A 26-year-old man has been involved in a motorbike accident. Although he is not seriously injured, he has sustained a skin flap on the dorsal surface of his wrist after hitting it against a wall. Upon examination, it is observed that the extensor pollicis longus tendon is exposed and can be seen changing direction around a bony projection. What is the name of this bony feature?
An 8-year-old boy arrives at the Emergency Department after falling on his outstretched hand. He is experiencing severe pain and cannot move his arm. An X-ray shows a fracture of the distal radius, along with dislocation of the distal radioulnar joint. The ulna appears to be intact. What is the most probable type of injury that this patient has suffered?
A 22-year-old man was brought to the Emergency Department with a knife still in his abdomen after being stabbed in the left upper quadrant. A CT scan revealed that the tip of the knife had pierced the superior border of the greater omentum at the junction of the body and pyloric antrum of the stomach. Which direct branch of a vessel is most likely to have been severed by the knife?
As an FY1 on medical ward cover, you have been tasked with cannulating a 72-year-old female with type-1 diabetes. She is currently being treated for pneumonia, has a right below the knee amputation, and suffers from diabetic neuropathy. What would be the appropriate course of action in this scenario?
A 22-year-old student is hit by a bus while cycling to university at moderate speed. He falls and lands on the curb, hitting his left ribs. There is no loss of consciousness. He is brought into the Emergency Department, complaining of left upper quadrant (LUQ) pain. On examination, his heart rate is 120 bpm after morphine analgesia; his blood pressure is 100/65 mmHg and he is peripherally cold; the respiratory rate is 25 and saturations are 99% on room air. Chest X-ray reveals displaced left lower rib fractures, without other thoracic pathology.
What diagnosis would you be most concerned about?
Mrs Chen is a 55-year-old female involved in a high speed motor vehicle accident. After controlling her cervical spine with tapes, blocks and a collar, you note that her breathing is laboured and there is significant stridor. She has multiple bruises over her face, bilateral periorbital ecchymosis and Battle’s sign. She also has significant nose, mouth and jaw injuries and bleeding and when you attempt to intubate, you are unable to get a clear view of the cords due to the distorted anatomy.
Which of the following is the next best step to ventilate the patient?
A 51-year-old man presents to the Emergency Department as a trauma alert, with knife stab wounds in the right arm and thorax. On arrival, he has a heart rate of 120 bpm, blood pressure (BP) of 100/70 mmHg, a weak pulse and raised jugular vein pressure (JVP) (+5 cm), respiratory rate (RR) of 20 breaths/min, with widespread wheeze bilaterally, and oxygen saturations of 100% on 5 litres of oxygen. He is complaining of chest pain despite just having had 1 g of paracetamol.
What complication is he likely to have suffered as a consequence of his injuries?
A 21-year-old man is brought to the Emergency Department after a car accident. He is breathing irregularly, with a respiratory rate of five breaths/minute, and has a Glasgow Coma Scale (GCS) score of three. The trauma team decides to intubate him in the department, but due to oropharyngeal swelling caused by the trauma, they are unable to do so. His condition rapidly deteriorates, and he is now hypoxic, with an oxygen saturation (SpO2) of 70%, despite receiving mechanical ventilation with a bag-valve-mask and basic airway manoeuvres. What is the most appropriate intervention to restore his oxygenation?
A 32-year-old man is brought in by air ambulance following a crush injury while working on his farm. He became sandwiched between two pieces of equipment at the level of the umbilicus. He has been stabilised by the team on the field and has good pedal and femoral pulses, without sign of any acute pelvic damage. A bedside ultrasound-focused assessment with sonography in trauma (FAST) scan is positive.
What is the most important initial step in the management of this patient?
A 50 year old woman comes in with a 3 cm breast lump. After undergoing a mammogram, biopsy, and CT scan for staging, it is discovered that she has a single ER+ve, HER2-ve tumor that is confined to the breast. What is the next step in her management?