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The Daily Dozen - Saturday, 21st September 2019.

What does this Audiogram show?
Bilateral mixed hearing loss.
Visual disturbance (blurred or transient loss) + weakness in limbs +/- paraesthesia
Murtagh's Triads
What does this Audiogram show?
Noise-induced hearing loss. Note the notch at 4000Hz. This is common but not diagnostic – there are other causes of this notch apart from noise.
Finger discomfort + arthralgia + reflux (+/- skin tightness)
Murtagh's Triads

Dental Preventive Health

  • ‘Lift the lip’ screening - teach parents to look for signs of tooth decay once a month
  • Dental hygiene - brush twice a day, but no toothpaste under 17 months and only use low fluoride toothpaste up to 5 years
  • Dental visits annually after 12 months
Male with dysuria + fever + perineal pain
Murtagh's Triads

Neonatal Preventative Health Check

  • Metabolic screen
  • Feeding
  • Hearing - universal assessment
  • Physical exam as outlined in the Child Health Record
  • Any parental concerns
  • Maternal health
  • Settling
Injury Prevention Advice
  • passive smoking
  • SIDS prevention
  • UV exposure
Arthritis + pigmentation of ear cartilage + black urine with alkalisation
Murtagh's Triads

Skin Cancer Risk

People at increased risk of skin cancer:
  • Family history of melanoma in a first degree relative
  • Fair complexion
  • Age >30, especially if >50
  • Presence of solar lentigines
  • Childhood sunburn and high levels of UV exposure
People with multiple dysplastic naevi or a history of melanoma in themselves or a first degree relative are at high risk and are advised to have regular skin checks and self examination. People exposed to arsenic or patients who are immunosuppressed are also at risk of nonmelanoma skin cancer.
Arthralgia + purpuric rash +/- abdominal pain
Murtagh's Triads
Larry, age 50, presents for a routine eye examination. He is systemically well.
Choroidal melanoma. There is a malignant melanoma.

Jonathon Trobe University of Michagen Kellogg Eye Center

Fever + myalgia / headache + dry cough
Murtagh's Triads