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14.04.01 Foolish

Rosier
  • Minus 1:
    • Has there been loss of consciousness or syncope? 
    • Has there been seizure activity? 
  • Plus 1
    • Is there a NEW ACUTE onset (or on awakening from sleep)? 
      • I. Asymmetric facial weakness 
      • II. Asymmetric arm weakness 
      • III. Asymmetric leg weakness 
      • IV. Speech disturbance 
      • V. Visual field defect
  • Stoke is likely if score >0
Notes
  • Adson's sign 
    • Loss of the radial pulse by rotating head to the ipsilateral side with extended neck following deep inspiration
    • Sign of thoracic outlet syndrome
    • e.g. Cervical rib, Pancoast tumour
  • CKD: only diagnose stages 1 & 2 if supporting evidence to accompany eGFR (i.e. Abnormal U+Es, Proteinuria)
  • Pyoderma gangrenosum
  • Percultaneous Transhepatic Cholangiogram
  • Psoas sign
    • Psoas abscess
    • Retrocecal appendix
    • Dissection AAA going down leg
  • Man returns from trip abroad with maculopapular rash and flu-like illness - think HIV seroconversion
  • Offer LTOT to patients with a pO2 of < 7.3 kPa or to those with a pO2 of 7.3 - 8 kPa and one of the following:
    • secondary polycythaemia
    • nocturnal hypoxaemia
    • peripheral oedema
    • pulmonary hypertension
  • Combined oral contraceptive pill
    • increased risk of breast and cervical cancer
    • protective against ovarian and endometrial cancer
  • Erythromycin can cause cholestasis but gastrointestinal upset is by far the most common side-effect
  • WAGR syndrome with Aniridia, Genitourinary malformations, mental Retardation
  • The presence of psychotic symptoms differentiates mania from hypomania
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