Case of the Month
A 23-Year-Old Woman with Lower Abdominal Pain
A 23-year-old woman presents with lower abdominal pain, dysuria, dyspareunia, and purulent vaginal discharge. A pregnancy test performed today is negative. She is afebrile and her observations are normal. On examination, her abdomen is soft but she cervical motion...
A 3-Week-Old Baby with Projectile Vomiting
A 3-week-old baby boy is brought in by his parents with projectile vomiting. He is vomiting approximately half and hour after every feed but remains hungry. On examination he appears dehydrated and you can palpate an olive sized mass in the upper abdomen. What is the...
A 19-Year-Old Man with Testicular Pain
A 19-year-old man presents with severe pain in his right testicle that woke him from sleep. He feels nauseous and has vomited twice whilst in the waiting room. When you examine him, his right testicle is extremely tender and he has abdominal tenderness in the right...
A Patient with Bleeding Gums and Spontaneous Bruising
A 27-year-old man presents with bleeding gums and easy bruising. He also states that he has felt very tired lately and has had recurrent chest infections over the past few months. He had glandular fever approximately 6 months ago and feels that his...
A Patient with von Willebrand Disease
You are working at a local walk in centre on a busy Saturday afternoon. A patient presents with epistaxis. You are having difficulty in controlling the bleeding and consider packing his nose and transferring him to the nearest Emergency Department. The patient tells...
A 4-Month-Old with Bronchiolitis
A 4-month-old boy is brought by his parents to see his GP due to a history of fever, cough and breathing difficulties. A diagnosis of acute bronchiolitis is made. What is bronchiolitis? Bronchiolitis is an acute infection of the lower respiratory tract that is most...
A Crashing Asthmatic
A 24-year-old woman with a history of brittle asthma is brought to the Emergency Department by her boyfriend. She is very short of breath and wheezy and her condition deteriorates rapidly. Following back to back nebs, hydrocortisone and IV magnesium sulphate, she is...
An Overdose with an Unknown Substance
A 30-year-old woman presents having taken an overdose of an unknown substance. She is drowsy and slurring her speech. Her observations are as follows: HR 116, BP 91/57, SaO2 96% on air. GCS 11/15. The results of her arterial blood gas (ABG) on air are shown below:...
A Vomiting Medical Student
A 21-year-old medical student presents with severe retrosternal pain, pain on swallowing, and breathlessness. Over the weekend he went on a heavy drinking binge after finishing his exams and spent most of the previous evening vomiting and retching forcefully. You...
An Intravenous Drug User with Back Pain
A known intravenous drug user of no fixed abode presents with very severe back pain, fever, and left leg weakness. He has been woken at night several times because of the pain and is having difficulty walking. On examination he has tenderness over the lower lumbar...
