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The Daily Dozen - Wednesday, 21st August 2019.

Factors increasing the likelihood of Asthma

  • More than one of wheeze / breathlessness / chest tightness / cough
  • Recurrent or seasonal
  • Worse during the night or in the early morning
  • Atopy
  • Triggered by exercise, cold air, irritants, medicines (eg aspirin or beta blockers), allergies, viral infections, laughter
  • Family history of asthma or allergies
  • Symptoms began in childhood
  • Eosinophilia or raised blood IgE level, without other explanation
  • Rapid relief from SABA bronchodilator
Fair females under 5 + thin wispy hair + easy loss with pulling
Murtagh's Triads
In airway management, when should head tilt not be done?
If c-spine injury is suspected (do jaw thrust and manual in-line stabilisation) or in an infant (neutral head position is required, consider a towel under shoulders as their head is proportionally large).
Blood in stool + abdominal discomfort + change in bowel habit
Murtagh's Triads

Safe paralysis tick removal: Squeeze don’t Freeze, and Dab don’t Grab!

Painful swallowing + referred ear pain + hoarseness
Murtagh's Triads

Sexual Infection Screening

  • All sexually active people 15-29: chlamydia annually
  • Low risk heterosexual asymptomatic requesting ‘STI check-up’: chlamydia, Hepatitis B, Syphilis and HIV
  • Sexual contacts from the last 6 months of infected women and men: Treat presumptively, retest 3-12 months for re-infection (not retesting for cure).
  • Asymptomatic men who have sex with men: urine and rectal swab for chlamydia, throat and rectal swab for gonorrhoea, HIV, syphilis, Hep A and B if not immune (offer vaccination)
  • HIV positive or history of IVDU: Hepatitis C
Recurrent oral & genital ulcers + uveitis + arthritis
Murtagh's Triads
What does this Audiogram show?
Unilateral mild conductive hearing loss in the right ear, ie impacted wax or perforated tympanic membrane.
Knee pain (after activity ) + tender knee 'lump' + pain on kneeling
In an older child, usually with a growth spurt
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.
Fever + bradycardia + jaundice
Murtagh's Triads