These are the items you should have listed:
Are there any additional features about Mr Kara that you would like to find out? Ask the facilitator - maybe the doctor missed these or omitted to document them.
Answer: Past work;...
Does this client suffer any health effects of shiftwork? List them.
Answer: Gastro-intestinal disturbances; Family and social life disruption; Cardio-vascular effects.
What hazards is he exposed to at work? Think about all categories of hazard.
Answer: Physical: cold, poor light, injuries from postal items (paper cuts etc.)
Chemical -
Biological - anthrax;
Ergonomic - repetitive strain;
Psychosocial - shiftwork, fatigue, etc.
How many hours does he work per week?
Answer: 36 hours.
What is the legal limit?
Answer: 40 - 45 hours
Which law prescribes working hours?
Answer: The Basic Conditions of Employment Act, with special reference to the Code of Good Practice on the Arrangement of Working Time.
What is your medical assessment of your client?
Depressed, gastro-intestinal effects; mild hypertension.
Outline a plan of management for this client.
Discuss the management of each of the conditions above. Cover at least the following:
Investigations, Treatment, What you tell the patient, Administrative work that needs doing, Follow-up plans.
Share your practical method of ensuring comprehensive management for your patients with your colleagues.
Is there any information the doctor omitted to gather?
Answer: Yes. Each of the diagnoses from the first visit should have been measured and assessed.
What is your diagnosis now?
Answer: Peptic ulcer disease, as the primary diagnosis.
What is your management?
Answer:
Schedule follow-up
What do you tell your client?
Answer: Explain the diagnosis and COIDA process, Inform of rights, Any questions?
Are any health effects of shiftwork scheduled as occupational diseases?
Answer: Not as such.
Answer:Continue the COIDA process, and include his general or family medicine practitioner in his management