Request FSH test to confirm she has entered the menopause
Advise her that she can stop taking her contraceptive as she is no longer fertile
Offer topical oestrogen to prevent vaginal atrophy
Offer sequential combined hormone replacement therapy
Offer continuous combined hormone replacement therapy
Refer to the metabolic clinic for suspected familial hypercholesterolaemia.
Initiate lifestyle interventions, and simvastatin 40mg daily at night.
Initiate lifestyle interventions, aspirin 75mg daily and simvastatin 40mg at night
Initiate lifestyle interventions in addition to simvastatin in combination with a fibrate and repeat the cholesterol test in 3 months.
Advise 6 months lifestyle intervention followed by repeat fasting cholesterol.
Topiramate 50mg per day
Amitriptyline 75mg per day
Urgent Referral to Neurology
Sodium Valproate 800mg per day
Almotriptan 12.5 mg at onset of an attack
Screening is offered to all patients aged 60-69
Screening is via faecal wipes which are returned in the post
Over 70s can request to be screened
Screening is at 2 yearly intervals
Approximately 5% of those screened will require colonoscopy
Patients with chronic renal failure
Children with cystic fibrosis over the age of 6 months
All those over 60
Staff in nursing homes
Patients with Chronic Obstructive Pulmonary Disease
Refer urgently to ENT
Start oral fluclonazole 50mg daily for 7 days
Refer routinely to ENT
Advise the patient to make an appointment with his dentist
Start oral nystatin for 7 days 1 ml QDS after food
Carcinoma of the colon
Poor fibre intake
Ingrowing eye lash
Recurrent erosion syndrome
The risk of her children inheriting Huntingtons is 1 in 4.
Huntingtons is an autosomal recessive condition so the chances of her inheriting the disease are approximately 1 in 2.
As a female her risk of inheriting Huntingtons is low because the gene is X linked
Her chance of inheriting the disorder is around 1 in 2 because Huntingtons is an autosomal dominant condition.
Huntingtons is an autosomal recessive condition so the chances of her inheriting the disease are low provided her mother is not a carrier for the Huntingtons gene.