Kindly supplied by Drs Tim Norfolk and Lily Shevlin, teaching fellows at South Tyneside NHSFT
Jade Simon (PAS 246810, DOB 15/2/86) is brought to A&E by her boyfriend as he is concerned that she’s drowsy and confused. He says she complained of a headache earlier. She is taken into resus.
Past Medical History: Asthma
Drug History: Salbutamol 100 micrograms. Two puffs PRN, COCP
A: Patent, self
B: RR28, Sats 95 on air, Chest clear on auscultation, Central trachea and symmetrical expansion
C: BP 110/64, Pulse 108, reg, Cool peripheries and CRT 5 secs centrally
D: GCS 12 (E3, V4, M5)
E: No rash. No evidence neck stiffness. Some photophobia.Temp 39.0
Abdo SNT. Calves SNT. No clinical DVT.
Estimated weight 60 Kg
Hb 128, WCC 14.4, Plts 376
Na 137, K 3.8, Urea 5.9, Creat 63
Appearance - clear
Opening pressure normal
Protein 0.6 (0.00 - 0.40)
Glucose 3.1 (2.2 - 4.4)
WCC 25 (less than 5)
In order to get some prescribing resources out there we intend to publish a series of prescribing problems on the website. The problems will appear at least weekly with the "answers" appearing a couple of days later. We'll use the standard exam stationery available on the LSE, but also available below in case you haven't got access to the LSE.