Module 3: Common problems in FM: Chronic disorders in FM

Name: Dr / NAYEF KASSAM ABAZYED sector: SARAT ABIDAH phcc: AL- FARAHA group: 6

CASE No 1
Q 1 A person experiencing severe hypoglycemia when: A (C ) Q 2 Which of following is not cause of hypoglycemia: A (D) Q 3 CGM may be helpful in identifying all of following except: A (B) Q 4 If an insulin pump user experiences an unanticipated glucose level > 13.9mmol|l, it is recommended he \ she takes correction bolus via the pump and check for ketones .What is the next recommended step , if ketones are not present? A - (E)

Module 3: Common problems in FM: Chronic disorders in FM

Name: Dr / NAYEF KASSAM ABAZYED sector: SARAT ABIDAH phcc: AL- FARAHA group: 6

Case 2
Q 5 - What features may help to distinguish between asthma and COPD in this patient? compare COPD and BA
Symptoms<35y Smoking history Breathlessness COPD Rare Nearly all Persistent and progressive. Poor response to inhaled therapy- if good response reconsider the diagnosis. Common Common BA Common May be Variable amount throughout day and from day to day. Good response to inhaled therapy. Uncommon Uncommon

Chronic productive cough Waking at night with cough and

Module 3: Common problems in FM: Chronic disorders in FM

Name: Dr / NAYEF KASSAM ABAZYED sector: SARAT ABIDAH phcc: AL- FARAHA group: 6
wheeze history of smoking (18 years) , persistent cough , and shortness of breath all are in favour of COPD. Her non productive cough leads little hint towards ( BRONCHIAL ASTHMA). Q 6 - Based on the information you have now; A (B) Q 7 - How do you currently diagnose COPD in your practice ? A. Consider diagnosis in any patient > 35 with risk factor for COPD (generally smoking) equal or more ONE of following: - shortness of breath on exertion - sputum production . -frequent winter bronchitis. -wheeze. If diagnosis is suspected also asked about decrease in weight ,effort intolerance, waking at night, ankle swelling and occupational hazards.

Module 3: Common problems in FM: Chronic disorders in FM

Name: Dr / NAYEF KASSAM ABAZYED sector: SARAT ABIDAH phcc: AL- FARAHA group: 6
A diagnosis of airflow obstruction can be made if: -FEV1/FVC<70% and -FEV1<70% predicted and -<15% response to a reversibility test. Q 8 - In your practice what strategies do you effective to achieve compliance in patient who have no interest in taking their asthma medication? A In such patient we can adopt following procedures. -by improving health education about symptoms and danger signs of asthma in case of not taking of drugs and benefits of taking drugs of Asthmas -by open-ended question session -patient centered discussion -by prescribing simple regime of drugs -by supplying printed literature about asthma. -by regular follow up