Study notes - Examples

PRESENTING COMPLAINT – AN EXAMPLE

ABDOMINAL PAIN

DIAGNOSTIC MATRIX

 

Common

Uncommon

Benign

Mesenteric adenitis

Dysmenorrhea

Ovarian cyst rupture

 

Serious

Appendicitis

PID

 

Renal colic

Ovarian cyst torsion

Life-threatening

 

Ruptured ectopic (pregnancy)

HISTORY TAKING

Bullet point a list of important questions necessary to achieve a diagnosis

RED FLAGS / AT RISK PATIENTS / PROBABLE ADMISSION/REFERRAL CRITERIA

DIAGNOSTIC DATABASE

 

History

Exam

Tests

Treatment

Cholecystitis

RUQ constant pain +/- fever

Murphy’s +ve

Biliary U/S

IV Abs

Surgery

Pancreatitis

Epigastric pain to the back. Vomiting. Hx of gallstones or alcohol

Tender epigastrium

Lipase / Amylase

Fast

IVT

Appendicitis

RIF pain. LOA. +/- fever

Tender McBurney’s with rebound

Nil conclusive.

WCC/CRP ^

+/- CT abdomen

Surgery

Diverticulitis

LIF (or RIF) pain +/- fever

Tender LIF with rebound

Nil conclusive.

WCC/CRP ^

+/- CT abdomen

IV Abs

Pyelonephritis

Loin pain. Dysuria. Fever

Tender loin.

MSU – nitrite/WCC +ve

IV abs

FOOTNOTES / DEFINITIONS / DICTIONARY

DISEASE – AN EXAMPLE

MYOCARDIAL INFARCTION

Classical presentation and diagnostic criteria

Diagnostic traps

Complications

 

Common

Uncommon

Benign

Atrial arrhythmia

Dressler’s syndrome

Serious

Heart failure (acute and chronic)

 

Life-threatening

Ventricular arrhythmia (early)

Cardiac rupture

Ventricular arrhythmia (late)

Initial treatment

Complications of treatment

 

Common / Benign

Uncommon / Serious

Heparin

Skin bleeding / bruising

Intracranial bleeding

GIT bleeding

PTCA

 

Haemorrhagic CVA

Thrombolysis

Reperfusion arrhythmias

Haemorrhagic CVA

GIT bleeding