RACGP KFP 2016.1.12 – Maria receives palliation

RACGP KFP 2016.1.12 – Maria receives palliation

by | Feb 9, 2018

Maria, an 81 year old is a new resident at the nursing home in the rural town you visit 500km away from a tertiary hospital.  On your first review she states her pain in her upper abdomen is quite severe, and has been getting worse for 9 months.  She also has widespread muscle aches and pains and feels tired constantly. 

Her previous GP put it down to her past peptic ulcer disease and osteoarthritis and doubled her nexium and added endep 10mg and regular mobic.  She has a past history of peptic ulcer disease, cholecystectomy for gallstones, hypertension, osteoarthritis of her back, right THR 15 years ago and hypercholesterolaemia.

Her medications include perindopril 5mg/indapamide 1.25mg combination, atenolol 50mg, atorvastatin 80mg, nexium 40mg bd, endep 10mg nocte, temazepam 10-20mg nocte, panadeine forte 1g/60mg qid, meloxicam 15mg daily.  She has no allergies. Her BP is 105/70 and HR 52. 

Abdominal exam reveals a tender RUQ with hepatomegaly, but the epigastrium is soft and non tender.   

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RACGP KFP 2016.1.11 – Erin has a Red eye

RACGP KFP 2016.1.11 – Erin has a Red eye

by | Feb 9, 2018

Erin, an 8 year old girl is brought in by her father because her left eye is red.  Her whole eye is red and painful, getting worse over the past 18 hours.  There is mild watery discharge but no pus.  There is no rash on her face or eyelids. 

She was playing with her friends after school yesterday afternoon in the backyard when she noticed it coming on.  She has also been complaining of aching joints over the past 1 month which the parents put down to a viral infection she had around this time.  She has no past medical history.

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RACGP KFP 2016.1.10 – Ben is Suicidal

RACGP KFP 2016.1.10 – Ben is Suicidal

by | Feb 9, 2018

Ben, aged 16, who is brought in by his mother because she is concerned about his anxiety.  Over the last 2 years he has become more anxious about going to school and social events.  He was performing well in school but now he is leaving school early and having panic attacks.  These are “bringing me down”, and make him enjoy his skateboarding less and he is becoming depressed.  His sleep is poor because he is up ruminating for hours about the next day.  He denies any hallucinations and there is no thought disorder or delusions evident.    He reports he has had suicidal thoughts for the past 3 months.  He has no other past medical history,  His mother and father are divorced when he was young.  His father has major depression disorder.

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