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What are the typical clinical features of peptic ulcer disease?
- Epigastric pain (often described as 'burning' and may radiate to the back)
- Epigastric tenderness (gives rise to 'pointing sign' (patient able to point to the precise site of pain using finger)
- Nausea ± vomiting
- Improvement of symptoms with use of antacids
- Changes to weight
- Signs of gastrointestinal bleeding
Tip: Gastric ulcers typically cause increased pain shortly after eating, whereas duodenal ulcers are associated with pain relief after eating.
Link: Peptic ulcer disease
What initial investigations are recommended in suspected melanoma?
- Dermatoscopy: aids differentiation between early stages of melanoma from benign melanocytic lesions; allows clinicians to determine the need for biopsy
- Biopsy: full-thickness excision of the entire lesion if melanoma is suspected, will show abnormal melanocytic proliferation if melanoma
Describe the management of blepharitis
- Warm compression of the eyelids with cotton wool dipped in hot water to loosen debris
- Eyelid massage to empty glands of debris
- Cleaning eyelids with cotton wool to remove debris
- Consider antibiotics (e.g. chloramphenicol) if symptoms do not improve despite lid hygiene
Link: Eyelid disorders
Describe the prognosis of motor neurone disease
- Usually a rapidly progressive and fatal disease (median survival is two to four years)
- Respiratory failure is the most common cause of morbidity and mortality
- 5-10% of patients survive for a decade or more
Link: Motor neurone disease