C09993521 / invoice 10000

Appointment Notes: Overdue remindersStung by something on walkAttendees:History:Eating drinking urinating defaecating normallyNo vomiting/retchingNo coughing, no exercise intolerance, no breathing difficultyNo lameness, stiffness or sorenessNo itching and scratchingBright Alert ResponsiveBody condition scoreInsect bite LPL while on walkWill not stop lickingExamination:Mucous membranes – pink moist crt <2sOral cavity – clear, no evidence of ulceration, tongue normal, hard palate fineTeeth – grade Nasal planum – normal pigmentation and architecture, no crusting, no dischargeEyes – eyelid conformation normal, PLR normal, no chemosis,  no dischargeEars – no discharge, no erythema, pinna fineLymph nodes - normalHeart – normal regular rhythm no pulse deficits, no murmur Lungs – clear sounds bilaterally, no crackles or wheeze, tracheal pinch negativeAbdomen – comfortable on palpation, bladder normal, no masses palpatedLimbs – all good range of movement, no swelling or pain on palpationNeck and spine – no pain on palpationSkin – erythema interdigital and edema of the metacarpal padNails – fineAnal glands – not scooting/expressedTemperature – Genital region - no masses or swellingsDiagnosis:Insect bite vs otherTreatment:Dexamethasone 0.12mg/kgIramine 0.1ml SCPyohex topical next 3-4 days O to monitor for ongoing dermatitis Plan: FUC days    Vital Signs    Weight: 3.1;