The Daily Dozen - Thursday, 13th December 2018.

Molly, age 24, complains that both of her eyes are constantly itchy, red and watering. This seems to happen every spring, especially on hot windy days or after thunderstorms. Her vision is normal and she is otherwise well.
Allergic Conjunctivitis. Red, itching eyes with watery discharge.

Jonathon Trobe University of Michagen Kellogg Eye Center

Malaise + headache + undulant fever
(with cattle contact, unpasteurised milk or undercooked meat)
Murtagh's Triads

Infant (2-6 months) Preventive Health Check

Assessment
  • Any parental concerns
  • Feeding including introduction of solids
  • Development including vision and hearing
  • Quality of child–parent relationship
  • Parental health, support and family functioning
  • Physical activity ie. supervised floor-based play
  • Physical exam as outlined in the Child Health Record
  Preventive counselling and advice
  • Injury prevention, including:
    • passive smoking
    • SIDS
    • UV exposure
    • water
    • home environment
  • Settling
  • Teething
  • Play
Fatigue + psychiatric symptoms + myoclonus
Murtagh's Triads
What does this Tympanogram show?
Type C tympanogram. There is a peak but it is shifted to the left of normal. This suggests there is negative pressure in the middle ear, such as sinusitis or eustachian tube dysfunction without a middle ear effusion.
Anorexia/nausea + faecal leaking + abdominal bloating
Murtagh's Triads

Type 2 Diabetes Risk

People at high risk of Type 2 Diabetes:
  • AUSDRISK >12
  • History of heart attack or stroke
  • Women with a history of Gestational Diabetes or PCOS
  • Patients prescribed antipsychotics
  • IFG or IGT on a glucose tolerance test
Typical facies (temporalis atrophy and frontal balding) + muscle weakness (+/- myotonia) + cataracts
Murtagh's Triads
In a paediatric emergency, why is a surgical airway contraindicated? What is the alternative?
Children's airways are anatomically different shapes and vital structures could be damaged by a scalpel cricothyroidotomy. The alternative is a needle cricothyrodotomy and jet insufflation (you can oxygenate but not ventilate through this).
Weakness + constipation + polyuria
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
Blank spell + lip smacking (or similar automation) + olfactory / gustatory hallucination
Murtagh's Triads
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