13.09.13 Passmedicine revision

Lichen

• Planus

  • Purple, Pruritic, Papular, Polygonal rash

  • On flexor surfaces

  • Wickham's striae over surface

  • Oral involvement common

• Sclerosus

  • Itchy white spots typically seen on the vulva of elderly women

Septic six

• Blood cultures

  • Before antibioitics are administered

• Antibiotics

  • Mortality is reduced by 50% in severe sepsis if these are given within an hour of diagnosis

• Oxygen -

  • Even if they are not desaturating

  • If they are severe sepsis, give 100% at 15L/m via a non-rebreath mask

• Fluids

  • They are highly likely to develop hypovoloemia

  • Lactate

  • A lactate above 2 means ITU involvement

  • Catheterise

  • You need to monitor urine output

Childhood infections