Case of the Month
A 60-year-old Man with Dizziness and Palpitations
A 60-year-old man presents with dizziness and palpitations. Whilst in the Emergency Department the following rhythm strip is recorded: 1. What does the rhythm strip show? The rhythm strip in this case shows torsades de pointes. 2. Which underlying ECG...
A Patient with Syndrome of Inappropriate ADH Secretion
A 74-year-old man, who is a lifelong smoker, is diagnosed with a small cell carcinoma of the lung. Following further investigation, it is discovered that he has developed the syndrome of inappropriate ADH secretion (SIADH) as a consequence of this. 1. What typical...
A 15-Year-Old Boy with a Sore Throat and a Fever
A 15-year-old boy presents with a 7-day history of a sore throat, low-grade fever, and malaise. He states that a week ago he had a fine rash over his body that faded quickly. On examination, you note the presence of mild splenomegaly. He is eating and drinking well,...
A 24-Year-Old Woman with Conjunctivitis
A 24-year-old woman presents with a sudden onset of left-sided acute follicular conjunctivitis. She complains of severe pain in the eye, and she has blurred vision with copious watery discharge evident. On examination, you note the presence of pseudomembrane formation...
A 24-Year-Old Man with Abdominal Pain and Dark Urine
A 24-year-old man presents complaining of recurrent episodes of abdominal pain and passing dark brown urine first thing in the morning. On examination, he has raised, painful, red nodules on the skin covering his entire back. You organise a set of blood tests, which...
A 30-Year-Old Man with Heartburn and Dysphagia
A 30-year-old man presents with symptoms of persistent heartburn, dysphagia and intermittent food bolus obstruction. He was recently prescribed a short course of standard-dose omeprazole by one of your colleagues but has this has not improved his symptoms. An...
A Patient with Troublesome Acne
You review a patient with moderately severe acne that has been treated with a variety of topical agents over the past 6 months. There has been a poor response treatment and you consider switching to an oral antibiotic. You are aware that there is an increasing issue...
A 67-Year-Old Woman with Anxiety and Confusion
A 67-year-old lady presents anxious, confused and agitated. She has also vomited several times. She has recently been started on a course of amoxicillin for a presumed chest infection by one of your colleagues. You are unable to take a coherent history from her but...
A 25-Year-Old Woman with a Neck Injury
A 25-year-old female patient is being assessed for a possible cervical spine injury following blunt trauma. Her C-spine X-ray series is inadequate and a decision is made to organise a CT scan of her cervical spine. Under what circumstances should CT scanning be used...
A 50-Year-Old Woman with Forearm and Hand Pain
A 50-year-old woman develops pain and parasthesia on the ulnar border of her left forearm and hand. On examination, her radial pulse is weaker on the left-hand side and her arm appears pale when elevated above her head. What is the most likely diagnosis? This patient...
