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