A 70-year-old man is admitted to the orthopaedic ward for a planned hip replacement surgery. He has been evaluated for VTE prophylaxis. Despite his age, he has no other risk factors for VTE or bleeding. What are the recommended VTE prophylaxis measures for this patient?
A 67-year-old man presents to the emergency department with sudden onset epigastric pain described as burning and radiating into his back. He reports vomiting and ongoing nausea. The patient has a history of recurrent gallstones and is awaiting a semi-elective cholecystectomy. He is not taking any regular medications. On examination, the patient has jaundiced sclera and diffuse abdominal tenderness with guarding. There is also periumbilical superficial oedema and bruising, and decreased bowel sounds on auscultation.
What is a crucial aspect of the immediate management of this patient, given the likely diagnosis?
A 49-year-old female patient complains of loin pain and haematuria. Upon urine dipstick examination, the results show:
Blood ++++
Nitrites POS
Leucocytes +++
Protein ++
Further urine culture reveals a Proteus infection, while an x-ray confirms the presence of a stag-horn calculus in the left renal pelvis. What is the probable composition of the renal stone?
A 25-year-old man was driving under the influence of alcohol at a high speed, with his seat belt on. He crashed into a brick wall at approximately 140 km/h. Upon arrival at the emergency department, he was found to be in a comatose state. Although his CT scan showed no abnormalities, he remained in a persistent vegetative state. What is the probable underlying reason for this?
A 48-year-old man is brought to the emergency department by ambulance with multiple stab wounds. During clinical examination, eight stab wounds are identified on his abdomen and one on the front of his chest. His airway has been secured, and he is receiving oxygen at a rate of 15 L/min while IV fluid resuscitation has been initiated.
Following CT scans of his abdomen, the patient has been transferred to the operating room for an emergency laparotomy. The surgeons are assessing the condition of his spleen based on the CT and laparotomy findings to determine the next steps in his treatment.
What is one reason that may indicate the need for a splenectomy in this patient?
A 50-year-old woman is planning to undergo a total hip replacement surgery in 3 months. She has a medical history of hypothyroidism, hypertension, and menopausal symptoms. Her current medications include Femoston (estradiol and dydrogesterone), levothyroxine, labetalol, and amlodipine. What recommendations should be provided to her regarding her medication regimen prior to the surgery?
An 80-year-old man presents to the surgical assessment unit for evaluation before an elective Hartmann’s procedure in a week due to bowel cancer. He has a medical history of hypertension, atrial fibrillation, and a previous cerebrovascular accident. The registrar requests you to assess him before his surgery next week. During your review, you observe that he is currently on warfarin, and his INR is 2.6 today. All other blood tests are normal. What is the most appropriate approach to manage his anticoagulation during the peri-operative period?
A 55-year-old male patient complains of pain in the right upper quadrant that has been bothering him for the past 5 hours. During examination, his blood pressure is 120/80 mmHg, heart rate is 75 bpm, temperature is 38.5ºC, and he displays signs of jaundice. What is the probable causative organism for this diagnosis?
A 50-year-old man presents to his GP with complaints of left flank pain. He has a history of smoking a pack of cigarettes a day for 25 years. On physical examination, there is tenderness in the left flank but no palpable mass. Urine dipstick testing reveals the presence of blood. A CT scan of the abdomen shows a complex cystic mass with solid and liquid components, arising from the parenchyma of the left kidney and with septations. What is the most probable diagnosis?
A 67-year-old man with stage 5 chronic kidney disease has been on haemodialysis for the past few years. Due to an unplanned holiday, he has missed 6 dialysis sessions and has presented to the emergency department this morning in a poor way. The registrar orders an ECG and is extremely worried.
What is the most concerning ECG sign for this patient?