GP Notes

Complains of white lesions on the tongue some mild pain while swallowing Dry mouth and bad breath Examination: White lesions on the tongue Reason for contact: Oral Thrush Management: 1. Anti-fungal lozenges prescribed Prevention advised: 1. Rinse Mouth 2. Brush teeth regularly 3. Regular Dental visits

Preventative Health Screen Height: Weight: BMI: BP PSA Testing: Recently completed and no issues Exericse: Exercises regularly Diet: Eating a good balanced diet Bowel Cancer Screening: completed and nil abnormalities Mood: Happy and no concerns about mood Bloods: Completed in the last 2 years and no issues Smoking: Non smoker Alcohol: Social drinker with no concerns regarding alcohol consumption Actions

Preventative Health Screen Height: Weight: BMI: BP Pap Smears: UTD Exericse: Exercises regularly Diet: Eating a good balanced diet Bowel Cancer Screening: completed and nil abnormalities Mood: Happy and no concerns about mood Mammograms: UTD and no issues Bloods: Completed in the last 2 years and no issues Smoking: Non smoker Alcohol: Social drinker with no concerns regarding alcohol consumption Actions:

Patient advises they have recently given up alcohol Heavy Drinker Usual daily consumption: Experiencing the following symptoms: - headaches - nausea - tremors - anxiety - hallucinations  - seizures. - Insomnia On Examination Appears agitated / in a withdrawal State Vital signs noted  Impression: Alcohol Withdrawal Management: 1. Valium 5mg qid 2. Maxolon 10mg tds prn 3. Thiamine 4. Given details to contact nearest detox centre for phone assessment and admission as soon as possible 5. Continue to try to maintain abstinence 6. Mental Health Plan prepared and referral psychologist arranged Present to ED or call ambulance if any seizures

A prescription for Temazepam has been provided to be used as a short term treatment for insomnia. The patient was advised of the risk associated with this treatment: 1. Possible dependence 2. Tolerance ie.  Continued use may cause the drug to lose its effectiveness 3. Morning sedation Encouraged to only use for a short term and try not to use more than 2 nights in a row I have also suggested other methods to assist with insomnia : - Guided meditation with apps / youtube - Don't drink coffee after 3pm - Reduce blue light exposure before bed or use apps to remove blue light on iphone/ipad - Increase physical output during the day but not immediately before bed Advised patient I would not prescribe this medication on an ongoing basis

Patient presents with lower back pain Associated burning pain going down the back of leg Side: Denies numbness of the leg Denies any weakness No trouble toileting and no numbness around the perianal region On Examination: Palpation of the lower back in the midline does not elicit any tenderness Straight Leg Raise: Pain on lifting the affected leg Unaffected leg did not cause any pain Slump Test - Positive Brief neurological examination of the lower limbs: - Normal power both sides - Normal gross sensation - Normal knee and ankle reflex Imp:   Sciatica ? Lumbar Disc prolapse Management: Explained the diagnosis to the patient and that usually improves in 6-12 weeks Discussed possible investigations: - Xray not advised - MRI-  Will usually determine the cause of pain but private fee involved Suggested seeing a physio for further assessment and exercise program Exercise and stretching particularly swimming Weight control Return immediately here or t