Escolar Documentos
Profissional Documentos
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Guide to Good
Prescribing
A practical
manual
Patient 1:
Man, 54 years.
Complains of a severe
sore throat. No general
symptoms, no fever,
slight redness in the
throat; no other
findings.
Patient 2:
Woman, 23 years.
Complains of a sore throat
but is also very tired and
has enlarged lymph nodes
in her neck. Slight fever.
She has come for the
results of last week's
laboratory tests.
Patient 3:
Woman student, 19 years.
Complains of a sore
throat. Slight redness of
the throat; but no fever
and no other findings.
She is a little shy and has
never consulted you
before for such a minor
complaint.
Patient 4:
Man 43 years. Complains
of a sore throat. Slight
redness of the throat; no
fever and no other
findings. Medical record
mentions that he suffers
from chronic diarrhoea.
Patient 5:
Woman, 32 years. Very
sore throat, caused by
a severe bacterial
infection, despite
penicillin prescribed
last week.
Patient 1
The sore throat of patient 1
probably results from a
minor viral infection.
Perhaps he is afraid of a
more serious disease (throat
cancer?). He needs
reassurance and advice, not
drugs. He does not need
antibiotics, because they
will not cure a viral
infection.
Patient 2
Her blood test confirms
your clinical diagnosis of
AIDS. Her problem is
completely different from
the previous case, as the
sore throat is a symptom
of underlying disease.
Patient 3
You noticed that she was
rather shy and remembered
that she had never consulted
you before for such a minor
complaint. You ask her gently
what the real trouble is, and
after some hesitation she
tells you that she is 3 months
overdue. Her real concern
had nothing to do with her
throat.
Answer:
To be blunt, yes it can be. But don't rely
on a sign. Use multiple pregnancy
tests, up to 2 or 3, just to be sure
Patient 5
A careful history of patient 5,
whose bacterial infection
persists despite the penicillin,
reveals that she stopped
taking the drugs after three
days because she felt much
better. She should, of course,
have completed the course.
Her problem has come back
because of inadequate