A 72-year-old man arrives at the emergency department with severe chest pain that spreads to his left arm and jaw. After conducting an ECG, you observe ST-segment elevation in leads I, aVL, and V4-V6, leading to a diagnosis of anterolateral ST-elevation MI. What is the primary artery that provides blood to the lateral region of the left ventricle?
A 65-year-old man visits his doctor with complaints of shortness of breath and swelling in his lower limbs. To aid in diagnosis, the doctor orders a B-type natriuretic peptide test. What triggers the production of B-type natriuretic peptide in heart failure?
A 75-year-old man presents to the clinic with a chief complaint of dyspnea while in a supine position. Despite having a normal ejection fraction, what could be a potential cause for his symptoms?
A 75-year-old man has been experiencing illness for several years and after his passing, an autopsy is conducted. Microscopic examination of tissue samples reveals the presence of apple green birefringence under polarised light in sections of the myocardium. What is the probable diagnosis?
A 13-year-old boy collapses at home and is taken to the hospital. After all tests come back normal, what is the underlying mechanism behind a vasovagal episode?
An individual who has been a lifelong smoker and is 68 years old arrives at the Emergency Department with a heart attack. During the explanation of his condition, a doctor mentions that the arteries supplying his heart have been narrowed and damaged. What substance is increased on endothelial cells after damage or oxidative stress, leading to the recruitment of monocytes to the vessel wall?
A 68-year-old woman has a left ankle ulcer that has been present for nine months. She had a DVT in her right leg five years ago. Upon examination, there is a 6 cm diameter slough-based ulcer on the medial malleolus without cellulitis. What investigation is required before applying compression bandaging?
A 68-year-old man visits his doctor complaining of exertional dyspnea and is diagnosed with heart failure. Afterload-induced increases can lead to systolic dysfunction in heart failure.
What factors worsen his condition by increasing afterload?
A 72-year-old man has been discharged after an elective laparoscopic cholecystectomy and his GP is reviewing his discharge letter. The patient has a history of atrial fibrillation and takes warfarin to reduce the risk of stroke. The GP notices an abnormality in the coagulation screen that was performed before surgery. The discharge letter confirms that this is expected with warfarin use.
What is the most likely abnormality on this patient’s coagulation blood results?
Reference ranges:
International normalised ratio (INR) 0.9-1.2
Prothrombin time (PT) 10-14 secs
A 67-year-old woman visits the anticoagulation clinic for her regular INR test. She has a medical history of deep vein thrombosis and pulmonary embolism and is currently taking warfarin for life. During this visit, her INR level is found to be 4.4, which is higher than her target of 3.0. Upon further inquiry, she reveals that she had been prescribed antibiotics by her GP recently. Can you identify the clotting factors that warfarin affects?