Transcript Sorting symptoms - Welcome to the BHBT Directory

Sorting symptoms
Breathlessness
• Respiratory
• Cardiovascular
• Anaemia
• Endocrine
• Obesity
• Ageing
Respiratory
• COPD
• Asthma
• RTI
• PE
• Pneumothorax
• Hyperventilation
Cardiovascular
• LVF
• CCF
• Atrial fibrillation
• High output failure
– Thyrotoxicosis
– Pagets
Anaemia
Endocrine
• Thyrotxicosis
– High output failure
– Causing atrial fibrillation
• Diabetic ketoacidosis
Obesity
Old Age
• Exclude all other causes
Examination
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Pulse rate rhythm
BP
Chest
HS
JVP
Ankle swelling
Mucosae
Investigations
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Fbc, u&e lfts, t4
CXR
ECG
Spirometry
Echo
N naturetic peptide
Dizziness
• Vertigo
• Light headed
Vertigo
• Acute
– Vestibular neuronitis
– Benign positional vertigo
– CVA
– Ear infection
– Meniere’s
– Cervical spondylosis
Vertigo
• Chronic
– MS
– V111 nerve damage drugs
– Post CVA
– Cerebellar disorder
Lightheaded
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Muzziness
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Loss of balance
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Arrythmia
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Anxiety
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Depression
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Drugs
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Blood pressure
Examination
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BP sitting and standing
Cranial nerves
Coordination
Balance
Fundi
Cervical spine
CVS
HS Bruits pulse rat rhythm
Investigations
• Fbc, u&e, t4, lft’s
• Cervical spine xray
• ? Ecg
Anaemia
• Men < 12.5
• Women <11.5
History
• Frank bleeding
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Haematemesis
Malena
Haematuria
Haemoptysis
Menorrhagia
Epistaxsis
History
• Poor diet
• Malabsorption
• Haemoglobinopathy
• Haemopoetic disorder
Examination
• Chest
• CVS
• Glands
• Abdo ? Including PR/PV
Investigations
• Fbc/esr
• B12/folate
• Ferritin
• Lft’s
• U&e’s
• Others psa cxr
Referral
• Urgent colorectal appt
• Urgent OGD
• Haematology
Weight loss
• Causes
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Malignancy
Thyrotoxicosis
Depression
Malabsorption
Anorexia nervosa
Age
Low fat diet
History
• Dietary
• GIT vomiting, dysphagia, diarrhoea
• Palpitations sweating tremor
• Cough haemoptysis breathlessness
Examination
• Weigh
• Fbc esr lft’s t4 u&e ?b12 folate
• If appropriate cxr
Tired all the time
• Causes
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Life
Depression
Anaemia
hypothyroid
Recovery from major illness
Chronic fatigue syndrome
History
• Symptoms of anaemia
• Symptoms of hypothyroidism
• Check for depression
• Recent life events
• Recent illnesses
• What they think is causing it
Examination
• Only if indicated then approprairte
system
• CFS general examination
• Weight
Investigations
• Fbc esr
• T4
• Others as indicated
Management
• Review with results of blood tests
• If normal discuss lifestyle
• Check on depression anxiety
prolonged stress