A 82-year-old man visits the urology department complaining of a painful swelling in his left testicle that has been present for the past month. Upon examination, it is diagnosed as a left varicocele. Further CT scans reveal enlarged lymph nodes obstructing the venous drainage in the middle portion of his abdomen. Which vein is most likely to be compressed?
A 3-week-old male is brought to the paediatrician with concerns of inadequate feeding and weight gain. During cardiac examination, a continuous ‘machine-like’ murmur is detected. An echocardiogram confirms the presence of a patent ductus arteriosus (PDA).
What is the name of the structure that would remain if the PDA had closed at birth?
Mrs. Smith is a 75-year-old woman who presents to the emergency department with progressive shortness of breath over the past 5 days. Last night she woke up suddenly because she couldn’t catch her breath and developed a dry cough. Her breathing improved when she sat upright on the edge of her bed. She denies any chest pain, leg pain or fainting spells.
Her past medical history includes a myocardial infarction 5 years ago for which she underwent a coronary artery bypass graft, hypertension and type 2 diabetes. She has been smoking for 30 years and doesn’t drink any alcohol.
What is the most likely diagnosis?
You are a doctor working in the intensive care unit. A 35-year-old man has been admitted to the ward due to suddenly vomiting large volumes of fresh blood. His blood pressure is 90/60 mmHg and his heart rate is 150bpm. He needs urgent intravenous fluids. Several attempts at intravenous cannulation have been made but to no avail. The on-call anaesthetist suggests performing a great saphenous vein cutdown.
Where should the anaesthetist make the incision?
Which nerve is most vulnerable to damage when there is a cut on the upper lateral margin of the popliteal fossa in older adults?
As a young medical trainee participating in the ward round for diabetic foot, your consultant requests you to evaluate the existence of the posterior tibial pulse. Can you identify its location?
A 65-year-old man with diabetes presents to the vascular clinic with a chronic cold purple right leg that previously only caused pain during exercise. However, he now reports experiencing leg pain at rest for the past week. Upon examination, it is noted that he has no palpable popliteal, posterior tibial, or dorsalis pedis pulses on his right leg and a weak posterior tibial and dorsalis pedis pulse on his left leg. His ABPI is 0.56. What would be the most appropriate next step in managing his condition?
A woman with longstanding angina visits her doctor and reports persistent symptoms. The patient was previously prescribed a calcium channel blocker, but due to her asthma, a beta blocker cannot be prescribed. The doctor decides to prescribe ivabradine. What is the site of action of ivabradine in the heart?
A 50-year-old man with a history of rate-controlled atrial fibrillation (AF) presents with chest pain, palpitations, and dizziness. The patient has a past medical history of a transient ischemic episode and is taking warfarin to prevent further ischemic episodes. He also has a history of gout, low back pain, depression, and polymyalgia rheumatica.
Upon immediate ECG, the patient is found to have an irregularly irregular rhythm consistent with fast AF. You decide to perform electrical cardioversion and prescribe a course of amiodarone to prevent recurrence.
What drug interaction should you be cautious of in this patient?
A 70-year-old man has a brain mass, but there is no rise in intracranial pressure. What could be the reason for the absence of increased intracranial pressure?