By Michael Vassallo
This publication has major reasons: formative case research and self-assessment of medication in outdated age. It offers clinicians with a sequence of situations on which to base dialogue of the research and administration of sufferers. It additionally presents the trainee, or confirmed health practitioner, with a medium to aid organize for post-graduate examinations and medical practice.
The authors have selected 109 situations, a complete of 250 questions/answers, illustrated by way of colour photos, diagrams, and tables. The situations disguise the most modes of presentation of acute affliction in previous age, similar to fall, confusion, incontinence, weight reduction and immobility, with examples from the entire significant structures. those illustrate the complexity of analysis and therapy of scientific disease in frail older humans and the necessity to imagine extensively and laterally while taking good care of such patients.
The questions are usually in best-of-five structure to mirror the present kind of a number of selection questions utilized in exam, although a few are open questions because the foundation for tutorials. a few of the scientific stems were extended to enhance the tutorial functionality of the booklet and to check extra carefully the reader’s deductive thinking.
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Extra resources for Rapid review of medicine in old age
Example text
After further review by her GP, she was admitted to hospital. The appearance of her sigmoid colonic mucosa is shown in Figure 20. 4) 20 4 Which of the following courses of action would have been best when this patient was observed to be slightly more drowsy than usual at the beginning of the episode described above? A Prescribe trimethoprim rather than amoxicillin. B Wait for the result of the catheter specimen of urine and give antiobiotics if it is positive. C Daily bladder irrigations with an antibacterial solution.
E Gastric cancer. 19 19 Two films from the patient’s ‘barium’ meal. 31 Patients 18, 19 Patient 18 Answer 1 C Flatus tube. The abdominal radiograph reveals gross distension of the sigmoid and descending colon. The acute onset of the symptoms suggests volvulus as the diagnosis. The best initial intervention for this condition would be the insertion of a flatus tube under sigmoidoscopic guidance. With a history of constipation, now complicated by volvulus, it is unlikely that senna will be of any benefit.
A catheter specimen of urine was positive on routine testing to blood, protein, nitrites, and leukocytes, and had a mixed growth of bacteria. 21 1 Which of the following investigations is most likely to provide the best diagnostic information? A Wound swab for bacterial culture. B Biopsy of the ulcer base for bacterial culture. C Plain radiograph of the sacrum. D Isotope bone scan. E MR scan of the sacrum and pelvis. 2 At this stage, which of the following methods of ulcer treatment is the best option?