A 67-year-old woman visits her GP complaining of left flank pain and haematuria that has persisted for 3 weeks. She also reports a dry cough that has worsened over the past month. The patient has a history of smoking for 10 pack years. During the examination, a palpable mass is detected in the left flank. The patient is prescribed pembrolizumab and axitinib for treatment. What stage of cancer is likely to have been present at the time of diagnosis?
A 49-year-old woman arrives at the surgical assessment unit with fever, right upper quadrant pain, and yellowing of the sclera. Imaging confirms ascending cholangitis. She has a history of multiple hospitalizations for biliary colic. What is the primary cause of this condition?
A 70-year-old male is recuperating from a partial colectomy that he underwent 2 days ago. The patient reports an aggravation in pain at the incision site. Upon closer inspection, there is a discharge of pink serous fluid, a gap between the wound edges, and protrusion of bowel. The patient does not exhibit any other apparent symptoms. What is the immediate course of action for managing this patient?
During a pre-anaesthetic assessment, a teenage patient informs you that her mother had a negative reaction to certain drugs during an appendicectomy procedure several years ago and had to spend some time in the ICU on a ventilator. There were no lasting complications. What is the primary concern you should have?
What is the most frequent complication associated with a clavicle fracture?
Which complication is the least frequently linked to Colles’ fracture?
A sixty-seven-year-old woman on a colorectal surgery ward is recovering from a left hemi-colectomy 5 days previously for a tumour in the descending colon. She is eating and drinking as normal and has been able to mobilise with a walking aid during her physiotherapy sessions.
During the night she complains to the nurse that she is experiencing palpitations and feels very unwell. She has no significant past medical history and no previous surgery prior to this operation. Following her initial assessment, the nurse contacts the foundation year one doctor on call to assess the patient.
On examination:
Heart rate: 124/minute and irregularly irregular; Respiratory rate: 16/minute; Temperature: 38.2 ºC; Blood pressure: 132/82 mmHg; Oxygen saturations levels: 98%; Capillary refill time: <2 seconds. Heart sounds normal. Lungs clear. Abdomen distended. Wound on left flank healing well. No erythema or suppurative exudate. Firm and non-tender. No organomegaly. Kidneys non-ballotable. No pulsatile mass. Bowel sounds absent. No renal bruit. There is feculent material present in the abdominal wound drain. What is the most likely cause of this patient’s symptoms?
Linda, a 55-year-old woman with COPD and a 45-pack-year history, recently underwent a hysterectomy for uterine fibroids. She received standard anesthesia induction with propofol and rocuronium, and maintenance with sevoflurane. During her postoperative recovery, she experienced apnea upon extubation and required a prolonged stay in the ICU until she could be weaned off the ventilator. Upon further questioning by the ICU doctor, Linda revealed that she had been experiencing double vision and weakness in her hands and fingers, which worsened throughout the day. She had attributed these symptoms to fatigue. What is the most likely cause of her prolonged reliance on the ventilator?
In which joint is recurrent dislocation most frequently observed?
A 73-year-old man is undergoing an elective transurethral resection of prostate (TURP) for benign prostatic hyperplasia with spinal anaesthesia. After 40 minutes into the procedure, he complains of headache and visual disturbances. A venous blood gas analysis is ordered, and the results show severe hyponatremia. What could be the reason for this presentation?