Mr JQ (age 56 years) has type 1 diabetes and has been in hos…
Mr JQ (age 56 years) has type 1 diabetes and has been in hospital for the last 3 days with a chest infection. This has cleared up significantly and he is now on oral antibiotics and looking forward to being discharged soon. This afternoon however he has complained of feeling sweaty, dizzy and ‘just awful’. It is 3 pm, 2 hours after he ate lunch. His capillary blood glucose is tested and found to be 3.10 mmol/L. It was noted that yesterday’s blood glucose mid-afternoon was 3.90 mmol/L. Other blood glucose readings have been within range. The list of medication he is currently prescribed in hospital is shown below. Levemir FlexPen 100 units/ml 20 units BD (8am and 6pm) NovoRapid FlexPen 100 units/ml 8 units TDS with meals Co-amoxiclav 625mg tablets TDS for 4 more days to complete 7 day course (Co-amoxiclav 1.2g IV now finished) From the options given, what is the MOST APPROPRIATE course of action?
Read DetailsMr YW is receiving treatment on the gastroenterology ward du…
Mr YW is receiving treatment on the gastroenterology ward due to liver cirrhosis secondary to non-alcoholic fatty liver disease (NAFLD). He undergoes large volume paracentesis due to ascites. The ascitic fluid is found to contain 300 neutrophils/mm3. What does this indicate and what is the MOST APPROPRIATE treatment option?
Read DetailsMiss PU (age 41 years, weight 65 kg, height 1.64 m, of black…
Miss PU (age 41 years, weight 65 kg, height 1.64 m, of black African family origin) had her blood pressure measured in clinic and it was 162/110 mmHg. Following this she had ambulatory blood pressure monitoring, which gave a daytime average of 152/96 mmHg. She has no other past medical history and does not currently take any medication. What would be the MOST APPROPRIATE treatment to recommend to Miss PU?
Read DetailsMrs MA (31 years old, weight 65 kg, height 1.68 m) attends h…
Mrs MA (31 years old, weight 65 kg, height 1.68 m) attends her GP surgery complaining of feeling tired, depressed, having difficulty concentrating, and tearful. Her GP orders some blood tests, the results of which are shown below. What would be the MOST APPROPRIATE course of action? T3 2.5 pmol/L (3.5 – 7.8) T4 1.8 pmol/L (9.0 – 25.0) TSH 6.8 mU/L (0.4 – 4.0) eGFR >90 ml/minute/1.73m2
Read DetailsMr TR (age 62 years, weight 80 kg, height 1.70 m) comes into…
Mr TR (age 62 years, weight 80 kg, height 1.70 m) comes into your community pharmacy for advice on his hips. He complains of these being painful and sometimes making a grating noise. The pain comes and goes, tending to be worse if he works overtime at work – he is employed as a postal worker and delivers mail on foot. What is the MOST LIKELY diagnosis?
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