InnovAiT 2008 1(6):465; doi:10.1093/innovait/inn100
© The Author 2008. Published by Oxford University Press on behalf of the RCGP. All rights reserved. For permissions please e-mail: journals.permissions@oxfordjournals.org
AKT answer relating to Asthma
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AKT answer relating to Asthma
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Answer D. This man has a moderate exacerbation of his asthma
but his condition is not critical (i.e. his PFR is >50% of
predicted, his respiratory rate is <25 per minute, he can
speak in sentences and his pulse is <110 beats per minute.
He does, however, require careful review and ‘safety netting’
as well as steroids in full dose until recovery.
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AKT answer relating to Back Pain
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Answer C. Thoracic pain (especially with nocturnal pain) is
a red flag for serious disease. While lytic lesions would be
characteristic for myeloma on a skeletal survey, lack of bone
density can be a feature. While bone chemistry is important
in a patient with myeloma, it would be unusual for example Hypercalcamia
to present as bone pain in isolation. Equally, prostatic bone
metastases are characteristically sclerotic. Around 20% of cases
of myeloma will have non-diagnostic immunoglobulins but positive
urine free light chains (Bence-Jones protein).
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