Family Medicine/General Practice MEQ 2006

Jun 29th, 2015
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. A 34yo female journalist presents to you, her GP complaining of generalised severe frontal headache for past 6mo. Her only past hx of significance is sprained R ankle 2 years ago for which she took codeine for 4mo. Her ankle recovered fully

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Family Medicine/General Practice MEQ 2006 QUESTION 11. A 34yo female journalist presents to you, her GP complaining of generalised severe frontal headache for past 6mo. Her only past hx of significance is sprained R ankle 2 years ago for which she took codeine for 4mo. Her ankle recovered fully.Today, apart from headache, she tells you her greatest fear is she feels she must have done "permanent damage to her nervous system" due to taking codeine tablets. She is very guilty about this and is not sleeping well in recent weeks.Your complete physical exam, including CNS entirely normal.a) name 5 key pieces of info you need to collect from patient's hx that might help in reaching clear definition of clinical problem here? (10 marks)1. symptom: radiation, quality, frequency, duration2. aggravating and relieving factors3. nausea and vomiting, photophobia, aura, pulsating4. diurnal variation, URTI, sinusitis or rhinitis hx5. cyclical, a/w rhinorrhoea, lacrimation and red eyesb) what 4 approaches to management might you consider in helping this patient to recover? (2 marks)1. Careful patient education2. Investigation TRO serious disorders e.g. neoplasia, pitfalls e.g. cervical spondylosis, and masquerades e.g. depression3. Counselling and relevant advice4. Medicationc) if you decide meds might help her, name 4 classes of drugs available to treat her. (2 marks)1. NSAIDs2. Opiates3. Ergots4. Anxiolyticsd) choose 1 med and name three SEs a/w it. (3 marks)Na

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