neuroblastoma wrote:
A 65-year-old female had open cholecystectomy 10 days ago. She now presents to you with a painful rash, which is just above the scapula and is distributed all the way to her right nipple. She says the pain is severe and the rash is very itchy. She denies taking any medications. She has tried several over the counter medications without success. On examination, the skin is red and excoriated. There are some intact vesicles distributed from underneath the scapula extending all the way to the right breast. The most effective treatment is:
A. Acetaminophen
B. Topical steroids
C. Lidocaine
D. Acyclovir
E. Tricyclics
this is not the case of postherpetic neuralgia.
It is shingles.
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| me007
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d.
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| neuroblastoma
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herpes zoster...: http://www.nlm.nih.gov/medlineplus/shingles.html
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| neuroblastoma
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correct D
Explanation:
Postherpetic neuralgia is pain that sometimes follows resolution of acute herpes zoster infection. It can be accompanied by itching and can be extremely painful. Herpes zoster infects the sensory ganglia and is characterized by pain along the distribution of the affected nerve and crops of clustered vesicles over the area. The virus usually gets reactivated in the dorsal root ganglia. The best treatment for this condition is acyclovir given for 5-10 days. In immunocompromised patients, varicella zoster immunoglobulin can be administered.
Choice E: Tricyclics were previously used to treat the neuropathic pain of herpes zoster. These agents did not always work in all patients.
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| neuroblastoma
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THANKS SACHIDA AND ME007 ....my confusion is cleared now... presentation is different in both questions.
thanks guys.
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