notes-1 - usmlevictory1

[ArchivalUser]

Asthma and allergic
rhinitis can be associated with atopic dermatitis.

[ArchivalUser]

A 49-year-old obese white male with poorly controlled
diabetes mellitus, hypertension, and hyperlipidemia
presents to clinic for a regularly scheduled visit.
He complains that his left lower extremity is red. He
denies constitutional symptoms or pain. His vital signs
are within normal limits. He has a warm leg with circumferential
erythema extending from the ankle to
the mid-calf. He has 2 pitting edema bilaterally with
hemosiderin staining (brownish macular lesions) of
the ankles. There are no open sores or minor trauma
noted. See Figure 18-4; see also color section. His
complete blood count with differential is within normal
limits. You send him for Doppler studies that fail
to reveal venous thromboses. You prescribe 7 days of
oral cephalexin and send him home.
He returns the following day with modest improvement
in the redness. After completing the antibiotic
course, he presents to clinic 3 weeks later, complaining
of return of the redness.
The most effective treatment or study at this
time would be:
A) A third course of oral antibiotics for 14 days.
B) Admit the patient to the hospital for intravenous
antibiotics.
C) Send a punch biopsy of skin for bacterial culture.
D) Recommend daily leg elevation and compression
hose use.
E) Prescribe diuretics (e.g., furosemide).

[ArchivalUser]

B