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Guest khuram

Lithium

5 posts in this topic

Patient stable on Li for 20 years.

Now diagnosed with mild renal impairment and polycystic disease.

Would you stop Li?

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I got this PMP when I did my exam.I don't think the patient was stable for 20 years- it was 5 years as far as i remember

Anyway since it is mild renal failure- u should do a risk- benefit analysis- look into his history when he had the manic/depressive episodes. Liaise with the nephrologist, keep a close eye on his kidney functions and continue Lithium if benefits outweigh risks. And of course there is patient choice as well. Discuss with him about the risks/benefits/alternatives and come to a conclusion

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I've read that and thanks.

All the probes and are okay except the last one concerning about 'medical negligence'.

I don't know if answering in this way is correct

- Defining medical negligence: did not reach the standard of care supposed to have in your level (SHO) or duty of care

- Duty of care relevant in this case may include:

** failure to warn of risks in treatment

** failure to obtain proper consent to treatment (lithium, at 5 years ago)

** delayed referral to specialists (if renal impairment's in place for years).

Note they may not relate to your care but issues happened years ago.

What to do:

- Make sure you have done your duty of care

- Clearly documentation required

- Discuss case with your senior

- Ask legal assistance promptly

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