abscess?

  Erythromycin
• What do you call the vectors for head lice?

  Pediculus humanus capitis
• They are also known as pubic lice or crabs

  Pediculosis cruris
• What could patients with crabs experience?

  Pruritic papules (itchy bumps)
• What causes Pediculosis corporis?

  Pediculus humanus corporis
• This also known as body lice

  Pediculosis corporis
• Oval shaped, yellow-white lice eggs

  Nit
• An adolescent louse

  Nymph
• A stage of a body lice where they appear as yellow-gray or brown-red that they are a size of a sesame seed

  Adult louse
• What causes AIDS

  Retrovirus HIV
• What causes HIV?

  Primate Lentivirus
• Where is HIV 1 most common?

  Sub-Saharan Africa and throughout the world
• Where is HIV-2 is often manifested?

  West Central Africa, parts of Europe and India
• What does HIV specifically infect?

  CD4+T cells
• What is the repeated episode of bacteriuria or symptomatic UTI?

  Recurrent UTI
• It is the presence of bacteria in the urine

  Bacteriuria
• The bacteriuria is accompanied by fever and other physical signs of UTI

  Febrile UTI