Dear Claire, Thank you for referring your friend to his GP, which I assume you have done out of concern for his welfare, and not only because you are hoping for divine intervention in terms of organizing your study. He presented today with a 4 day history of acute severe sinus headache, congestion, and intermittent low grade fever on a history of allergic rhinitis, unrelieved by beconose or oral anthistamines, so I have prescribed antibiotics for presumed sinusitis, and suggest you revise antibiotics, allergy, and all of immunology, because you would feel pretty silly if you didnt. In addition, he has a 24 hour history of severe neuropathic pain and mild erythema that would appear to herald the imminent re-occurance of shingles. (Is herpes zoster or virology/viral latency likely to feature in your exams? If it is, you should study that, and maybe something about painkillers, yeah?) While there are no red flags symptoms and Im pretty much persuaded that the patient has shingles (or is about to), in the absence of characteristic zoster lesions, and in combination with the headache, I have also referred the patient for an xray of the spine to rule out more sinister causes as I have had a run of patients with neuropathic back pain 2ndry to malignancy, and am feeling cautious. (Are you feeling cautious? Do you need to know anything about xrays or malignancy for your exam? Oh, wait...didnt you have an osce on lumbar pain and sciatica? Do you have a friend with lymphoma? Several friends, huh? Yeah, well, now you have two reasons to study that, then). Once again, thank you for your concern about your friend/exams. I am confident that commencing the prescribed regime of magical thinking should lead to a significant improvement in your study timetable; note that we may need to commence at a high dose of superstitious magical thinking, and wean down over the next 3-7 days (like steroids, which are probably examinable). If symptoms persist, find out if anxiety disorders/ benzos are examinable. If they arent, symptoms wont. Love and kisses, Your GP. PS. Your kids father has not combed their hair today, and you will have to do it on Monday night, as headlice is going around. By extension headlice is examinable. Also, you are being mental, but not in a bad way. (note, true story: what are the chances of my having friends who are suddenly, unfortunately unwell with examinable content?).
Posted on: Sun, 27 Oct 2013 12:24:38 +0000
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