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june 2016 recalls.pdf

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  161 ﮫﺣﻔﺻ   ﻰﻟ لوﻠﺣﻣ   You receive a call from a school about a boy who is your patient and asthmatic. They are immediately about to leave for a camp and wants to know if the child’s asthma management plan can be given as they could not reach his parents. What will be ur next step? a. Give the teacher the prescription for management plan b. Ask them to bring the child to your practice c. Try contacting his parents ! # %&'()&*+, '(-, .% - # /-*-# ! #$ %&''&$ ()* ) +,-.%,)/0 /1()2,&$34,5 16,323 ,$ )$0 /1()2,&$34,5 *4,%4 7,813 &$1 &+ 241 5)/2,13 )$ &55&/2.$,20 2& 161/%,31 5&*1/ 2& 241 -12/,'1$2 &+ 241 &241/ 5)/20 *4& -151$-3 &$ 24)2 person to act in their interest. That is, a ‘fiduciary relationship’ is one where the ‘fiduciary’ .$-1/2)913 2& )%2 ! $%&'() !) ' * + ,&% + ,%-%., !) )$&241/ 51/3&$! : +,-.%,)/0 -.20 ,3 241/1+&/1 )$ &;(,7)2,&$ 2& )%2 ,$ 7&&- +),24 2&*)/- 3&'1&$1 +&/ *4&' /135&$3,;,(,20 4)3 ;11$ )%%1521- ,$ 3.%4 ) *)0 )3 2& %&$+1/ ) ;1$1+,2 &$ 24)2 51/3&$! <4,3 '1)$3 241 5&*1/ &+ 241 32/&$71/ 5)/20 &.742 !,   ;1 161/%,31- 2& 241 -12/,'1$2 &+ 241 *1)91/ 5)/20! <41 $&2,&$ .$-1/(0,$7 +,-.%,)/0 &;(,7)2,&$3 ,3 ,$41/1$2 ,$ 241 /1()2,&$34,5 ;12*11$ 241 32)21= *&/91/3 )$- 241 0&.$7 51&5(1!  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the exclusion of the fiduciary’s own ,$21/132! D./241/= 51/3&$3 3.;E1%2 2& 24,3 -.20 )/1 $&2 1651%21- 2& 5/&+,2 +/&' 241 /1()2,&$34,5= &/ 2& 5.2 241'31(813 ,$ ) 5&3,2,&$ *41/1 241 +,-.%,)/0 &;(,7)2,&$ )$- 51/3&$)( ,$21/132 ')0 %&$+(,%2 B Butterworth’s Aust  -'(+' 1%2'( 3+/,+! '-4  = ?FFGH IG?C! D,-.%,)/0 &;(,7)2,&$3 /1%&7$,31 241 5&3,2,&$ &+ -,3)-8)$2)71 &/ 8.($1/);,(,20 &$ 241 5)/2 &+ 241 *1)91/ 5)/20 *4,%4 %).313 24)2 51/3&$ 2& /1(0 &$ 241 &241/ )$- /1J.,/13 241 5/&21%2,&$ &+ 1J.,20 )%2,$7 .5&$ 241 %&$3%,1$%1 &+ 241 &241/ BK)2(10 ,$ L#:M ?FFG= 55! >N O >>C! mother came for followup of child. child normal however mother is silent and withdrawn. wat to ask mother? -mood -financial strain -maritial status Neonate with skin lesion (described only) with pus .. Organism asked: - Staph - HSV 2) molluscum pic ... No exclusion 3) man from Ethiopia with hx of hCG vaccination now mtx 12 mm no s/s asked next .... Chest Xray  4) swollen inflammed scrotum with black tissue in DMII patient after Antibiotics and IVF what to do: - blood culture - wound debridement 4) CT IMAGE subdural hge 5) CT IMAGE ICH white rounded lesion next Inv. - CT angio - MRI 6) complete heart block with heart rate of 36 .. Pt on digoxin enalpril n metoprolol .. Mx: pace maker 7) ECG Rapid AF asking Dx 8) ECG mobitz type II what to stop? - Digoxin - ACEI - Apirin 9) 5 sentences about CTG to select which one is the right one ! 10) Chest trauma with bilateral # ribs .. Hemothorax is there too .. Patient is vitally stable n maintaing oxygen saturation .. Not breathing well because of pain .. Next step : morphine Old man with Fx one leg he will use the walking cane (crutches) where he will put it?!! same side of affected leg and move it with the healthy leg The side of the healthy leg and move it with the affected leg Risk factor for osteoporosis in a 60 year old : early menopause at 35 Patient on treatment for AIDS . Developed Hematuria and dysuria with flank pain : non contrast CT Ribavirin side effect is hyperuricemia in 38% of its users uric acid stones non contract ct Noncontrast CT scanning (spiral CT scanning) is the most sensitive and specific study to search for uric acid stone MEDSCAPE But there is another scenario when the patient is on indinavir for HIV presented with the same symptoms ,, choose ct with contrast as the stones here is radiolucent   least 5 yrs survival rate Cx : - testis - lung - pancreas - stomach Q about staging of colon Cx ?????   MI from 8 months , known AF on warfarin . New X Ray of Cx colon, patient was stable, no distressing symptoms what to do: - urgent operation - postpone until warfarin effect reversed If apple core x ray so its not emergency , no need to rush ,,, if x ray or signs of IO then urgent op. and give FFP  18) Another similar Q but patient with prosthetic valve apple core x ray so its not emergency , no need to rush ,,, if x ray or signs of IO then urgent op. but without giving anything  19) Mother brought her daughter claiming that she is behaving differently and some troubles with father , sitting alone , lack of interest asking which Q (interviewing the daughter alone) will help you know if she has depression ? - ideas about suicide - does she feel satisfied about herself - lack of sleep there is a missing option for mood and appetite  20) recurrent candidal vaginitis treated every time with clotrimazole this time when you swab the surface bleed asking what to do ? - cervical swab for culture - vaginal swab for culture - HIV test The next step is a pelvic exam. Your doctor will examine your vagina and the surrounding area to see if there are external signs of infection. They will also examine your vaginal walls and cervix. Depending on what your doctor discovers, they will take a vaginal culture to send to the lab for confirmation. Tests are usually ordered only for women that have yeast infections on a regular basis or for infections that won’t go away.  3 or 4 milestones Q one of them 12 months and another 18 months ! #$ &'(#)*+ , &- ,(*)-+.( ')&( / 0+.(*-+'1!+-+&2&1*$( # *(3 .(0 -4( -4( )//('-(0 ,)*- / ' ! # )#0 3)0( ) ' ! &- 3522 6 7 8+#$ /
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