Case of the Month
A 32-Year-Old Woman with Leg Weakness
A 32-year-old woman has noticed increasing weakness and numbness in her legs over the past few days, and she is feeling short of breath when she walks. Three weeks ago, she had diarrhoea whilst on holiday, and stool culture confirmed infection with Campylobacter...
A 55-Year-Old Woman with Tiredness and Depression
You review a 55-year-old woman with a 6-month history of feeling tired and depressed. She has been constipated for the past 3-months, for which she is taking 15 ml of lactulose twice daily. She is otherwise fit and well and has no past medical history of note. You...
A 9-Month-Old Baby with Failure to Thrive
A 9-month-old baby boy is brought to your surgery by his mum, who is concerned about his weight gain. His red book measurements have dropped from above the 50th centile to below the 25th centile over the past 4 months. He has had several chest infections, and mum...
Family Planning in Sickle Cell Disease
A West African couple present to your surgery, they are planning on having a baby, but they are both known to be sickle-cell trait. They have come to discuss the chances of their baby being affected by the disorder.1. How is sickle-cell disease inherited? Sickle-cell...
A 21-Year-Old Woman with an Intensely Itchy Rash
A 21-year-old woman develops a rash on her forearms shortly after spending the afternoon washing up at a restaurant where she has just started working. The rash is very itchy, but she has no other symptoms and feels well otherwise. The rash is shown below: 1. What is...
A 70-Year-Old Man with Severe Leg Pain
A 70-year-old man presents to the ED having developed sudden onset severe pain in his right leg. This occurred whilst he was watching television 1 hour earlier. On examination he is distressed, and his right leg is pale in appearance. His right foot feels cold to...
A Very Concerned Mother
A mother brings her 2-year-old son to the Emergency Department. They have previously presented 10 times over the past six months and on each occasion have been discharged. He has previously been investigated for multiple episodes of rectal bleeding, and no cause...
A 70-Year-Old Man with Acute Shortness of Breath
A 70-year-old man with a history of stable angina and hypertension develops sudden onset breathlessness at night. He is unable to lie flat and appears, sweaty and anxious. He is brought into the resus area and the sister in charge has sat him upright and commenced...
An 80-Year-Old Woman with an Itchy, Blistering Rash
An 80-year old woman presents with an itchy, blistering rash affecting her arms and trunk. She is systemically well, and her observations are normal. The rash is mainly localised to her right arm and is shown below: 1. What is the most likely diagnosis?Bullous...
A 50-Year-Old Woman with an Itchy, Blistering Rash
A 50-year-old woman presents with a painful, blistering rash affecting her face, limbs and trunk. She initially noticed painful blisters in her mouth, but these subsequently spread to the skin a few weeks later. The blisters, where present are large and flaccid. Most...
