Follow up DFASM2 1 – Dialogues

Dialogues extraits de How Can I Help You Today?,
F.Pastore Ellipses 2015- ISBN 9782340005921

 

 

 

 

Listen to the dialogue. When you have finished click on the question to see the answer.

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1/ Dermatology
Patient’s name:

Brian CARLISLE

Age:

17

Marital status:

single

Presenting complaint:

– painful rash on face for 10 days
– started with pimples over forehead & cheeks then spread to right side of face
– no weight loss
– no headaches, dizziness, photophobia, fever or chills

Treatment: given by GP

– amoxicillin-clavulanic for 8 days
– trimethoprim-sulfamethoxazole

Allergies:

no

Further investigations:

FBC

 2/ Infectious diseases
Patient’s name:

Patrick DWERRYHOUSE

Age:

35

Marital status:

single

Presenting complaint:

– feverish after trip abroad 2 weeks ago
– spent 3 weeks in Gabon
– had yellow fever shot + antimalarial drugs for 3 weeks + 1 after return
– no cough, no headaches
– watery stools
– no vomiting
– never used injectable recreational drugs
– sexual contacts abroad

Further investigations:

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3/ General medicine
Patient’s name:

Adam CUMMINGS

Age:

45

Presenting complaint:

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Immediate past medical history:

– started coughing before fever
– phlegm without streaks of blood
– chokes when coughs

Living habits:

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Further investigations:

blood tests

Treatment:

syrup in the meantime

 4/ Emergency medicine
Patient’s name:

John COLLINGWOOD

Age:

21

Presenting complaint:

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Living habits:

– has alcohol 4 times/month
– 4-5 drinks each time
– 6 or more once a month
– felt not able to stop: monthly
– felt unable to remember what happened the night before: less than monthly
– no injure to himself or other…yet

Advice:

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5/ Respiratory medicine
Patient’s name:

Godfrey NORTHROP

Age:

61

Presenting complaint:

–    fever
–    difficulty breathing for a week
–    knees & ankles painful

Immediate past medical history:

–    lost 10 pounds (4.5kgs) over 2 months
–    80 pack-year history but stopped smoking

Treatments:

–    ATBs for a week
–    OTC painkillers

On examination (O/E):

–    Temp: 38.6°C (= 101.4°F)
–    Pulse: 100bpm
–    BP: 110/70
–    Respiration: 26 breaths/min
–    Deceased breath sounds in right lung base+ scattered fione rales
–    Heart sounds: reg. without murmurs, rubs or gallops
–    Abd.: no tenderness or masses
–    Finger clubbing
–    No evidence of pedal edema, joint swelling, erythema, joint tenderness
–    No skin rashes

Further investigations:

–    Lab tests
–    Chest X-Ray
–    Hospitalisation for further investigations

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