Saturday, 3 June 2017

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

Skin Ointments

Betagenic Cream
For Dermatitis and allergic rash

Healit cream
Superficial skin bruises

Cutis Lotion
Fungal Infection

Lotrix/Scabion/Scabrid Lotion
Scabies

Melas-H
Antibaterial oitment

Quench cream
Burn

Urology

Urology:

  • Solfy (soliflnacin) 10mg OD
Urinary Frequency/Incontinence
Contraindication: urinary/gastric retention

  • Maxflow (Tamsolusin) 0.4mg HS (2 weeks)
BPH, Urinary obstruction d/t calculus
Only for obruction at 2/3 of ureter or below

  • Antibiotic of choice
Cipro 500mg BD
RFT's derranged than Cefixime

  • Furadantin 100mg BD
UTI prophylaxis


  • Citro-Soda Sachet for acidic urine
  • Crane care Sachet for alkaline urine

Paediatrics

Colic Drops 
Antispasmodic

ZincIT in diarrhea

Gutcare sachet
Diarrhea

Myteka 4mg sachet below 6yr
Myteka 5mg chewable tablet 6-14yr

Cefotaxime+Amikacin
GIT/UTI

Constipation in child below 5yr


Lexoberan syrup 1TS TDS