electives day 1

flow of events-

1. 6AM wake up
2. 8AM went to Dr's office
3. had lunch at 130
4. started again at 2
5. ended at 6

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points of notice

• a good way to improve medication compliance is to make patients bring their medication with them, package included to ascertain what they are actually taking.
• Physical examination was very through, stomache -> femoral pulse -> pedal edema -> auscultation
• documentation of PSVT - essential to take normal ECG to document that there is normal rhythm
• review drugs all the time. follow up on patients about smoking cessation and etc.

good practice

• medication bring-in
• BP diary taking at home - to prevent white coat hypertension
• minimal use of drug - always review the use of drug and doubt the need for medication
• advocate smoking cessation

problem faced

• drug compliance
• patient's financial concerns

signs/symptoms observed

• Thyrotoxicosis - warm extremities, fast pulse, neck enlargement, weight loss
• DVT - femoral pulse not felt - lower extremities no pulse
• PSVT - intermittant tachyarrythmia
• SSS - bradycardia, even with stress test.