.ethics question ; you are locum doctor at some palce ; all the doctors there some marijuana
in their break; you are aware they have marital problem ; who will you report
Manager
Health authority
Discuss with them
The Nurse at your GP Clinic wants you to see a Gentleman in the treatment room who presented for wound cleaning and dressing. The Nurse is concerned that he may need Antibiotics before he leaves.O/E The Picture is Given below . What is the NEXT STEP
- Regular wound swapping + Long Term Antibiotics
2.Compression Bandaging during day time
3.Referral to Vascular Surgery after US Doppler Studies
4.Advise the patient to Elevate the Leg when sitting
5.Referral to General Surgeon for skin Grafting .
2 YRS old child brought to you by a concerned mum that the child has developed skin rashes on the hand and feet.She is worried whether child is developing “meningococcal disease”.
O/E The picture is given below .The same skin rashes on the Feet ,buccal mucosa has vesicles.T 37.7 ,Child not unwell looking.What is the next step
1.needs basic bloods like FBE+U+E/LFT,CRP
2.Reassure the Mother as this is a Benign condition and self limiting.
3.needs blood cultures when the child is febrile
4.Needs antibiotics and review in 2 days
5.Non of the above .
Preg Woman At Term. Fhr 60/ Min. Emergency Lscs Done. Baby Still Has Heart Rate 60 .
What Antibody Will U Look For In The Mother ?
Lupus Anticoagulant
Anti Ro
A young man 30yr got coup/ countercoup on falling during joging , and become unconcious for 15 seconds soon after falling ,
1 day after he felt.
Heaviness in head
Low blood pressure 90/65
These symptoms go long for 15 days
After 15 days 1 aditional symptom of low grade intermitent fever come to appear alongside.
****(Fever is intermittent 3~4times /d and only for 1 hr then come back to normal and again go up.)
Now current symptoms are
Low BP 90-100/65-70
HEAD heaviness
Low grade intermittent fever max.grade 37.5
48 yrs old man with chronic Renal Insufficiency presenting for Bloods review today .His Medications list as follows Lisinopril 40 mg,HCT 25mg,Panadol as needed for joints pain,and Allopurinol 300mg daily.He does not smoke but drinks 2 units of Wine per 3-4 days per week.O/E BP 147/87,P 76,A soft S4 Gallop and mild Ankle Oedema. UA Protein + other wise unremarkable.U+E -eGFR 42ml/minute (Stage 3).What is the next BEST MANAGEMENT OF CHOICE.
1.Discontinue all Alcohol consumption
2.Discontinue his Panadol for joints pain
3.Adding a CCB Eg Diltiazem
4.Change ACEI into A2RBs
5.CT Renal Angiography to rule out Renal Stenosiss