C09998648 / invoice 20000

Appointment Reason: RecheckHx: Was seen 10 days ago for possible abscess. This morning, cyst opened up and O squeezed out small hard ball. Not as active as usual. Eating a bit less than normal. Drinking, defecation, urination normal. Ex: the right lateral hip area has a small open wound which O has expressed whitish sebaceous material from. In consult, expressed more sebaceous material. Doesn't feel like there is more left behind. Cleaned with saline. Skin surrounding opening is erythematous and swollen. Assessment: likely sebaceous cyst. Tx: Dispensed Amoxiclav PO for 5 days. Client comm: Advised that it might heal now that the cyst is open and sebaceous material is gone. Or might fill up again and become cystic again. Plan: if cyst returns, recommend surgical removal.     Vital Signs    Weight: 7.1;       MMColour: Pink;       HeadEyes: Normal;       Nose: Normal;       Skin: Abnormal;       Ears: Normal;       Neck: Normal;       LymphNodes: Normal;       Heart: Normal;       Lungs: Normal;       Abdomen: Normal;       RectalGenetalia: Normal;       Demeanour: BAR;       Hydration: Normal;       Gingivitis: 0;       Calculus: 1;       Temperature: 39;       HeartRate: 116;       RespirationRate: 20;       BodyScore: 6;       DentalGrade: 1;       CRT: 1-2;       

Appointment Reason: Lump (s), Appointment Notes: check cyst on hind right leg near the hip. Chewed on it over night and is now oozingcyst has now grown to about 2 cm. Aspirate brown and yellow cystic contents.quite dry at presentation in consult. a/bs not inficated.trial bitterent but advise may need removal is continue to nibble at it.check ears - both quite itchy. scope - clean ears with moderate amount of hair. inflammation only. use elocon down both ears twice weekly    Vital Signs    Weight: 6.94;       

Reason: VaccinationKC dueProtech pi2/ oral bbBatch 5264016/5245046AOverweightHr 90, Rr 20Grade 1 tartar.Browny/red crusts media lcanthi where tears overflowing. Flourescein stain negative to nostril suggesting blocked or stenotic ducts.Disucss Ga and cannulate and flush.sebaceous cyst on nape of neck and right thigh. both a 3-4mm nodule at this stage.    Vital Signs    Weight: 7.25;