tag:blogger.com,1999:blog-4078711896790515112.post3019832405221218036..comments2024-02-25T17:46:00.407-08:00Comments on Welcome to gpexamsupport.com.au: CASE 4 Standard Consultation on bilateral leg swelling postpartum (8 mins)Perpetual Healthhttp://www.blogger.com/profile/08370965026844641346noreply@blogger.comBlogger9125tag:blogger.com,1999:blog-4078711896790515112.post-71937655763380877862011-10-13T14:44:47.179-07:002011-10-13T14:44:47.179-07:00pre-eclampsia
Triciapre-eclampsia <br /><br />TriciaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-37748351159213347552011-10-09T07:08:49.690-07:002011-10-09T07:08:49.690-07:00Besides, nephritic syndrome what other syndrome is...Besides, nephritic syndrome what other syndrome is possible?<br /><br />And if she is postpartum with "new" hypertension, what else should you consider here?<br /><br />Dr Vinh Tran<br />MBBS FRACGPPerpetual Healthhttps://www.blogger.com/profile/08370965026844641346noreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-9507955888261158232011-10-08T23:53:32.046-07:002011-10-08T23:53:32.046-07:00Dx:glomerulonephritis -nephritic syndrome
Mx:
1. h...Dx:glomerulonephritis -nephritic syndrome<br />Mx:<br />1. hospital admission <br />2. bed rest, daily weighing and fluid chart<br />3. restrict salt, protein and fluid intake<br />4. antihypertensive or diuretics<br />5. penecilline (if ASOT elevated)<br /><br />TriciaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-52598583991735359942011-10-06T22:23:48.669-07:002011-10-06T22:23:48.669-07:00BP 170/95 usually 110/60
Albumin low
Urine high p...BP 170/95 usually 110/60<br />Albumin low<br />Urine high protein<br /><br />What is your diagnosis?<br />And how would you manage this further?<br /><br /><br />Dr Vinh Tran<br />MBBS FRACGP Qld<br />www.doyouhavedepression.blogspot.com<br />www.fracgpexamsupport.blogspot.com<br />www.priorityhealthmedicalcentre.com.auPerpetual Healthhttps://www.blogger.com/profile/08370965026844641346noreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-78493018975323439102011-09-24T19:28:15.084-07:002011-09-24T19:28:15.084-07:00I would like to order-
FBC, ELFT, ASOT, CRP, ESR, ...I would like to order-<br />FBC, ELFT, ASOT, CRP, ESR, C3/4,<br />24 hour urine protein/cr ratio<br />ASAPAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-76236687708527991732011-09-20T05:55:13.459-07:002011-09-20T05:55:13.459-07:00Tricia,
Would you order any pathology test and ho...Tricia,<br /><br />Would you order any pathology test and how urgent?<br /><br />Dr Vinh Tran<br />www.doyouhavedepression.blogspot.com<br />www.fracgpexamsupport.blogspot.com<br />www.priorityhealthmedicalcentre.com.auPerpetual Healthhttps://www.blogger.com/profile/08370965026844641346noreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-21968684451994375822011-09-20T02:16:24.808-07:002011-09-20T02:16:24.808-07:00DDx - nephrotic syndrome/ nephritic syndrome/glom...DDx - nephrotic syndrome/ nephritic syndrome/glomerulonephritis/acute tubular damage, DVT left calf<br /><br />Next step - urgent Duplex USS, bed rest, fluid restriction, antihypertensives, diuretics, referral to Nephrologist or at least ask for advice form Nephrologist<br /><br />TriciaAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-63994555898642148422011-09-18T04:33:22.426-07:002011-09-18T04:33:22.426-07:00Tricia,
You have covered it very well here so goo...Tricia,<br /><br />You have covered it very well here so good work...<br /><br />Challenge...<br /><br />If on the day she was well and....<br /><br />1 no fever<br />2 bp 150/90 usually "normatensive"<br />3 urine protein+++<br />4 bilateral swelling but L side is worse<br />5 chest clear not in heart failure<br />6 abdo nil significant findings....<br />7 leg not red but L side calf seems more tender<br /><br />AND she does not want to go to hospital yet...<br /><br />??What is your differential at this point and<br />??What is your next step<br /><br />Dr Vinh Tran <br />MBBS FRACGP Uni of Qld<br />www.priorityhealthmedicalcentre.com.au<br />www.doyouhavedepression.blogspot.com<br />www.fracgpexamsupport.blogspot.comPerpetual Healthhttps://www.blogger.com/profile/08370965026844641346noreply@blogger.comtag:blogger.com,1999:blog-4078711896790515112.post-78097563540180113682011-09-17T19:01:52.005-07:002011-09-17T19:01:52.005-07:00Hx-
1. Delivery details, issues during this pregn...Hx- <br />1. Delivery details, issues during this pregnancy<br />2. Onset, progress and nature of bilateral leg swelling<br />3. Associated symptoms of legs, such as red/hot/pain legs<br />4. Other symptoms, fever, PV bleeding/discharge, pelvic pain, appetite, mobility post delivery, feeding model<br />5. Asso symptoms in other systems, such as SOB, cough, chest pain, jaundice, ascites, vision disturbance, headache and neurological symptoms<br />6. Medications<br />7. PMHx of HTN, heart diseases, liver disease, renal diseases, DVT/PE, varicose veins, arthritis, <br />8. Delivery models and complications of previous pregnancies<br />9. FHx of DVT/PE or thrombophilia <br /><br />O/E:<br />1. General appearance, BMI<br />2. Vitals – T, P, Bp, RR, SO2<br />3. CVS: HS, murmur, apex<br />4. Chest: AE, crackles<br />5. Abdo/pelvis: tenderness, ascites, liver, spleen, tenderness at kidney area, <br />uterus level and tenderness<br />6. Legs – type and degree of swelling, ?hot/red/tender, ?Calves , varicose veins<br />7. Eyes: VA, vision field, fundi<br />8. Neurological examination<br /><br /><br />DDX: prolonged sitting/standing, Varicose veins/thrombophlebitis, malnutrition, idiopathic oedema, arthritis, cellulitis, DVT, Thyroid dysfunction, heart/liver/renal failure, malignancy<br /> <br />Management:<br />1. Urinanalysis, blood sugar and ECG in surgery<br />2. hospital admission if history, physical examination and office tests pointing to heart failure or renal failure/nephritic syndrome, or liver failure<br />3. Urgent Doppler USS if pointing to DVT <br />4. Oral or IV Abs if pointing to cellulitis or endometritis, may need admission depends on severity<br />5. Elevate legs, rest, TEDs,Anonymousnoreply@blogger.com