-
Risk stratification for cardiovascular risk
- Very high
- - established CVD
- - DM with proteinuria or with major risk factors (ex: smoking, hpt, dm)
- - CKD <30 (stage 4 and above)
- High
- - DM w/o target organ damage
- - CKD >30 - <60 (stage 3)
- - individual risk factor (LDL-C >4.9 mmol/l, BP >180/110mmHg)
- - FRS > 20%
- Intermediate (Moderate)
- - FRS 10-20%
-
Different type of headache
- 1. Tension headache - tight band around head
- - d/t stress
- - last days
- - tx: relaxation
- 2. Cluster headache - pattern
- - rhinorrhea + lacrimation + retroorbital headache
- - last hours
- - tx: oxygen, tryptan
- 3. Temporal artertitis - elderly
- - pulsating headache, palpable pulsating artery at temporal
- - worsen with combing hair, tender scalp
- - complication: blindness
- - tx: prednisolone
- 4. SOL - ex: SAH
- - worsen with valsava maneuvre
- 5. Migraine - classical & modified, unilateral, same place
- - + aura, n&v
- - tx: avoid triggering factor, pcm, rest, anti-emetics
- 6. Sinusitis - frontal sinus
- - tx: steaming inhalation to drain sinus
- 7. Meningitis
- - kernig & brudzinski, neck stiffness, photophobia
-
Treatment for obesity (pharmacological)
- GIT
- 1. Orlistat - inhibit lipase thus reduced absorption of fat, long term use
- - improve lipid, glucose & BP
- - SE: cramp, flatulence with discharge, fecal incontinence, increase bowel frequency
- - decrease vitamin A & E absorption - take multivitamin supplement
- CNS
- 1. Phentermine/Duromine
- - suppress appetite, short term use (< 3 months)
- - SE: euphoria, insomnia, dry mouth, constipation, palpitation, hpt
- Other drugs induce weight loss
- - metformin, glifozin, fluoxetine
-
Treatment for obesity (non-pharmacological)
- 1. Calorie counting - 20-25kcal/kg
- 2. Physical activity
- 3. Intermittent fasting - eat w/in 8hr window period
- 4. Low calorie diet - 1000-1200cal/day
- 5. Meal replacement - protein shake
-
How to diagnose metabolic syndrome?
- 1. Waist circumference
- 2. HDL
- 3. TG
- 4. BP
- 5. FPG
-
How to assess asthma control ?
- 1. Daytime sx
- 2. Night time sx
- 3. Frequency of using reliever therapy - >2/week
- 4. Limitation of activities
- 5. Frequency of exacerbation
- - admit hospital
- - pergi hospital for gas
-
5 A's for smoking cessation
- 4. Assist - BAND
- - Booklet
- - Action plan
- - Nicotine replacement - gum, patches, lozenges
- - Date for quitting
5. Arrange
-
What are the steps in Prochaska model/stage of changes model? PCPAM-R
- 1. Pre-contemplation
- 2. Comtemplation
- - think to quit w/in 6 months
- 3. Preparation
- - set stop smoking date
- 4. Action
- - quit smoking w/in 6 months
- 5. Maintenance
- - quit > 6 months
- 6. Relapse
|
|
