GP Notes

Patient presents with pain in the hand Side: Pins and needles shooting down from the wrist joint into the hand Reduced strength Worse after manual labour Examination: Hand examination: Loss of muscle mass over the thenar eminance Tinels test positive Phalens test positive Diagnosis: Carpal Tunnel Syndrome Management: Disucssed treatment options 1. Steroid injection into the wrist joint for temporary relief 2. Referral to orthopaedic surgeon for Carpal Tunnel release Keywords:  +CTS

Discussed the procedure with the patient Advised how the lesion would be removed Advised of the following potential complications: - Infection - Wound dehiscence - Post operative pain - Insufficient removal of the lesion requiring further excision Patient was given the opportunity to ask any questions They have provided verbal consent to proceed Keywords:  +skinsconsent

Patient presents with a productive cough Generalised Malaise Sputum green in colour Occasional fevers Examination: Respiratory exam: Good Air entry bilaterally No Resp distress CREPITATIONS HEARD Reason for visit: Chest infection Management: Oral Antibioitics as prescribed Patient advised to: - Rest - Regular paracetamol +/- Ibuprofen - Drink plenty of fluids They have been advised to return here or present to ED should their symptoms worsen or if they have any concerns Keywords:  +chestinfection, Penumonia

Patient presents with bruising for the last Does not recall any trauma to account for the bruises Has not had any significant bruising in the past Denies abdominal pain, haemoptytis, PR bleeding, malaena or nose bleeds Feels otherwise well No chest pain, abdominal pain or SOB No fatigue No personal or family history of blood clotting disorders, haemophilia, thalassaemia Examination: The patient appears well.  There is clinically no evidence of anaemia Vitals as noted Bruises noted in the following areas: Respiratory exam : good air entry bilaterally No respiratory distress No crepitations or wheeze Abdominal exam: soft No tenderness, guarding or rebound No hepatomegaly or splenomegaly Brief examination of the Cardiovascular system was normal: - Heart sound were dual with no obvious murmurs - JVP was not elevated - No peripheral oedema - No fine creps throughout the lung fields Throat exam was normal: - Pharynx showed no redness or pus - Tonsils norm

Patient presents with a non-productive cough Duration: Describes a recent upper respiratory tract infection which has now settled Not feeling unwell No fevers Normal energy Cough is worse at night Examination: Patient looks well Respiratory exam : good air entry bilaterally No respiratory distress No crepitations or wheeze Ear nose and throat exam: Both ears normal with no redness on ear drum No rhinorrhoea Normal throat exam with no enlarged tonsils or pus Pharynx normal Reason for visit: Cough, post infective Management: Reassured this cough is unlikely pathological The cough should settle in the next few weeks No need for antibiotics If change in symptoms or concerns return here for review Keywords:  Post Viral cough,  Post infective cough, chronic cough, +postviralcough

Patient presents with a painless lump Site: Describes as slow growing Examination: Lump:  Soft subcutaneous lump Approx diameter: Impression:  Lipoma Management: Advised patient this is a benign lump An USS has been requested to confirm diagnosis Lumps can be removed if there is a cosmetic requirement or they become big enough to be symptomatic Keywords: Lipoma, +lipoma