A 21-year-old male student is admitted in the second week of university after a night-out for a basketball club social.
He presents with rigidity, disorientation and a temperature of 39.5ºC. You suspect he may have serotonin syndrome.
Which of the following drugs is most likely to be responsible in this case?
You are with the on-call anaesthetist who is asked to assist with a distressed elderly patient who has just walked into the Emergency Department. The anaesthetist is in the middle of an epidural but sends you down to see what is going on. The patient has been stung by a wasp while gardening, and her arm has become very swollen and red. She kept gardening, but within a few minutes she began feeling light-headed and experienced difficulty breathing. The nurses are getting some monitoring set up. She looks flushed and has stridor and tachypnoea. Her first blood pressure is 76/40 mmHg and she is tachycardic at 150 bpm.
What is the best initial treatment?
A 67-year-old male complains of swelling in both ankles. He reports no difficulty in breathing. Upon examining his chest, no abnormalities were found. The patient has a medical history of hypertension, diabetes, and angina. Which medication is the most probable culprit for his symptoms?
What is the mechanism of action of teriparatide in the management of osteoporosis?
A 21-year-old female student presents to the GP clinic complaining of dysuria and frequent urination. Upon urinalysis, proteinuria, haematuria, and nitrite positivity are detected. The patient is currently taking Microgynon 30 as a contraceptive. The physician prescribes a five-day course of Augmentin. What recommendations should be provided to the patient?
A 68-year-old woman presents to the emergency department after collapsing at home. She has a medical history of COPD, recurrent urinary tract infections, hypertension, and hypercholesterolemia. Recently, she visited her general practitioner for a chest infection and was prescribed antibiotics and medications for symptom control. Additionally, she started taking medications for newly diagnosed hypertension. During her examination, there were no notable findings. However, her twelve lead ECG revealed a significantly prolonged QTc interval of 560ms. Which of the following medications is the most likely cause of this ECG abnormality?
A 32-year-old male comes to your travel clinic requesting anti-malarial medication for his upcoming trip to rural Philippines. After consultation, you decide to prescribe him doxycycline. Can you advise him on a common side effect of this medication?
A child is put on a new agonist medication for asthma. While it works well at first, its effectiveness appears to diminish after a few months. What is the probable reason for this outcome?
A 50-year-old woman arrives at the emergency department with symptoms of sweating, confusion, and agitation that have developed over the past hour. She has a history of schizophrenia, hay fever, and lower back pain and is currently taking sertraline, cetirizine, and olanzapine. The patient admits to occasional recreational use of cannabis and diazepam and also uses her partner’s tramadol. Upon examination, the patient has a temperature of 39.0ºC, a heart rate of 105 bpm, and a blood pressure of 143/75 mmHg. The doctor notes hyperreflexia, rigidity, bilateral mydriasis, and bilateral ankle clonus. What is the most likely cause of her presentation?
A 25-year-old female patient presents at the clinic for a check-up. She reports experiencing heavy periods with menstrual bleeding and clots for up to eight days every month. The patient is sexually active, using barrier contraception, and has no plans of getting pregnant in the near future. Upon examination, her blood pressure is 100/60 mmHg, pulse is regular at 64 bpm, and her BMI is 23 kg/m2. Abdominal and pelvic examination shows no abnormalities, and an ultrasound reveals no fibroids. Her 21 day progesterone level is also normal. What is the most appropriate treatment to alleviate her bleeding symptoms?