Tutorial 5: Case 2

Question 1

Bianca is 26, asks can I get something for my sore ankle so I can continue running?

A) Who is it for?

B) What are the symptoms?

C) How long have you had these symptoms?

D) Action taken

E) Medications being taken?

F) Medical conditions

G) Allergies?

H) P/BF (female)

Answer 1

A) Myself

B) I have this pain in around my ankle

C) For the past few days

D) I read tea tree oil was good for the feet so I tried rubbing some tea tree oil on it –> although it did nothing

E) I take pantoprazole 40 mg daily (PPI)

F) I get indigestion and reflux, I take pantoprazole for it

G) Bees

H) No

Question 2

Appropriate extended questions

1. Are they any other symptoms including fever, pain elsewhere in the body or weakness?
2. Describe the pain? Is the pain affected by movement or rest?
3. How you rate the pain out of 10 (scale of 1-10 with 0 being no pain and 10 being worst pain)
4. Have you had this before?
5. Any swelling/bruising on the foot?
6. Are you able to stand on the foot?
7. Has anything changed recently

Answer 2

1. No
2. Sore most of the time though just general pain, not stabbing, not a sharp pain
3. 2-3 out of 10 pain, it is worse when I try and run on it and seems to be getting worse with each day I keep running on it
4. No
5. No bruising, a little bit of swelling
6. Yes, I can move my foot, just hurts when I run on it or walk too much on
7. Running after a long time of not running, stumbled on rocks a couple of times one of the days, it may have started then.

Question 3

What is the diagnosis? Explain reasoning to patient.

Answer 3

Based on the signs and symptoms you have told me, I believe you have an acute ankle sprain. The general pain and swelling you have described confirms my diagnosis. It is most likely triggered by you stumbling over the rocks.

Question 4

What product would you recommend for this patient? Provide IDARL.

Answer 4

Paracetamol (Panadol)

• Indication: It is an antipyretic and analgesic. Will help relieve the pain.
• Dosage: Take 1-2 tablets every 4-6 hours, dont use any other products containing paracetamol
• Adverse effects: Generally well tolerated, may cause nausea if taken excessive amounts
• Duration of treatment, time to recovery, when to refer: Take it for one week, if it does not get better, I will refer you to a doctor. Will also refer you if you have any sort of head injury and if there is severe pain at rest.
• Lifestyle/self care: Do RICER, run on even surface, warm up before sport

I will give you a self care-card for ankle pain and a consumer medication information leaflet. Do you have any questions for me?

Ricer

> R: rest (24-48 after injury)

> I: Ice (reduce swelling)

> C: Compression (reduce swelling)

> E: elevation (reduce swelling)

> R: referral