October 10, 2018
The Daily Dozen - Monday, 17th June 2019.
Nutrition AdviceEnjoy a wide variety of foods each day:
- five portions of vegetables and two portions of fruit
- three portions of cereals (including breads, rice, pasta and noodles)
- one to two portions of lean meat, fish, poultry and/or alternatives
- at least 2 g per day alpha-linolenic acid by including foods such as canola-based or soybean-based oils and margarine spreads, seeds (especially linseeds), nuts (particularly walnuts), legumes (including soybeans), eggs and green leafy vegetables
- drink plenty of water.
- limit saturated fat and moderate total fat intake but consume about 500 mg per day of combined docosahexaenoic acid and eicosapentaenoic acid through a combination of the following: two or three serves (150 g serve) of oily fish per week, fish oil capsules or liquid, food and drinks enriched with marine omega-3 polyunsaturated fatty acids
- limit salt intake to less than 6 g of salt a day (approximately 2300 mg of sodium a day), which is approximately 1½ teaspoons of salt
- limit alcohol intake
- consume only moderate amounts of sugars and foods containing added sugars.
- prevent weight gain: be physically active and eat according to energy needs
- care for food: prepare and store it safely
- encourage and support breastfeeding.
Cramps + confusion + tetany
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
Genital pruritus + soreness + white wrinkled plaques
Paul, age 74, presents with double vision and a drooping right eyelid. On examination, when his eyelids are elevated with assistance, his eye appears 'down and out' and his right pupil is dilated.
Third nerve palsy. The 3rd cranial nerve is damaged, leading to ptosis, impaired occular movements, diplopia and mydriasis.
Wang et al via Wikimedia
Fatiguable weakness of eyelids / eye movement + limbs + bulbar muscles of speech and swallowing
What does this Tympanogram show?
Type B. The tympanogram is flat. This can suggest a middle ear effusion, or tympanosclerosis / cholesteatoma / tumour.
Young female + nulliparous + dyspareunia
Vulvar vestibular syndrome
Toddler (12-18 months) Preventive Health CheckAssessment
- ‘Lift the lip’ dental check
- Physical activity
- Risk of iron depletion and vitamin D deficiency
- Developmental progress including vision and hearing
- Family functioning
- Social and emotional wellbeing
- Toilet training
- Behaviour management techniques
Fever + sore throat + cervical lymphadenopathy
Epstein Barr Mononucleosis
Loss of vision with washed out colours, pale optic disc on fundoscopy.
Optic atrophy. DDx ischemia, optic neuritis, tumours, inflammation / infection, trauma.
‘elfin’ face + intellectual disability + aortic stenosis
Article of the Month
Paediatric inhaled airway foreign bodies: An update
AJGP April, 2019
Recently Added Links
GP trove is an independent Free Open Access Medical education (FOAM) website for GP registrars and other FRACGP candidates in Australia.