Regis NU664B Week 11 Discussion Latest 2022 October

NU664B Primary Care of Family I

Week 11 Discussion

Atopic Dermatitis

Imagine that you are a primary care provider in the middle of your busy Thursday and your 4:15 pm appointment is as follows:

HPI: A 9-year-old boy, Taumi, with a history of recurrent skin infections presents with extensive redness and pruritus of the popliteal and antecubital fossae, arms, and abdomen. He’s scratched the lesions, especially at night, with the result that his sleep was disturbed. Despite the use of chronic moisturizing therapy and topical corticosteroids, he is having a seasonal flare of his condition. When he was 6 years old, he also experienced bronchial asthma with a persistent cough. This is not the first time he’s experienced this type of rash and has had issues since he was 4 years old. His mothers, Patricia and Fran, are bringing him into the clinic today for another exacerbation. They have tried the following: diphenhydramine 25mg q8h prn, hydrocortisone 2% QID, Zyrtec 10mg QD, and Aquaphor QID. The medications help some, but he’s still uncomfortable.

Family history: His father has asthma, and his younger sister has allergic rhinitis and cow’s milk allergy.

Physical Exam:

Vitals: BP 102/60, HR 68, RR 18, Wt 88 lbs (22 kg), Ht 4’11”

HEENT: Injected conjunctivae and presence of Dennie-Morgan lines. There was a ‘cobblestone’ appearance of his posterior pharynx.

Respiratory: Lungs were clear bilaterally with good aeration.

Cardiac and abdominal examinations were unremarkable.

Integumentary: Skin examination demonstrated scattered scaly eczematous patches along with the flexural areas of his upper and lower extremities. Impetigo “crust-like” lesions with serum oozing were found on the left elbow.

Complete the following:

List 10–20 questions of subjective information that your patient will need to provide to help you formulate your differential diagnoses and plan. Include two scholarly references for the questions that you ask of your patient. See the Grading Rubric for more detail.

Initial Response Post by Friday (Day 5) 11:59 p.m. Choose a classmate’s questions to answer:

Every peer post should only have one response post. Please do not reply to a peer if a response is already posted.

You are answering as the patient. Make it case appropriate but imaginative. Be creative and answer thoroughly. No references are needed.