Fam Med II: Rashes & secret code

So we see large amounts of strep throat, coughs, colds, ear infections, occasional pneumonia and other viral upper respiratory infections.  I struggle with the latter, because I never know when to give an antibotic (for a bacterial infection) and when not to (viral).  Every time the doc pressures me into making a guess I always guess wrong. Its a bit frustrating actually. But basically we always use Augmentin (amoxicillin/clavulinic acid for those of who don't know brands).  And I can now do a flu test and rapid strep in my sleep (not that it was hard to begin with). I'm actually surprised I'm not sick myself.

We also see lots of rashes. So i thought i'd share the fun, because i know NOTHING about derm and sorta wish I did. So this rash (on the hand) looks circular to me. It wasn't raised or itchy. And the doc thought it was simple eczema. I wasn't sure but I guess that we'll find out if she comes back in a week. Also the rash to the left that looks almost like pimples is on an 8y.o. I know the picture isn't the best, but the doc thought it was moscullosum... an extremely infectious rash caused by a special virus. Usually spread in daycares or around the genitals as an STD.


We also see TONS of depression. As a matter of fact, I think I see more depression than I did when I was on psych. People always come in for a 'med check' but its really not.  And then I say anything else? they say well... I have had trouble sleeping. But they don't mean sleeping. Sleeping is a code word. It means if you dig deeper they are depressed. Maybe a good 1/4th of all patients I see are people who want to talk about this. And about 1/3 of those patients do not complain of being sad but rather uncontrollable rage/irritability.  It gets messy. Especially trying to convince patients that depression/psych meds don't mean they are crazy.