14 Scenarios contain the text: 'upper resp' |
| Title | Description |
|---|---|
| Infant or child with easy bruising | A 3 year old NZ European boy is taken to the GP by his mother because he has a number of bruises on his legs. Recently when he slipped off a step, he developed a large bruise over his buttock. He is otherwise well but had an upper respiratory tract infection 2 weeks earlier. D/O: Haematology (•••), Paediatrics (•••) PTT: Blood and lymph |
| Upper respiratory tract symptoms | A 4 year old NZ European girl is brought to your practice by her mother because she has had a 'runny nose' for two days and is now complaining of a sore throat. She has presented to the practice with similar problems twice in the last 6 months. On both previous occasions another doctor has prescribed antibiotic treatment (amoxycillin/clavulanate on one occasion and cefaclor on another). Her mother is concerned that there may be something wrong with her immune system. The child is up to date with all her immunisations. D/O: General Practice (•••), Infectious Diseases (•••), Otorhinolaryngology (•••), Paediatrics (•••), Respiratory Medicine (•••), Respiratory System (•••), Microbiology (••) PTT: Child health, Infectious disease, Respiratory |
| Chronic sputum production | A 25 year old NZ European woman, who has recently moved into the area, presents to your GP clinic with an increase of her cough and sputum production and recurrent small haemoptyses (about a teaspoon in volume). She has a history of cough and purulent sputum production since early childhood. D/O: Respiratory Medicine (•••), Respiratory System (•••), Immunology (••), Infectious Diseases (••), Medical Genetics (••), Microbiology (••) PTT: Respiratory |
| Epistaxis | An 86 year old NZ European woman calls an ambulance when she develops a nose bleed that 'just won’t stop'. Her daughter, who lives with her, has tried pinching the end of her nose but that has not helped. You are asked to obtain some more information from the daughter. She tells you that her mother has been complaining of a blocked nose for the past few months and has had intermittent small nose bleeds. D/O: Emergency Medicine (•••), Otorhinolaryngology (•••) PTT: ENT |
| Neonatal stridor | A 3 week old Cook Island Māori infant is seen by her GP. The Plunket nurse is concerned about stridor, which has been present almost all the time since birth. D/O: Otorhinolaryngology (•••), Paediatrics (•••), Respiratory System (•••), General Practice (•) PTT: Child health |
| Pneumonia | You visit an 80 year old NZ European woman with the GP you are shadowing. She has a fever and is coughing up purulent sputum. She is in a private hospital because of advanced dementia and has been a resident for the past 3 years. A mobile chest X-ray taken in the private hospital shows 'confluent shadowing in the left lower lobe and a left-sided pleural effusion'. The GP sends her to the local Emergency Department and contacts her family. The patient has an advance directive stating that if she becomes very unwell she should not be 'kept going by machines', although her family is not comfortable with letting her die at present. D/O: Geriatric Medicine (•••), Infectious Diseases (•••), Microbiology (•••), Respiratory Medicine (•••) PTT: Infectious disease, Respiratory |
| Upper airway disease | A 65 year old Chinese man is seen by a GP on a house call. His breathing has become more difficult over time. Now he is making a harsh noise when he breathes in. D/O: Emergency Medicine (•••), Otorhinolaryngology (•••), General Practice (••), Ethics (•) PTT: Seriously ill patient |
| Child with respiratory distress | A 2 year old Māori boy presents to the Emergency Department with a 2 day history of coughing. He has a low grade fever, rapid breathing and audible wheeze. He is with two female caregivers. This is his fifth attack of cough and wheeze. D/O: Paediatrics (•••), Respiratory System (•••), Emergency Medicine (••) PTT: Child health |
| Chronic illness in paediatrics | A 12 year old Samoan girl presents to Emergency Department with her mother after a fall from her wheelchair during a seizure. They have a recent outpatient clinic letter which outlines her past medical history to include spastic quadriplegic cerebral palsy from birth; she is wheelchair-bound and fully dependent for all self-cares. She has epilepsy and global developmental delay and is nonverbal. She has had a gastrostomy for night feeding since 4 years of age and has orthopaedic problems including scoliosis and tendoachilles contractures. She has bronchiectasis with two previous episodes of severe pneumonia, the last of which 6 months ago required a prolonged admission and she now remains on nocturnal VPAP (variable positive airway pressure). She attends the local intermediate school via satellite class and has multiple community services involved in her schooling, transport and therapy. D/O: Paediatrics (•••), Nervous System (••), Neurology (••), Orthopaedics (••), Respiratory Medicine (••), Musculoskeletal System (•), Respiratory System (•) PTT: Child health |
| Febrile infant | A 6 month old Chinese/Samoan baby girl is brought in as she has a fever of 39°C. She has been unwell for 2 days, has a rapid pulse and has not had a wet nappy for 24 hours. D/O: Emergency Medicine (•••), General Practice (•••), Infectious Diseases (•••), Paediatrics (•••) PTT: Child health |
| Fever and headache | A 17 year old NZ European man presents with a severe headache and a fever. He was well yesterday and played football after school. On examination he is sleepy, febrile, tachycardic and has neck stiffness. D/O: Infectious Diseases (•••), Microbiology (•••), Intensive Care Medicine (••), Paediatrics (••), Nervous System (•), Neurology (•) PTT: Infectious disease, Seriously ill patient |
| Sore throat management in the New Zealand context | A Māori mother brings her 9 year old son to the drop-in sore throat clinic in Dargaville after he complained of a sore throat for a few days. His sore throat is improving and on clinical examination he does not have any coryzal symptoms or fever currently. His mother says that her older son had treatment for “strep throat” a few weeks ago and is allergic to penicillin. D/O: Infectious Diseases (•••), Microbiology (•••), General Practice (••), Immunology (••), Paediatrics (••) PTT: Blood and lymph, Child health, Infectious disease |
| Altered level of consciousness in a child | A 3 year old Samoan girl is brought by ambulance to Emergency Department. She is breathing by herself, groaning and only responding to pain. Her mother says she has had a 'fit' at home. D/O: Emergency Medicine (•••), Nervous System (•••), Neurology (•••), Paediatrics (•••) PTT: Neurological |
| Child with abnormal gait | A Somali woman brings her 2 year old son to the GP, because her husband is concerned about the way he is walking. His mother wears a veil for religious reasons. D/O: Musculoskeletal System (•••), Orthopaedics (•••), Paediatrics (•••), General Practice (••) PTT: Musculoskeletal |
| Title | Description |
