A | 1 | 0 | … this is clearly a urinary tract infection. I will write a prescription for co-trimoxazole … and that she brings some urine to check if it is clean (case 1) |
| | | |
B | 1 | 1 | … the relief is doing so much already that I wonder whether you should give something, so I would give something simple like Antagel (case 4) |
| | | |
C | 1 | 2 or more | … I think that I will give her those tablets, two reasons, I don't think she has anything serious … I don't think I can do wrong with it. I also think I can help her by giving them. And then I have a satisfied person because she wants those tablets, but that is not the most important reason. She goes on holiday next week, so I think I give her Zantac for 2 weeks (case 3) |
| | | |
D | 2 or more | 0 | … she gets furadantine from me, and not trimethoprim, 4 times daily 100 mg for a week … and then come back the last day for a urine check (case 1) |
| | | |
E | 2 or more | 1 | … I would talk with her … that precisely when she is very busy those complaints may get worse … so that's the talk-side of the story … and then I would give something like Ulcogant or Gaviscon … well, I will give Ulcogant, it attaches to the spots themselves, Gaviscon works more superficially (case 5) |
| | | |
F | 2 or more | 2 or more | Yes, I could do two things. Should I give her a blocker again … few months without complaints, that is rather short … I would rather give her a kinetic, Prepulsid, together with an H2-blocker, or maybe something stronger like Losec, because the complaints came back so soon. But this final step may be premature, she could do well on a maintenance treatment, that her complaints disappear completely. Yes, I would give her twice daily the H2-blocker and for a short period also Prepulsid, to reduce her complaints at a faster rate. Prepulsid alone might be enough, but I don't think she will be motivated for that, she will also want the H2-blocker … she has had good experience with it (case 5) |
| | | |
N | 0 | 0 or more | I wouldn't prescribe any medication, I would put it clearly to her that I do understand that she comes to me with those complaints, also giving the relation, but that her complaints do not point at an ulcer, they are too variable, left and right … (case 3) |