A 12-year-old girl presents to the Emergency department with a scalp laceration she sustained while playing basketball.
Upon examination, it is found that she has a clean incised wound on her scalp that is approximately 2 cm in length.
What is the most appropriate method of managing this wound?
An 80-year-old woman came in with an acute myocardial infarction. The ECG revealed ST segment elevation in leads II, III, and aVF. Which coronary artery is the most probable to be blocked?
A 35-year-old woman presents with a sudden onset of right-sided facial weakness within 24 hours. Based on your initial assessment, you suspect Bell’s palsy and proceed to conduct a thorough examination to confirm your diagnosis.
What specific finding would support a diagnosis of Bell’s palsy?
A 32-year-old man is brought to the Emergency department from the local psychiatric hospital where he is being treated for resistant schizophrenia.
His medical history is otherwise significant only for depression, asthma and occasional cannabis use.
He is extremely agitated and confused and unable to deliver a coherent history. Examination is difficult as he is unable to lie on the bed due to extreme muscle rigidity and his limbs are fixed in partial contractures and there is mild tremor. Chest and heart sounds are normal although he is tachycardic at 115 bpm. He is sweating profusely and his temperature is measured at 40.2°C. Blood pressure is 85/42 mmHg.
Blood tests reveal:
Haemoglobin 149 g/L (130-180)
White cells 21.7 ×109/L (4-11)
Neutrophils 17.4 ×109/L (1.5-7)
Lymphocytes 3.6 ×109/L (1.5-4)
Platelets 323 ×109/L (150-400)
Sodium 138 mmol/L (137-144)
Potassium 5.7 mmol/L (3.5-4.9)
Urea 10.3 mmol/L (2.5-7.5)
Creatinine 145 μmol/L (60-110)
CRP 45 g/L –
Bilirubin 14 μmol/L (0-3.4)
ALP 64 U/L (45-405)
ALT 38 U/L (5-35)
Calcium (corrected) 2.93 mmol/L (2.2-2.6)
CK 14398 U/L –
The registered psychiatric nurse who accompanies him tells you he has been worsening over the previous 48 hours and his regular dose of risperidone was increased a few days ago. Other than risperidone 10 mg daily, he is also taking salbutamol four times a day.
What is the likely diagnosis?
An 80-year-old male is brought to the Emergency department and has a witnessed seizure in the resuscitation room. His blood glucose is recorded as 1.0 mmol/L. He does not have diabetes, nor other significant medical history. He is given 50 ml of 50% dextrose and he slowly recovers over the next one hour. A serum cortisol concentration later returns as 800 nmol/L (120-600). What investigation would be most relevant for this man?
A 40-year-old asthmatic has been admitted to the hospital with a worsening wheeze that has persisted for 24 hours. You are urgently called as the patient has become acutely short of breath despite receiving three sets of salbutamol nebulisers. The patient is now hypotensive and desaturating. Upon examination, you notice reduced air entry with a resonant percussion note in the left lung field and a trachea deviated to the right. Based on these symptoms, what is the most likely diagnosis?
A 57-year-old male presents to the cardiology clinic with complaints of weight loss, lethargy, and diarrhea. Upon examination, he is found to be tremulous, tachycardic, and has a palpable goiter. His thyroid function tests reveal a TSH level of <0.02 mU/L (normal range: 0.5-5), a free T4 level of 45 pmol/L (normal range: 9-23), and a free T3 level of 6.0 pmol/L (normal range: 3.5-5.5). Which medication is most likely responsible for his symptoms?
You are the foundation year doctor on the medical admissions unit and have been asked to review a 60-year-old female who has been referred to the unit for palpitations.
The venous gas has been performed by the nurse and has revealed a potassium of 6.5 mmol/L. The patient’s ECG shows tented T waves.
What is the most important first drug intervention?
A 28-year-old accountant presents to the Emergency department with a sudden and severe headache that started six hours ago. She also reports feeling nauseous and has vomited three times. Upon examination, she has neck stiffness and photophobia, but her GCS is 15 and she has no fever. What is the most probable diagnosis?
A 4-year-old girl is brought to the Emergency department by her mother.
The girl is experiencing elbow pain and is refusing to use her arm. Her mother reports that she was lifted up by her outstretched arms earlier in the day.
What is the probable diagnosis for this case?