GP Notes

Patient presents with a painless cyst in the eyelid Location: Duration: Describes a irritation in the eyelid with no changes to visual acuity On examination: Lump consistant with a chalazion Treatment: Advised the patient of the diagnosis and reassured them this is not serious Discussed the following options: 1. Leave alone and allow to resolve on its own over a few months 2.Steaming the eyelid with  hot water (left for about 5 to 10 minutes after boiling) in a thermos onto the closed eye for 10 to 15 minutes combined with massage. 3. Soak a hand towel or similar cloth in hot water and press it firmly but gently against the closed eye for several minutes. 4. Surgical referral to opthalmologist for excision Advised to return if the lump becomes infected Patient has elected to trial conservative measures and return if these fail keywords:  chalazion, meibomian cyst , tarsal cyst

Abdominal exam: Soft No tenderness No rebound guarding No masses Keywords:  GIT exam, GITN

Throat exam: Normal pharynx and tonsils with no signs of inflammation or pus Keywords: throatn, throat examination

Respiratory exam: No respiratory distress Normal air entry both sides No crepitations No wheeze Keywords:  Respiratory examination, respiratory exam, RSN, Chest examination, chest exam

Ear Nose and Throat exam: Ears:  Normal TM both sides Nose: No discharge Throat: Normal pharynx and tonsils with no signs of inflammation or pus Keywords:  ENT examination, ENT exam, ENTN

Neurological Examination of the Upper Limbs was normal: Left side: Tone - Normal Power - 5/5 for all movements. Normal grip power Sensation - Gross sensory examination of the upper limb dermatomes was normal Reflexes - Bicep tendon reflex normal; Wrist reflex normal; Proprioception - Not examined Right side: Tone - Normal Power - 5/5 for all movements. Normal grip power Sensation - Gross sensory examination of the upper limb dermatomes was normal Reflexes - Bicep tendon reflex normal; Wrist reflex normal; Proprioception - Not examined Keywords:  Upper Limb Neuro exam, +ULNNAD

Counselled to take daily, check BP and weight at 1/52 and 4/52. At 3/12 must have lost 5% body to weight to continue. Take for shortest time as needed. If 5% loss to continue losing 5% per weeks. To be taken in conjunction with seeing an exercise physiologist and dietician. Not to be taken during pregnancy or lactation. Counselled that Duromine can cause lightheadedness and not to drive if symptomatic while on duromine.