June 14, 2021 Flashcards
11month boy, 5/7 hx of rash and fever, decreasing intake, temp 38.2, ears and lung are clear, has submandibular nodes, picture of red and swollen nappy area. 3 ddx
- kawasaki disease
- streptococcal perineal dermatitis
- staphylococcal scalded skin syndrome
- impetigo
11month boy, 5/7 hx of rash and fever, decreasing intake, temp 38.2, ears and lung are clear, has submandibular nodes, picture of red and swollen nappy area. likely Kawasaki, 2 Rx in hospital
- intravenous immunoglobulin
- aspirin
11month boy, 5/7 hx of rash and fever, decreasing intake, temp 38.2, ears and lung are clear, has submandibular nodes, picture of red and swollen nappy area. treated for Kawasaki with IVIG, now 13 months, list 2 vaccinations other than influenza
- mening ACWY
- pneumococcal
2/12F with mum breastfeeding, traumatic cracked nipples, right nipple, no erythema, lump, or fever, baby no tongue tie, weight is good. single most likely diagnosis
-poor latch of baby
2/12F with mum breastfeeding, traumatic cracked nipples, right nipple, no erythema, lump, or fever, baby no tongue tie, weight is good. 4 mx of poor latch
- referral to lactation consultant
- paracetamol PRN
- break suction with finger when removing Ruth from breast
- hand express on affected side to maintain supply
- hydrogel to nipples
49M bloods, platelets 48, fhx AF, HTN, non smoker 4-5SD, cyclist HR 56, BP 136/86, vegan with iron supplement, on doxy for malaria prophylaxis post trip from Thailand 2/52 ago. 3 ddx
- doxycycline induced thrombocytopenia
- Vitamin B12 deficiency
- chronic liver disease
- haematological malignancy
49M bloods, platelets 48, fhx AF, HTN, non smoker 4-5SD, cyclist HR 56, BP 136/86, vegan with iron supplement, on doxy for malaria prophylaxis post trip from Thailand 2/52 ago. now platelets of 8, 4 features on examination
- oral-mucocutaneaous bleeding
- petechiae
- haematuria
- neurological features - confusion/weakness/sensory changes
49M bloods, platelets 48, fhx AF, HTN, non smoker 4-5SD, cyclist HR 56, BP 136/86, vegan with iron supplement, on doxy for malaria prophylaxis post trip from Thailand 2/52 ago. hospitalised, Immune thrombocytopenia purport, 3 points of discuss re: Mx
- restrict activity to minimise risk of head injury
- avoid NSAIDs
- monitor for sudden severe headaches
72F after show sudden onset right eye pain, nausea, hx psoriasis, impaired glucose. single dx
right eye acute angle closure glaucoma
72F after show sudden onset right eye pain, nausea, hx psoriasis, impaired glucose. 5 exam findings
- mid-dilated right pupil
- right pupil poorly reactive to light
- decreased right visual acuity
- injected right conjunctiva
- right cloudy cornea
- increase intraocular pressure of right eye
72F after show sudden onset right eye pain, nausea, hx psoriasis, impaired glucose. acute glaucoma, 4 mx at GP clinic
- urgent referral to hospital for ophthalmology review
- antiemetics - ondansetron
- analgesia: morphine
- do not patch the eye
- lie supine
- keep nil by mouth
72F after show sudden onset right eye pain, nausea, hx psoriasis, impaired glucose. treated for acute glaucoma, now has bilateral burning in both feet, no hand symptoms, Hba1C: 5.1%, 4ddx?
- erythromyalgia
- arterial claudication
- chillblains
- B12 deficiency
72F after show sudden onset right eye pain, nausea, hx psoriasis, impaired glucose. treated for acute glaucoma, now has bilateral burning in both feet, no hand symptoms, Hba1C: 5.1%, 3 mx of chilblains?
- betamethasone dipropionate 0.05% ointment BD
- nifidipine SR 20g, daily
- thick socks
- indoor exercise
80F 1/52 hx mid back pain, fall onto back, focal/dull nature, drives, 5 cigs/day, 2 SD, hx of GORD, esomeprazole 40mg, phx perforated gastric ulcer, no other PMHx, mid T-spine. 2 ddx?
- osteoporotic compression fracture
- pathological fracture
80F 1/52 hx mid back pain, fall onto back, focal/dull nature, drives, 5 cigs/day, 2 SD, hx of GORD, esomeprazole 40mg, phx perforated gastric ulcer, no other PMHx, mid T-spine. 4 non Pharma
- ensure adequate calcium 1300mg/day
- sun exposure 15 minute per day
- balance retraining
- stop smoking
- falls prevention strategies
