Reference no: EM133317538
56 year old female with history of diabetes, hypertension and hyperlipidemia presents to the office for a painful rash on her right abdomen and side. She indicates that it started about 36 hours ago and seems to be spreading and getting worse. She notes that she had a cold about 2 weeks ago and has been feeling pretty run down ever since that time. She denies nausea, vomiting, diarrhea, cough, congestion and runny nose. She denies recent camping, hiking or outdoor activity. She works as a CPA and it is tax season so she has also been really busy and stressed at work.
On physical exam:
Vital Signs: T 99.6, BP 134/82, HR 82, RR 14
Derm: A linear group of vesicles with erythema over the right flank area. There is some erythema with a few areas of excoriation.
Allergies:None
Social HX: Drinks 1-2 glasses of wine 3-4x a week, Denies drugs/tobacco. Married with 2 grown children.
Random glucose in office = 256
Last A1c 1 month ago was 9.5
1. What is your primary diagnosis for this patient and what is your rationale?
2. What are three other additional differential diagnosis for this patient and what is your rationale? How can you rule them in or out?
3. List 2 possible ways that you could consider using to confirm your diagnosis (i.e. what tests could you perform)?
4. List 2 non-pharmacological modalities that you can treat her with.
5. List 2 pharmacological medications that you can use to treat her (list the specific name and dose of the medication).