A 27-year-old soccer player suddenly collapses during a game. He is immediately taken to the Emergency department where he is diagnosed with ventricular tachycardia. Despite successful defibrillation, he experiences a recurrence of ventricular tachycardia and unfortunately passes away after prolonged resuscitation. The 12 lead ECG taken after resuscitation reveals left ventricular hypertrophy. What is the probable diagnosis?
A 65-year-old male presents with a one day history of right-sided chest pain and dyspnoea that has worsened throughout the day. He underwent a right hip replacement and was discharged from BUPA one week ago. On examination, his temperature is 37.5°C, pulse is 96 bpm, blood pressure is 138/88 mmHg, and oxygen saturations are 90% on air. There are no specific abnormalities on chest examination, but his chest x-ray shows consolidation at the right base. The ECG is also normal. What is the most appropriate investigation for this patient?
A 14-year-old boy is brought to the Emergency department by his parents. He has a two day history of general malaise, vomiting and vague abdominal discomfort. Over the past twelve hours he has become increasingly drowsy.
On examination, he was unresponsive to verbal commands. His temperature was 36.5°C and his blood pressure was 74/48 mmHg. The following investigations were done:
– Sodium: 121 mmol/L (137-144)
– Potassium: 6.2 mmol/L (3.5-4.9)
– Urea: 11.6 mmol/L (2.5-7.5)
– Creatinine: 162 µmol/L (60-110)
– Glucose: 1.1 mmol/L (3.0-6.0)
– Chloride: 91 mmol/L (95-107)
– Bicarbonate: 14 mmol/L (20-28)
After giving emergency treatment, what single investigation would be most valuable in confirming the diagnosis?
A 35-year-old woman presents with sudden chest pain and difficulty breathing. She recently returned from a trip to Italy with her family. She has no significant medical history but takes oral contraceptives. On examination, her pulse is 100 bpm, temperature is 37°C, oxygen saturation is 95%, respiratory rate is 28/min, and blood pressure is 116/76 mmHg. Chest examination is unremarkable and chest x-ray is normal. What is the most appropriate diagnostic test to confirm the diagnosis?
For which group is hepatitis B vaccination not typically recommended due to their low risk status?
As a foundation year doctor, you have been requested by the resuscitation nurse to prescribe Tazocin in accordance with departmental policy for a 50-year-old patient with COPD who was previously seen by your colleague and is currently undergoing treatment for severe sepsis. However, ten minutes later, you receive a fast bleep to the resuscitation room where the patient is now experiencing hypotension, tachycardia, and developing a urticarial rash and wheezing. The patient’s medical records indicate that they have an allergy to penicillin. What is the next therapeutic measure you will prescribe?
A 22-year-old individual is brought to the medical team on call due to fever, neck stiffness, and altered Glasgow coma scale. The medical team suspects acute bacterial meningitis.
What would be the most suitable antibiotic option for this patient?
A 48-year-old man with a history of intravenous drug use has been diagnosed with hepatitis B. His blood tests show positive results for hepatitis B surface antigen and hepatitis B core antibodies. However, he tests negative for IgM anti Hbc and anti-hepatitis B surface antibody. What is the man’s current disease status?
An 80-year-old woman presents to the Emergency department with a Pretibial laceration and skin flap after injuring her leg on furniture at home. She is currently taking prednisolone for polymyalgia rheumatica. What is the optimal approach to managing this injury?
A 50-year-old man with a history of intravenous drug use presents with abnormal blood results. His test results show Hepatitis B surface antigen positive, IgG Anti-HBc antibody positive, IgM Anti-HBc antibody negative, and Anti-Hepatitis B surface antibody negative. What is the most likely diagnosis for this patient?