May18th, 2021 Flashcards

1
Q

57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide 3 ddx other than peptic ulcer

A

NSAID induce gastritis
GORD
gastric carcinoma
helicobacter pylori

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2
Q

57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide, 3 hx leading to gastroscopy

A

haematemesis
dysphagia
vomiting
severe, frequent symptoms

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3
Q

57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide pre sx, med changes?

A

withhold empagliflozin
withhold metformin
cease ibuprofen
continue ramipril

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4
Q

57M lawyer, nausea/bloating, worse after meals, on NSAIDS, BMI 24, DMII on met, empagliflozin, atorva, ramipril, indapamide, helicobacter eradication regimen?

A

20mg, pantoprazole, PO, daily, 7/7
amoxicillin 1G, Po, BD 7/7
clarithromycin 500mg, PO, bd, 7/7

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5
Q

4F rural, 400km away from hospital, asthma attack on montelukast 5mg/day, PRN salbutamol. 5 physical exam findings

A
  • speaking full sentences?
  • accessory muscle usage?
  • reduced level of consciousness
  • O2 saturations <94%
  • cyanosis
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6
Q

4F rural, 400km away from hospital, asthma attack on montelukast 5mg/day, PRN salbutamol. 6 immediate management

A
  • 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
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7
Q

10M 4/52 of limp, left hip, increase BMI, antalgic gait, 4 ddx

A
  • chronic left hip slipped upper femoral epiphysis
  • left hip perthes
  • left hip stress fracture
  • left hip soft tissue strain
  • NAI
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8
Q

10M 4/52 of limp, left hip, increase BMI, antalgic gait, SUFE 2 mx

A
  • strict non-weightberaing

- urgent referral to orthopaedic tertiary centre review

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9
Q

10M 4/52 of limp, left hip, increase BMI, antalgic gait,molluscum 3 mx

A
  • cryotherapy
  • curettage
  • no treatment needed, self resolves in 3 years
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10
Q

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

A
  • topical estrogen/cyclical progesterone oral
  • desvenlafaxine
  • escitalopram
  • gabapentin
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11
Q

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

A
  • cease aspirin
  • cease nitazadine
  • change indapamide to amlodipine 2.5mg-5mg, PO, daily
  • change esomeprazole to PRN
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12
Q

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

A
  • commence propranolol 10mg, PO, BD, PRN

- commence carbimazole 30-45mg, daily in 2-3 divided doses

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13
Q

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

A
  • ensure ordering doctor responsible for chasing up
  • recall system with multiple modes of communication: SMS/phone
  • assigned staff member to manage recalls
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14
Q

53M hand, 6/12 ago, ETOH, dupuytren’s, 3 hx

A
  • history of repetitive manual labour
  • history of smoking
  • fhx of dupuytren’s
  • Peyronie’s disease?
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15
Q

53M hand, 6/12 ago, ETOH, dupuytren’s, 2 mx

A
  • watchful waiting
  • hand therapy stretching
  • collagenase injection
  • reduce alcohol
  • surgical release
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16
Q

53M hand, 6/12 ago, ETOH, dupuytren’s, 3 contraindications to home detox:

A
  • hx of withdrawal seizures
  • hx of delirium tremens
  • concurrent acute medical illness
  • inadequate social support
  • high suicide
17
Q

53M hand, 6/12 ago, ETOH, dupuytren’s, 2 meds for prevention

A
  • naltrexone
  • disulfiram
  • acamprosate
18
Q

65M builder 2/12 fatigue, bones ache, right hip pain, Panadol NAD, on 5mg period, esomeprazole 20mg, 5 ddx

a,b,k,l,p,N

A
  • multiple myeloma
  • right hip osteoarthritis
  • pathological fracture right femur
  • osteoporotic fracture
  • Paget’s disease
19
Q

65M builder 2/12 fatigue, bones ache, right hip pain, Panadol NAD, on 5mg period, esomeprazole 20mg, PSA counselling 4 issues

A
  • PSA can be raised for other reasons
  • normal PSA does not rule out prostate cancer
  • invasive testing can cause harm
  • positive test: significant mental distress
  • if undertaken needs every 2 years until age 69