June 11th-2, 2021 Flashcards
54M right foot pain lost 15kg on purpose, now 95kg, ++running, diet controlled diabetes, depression. pain medial side of heel. 3 ddx
- right foot plantar fasciitis
- calcaneal stress fracture
- calcaneal fat pad syndrome
54M right foot pain lost 15kg on purpose, now 95kg, ++running, diet controlled diabetes, depression. pain medial side of heel. 4 mx
- ice massage
- rest from running
- physiotherapy for calf stretching
- paracetamol 1G, po, QID, PRN
- orthotics - heel cup
5 examination findings of haemochromatosis
- hepatomegaly
- bronze coloured skin
- cardiac arrhythmia
- joint swelling/tenderness
- testicular atrophy
- cirrhosis signs - ascites
32M new onset itchy rash on knee, training half marathon, taking ibuprofen no help, 4SD, smokes 10 a day, 3 ddx for rash?
- atopic dermatitis
- lichen Planus
- tinea corporis
32M new onset itchy rash on knee, training half marathon, taking ibuprofen no help, 4SD, smokes 10 a day. likely plaque psoriasis. 6 mx, non- and pharma
- 0.1% mometasone ointment
- cease smoking
- avoid sunburn
- cease ibuprofen
- coal tar preparations
- emollients
- alcohol <2SD per day with 2 ETOH free days per week
32M new onset itchy rash on knee, training half marathon, taking ibuprofen no help, 4SD, smokes 10 a day. unprotected sex with woman 10/7 ago, 5 questions
- condom used?
- dysuria?
- urethral discharge?
- vaccinated against Hepatitis B?
- nature of encounter, ?anal sex
32M new onset itchy rash on knee, training half marathon, taking ibuprofen no help, 4SD, smokes 10 a day. 4Mx of gonorrhoea
- Cetriaxone 500mg, IM, stat, in 1%lignocaine
- Azithromycin 1G, PO, stat
- notify department of health
- no sexual contact for 7 days after treatment
- contact tracing, all partners in last 2 months to be treated
- no sex with partners from last 2 months until partners tested and treated
68F, collapse, LOC for 10seconds, no injuries, PMHx: HTN, BPPV, obesity, depression. on amlo10, sertraline 100, non smoker, occasional ETOH, 8 history questions
- any prodrome such as loss of colour vision?
- hx of headaches?
- hx of palpitations?
- previous collapses?
- collateral: any seizure activity?
- any post-ictal confusion?
- loss of bowel/bladder control
- any chest pain
- emotional stressors?
- hx of aortic stenosis?
68F, collapse, LOC for 10seconds, no injuries, PMHx: HTN, BPPV, obesity, depression. on amlo10, sertraline 100, non smoker, occasional ETOH, 3 specific findings on examination
- ejection systolic murmur in aortic region
- postural drop of 30mmHg sitting/standing
- irregular heartbeat
- evidence of tongue laceration
68F, collapse, LOC for 10seconds, no injuries, PMHx: HTN, BPPV, obesity, depression. on amlo10, sertraline 100, non smoker, occasional ETOH, what conditions can cause LVH?
- hypertension
- aortic stenosis
- aortic regurgitation
- mitral regurgitation
- HOCM
46M flight engineer, mixed indian/scottish, fhx of htn, IHD, BMI 28, BP 138/85, HR 82. LFTs shows mixed picture and high cholesterol, 5ddx?
- non-alcoholic fatty liver disease
- alcoholic fatty liver disease
- chronic hepatitis B
- autoimmune hepatitis
- haemochromatosis
46M flight engineer, mixed indian/scottish, fhx of htn, IHD, BMI 28, BP 138/85, HR 82. LFTs shows mixed picture and high cholesterol, metabolic syndrome, 4 features?
fasting glucose <5.5
triglycerides >1.7
HDL <1
SBP>130/DBP >85
46M flight engineer, mixed indian/scottish, fhx of htn, IHD, BMI 28, BP 138/85, HR 82. LFTs shows mixed picture and high cholesterol, 4 mx of NAFLD?
- referral to gastroenterologist for possible liver biopsy
- referral to dietician for weight loss
- exercise 150-300min moderate intensity spread over 5 days
- aim 5-10% weight loss
- cease alcohol intake
