May 13th, 2021 Flashcards
Differential for elderly with increase of months of cognitive decline, 5 things
Alzheimer’s Depression Illicit substances Space occupying lesion UTI/infection
CCF exacerbation 6 management steps in 72M
commence low dose ACEi, 2.5-5mg perindopril frusemide 40mg, PO daily spironolactone 12.5-25mg, po, daily low sodium diet <5g fluid restrict 1L-1.5L cardiac rehab daily weights
4 causes of hypercholesterolaemia
hypothyroidism familial cholesterolaemia diabetes type 2 nephrotic syndrome CKD
47M hypertension 175/82, Fhx brother 60 MI: 6 examination findings
papilloedema on fundoscopy neck circumference displaced apex beat bibasal crackles renal angle for enlarged kidneys goitre
CVD risk management SNAP?
smoking cessation
low sodium diet <5g per day
150-300min moderate physical city each week
maintenance of BMI 18-25
diet: 5 serves veg, 2 serves fruits per day
cease alcohol intake
19M struggles to get out of bed, alert later in the day. 5 ddx
depression delayed sleep phase disorder narcolepsy caffeine use at night chronic sleep restriction
19M struggles to get out of bed, alert later in the day. sleeps at 3am to 11am. 7 history
falling asleep during conversations? anhedonia? nature of insomnia, ?initiation stimulant use? screen time at night? snoring? restless limbs?
19M struggles to get out of bed, alert later in the day. 3 examination
blunted affect
hypertension
increase BMI?
68F seamstress, hand and back pain, phi dep, op, eGFR 40, right flank L1-5 pain, dipstick 2+haematuria. 5hx
dysuria? unintentional weight loss? recent NSAIDs use? previous renal calculi symptoms of diabetes: polydipsia
68F seamstress, hand and back pain, phi dep, op, eGFR 40, right flank L1-5 pain, dipstick 2+haematuria. 4 ddx
IgA nephropathy hypertensive nephropathy urinary tract malignancy polycystic kidney disease renal calculi
32F, first mum, 5/52 son, nipple pain R>L 5 hx
feeding frequency? nipple pain onset? history of dermatitis fever? use of breast pump?
32F, first mum, 5/52 son, nipple pain R>L 4 ddx
poor latch
infant factors: biting
nipple dermatitis
nipple vasospasm
32F, first mum, 5/52 son, nipple pain R>L
4 Mx of nipple candidiasis
- commence 150mg, fluconazole every 2nd day for 3 days
- nystatin 100 000units TDS + miconazole oral gel to nipples QID
- commence son on miconazole oral get QID
- keep nipples dry
- sterilise dummy daily
33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 6hx
bile in vomit? projectile vomiting after feeds? blood in stool? fever? malodorous urine? number of wet/soiled nappies? mum's mental health and supports?
33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 2ddx
purple crying
cows milk protein intolerance
33F mum, 9/52 girl unsettled, some vomiting, ?reflux, 3 mx
- referral to lactation consultant
- follow up in 5-7 days
- acknowledge impact of crying baby on mental health
26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 6hx
fever? Phx of disease among employees? mask usage at work? rash? wheeze? night sweats?
26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 4 ddx
occupational asthma
occupational silicosis
hypersensitivity pneumonitis
sarcoidosis
26M stone mason, 6/12 increasing SOB, bad exercise tolerance, 6 yrs exposure, 20cigs a day, 10py, finger and tender and swollen: 4mx
encourage SafeWork notification
cease exposure to silica dust
cease cigarette smoking
referral resp physician
52M, samoan, forklift driver, 4-24SD on weekends, 20py smoking, single, ?liver disease 8 physical exam signs?
palmar erythema dupytren's contracture metabolic flap spider naevi caput medusae scleral icterus hepatomegaly gynecomastia increase BMI
6F, 24/24 of severe ear pain, blocked for last 2/52, 7hx
fever? rash? otorrhea? headache? hx of swimming? recent trauma? aboriginal or torres strait? speech delay? coryza symptoms?
75M L>R hearing loss, hearing aids, worsening past 5 years hearing, bilateral tinnitus, 8hx?
fever? Otorrhoea headaches? loud noise exposure? prev ear surgery? vertigo? otalgia? facial pain? previous head trauma
75M L>R hearing loss, hearing aids, worsening past 5 years hearing, bilateral tinnitus, 3ddx?
presbycusis
noise-induced hearing loss
acoustic neuroma
59M, dmII new diagnosis, ACR 35, protein in urine ++, ddx?
diabetic nephropathy
nephrotic syndrome
hypertensive nephropathy
polycystic kidney disease
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker: 4hx
family history of bleeding disorders? recent nose trauma? heavy menstrual bleeding? bleeding from gums? NSAID use?
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker: 4 exam findings?
petechiae? hypotension oropharynx mucocutaneaous bleeding signs of anaemia, conjunctival pallor splenomegaly hepatomegaly
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker 4 ddx
Von Willebrand’s
haemophilia
immune thrombocytopenia
bone marrow failure
32F epistaxis, whole life, multiple cauterisations, 3ya last time, always bruised easily, on salbutamol and OCP, non smoker, iron oral advice 5 things
take on empty stomach take with vitamin C may cause nausea may cause dark stools may cause constipation
8yo boy with left leg limp past 7/7 associated cough, runny nose past 3/52
3ddx
left hip perthes disease
left hip transient synovitis
viral arthritis
stress fracture
8yo boy with left leg limp past 7/7 associated cough, runny nose past 3/52
Trans Synov: 3Mx
- paracetamol 1g, po, QID, PRN
- rest from aggravating activities
- review in 2-7 days
