Case of the Month
A 22-Year-Old Man with a Nasal Injury
A 22-year-old man has been struck on the bridge of the nose during an altercation outside a nightclub last night. He had a brief episode of epistaxis at the time, which stopped after pressure was applied to the nose. He is complaining of a painful, deformed nose and...
A 53-Year-Old Woman with Hypertension and Hypokalaemia
A 53-year-old woman has been visiting her GP with symptoms of tiredness, muscle weakness and headaches. She is known to be hypertensive and takes amlodipine to control this. Her blood results today show that her potassium level is low at 3.0 mmol/L, and her sodium...
A 40-Year-Old Woman with Intermittent Hypertension and Sweating
A 40-year-old woman presents with intermittent episodes of severe sweating, palpitations and an associated feeling of panic and anxiety. She measured her blood pressure at home during one of these episodes and found it to be 196/118 mmHg. You measure it today and find...
A 34-Year-Old Man with Hyperkalaemia
A patient with a history of renal problems generalised weakness, palpitations and chest pain. His serum potassium levels are measured and come back at 8.2 mmol/L. An ECG is performed, and it shows some very alarming changes. 1. What is the definition of...
A 74-Year-Old Man with Sudden Cognitive Decline
A 74-year-old man presents having suffered an episode of left arm and leg weakness that resolved after a few hours. His relatives have noticed that he has suddenly become very forgetful over the past week and is forgetting the names of people and places and having...
A 21-Year-Old Football Player with a Severely Painful Elbow
A 21-year-old football player presents with a deformed, severely painful elbow following a fall onto his right arm. An X-ray is performed, which is shown below. 1. What is the diagnosis?This patient has a posterolateral elbow dislocation. Elbow dislocations are...
A 4-Year-Old Child with an Elbow Injury
A 4-year-old child presents refusing to move their right arm after a sudden pull by the mother. The arm is held in slight flexion with pronation and adduction and there is tenderness over the radial head. 1. What is the most likely diagnosis? This child has suffered a...
A Patient with an Insect in Their Ear
A 19-year-old woman presents to the Emergency Department after an insect flew into her ear. She is complaining of significant pain and can hear the insect buzzing. The triage nurse has administered pain relief, and the patient is now comfortable.1. What should be your...
A 30-Year-Old Patient with a Thyroxine Overdose
A 30-year-old female patient with a history of hypothyroidism presents to the Emergency Department having taken 30 of her 200 mcg levothyroxine tablets 3 hours earlier. She tells you that she is ‘fed up with life’ and ‘can’t take it any more’. She is currently...
A 70-Year-Old Woman with Hypotension and Tachycardia
A 70-year-old woman presents with palpitations and breathlessness. Her observations show that she is hypotensive and tachycardiac, and she is complaining of chest pain. She is promptly transferred to resus. After being moved to resus she is administered three...
