October 10, 2018
The Daily Dozen - Saturday, 23rd February 2019.
Meredith, age 60, has noticed that the colour of her left eye is changing. She thinks the brown area has been enlarging over the past few months.
Iris melanoma. It could be a benign naevus or a melanoma, but if it is growing then melanoma should be suspected.
Transient amaurosis fugax or dysphasia or hemiplegia
Transient Ischaemic Attack
What is the chest compression ratio for adults? Is it the same or different for a child?
30:2 (compressions: breaths) in adults, 15:2 in children for trained health professionals.
Acute vertigo + nausea + vomiting
Judy, age 63, complains that her right eye feels irritated and uncomfortable. On examination it appears that her right lower eyelashes are rubbing against the surface of the eye.
Entropion. The eyelid is turned in and the eyelashes rub against the cornea. This can lead to corneal damage if persistent.
Young female + nulliparous + dyspareunia
Vulvar vestibular syndrome
Annie, age 17, presents with a red left eye that she has noticed since she woke up this morning. There is no pain or photophobia. Annie has a history of hayfever but is otherwise well. Acuity, eye movements, pupils and fundoscopy is normal.
Subconjunctival haemorrhage. This may be caused simply by sneezing, coughing or straining, although hypertension / blood dyscrasias are also possible causes.
Anorexia/nausea + faecal leaking + abdominal bloating
Factors Reducing the Likelihood of Asthma
- Dizziness, light-headedness, peripheral tingling
- Isolated cough with no other respiratory symptoms
- Chronic sputum production
- No abnormalities on physical examination of chest when symptomatic (over several visits)
- Change in voice
- Symptoms only present during upper respiratory tract infections
- Heavy smoker (now or in the past)
- Cardiovascular disease
- Normal spirometry or PEF when symptomatic (despite repeated tests)
Odour + hypertonicity + seizures (infancy)
Maple syrup urine disease
Tracy, age 32, has noticed increasing numbers of growths on her fingers since starting treatment for Crohn's disease. They are not painful or itchy.
Common wart. Warts are common, especially in children or in people who are immunosuppressed. Common treatment options include topical salicylic acid or cryotherapy. Read more on DermNet
Tremor (postural or action) + head tremor + absence of Parkinsonian features
Article of the Month
Removal of ear, nose and throat foreign bodies: A review
This is a practical guide to removing different shaped foreign bodies from the ear, nose or throat.
Apart from batteries and vegetable matter that may expand with moisture, most ear foreign bodies do not need to be removed immediately.
AJGP October, 2018
Recently Added Links
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