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The Daily Dozen - Sunday, 8th December 2019.

Assessment of Weight

Weight measurements:
  • BMI 18.5 - 24.9 = healthy weight
  • BMI 25 - 29.9 = overweight
  • BMI 30 - 39.9 = obesity
  • BMI >40 = severe obesity
  • Waist circumference <94 cm (males) or <80 cm (females) = normal
  • Waist circumference ≥102 cm in males and ≥ 88 cm in females = high risk
Adolescent with limp + knee pain + hip pain
Murtagh's Triads
Yasmin, age 26, is worried she might have got something in her eye as it has been a very windy day today and her eye is now sore and red. On examination, acuity is 6/5 bilaterally, uncorrected. No foreign body can be found on full examination, including eyelid eversion. There is a small corneal defect on fluorescein examination that does not appear dendritic.
Corneal abrasion. This may be a traumatic corneal abrasion, but it is important to consider infectious keratitis - especially if the patient was a contact lens wearer or did not have a history of trauma.

Jonathon Trobe University of Michagen Kellogg Eye Center

Knee pain (after activity ) + tender knee 'lump' + pain on kneeling
In an older child, usually with a growth spurt
Murtagh's Triads
Bill, age 67, presents with painless loss of vision in one eye that has been gradually worsening over the past day or so. He has a history of hypertension. On examination, acuity is reduced. Eye movements are normal.
Retinal vein occlusion. There are widespread retinal haemorrhages and distended retinal veins.

Jonathon Trobe University of Michagen Kellogg Eye Center

Plethoric moon facies + thin extremities + muscle weakness
Murtagh's Triads
Where should you insert an intraosseous needle?
Proximal tibia: Anteromedial surface, 2-3 cm below the tibial tuberosity
Distal tibia: Proximal to the medial malleolus
Distal femur: Midline, 2-3 cm above the external condyle
Fever + severe aching + rash
Murtagh's Triads
Bill, age 74, has numerous skin lesions over his face, arms and hands from many years in the construction industry. He has noticed that one on his right thumb has become thick, raised and firm.
SCC. SCC frequently occurs within an actinic keratosis, becoming thickened as it infiltrates. It may form a keratinous nodule or an erythematous plaque. It can ulcerate. Treatment is generally excision, or radiotherapy. Metastatic disease is possible.
Aching bones + waddling gait + deafness
Murtagh's Triads
Jim, age 64, presents with acute painless visual loss in the left eye. Jim has a history of type 2 diabetes, hypertension and hypercholesterolemia, but he does not take his medication. On examination, there is an absent red reflex in the left eye.
Vitreous haemorrhage. Bleeding from a retinal vessel has leaked into the vitreous cavity. Other causes include trauma, retinal detachment or malignant hypertension.

Jonathon Trobe University of Michagen Kellogg Eye Center

Pale child + severe 'colic' + vomiting
Murtagh's Triads