E.N.T.

Wax:

ear blockage after water entery, pain, release of blockage after ear stretching

Rx: wax Aid (soda glycerine) 8drops TDS+ airtal 100mg BD

Otomycosis:

Itching, ear blockage, pain, History of seborrhic dermatitis, external ear crusting

Rx: Dermosporin Ear drop 3drops TDS+ pain killer

For recurrent otomycosis: cortisporin tube

Acute otitis Externa:

d/t wax or otomycosis

Patient complaints pain after pressing tragus, swelling & narrowing of meatus,

Rx: Tab. Cipro 500mg BD for 7days+ pain killer

Acute otitis Media:

Pain after rhinopharingitis, serous discharge

Rx: tab.augmentin 1g BD+ pain killer+ Xynocine Nasal spray 3 puffs TDS for not more than 5days

CSOM:

Purulent & smelly Discharge, hearing loss

Rx: tab. Cipro 500mg BD+ dexatop ear drops 4 TDS/keunoxy 0.4% 4drops BD+ antipyretics

ASOM: Acute history

Tab.Augmentin 1g BD

Medicine Key Points

                   Medicine Key Points

• All patients presenting with new-onset oedema should have a urinalysis.
• Hypothyroidism should be considered in the differential diagnosis of any patient pre- senting with fatigue.
• FEVER AND SHORTNESS OF BREATH= Consider PNEUMONIA.
• CHEST PAIN, SHORTNESS OF BREATH & PALE Consider ANEMIA, go with CBC.
• ADPKD patients may present with loin pain or haematuria.
• Rheumatoid arthritis tends to spare the distal interphalangeal joints. Anaemia and ESR correlate with disease activity. NSAIDs may adversely affect renal function.
• Irritable Bowel Syndrome= Abdominal Pain+Bloating+Periods of frequent defaecation alternate with periods of relative constipation+ Stress(Headache+Menstrual irregularties)
• Carcinoid Tumor: Diarrhea, Abdominal Cramps, Facial Flushing, someimes Asthmatic Wheeze.
• Hypertension:
• Pheochromocytoma: High BP with paroxysmal symptoms of sweating, palpitations and anxiety.
• Coarctation of Aorta: High BP with radiofemoral delay.
• Conn's Syndrome: High BP with low Serum potassium.
• Glomerulonephritis: High BP with Hematuria & Proteinuria.
• Renovascular Disease: High BP with moderately raised creatinine.
• Retrosternal Pain & relation of pain to lying flat and bending with Normal ECG suggestive of GERD.
•  if Calcium increases and phosphate decreses then think about PTH.

Migraine

Tab. Imigran 50mg TID

Migraine

Excessive Sweating

Tab. Arinac BD for 5 days

Excessive Sweating

Irritable Bowel Syndrome

Irritable Bowel Syndrome= Abdominal Pain+Bloating+Periods of frequent defaecation alternate with periods of relative constipation+ Stress(Headache+Menstrual irregularties)

Tab ITP 1 bd

Cap Risek 20mg 1 before breakfast

Mevulake sache 1 hs mixed with water or milk

If depression element,

Tab fluoxetine 1 od

Diarrhea

Diarrhea:  BLOODY????

• Cap. Imodium 2mg BD/Entox-P
• Smecta Sachet 3g TDS/Mavolake
• Tab. Flagyl 400mg TDS in bloody diarrhea
• Tab.Cipro 500mg BD
• Tab. Nospa Forte BD
• Use ORS
• IV Fluids in case of severe dehydration or low urine output.

Hemoptysis

Hemoptysis

• Bed rest
• Tab. Lexilium/Relaxin 3mg/Citanew OD
• Cap. Transamin 500mg TID

Adv:

CBC, CXR,Sputum for AFP, HRCT