June 23, 2019
GP trove is an independent Free Open Access Medical education (FOAM) website for GP registrars and other FRACGP candidates in Australia.
October 10, 2018
September 25, 2018
September 11, 2018
June 12, 2017
January 2, 2017
December 18, 2016
The Daily Dozen - Saturday, 22nd February 2020.
George, age 60, has noticed sudden flashes of light occasionally when he moves his eyes over the past couple of days. He also has a floating ring in his vision that won't go away when he rubs his eyes. On examination, acuity is normal and there is no obvious visual field defect.
Vitreous detachment. As a normal part of ageing, the vitreous becomes more unstable and separates from the retina. This can lead to flashes and floaters. There is a risk of retinal detachment, which can start with subtle loss of peripheral vision.
Drowsiness + fever + purpuric rash
Aaron is brought in by mum as she has noticed his eyes are different colours in family photographs using a flash. On examination, the red reflex is absent in the left eye and he doesn't respond to visual stimulation when the right eye is covered.
Retinoblastoma. Leukocoria has many causes but the most serious is retinoblastoma.
Weakness + polyuria + polydipsia
Stroke RiskAll patients with suspected TIA should have stroke risk assessment including the ABCD2 tool:
- A = Age >60
- B = BP >140/90
- C = Clinical features of unilateral arm weakness (2 points) or speech impairment without weakness (1 poinit)
- D = Duration >60min (2 points) or 10-59min (1 point)
- D = Diabetes mellitus
Abdominal pain + malar flush + fever +/- URTI
In a child
If an AED is available immediately, when should the first shock be given? a) immediately b) after 30 sec CPR c) after 2 min CPR
Immediately. Defibrillation should be performed as soon as possible. 2 min cycles of resus only start AFTER this.
Abdominal pain + diarrhoea + fever
Preventing acute kidney injury: which are the key drugs to be avoided on a sick day?
SAD MANS mnemonic: S sulfonylureas A ACE-inhibitors D diuretics M metformin A angiotensin receptor blockers N non-steroidal anti-inflammatory S SGLT2 inhibitors
Malaise + night sweats + painless lymphadenopathy
Non Hodgkin lymphoma
Teenage Preventive Health CheckAssessment
- Use the HEADSS framework:
- H: Home
- E: Education / Employment
- A: Activities
- D: Drugs
- S: Sexuality
- S: Suicide
- Growth velocities including BMI
- Physical activity (at least 60 min / day)
- Screen sexually active young people for chlamydia
- Depression screen
- Injury prevention – harm minimisation.
- Sun protection
- Social and emotional wellbeing
- Oral health
- If chronic comorbidities: transition from tertiary paediatric care to effective primary care with access to adult specialist care
Fever (often with rigors) + upper abdominal pain + jaundice