June 15-3, 2021 Flashcards
48F 6/12 hx increasing urinary incontinence, coughing, sneezing, increased with jumping and squatting, increased freq and urgency, no dysuria, haematuria, no reg meds, no pmhx, single dx?
mixed stress/urge incontinence
48F 6/12 hx increasing urinary incontinence, coughing, sneezing, increased with jumping and squatting, increased freq and urgency, no dysuria, haematuria, no reg meds, no pmhx, 5 hx risk factors
I, K, N
- multiple vaginal births
- parity
- fhx of urinary incontinence
- smoking
- recent weight gain/obesity
- excessive caffeine intake
- faecal incontinence
- recurrent UTIs
48F 6/12 hx increasing urinary incontinence, coughing, sneezing, increased with jumping and squatting, increased freq and urgency, no dysuria, haematuria, no reg meds, no pmhx, 5 non-pharma mx
- referral to pelvic physiotherapist for pelvic floor exercises
- avoid excessive caffeine
- encourage weight loss 5-10%
- avoid constipation
- avoid heavy lifting
- timed voids
- limit fluid intake to 8 cups per day
48F 6/12 hx increasing urinary incontinence, coughing, sneezing, increased with jumping and squatting, increased freq and urgency, no dysuria, haematuria, no reg meds, no pmhx. dad bowel cancer age 60, mum bowel cancer age 73, current risk? 3 mx?
- FOBT now
- colonoscopy at age 50
- aspirin 100mg, po, for 2.5 years from 50yo
22F. 6/12 hx of lethargy, abdo bloating, loose stools, flatus, urgency, mucous in stool, no weight loss, no nausea/vomiting, no pmhx. 5 hx besides IBS?
d,e,h,a
- PR bleeding?
- steatorrhoea?
- fever?
- fhx of bowel cancer
- history of mouth ulcers?
22F. 6/12 hx of lethargy, abdo bloating, loose stools, flatus, urgency, mucous in stool, no weight loss, no nausea/vomiting, no pmhx. IBS, 3 non-pharma mx?
- low fodmap diet
- keep food diary
- regular meal times
- psychologist for CBT
22F. 6/12 hx of lethargy, abdo bloating, loose stools, flatus, urgency, mucous in stool, no weight loss, no nausea/vomiting, no pmhx. IBS, 2 pharma?
- loperamide
- hyoscine butylbromide
- amitriptyline
- citalopram
26M, unable to work, monosyllabic, 3 weeks of lowering mood, work in morning, poor sleep, appetite, wiehgt loss, anhedonia, no meds, no pmhx, no signs psychosis. Suicidal thoughts, no intent or plan, 5 hx for risk of suicide
- previous hospitalisations for suicide attempts
- access to weapons
- previous episodes of depression
- lack of social supports
- adverse life events
- fhx of suicide
- substance use
- impulsive behaviours
- giving away possessions
26M, unable to work, monosyllabic, 3 weeks of lowering mood, work in morning, poor sleep, appetite, wiehgt loss, anhedonia, no meds, no pmhx, no signs psychosis. 5/52 ago, happiest he’s ever been, 3 more hx?
b,g,l,d
- decreased need for sleep
- other risk taking behaviour: gambling?
- increased libido
- grandiosity
- flight of ideas
- distractibility
35M, solo trip to Thailand to visit beaches, rice fields for 2/52, take rizatriptan for migraines, no other meds or pmhx. 4 points of advice for malaria prevention
- wear bug spray with DEET
- wear light coloured long sleeve shirts/pants
- chemoprophylaxis - malarone
- bed nets at night time when sleeping
- avoid acitivities at dusk/dawn
35M, solo trip to Thailand to visit beaches, rice fields for 2/52, take rizatriptan for migraines, no other meds or pmhx. 4 points for travel consult
- avoid drinking non-bottled water
- travel insurance
- avoid new tattoos
- discuss safe sexual practices
- take first aid kit
35M, solo trip to Thailand to visit beaches, rice fields for 2/52, take rizatriptan for migraines, no other meds or pmhx. 2/7 post trip, gonorrhoea, 4 steps
-500mg ceftriaxone in 2mL of 1% lignocaine, IM, stat+
azithromycin 1G, po, stat
-no sex with anyone until 7 days post treatment
-notify department of heath
-notify all partners in past 2 months
