A 29-year-old male with schizophrenia is being evaluated by his psychiatrist. He expresses that he no longer takes pleasure in his usual pastimes. The patient used to enjoy playing video games and going to the gym, but now finds these activities uninteresting and lacks motivation to engage in them.
Which symptom of schizophrenia is the patient exhibiting?
A 66-year-old patient presents to the emergency department with complaints of feeling unwell and pain in a wound on their left leg. The patient reports sustaining the injury 10 days ago when they accidentally burned their leg on a hot stove. They did not seek medical attention at the time as they believed the wound was not severe. The patient has been experiencing episodes of feeling hot and cold for the past three days and the pain in their leg has been increasing. They deny any cough, dysuria, or pain in other areas of their body. Upon examination, a deep partial thickness burn is observed on the patient’s left leg with surrounding erythema and ascending lymphangitis tracking up past their left knee.
Investigations:
Investigation Result Normal value
White cell count (WCC) 14 × 109/l 3.6–11 × 109/l
C-reactive protein (CRP) 56 mg/l 0–10 mg/l
What would be the most appropriate course of action for this patient?
You are contacted by the nurse in charge of the ward to evaluate a patient who has been recently admitted from her nursing home with pneumonia and confusion. While bathing her, the nurses have observed a pressure sore near her sacrum and have requested for you to examine it. Upon assessment, you discover a 4 cm circular wound lateral to the sacrum with some surrounding redness. It is roughly 1-2 cm deep. The wound bed shows subcutaneous fat with some slough, but no bone, muscle, or tendon is exposed. What grade of pressure sore would be consistent with this?
You are asked to assess a patient in A+E with a burn. He is a 38 year old man who sustained a contact burn to the palm of his left hand and index, middle and ring fingers from a heated metal object an hour ago.
He is haemodynamically stable, and not in significant pain. He a right handed metalworker and is otherwise fit and well without drug allergies. On examination you find the burnt skin on the palmar aspect is white and leathery in appearance. It does not blanch to pressure and the patient can not feel you touching the skin in that area.
This assessment would be compatible with what depth of burn?
A 28-year-old metal worker slips onto a furnace wall. He presents with a leathery lesion on his chest. It is dry and insensate with a waxy appearance. It does not blanch.
How would you describe this burn?
A 25 year old patient presents to the accident and emergency department after being involved in a fight an hour ago. Due to being intoxicated, the patient is unable to provide much history. Upon examination, the patient has significant facial swelling on the lower left side and bruising around the left eye. The patient does not experience tenderness when palpated on either side of the nose. However, when asked to bite down, the patient complains of an unusual sensation in their mouth, and the left side teeth come together before the right side. Additionally, two teeth are missing on the left side. What would be the most appropriate next investigation?
A 7-year-old girl is brought to the Emergency Department after falling off her scooter and hitting her face. She had a brief episode of nosebleed which stopped on its own. However, her mother is worried about her breathing, which has become congested and noisy, and her right nostril is getting more swollen. Upon examination, there is an enlarged and red nasal septum on the right side, and a fluctuating swelling can be felt upon palpation. What is the best course of action for this likely diagnosis?
A 6-year-old boy spills boiling water on his hand. The lesion is wet, pink, highly tender and blistered. How would you describe this burn?
What is the definition of healing by secondary intention, which is the final stage of tissue response to injury involving regeneration and repair?
As a core trainee on call in England, you are faced with a situation where a 35-year-old patient who is informally admitted and may be suffering from psychosis threatens to leave the hospital while being suicidal. What section of the Mental Health Act can be used to detain this patient?