Case of the Month
‘Ripping’ Chest Pain in a 38-Year-Old Man
A 38-year-old man with Marfan syndrome presents with sudden severe chest pain that radiates through to his back. He describes the pain as being sharp and ‘ripping’ in nature. He smokes 25 cigarettes per day. He is sweaty, nauseated and appears pallid. On examination...
An HIV Positive Patient with Blurred Vision
A 34-year-old man with a known history of HIV presents with blurring of his vision and ‘floaters’ in his right eye that have gradually worsened over the past 10 days. He is experiencing no eye pain and there is no redness or injection of the eye. He states that he had...
A 60-Year-Old with Abdominal Pain
A 60-year-old woman presents with a one-week history of abdominal pain, nausea and reduced frequency of bowel motions. Her observations are as follows: HR 97, BP 113/76, RR 19, SaO2 98% on air. On examination she has right upper quadrant tenderness. Her chest X-ray is...
The Strange Case of the ‘Octopus Pot’ Heart
A 53-year-old woman presents with severe central crushing chest pain that radiates to her left arm. She has been under a significant amount of stress recently following the unexpected death of her husband. Her ECG is shown below: She is taken to the cath lab for a...
An 18-Month-Old with Stridor
A mother brings in her 18-month-old to the Emergency Department with breathing difficulties. The boy was seen earlier that week with a possible mild allergic reaction following eating a cake, but at that time his symptoms settled rapidly following administration of...
A 61-Year-Old Man with Widespread Hyperpigmentation
A 61-year-old man presents with generalised weakness and skin hyperpigmentation. His only past medical history of note is a bilateral adrenalectomy for Cushing’s syndrome 18 years earlier. On examination of his visual fields you discover a bitemporal hemianopia. 1....
A Young Footballer Presents with Palpitations
A 22-year-old athlete presents with a history of palpitations that have been occurring whilst he is playing football. They have become bothersome of late and his coach has advised him to have a medical check up. On questioning him you find out that his father died at...
A 45-Year-Old Woman With Unexplained Hearing Loss
A 45-year-old woman presents complaining of difficulty hearing out of her right ear. She reports that her hearing loss is worsening, and in the last couple of weeks she has also had a fairly constant headache and feels dizzy. When you examine her right ear, you note...
A 50-Year-Old Man With a Swollen Neck
A 50-year-old man from India presents with neck pain, fevers and a large right-sided submandibular swelling. On examination the swelling is non-fluctuant and is situated below the angle of the jaw. The floor of his mouth appears oedematous. His temperature is 39.5...
A 67-Year-Old Woman With an Unusual Rash
A 67-year-old woman comes to see you at the local walk-in centre with a rash on her left forearm. She has a past medical history of hypertension, which is usually well controlled on amlodipine 5 mg od. She feels well in herself today, but her arm feels a little sore....
