YL-II

IMS Case 1-Week 1

Handout 1

Identifying data:

LDM, 24 y/o, female, event organizer from Tawi-Tawi.

Chief Complaint:

Painful blisters on shoulders and back.

Objectives: -PE of blister identification

-medication, first aid
-pathophysiology
-HPI
-onset
Skin
-location
-layers
-duration
-epidermis
-character
stratum corneum, lucidum,
-alleviating/aggravating
spinosum, granulosum, basale
-radiation
-dermis
-timing
-subcutaneous
-blister classification
-PMHx -glands, cells
-Family and Social Hx -appendages
-Review: -moles - “nevus”
-Skin -intradermal
-Inflammation/repair -compound
-Burns -junctional
-cell adaptation -flora
-cell injury -S. epidermis – normal
-cell death - S. aureus – pathogenic
-NSAID/topical antibiotics
-Normal flora of skin -burns
-Possible complications Types:
-sun protection 1. thermal – e.g. scalding (Schwartz)
-lab tests 2. Radiation
-pathogenesis of bacterial infection 3. Chemical
-treatment and management 4. Electrical
 Degree -Fitzpatrick classification
1st- superficial -skin classification
2nd-superficial partial, deep partial (dito -macule
yung blisters) -patch
3rd-full deep – tx: skin grafting -papule
4th-destroyed -hyperkeratosis
-parakeratosis
-Cell adaptation/injury
-plaque
-compensatory mechanisms
-blister
-trophy-size
-vesicle
-plasia-number
-bulla
-death
-crust (lesion)
-necrosis
-nodule
-apoptosis
-scale (lesion)

Handout 2

HPI:

4 days PTC, SB was in the Masagana street Tawi Tawi, she was out under the sun from 9am to
6pm. According to her, she’s wearing a racerback tank top, and was able to apply a sunblock with an SPF
of 50. Later that night, one of her fire dancers did not arrive, so she decided to perform. While juggling
the poi, it accidentally brushed her shoulders thrice. After the performance, she applied toothpaste on
her shoulder.

3 days PTC, she woke up with a painful shoulder and back. She noticed redness on her back and
shoulders. She just applied aloe vera extract and took Ibuprofen 200mg/tab for pain.

Few hours PTC, she noticed blisters on her shoulders and her back was uncomfortably painful,
hence the consult.

Medical History:

(-) HPN, DM
(+) Asthma, last attacked December 2015

Family History:
(+) stroke, maternal side
(+) HPN, both sides
Handout 3:
VS:
HR: 82 RR: 18 Temp: 37.7 BP: 110/70

PE: