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