Archives for August 2011

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Undiagnose, Unprescribe, Unharm – part I

This is hopefully the first post in a series of posts looking at the concept of “undiagnosing” patients.  This might sound a bit daft, but it is something that we all do on a frequent basis – sometimes on our own patients, sometimes on others.  Usually the original diagnosis is in error – not because […]

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Fits, faints, funny turns and fakers. Prolactin to the rescue….NOT

My colleague (Dr Dave) asked me today about the use of a serum prolactin level to diagnose a seizure in a patient presenting with “syncope ? convulsion”.  This is not something I have really done in the past so I thought I would look into it a bit.  Actually I am sitting on the labour […]

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Clinical Case 022: the answers

Thanks for all of your answers.  I have to say – you guys are a smart bunch.  Pretty much everyone got HHT / Osler-Rendu-Weber syndrome right off the bat! A few liked endocarditis – and it is reasonable I think.  THe clincher that I did not give you was the history of recurrent nose bleeds. […]

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Clinical Case 022: Feeling faint and fatigued

This case is a spot diagnosis.  50 yo woman presents to the GP complaining of feeling chronically tired, and recently “faint” – pre-syncopal on standing. Check out the 2 pictures below and let me know the diagnosis in the comments section below.  The prize for the best answer =  the love and respect of your […]

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Placebo paradox: Descartes dilemma

Your intern in ED has just seen a 25 yo. woman who has presented with 30 minute history of SOB, tachycardia and feeling like she is going to faint.  Her obs at triage are normal other than tachypnea @ 30/min.  To examine her chest is clear.  She is sating at 100% on 6 l/m HM. […]