A 56-year-old man presents to the Emergency Department after experiencing syncope. He reports having a medical condition but cannot recall the name of it. However, he shows the doctor the medication he takes, which is a somatostatin analogue. What condition could potentially be treated with this medication?
A 70-year-old man presents to the Emergency Department with anorexia, fatigue, nausea and generalised pain. He has a medical history notable for palliate prostate cancer for which he has refused treatment, and remains independent. Routine blood results confirm your suspicions:
Investigation Result Normal value
Haemoglobin 89 g/l 135–175 g/l
White cell count (WCC) 8.5 × 109/l 4–11 × 109/l
Platelets 200 × 109/l 150–400 × 109/l
Sodium (Na+) 138 mmol/l 135–145 mmol/l
Potassium (K+) 4.0 mmol/l 3.5–5.0 mmol/l
Creatinine 130 μmol/l 50–120 µmol/l
Corrected Ca2+ 3.1 mmol/l 2.20–2.60 mmol/l
You commence treatment with intravenous fluid and the recommended intravenous drug infusion.
In which principal way will this medication correct the biochemical abnormality?
A General Practitioner is exploring treatment options for a 42-year-old woman who has a markedly elevated cholesterol level. Which of the following lipid-lowering medications works by inhibiting HMG-CoA reductase?
A 28-year-old woman is brought to the emergency department following an overdose at home. She reports taking 32 tablets of paracetamol 500 mg six hours ago. The patient is admitted to the observation unit for IV n-acetylcysteine. Which of the following factors is not linked to an elevated risk of developing hepatotoxicity in this case?
A 56-year-old man has arrived at the emergency department after ingesting 28 paracetamol tablets. He has a history of alcohol and drug addiction, as well as being under the care of the mental health crisis team. Prior to the overdose, he had been consuming alcohol heavily. His BMI is 24 kg/m² and he has smoked for 24 pack-years. He is currently taking a statin, omeprazole, and occasionally aspirin for pain relief. The results of his liver function tests show an AST level of 110 iu/l (3-30 iu/l). What aspect of this patient’s medical history places him at a heightened risk of hepatotoxicity following his overdose?
A 63-year-old woman presents to the emergency department after intentionally overdosing on paracetamol. She has a medical history of depression, epilepsy, and pulmonary tuberculosis and is currently taking carbamazepine, St John’s wort, rifampicin, and isoniazid. Upon examination, she appears emaciated and has a noticeable odor of alcohol. Given her overdose, what factors may be associated with a lower risk of hepatotoxicity in this patient?
A 55-year-old male visits his primary care physician complaining of a fine tremor in both hands that has been present for two months. He has a medical history of chronic depression and has been taking lithium for several years. He drinks 10 units of alcohol per week and has never smoked. During the examination, a fine bilateral postural tremor is observed in the hands and fingers, which is most noticeable when extending the arms in front of the body. What is the probable cause of this patient’s tremor?
You are requested to evaluate a patient on an inpatient psychiatric ward who has been feeling unwell for the past few days. The patient complains of severe tremors, muscle weakness, and diarrhea. As part of the workup, you order a lithium level since the patient is on lithium medication. The result comes back high at 1.9mEq/l. You observe that the nursing chart indicates that the patient, who is in their late 60s, has been bedridden and has refused food and drink except for smoking. What is the most likely factor that has contributed to this lithium toxicity?
A 42-year-old man visits his doctor with concerns about his seasonal allergies. He is employed as a truck driver and is seeking recommendations for an antihistamine that will not cause drowsiness. What antihistamine would you recommend for this patient?
A 21-year-old male student from Egypt presents to the emergency department with a 4-day history of increasing lethargy and reduced exercise tolerance. He also reports dark urine. These symptoms started 2 days after he finished a course of antibiotics for a lower respiratory tract infection.
On examination, you notice yellow sclerae bilaterally. His abdomen is soft and non-tender, respiratory and neurological examinations are unremarkable, cardiac examination shows sinus tachycardia of 110 beats/min.
His blood test results are as follows:
Hb 89 g/L (135-180)
Platelets 450* 109/L (150 – 400)
WBC 12 * 109/L (4.0 – 11.0)
Bilirubin 65 µmol/L (3 – 17)
ALP 90 u/L (30 – 100)
ALT 33 u/L (3 – 40)
Albumin 40 g/L (35 – 50)
Na+ 140 mmol/L (135 – 145)
K+ 5 mmol/L (3.5 – 5.0)
Urea 6 mmol/L (2.0 – 7.0)
Creatinine 110 µmol/L (55 – 120)
Reticulocytes 4 % (0.5 – 1.5)
Blood film Heinz bodies
Which antibiotic is responsible for the patient’s symptoms?