Pek Har's Reflux
Pek Har, 50, presented with chest pain (burning sensation)
Past 2-3 months, usually after big meals, lying down, and being anxious.
Duration of pain: couple of hours.
Medication to alleviate: Quik-eze and Gaviscon
Similar episode 30 years ago while pregnant
Medications: CCBs and NSAIDs
Smoking: 20/d Alcohol: 1-2 glasses of wine every night
BP: 135/80 Pulse rate: 80 BMI: 32
DDx:
GERD
Dyspepsia
Fun fact:
20% of adults experience heartburn once a week
Learning issues for GERD
Definition, Stats, Differences between GERD and Dyspepsia. (What is reflux? Stats.) - Huey Ting
Pathophysiology - Jun Beng
Causes and Risk Factors - Shakir
S&S (Typical, Atypical, Alert), What is PEG feed? (www.gesa.org.au/consumer/publications/peg/PEG.pdf) - Pik Yin
Examination and Investigation - When and how investigate. Advantages and disadvantages of endoscopy. Is the finding of hiatal hernia significant? Alternatives for endoscopy for GERD. Should you look for H. pylori? Is H. pylori the culprit? - Fuad, Ewe Jin
Treatment and Management - Management of GERD (lifestyle, medical, firstline, CAM, surgical) - Alexandra Kang, Kaarthikeshen
Complications, Prognosis (Barrett's oesophagus, dysphagia and causes for dysphagia) - Mona
Articles + oesophageal cancer, types of oesophageal cancer including risks - Prisheila, Lai Kee Hao
Thursday, August 12, 2010
Thursday, August 5, 2010
A Lot Of Fuss
DD
1.Crohns Disease
2. Irritable Bowel Syndrome-ulcerative colitis,
3.Celiac Disease
4.Gastric Cancer
5.Malabsorption
6.
Symptoms
abdoinal; pain, flatuence. anemia, bloating, fatigue
Learning Issues for Coeliac Disease
1.Crohns Disease
2. Irritable Bowel Syndrome-ulcerative colitis,
3.Celiac Disease
4.Gastric Cancer
5.Malabsorption
6.
Symptoms
abdoinal; pain, flatuence. anemia, bloating, fatigue
Learning Issues for Coeliac Disease
- Definition, Incidence and Prevalence, DD-why are ppl with celiac disease misdiagnosed with IBS -Pik Yin
- Causes(diet-gluten &gluten free diet,other causes of anemia, risk factors,prevention-Kee hao
- Signs and symptoms (nutritional deficiency among ppl with coeliac disease)-u jin
- Histology(funct of villi and microvilli), pathophysiology- jb, prisheila
- complication and prognosis,reason for bone deficiency test-mona
- investigations-blood test,antibody test.-alex
- treatments and management-other treatments besides gluten free diet-shakir
- phychososcial-impact of gluten free diet on personal lifestyle, challenges if a child is diagnosed with celiac disease,naturopath and dieticianm, role of dietician in management of celiac disease-huey ting, fuad
- health promotion-hw to increase the rates of diagnosis in the community, list of gluten free diets available in the market-kaarthik
Wednesday, August 4, 2010
Anatomy Practical
Q 1 and 2 - Prish, Jun Beng, Mona
Q 3 and 4 and 5 - Fuad, Alex , Pik yin
Q 6 and 7 and 8 - Ewe Jin, Kh, HT
Whoever not coming for practical speak now or forever hold your Peace!!
Q 3 and 4 and 5 - Fuad, Alex , Pik yin
Q 6 and 7 and 8 - Ewe Jin, Kh, HT
Whoever not coming for practical speak now or forever hold your Peace!!
Thursday, July 29, 2010
male, mid aged teacher,
passing small bowl motions, with fresh bloody crap
receding hair line and over weight
father had cancer at 60
little bro had it too
constipation
large solid mass upon rectal exam
occasional drinker
had colonoscopy 10 yrs ago
going for CAT scan and colonosocypy
wat wud u like to know????? biopsy, blood tests,
DD:
-colon cancer
-rectal cancer
-colorectal cancer
-internal hemorrhoids
-inflammation of rectum
-tchulangaishlonghe
-def. (incidence, prevalence),differential diagnosis, minor ---kee hai---
-pathophysio, pathology ---mona---
-risk factors, causes, signs and symptoms (how does the bleeding occur?) ---fuad---
-investigations,cancer markers ---shakir, prish---
-treatment, other treatment, and management, follow up, palliative care, what aspects of care might a palliative care team deal with? ---ujin, waiting---
-prevention, advice of dr to pts to reduce risks ---jun beng---
-complications, prognosis (staging of cancer, dukes criteria, TNM) ---alex--
-What factors influence outcome of surgery ---piggy---
-psychosocial, implications on family, can they influence incidence of cancer? religion? is it protective or causative? what sorta pain will he feel in the end of his life? ---tick---
passing small bowl motions, with fresh bloody crap
receding hair line and over weight
father had cancer at 60
little bro had it too
constipation
large solid mass upon rectal exam
occasional drinker
had colonoscopy 10 yrs ago
going for CAT scan and colonosocypy
wat wud u like to know????? biopsy, blood tests,
DD:
-colon cancer
-rectal cancer
-colorectal cancer
-internal hemorrhoids
-inflammation of rectum
-tchulangaishlonghe
-def. (incidence, prevalence),differential diagnosis, minor ---kee hai---
-pathophysio, pathology ---mona---
-risk factors, causes, signs and symptoms (how does the bleeding occur?) ---fuad---
-investigations,cancer markers ---shakir, prish---
-treatment, other treatment, and management, follow up, palliative care, what aspects of care might a palliative care team deal with? ---ujin, waiting---
-prevention, advice of dr to pts to reduce risks ---jun beng---
-complications, prognosis (staging of cancer, dukes criteria, TNM) ---alex--
-What factors influence outcome of surgery ---piggy---
-psychosocial, implications on family, can they influence incidence of cancer? religion? is it protective or causative? what sorta pain will he feel in the end of his life? ---tick---
Thursday, July 22, 2010
DD
Gastritis
Dyspepsia
Gastric ulcer
Duodenal ulcer
cron's disease
Acute cholecystitis
Lactose intolerance
Cholangitis
Choledocholithiasis - gallstone in the CVD' accumilates near papillae
Cholecystitis - stone in cystic duct from gallbladder
Learning issues
1. Definition, prevalence, incidence, Anatomy (biliary tree, site of obstruction)- (JB)
2. pathophysiology (cholesterol and bile pigment gallstone eg calcium binerubinate) ( Shakir)
3. Signs and symptoms - which disease causes which symptoms (all three!!) (Pik Yin)
4. causes and risk factors (Mona)
5. examination and investigations (blood test, liver function test, imaging techniques) and types of gallstones (Prish and HT)
6. treatment- pain relief, antibiotics, hydration and surgery. cholecystectomy (lapro and open)- ERCP, Spinchterotomy and stone collection, choledocholithomy
, bile duct clearance (Alex, kaarthik and KH)
7. complications (gallstone induced pancreatitis, surgical problems regarding choledocholithomy and mortality and morbidity) and prognosis (Fuad And EJ)
Gastritis
Dyspepsia
Gastric ulcer
Duodenal ulcer
cron's disease
Acute cholecystitis
Lactose intolerance
Cholangitis
Choledocholithiasis - gallstone in the CVD' accumilates near papillae
Cholecystitis - stone in cystic duct from gallbladder
Learning issues
1. Definition, prevalence, incidence, Anatomy (biliary tree, site of obstruction)- (JB)
2. pathophysiology (cholesterol and bile pigment gallstone eg calcium binerubinate) ( Shakir)
3. Signs and symptoms - which disease causes which symptoms (all three!!) (Pik Yin)
4. causes and risk factors (Mona)
5. examination and investigations (blood test, liver function test, imaging techniques) and types of gallstones (Prish and HT)
6. treatment- pain relief, antibiotics, hydration and surgery. cholecystectomy (lapro and open)- ERCP, Spinchterotomy and stone collection, choledocholithomy
, bile duct clearance (Alex, kaarthik and KH)
7. complications (gallstone induced pancreatitis, surgical problems regarding choledocholithomy and mortality and morbidity) and prognosis (Fuad And EJ)
Sunday, July 18, 2010
Learning Issues
1. Read the 2003 clinical practice guidelines www.acadmed.org.my/cpg/CPG-Obesity.pdf
www.nhmrc.gov.au/publications/pdf/n33.pdf (Ewe jin, Kaarthik)
2. visit www.ifnotdieting.com, read the 3 articles printed under Australian Family Physicians under Tips for long term weight management (Fuad)
3. using the internet or other sources, find out what each of the diet involves and what are the proposed mechanisms by which it is aimed to produce weight loss.
what is the scientific support for the diets being effective and what are the possible risks and disadvantages in following these diets (Atkins-Prisheila, Ornish and Pritikin-Mona, Sears-Kee Hao, The Zone-Huey Ting and The South Beach Diet-Alex, weight watchers-Pik Yin)
4. Search the internet beginning with the key words "unilever + atkins diet" to find example to explore the questions as to what potential impact a popular diet such as the Atkins diet mught have on:-
(a) the low fat diet industry
(b) the food industry in general. (Shakir)
The Atkins diet is apparently inconsistent with main stream healthy diet recommendations. What impact do these have on mainstream public health nutrition campaigns and how should these issues be addressed. (Jun Beng)
1. Read the 2003 clinical practice guidelines www.acadmed.org.my/cpg/CPG-Obesity.pdf
www.nhmrc.gov.au/publications/pdf/n33.pdf (Ewe jin, Kaarthik)
2. visit www.ifnotdieting.com, read the 3 articles printed under Australian Family Physicians under Tips for long term weight management (Fuad)
3. using the internet or other sources, find out what each of the diet involves and what are the proposed mechanisms by which it is aimed to produce weight loss.
what is the scientific support for the diets being effective and what are the possible risks and disadvantages in following these diets (Atkins-Prisheila, Ornish and Pritikin-Mona, Sears-Kee Hao, The Zone-Huey Ting and The South Beach Diet-Alex, weight watchers-Pik Yin)
4. Search the internet beginning with the key words "unilever + atkins diet" to find example to explore the questions as to what potential impact a popular diet such as the Atkins diet mught have on:-
(a) the low fat diet industry
(b) the food industry in general. (Shakir)
The Atkins diet is apparently inconsistent with main stream healthy diet recommendations. What impact do these have on mainstream public health nutrition campaigns and how should these issues be addressed. (Jun Beng)
Thursday, May 27, 2010
Week 13...tonight's gonna be a good night!!!
1. Definition, incidence, prevalence, what is thrombo-embolism and DVT?( Kaarthik) screw you Fuad!!!
2. Causes, risk factors (DVT)(Shakir)
3. Pathophysiology, Virchow's triad (Jun Beng, Kee Hao)
4. What underlying medical conditions can cause thrombosis and how they are managed? (Fuad)
5. Sign,symptoms, summary of clinical findings and why it occurs?( HT)
6. Investigations. What investigations are required and what they show? ( EJ, Mona)
7. Treatment and management of Anne's DVT. ( Pikky)
8. Complication and prognosis of DVT considering Anne's situation? Would there be any restrictions to Anne's lifestyle after diagnosis of DVT.? What is her prognosis and what are the possible complications and prevention of DVT? ( 1 page)( Alex, Prish)
2. Causes, risk factors (DVT)(Shakir)
3. Pathophysiology, Virchow's triad (Jun Beng, Kee Hao)
4. What underlying medical conditions can cause thrombosis and how they are managed? (Fuad)
5. Sign,symptoms, summary of clinical findings and why it occurs?( HT)
6. Investigations. What investigations are required and what they show? ( EJ, Mona)
7. Treatment and management of Anne's DVT. ( Pikky)
8. Complication and prognosis of DVT considering Anne's situation? Would there be any restrictions to Anne's lifestyle after diagnosis of DVT.? What is her prognosis and what are the possible complications and prevention of DVT? ( 1 page)( Alex, Prish)
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