thought i’d put a note to my shift yesterday.
Patient 1.
A flutter with syncope – admit telemetry
cause ? (probably too much flecainide and all the agents – alpha blocker/beta blocker/CCB/flecainide)
need to revise : Drugs for anti-arryhmics esp flecainide
Physiology : cardiac AP
2. Man seen yesterday w ? gastritis (used NSAIDs for weeks for arthritis) and today presents with worsening tummy pain and rash.
Rash – confluent maculopapular kind – distributed all over – not specific distribution. blanching. looks like drug rash.
Tummy – RLQ pain +++
diagnosis – perforated appendix w free fluid on CT.
lessons : good disposition for ppl with abdo pain – rash is a bad sign
need to look up literature about rash + abdo pain. ( i thought that was from nurofen !)
3. # cuboid + tuberosity of 5th metatarsal
anatomy – good to revise bones of feet and muscles of ant part of leg.
4. Scans done :
a. 1 FAST
b. 1 LUS – B lines in LLL suggestive of infiltrative process.
5. I+D right upper lip abscess
used infraorabital nerve block.
anatomy : revise face / triangle of danger
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