May18th, 2021 Flashcards
57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide 3 ddx other than peptic ulcer
NSAID induce gastritis
GORD
gastric carcinoma
helicobacter pylori
57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide, 3 hx leading to gastroscopy
haematemesis
dysphagia
vomiting
severe, frequent symptoms
57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide pre sx, med changes?
withhold empagliflozin
withhold metformin
cease ibuprofen
continue ramipril
57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide, helicobacter eradication regimen?
20mg, pantoprazole, PO, daily, 7/7
amoxicillin 1G, Po, BD 7/7
clarithromycin 500mg, PO, bd, 7/7
4F rural, 400km away from hospital, asthma attack on montelukast 5mg/day, PRN salbutamol. 5 physical exam findings
- speaking full sentences?
- accessory muscle usage?
- reduced level of consciousness
- O2 saturations <94%
- cyanosis
4F rural, 400km away from hospital, asthma attack on montelukast 5mg/day, PRN salbutamol. 6 immediate management
- 6puffs salbutamol MDI, via spacer, every 20 minute for 1 hour
- 4 puffs ipratropium bromide MDI via spacer every 20 minutes for 1 hours
- 2L O2 via facemask maintian sats >94%
- IV access
- minimise handling
- prednisolone 1mg/kg daily for 3-5days
10M 4/52 of limp, left hip, increase BMI, antalgic gait, 4 ddx
- chronic left hip slipped upper femoral epiphysis
- left hip perthes
- left hip stress fracture
- left hip soft tissue strain
- NAI
10M 4/52 of limp, left hip, increase BMI, antalgic gait, SUFE 2 mx
- strict non-weightberaing
- urgent referral to orthopaedic tertiary centre review
10M 4/52 of limp, left hip, increase BMI, antalgic gait,molluscum 3 mx
- cryotherapy
- curettage
- no treatment needed, self resolves in 3 years
48F 4/12 hot flushes, low libido, 15py smoker, depression, HTN , GORD, LBP, on 150mg aspirin, esomeprazole 20mg, nizatidine 150mg, perindopril 5mg, indapamide 2.5mg, celecoxib 100mg, Panadol 1G, BMI 36. 4 menopause drugs
- topical estrogen/cyclical progesterone oral
- desvenlafaxine
- escitalopram
- gabapentin
48F 4/12 hot flushes, low libido, 15py smoker, depression, HTN, GORD, LBP, on 150mg aspirin, esomeprazole 20mg, nizatidine 150mg, perindopril 5mg, indapamide 2.5mg, celecoxib 100mg, Panadol 1G, BMI 36. 3 med changes
- cease aspirin
- cease nitazadine
- change indapamide to amlodipine 2.5mg-5mg, PO, daily
- change esomeprazole to PRN
48F 4/12 hot flushes, low libido, 15py smoker, depression, hon, GORD, LBP, on 150mg aspirin, esomeprazole 20mg, nizatidine 150mg, perindopril 5mg, indapamide 2.5mg, celecoxib 100mg, Panadol 1G, BMI 36. TSH 0.02, T4: 36
- commence propranolol 10mg, PO, BD, PRN
- commence carbimazole 30-45mg, daily in 2-3 divided doses
48F 4/12 hot flushes, low libido, 15py smoker, depression, HTN, GORD, LBP, TSH 0.02, T4: 36 3 procedures for practice abnormal patient results
- ensure ordering doctor responsible for chasing up
- recall system with multiple modes of communication: SMS/phone
- assigned staff member to manage recalls
53M hand, 6/12 ago, ETOH, dupuytren’s, 3 hx
- history of repetitive manual labour
- history of smoking
- fhx of dupuytren’s
- Peyronie’s disease?
53M hand, 6/12 ago, ETOH, dupuytren’s, 2 mx
- watchful waiting
- hand therapy stretching
- collagenase injection
- reduce alcohol
- surgical release