Transcript 案例示范 DiseaseDex for General Medicine Question A 53

案例示范
DiseaseDex for General Medicine Question
• A 53-year old male smoker suffering from diabetes is being
assessed for the risk of hypertension. His cholestrol level was
taken. What data do you require as a starting point for discussion
of medications?
•
Select
– Hypertension
– DiseaseDex General Medicine Clinical Review
– Figure 1: Using the Framingham Data to Individualize
Risk for Men
DiseaseDex for General Medicine - Question
• A 33-year old patient with poorly controlled asthma was admitted with
another exacerbation. On the 2nd day her medications include albuterol
nebulisations and methyl-prednisolone IV and there was little
improvement. What additional measures might be helpful in having the
exacerbation under control?
• Select
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Asthma
DiseaseDex-Gen Med Clinical Review (15 related occurences)
ASTHMA-Complete Monograph
Drugs to Consider
Tables and Figures
Figures, Algorithms for management of asthma exacerbations in hospital /
emergency care
Diseasedex Emergency Medicine - Question
• A pregnant woman is seen in the ED with trauma as a result
of a car accident. Her white blood cell (WBC) count is 21,000.
Is this a sign of placental abruption (placenta tearing away to
result in fetal demise)
Select
Placental Abruption
Diseasedex Emergency Medicine Clinical Reviews
ABRUPTIO PLACENTAE – Clinical Reviews
Laboratory Data
White Blood Cells
Diseasedex Emergency Medicine - Answer
b. In pregnant trauma patients, an elevated WBC count on admission
(>20,000/mm(3)) is an indicator of ongoing placental abruption and
requires close monitoring (Shah, 2002).
CareNotes Systems
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• CareNotes Systems has 6 parts
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General Information
Pre-care
In-patient care
Discharge care
Long term home care
DrugNotes
CareNotes Systems - Question
• Demonstrate how to use a Metered Dose Inhaler (MDI)
Select
Access Patient Education
The CareNotes System
Inhaler
How to use a metered dosage Inhaler
Discharge care - English
CareNotes Systems - Answer
.
• Shake the inhaler, Remove the cap from the
mouthpiece……The following are the 3 methods to
use an MDI.
• Method 1: Hold the inhaler 1 to 2 inches in front of
your mouth
• Method 2: You may be given a spacer/holding
chamber to use with your inhaler. This is a piece of
plastic-like tubing that is put on the mouthpiece of the
inhaler. Chambers come in different shapes. The
medicine goes into the chamber first and slows the
mist going into your mouth and throat. Close your lips
loosely around the mouthpiece. Do not block the
opening with your teeth or tongue.
Poisindex - Question
• A 18 year-old tries to get high by consuming a
bottle of Robitussin DM. The poison centre is
called when he is in a stupor and has trouble
in breathing. What are the clinical effects and
treatment protocols?
Select
Robitussin DM
Robitussin DM from A.H. Robins (Australia)
Dextromethorphan
Clinical Effects
Treatment
Poisindex - Answer
Clinical effects –
c) Rammer et al (1988) report the fatality of an 18-year-old female
who ingested an unknown quantity of dextromethorphan. Drug
screen for other agents was negative. Death was attributed to central
respiratory depression.
Treatment
 a) Consider prehospital administration of activated charcoal as an
aqueous slurry in patients with a potentially toxic ingestion who are
awake and able to protect their airway. Activated charcoal is most
effective when administered within one hour of ingestion. (Thakore
& Murphy, 2002) Spiller & Rodgers, 2001).