History Prompts

Question 1

AF

Answer 1

History - Sx check
- Hyperthyroidism - Tremor, weight loss, anxiety
- OSA - Apnoea, daytime somnolence
- Diabetes - Polyuria / polydypsia, Sweating
- MI - Chest pain, diaphoresis
- Heart failure - Increased leg swelling, orthopnoea, weight gain.
- Hazardous alcohol use - Quantify
- Recreational drug use
- Infection - Fever, dysuria / cough / V + D

Investigations
- FBC, EUC, LFT, TFT, CXR, Echo, CMP, Urine MCS.

Management
- If symptomatic and first case -> ED for acute review
- If asymptomatic and rate-controlled, further investigation as outpatient with safety netting.

Question 2

Eating Disorder

Answer 2

Hx
- Fear of weight gain
- Body image disturbance
- Excessive exercise
- Preoccupation with food, weight and shape
- Ritualised eating
Oligomenorrhoea/amenorrhoea
- Laxative use
- Restrictive and binge-eating behaviours.

• Co-morbid presentations - Depression, anxiety, OCD, Substance abuse, self-harm and suicidal ideation.

Ex
- Low BMI
- Hypothermia
- Postural hypotension
- Dehydration
- Bradycardia
- Signs of self-harm (cutting)
- Enlarged parotid glands and/or dorsal hand calluses from purging.

Question 3

Differential for AKI

Answer 3

Pre-renal
- Dehydration
- Progressive renal artery stenosis
- Hypoperfusion (Sepsis / ischaemia / overdiuresis)

Renal
- Diabetic nephropathy
- Medication-induced nephropathy
- Contrast- induced nephropathy
- Intercurrent illness (UTI, pneumonia, gastroenteritis)

Post-renal
- Obstruction - Prostatomegaly, renal calculi.

Post-renal