Bakr GP past papers notes (dragged).pdf

- 6. 7. 8. 9. Book says Trial bathe the effect eye with boiled. Cooled water, avoid contact lens, simple hand hygiene for 3 days, if it doesn’t work then topical chloramphenicol for 5d - Lecture says if you see mucoid discharge then bacterial then topical chloramphenicol - Book says COLD compre...

- 6. 7. 8. 9. Book says Trial bathe the effect eye with boiled. Cooled water, avoid contact lens, simple hand hygiene for 3 days, if it doesn’t work then topical chloramphenicol for 5d - Lecture says if you see mucoid discharge then bacterial then topical chloramphenicol - Book says COLD compress for allergic rhinits (watery bilateral discharge) - Guidelines says to trial for 5-7 days as it goes away even if bacterial, only use antibacterial in severe or not limiting cases. - Pick warm compress Picture: hemorrhage with no traumaà refer to ophthalmology (I DISAGREE, I THINK IF THERE IS NOT HISTORY OF TRAUMA, IT WILL CLEAR SPONTANEOUSLY; REFER IF HX OF TRAUMA) – ophtha - Subconjunctival hemorrhage is common in elderly and clears spontaneously in 1-2 week, Reassure, ONLY REFER IF HISTORY OF TRAUMA - it clear spontaneously, if it reoccurs check BP, check clotting, check FBC for platelet count or leukemia; REFERAL ONLY IF TRAUMA PRECEDING THE HEM< OR IF YOU CANNOT SEE ITS POSTERIOR BORDER. Cauda equina à refer to ER – neuro - Compression below L2, L3/L4 - Presents with numbness of the buttocks and back thigh (saddle anesthesia) + urinary/fecal incontinence + lower motor neuron weakness where loss of dorsiflexion (L4) and plantarflexion + ankle reflex +eversion of foot (S1) Mastoiditis with ear painà refer to ER – ENT - Previous question: Girl with recent ear infection tx with Abx not resolved, now has protruding ear with bony tender prominence behind the ear, what is best next step - Symptoms: persistent, throbbing earache; creamy, profuse ear discharge; i conductive deafness; fever and general malaise. - Signs: tenderness ± swelling over the mastoid; ear may stick out; drum is red/bulging or perforated—if the ear drum is normal, it is not mastoiditis. - Refer to ENT as an emergency. Treatment is with IV antibiotics. - Symptoms: pain over mastoid region and white discharge from the ear; red or perforated ear drum. Gout secondary to medication à remove thiazide – MSK/renal - Do that 4-6 week after attack - Diuretic can cause uric acid to elevate and is risk factor page 494