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?
A 75-year-old man presents to his physician with concerns about alterations in his bowel movements, experiencing small droplets of stool, rectal bleeding, and abdominal discomfort. The physician orders a red flag colonoscopy, which reveals no signs of cancer but does show protrusions in the bowel wall that may be responsible for the patient’s symptoms. Which section of the large intestine is most likely to exhibit these protrusions?
A 60-year-old man visits his doctor with worries about blood in his stool. He has been noticing red blood for a few weeks now. Recently, he experienced pain while passing stools and felt a lump around his anus. During the examination, a purple mass is observed in the perianal area. Upon direct rectal examination, a tender lump is confirmed at the 7 o’clock position. What is the best course of action for managing this presentation?
A 40-year-old male presents to his GP with concerns about his recent difficulty achieving erections, which is causing strain in his relationship. He reports a sudden onset of this issue a few weeks ago, but denies any changes in mood or previous medical or psychiatric conditions. The patient smoked occasionally in his teenage years but has been smoke-free for over 20 years. He maintains a healthy diet and exercises by cycling for an hour each week. Based on this history, what features suggest an organic cause for his erectile dysfunction?
What is the most probable diagnosis for a 56-year-old man who has lethargy, haematuria, haemoptysis, hypertension, and a right loin mass, and whose CT scan shows a lesion in the upper pole of the right kidney with a small cystic centre?
A 65-year-old Asian man, residing in the United Kingdom for the last 20 years, visits the clinic with a complaint of painless haematuria. He is a regular smoker, consuming 10 cigarettes per day. Upon examination, his haemoglobin level is found to be 110 g/L (120-160), and urinalysis shows ++ blood. Additionally, a PA chest x-ray reveals small white opacifications in the upper lobe of the left lung. What is the probable diagnosis?
A 72-year-old man, who used to smoke and has a smoking history of 24 pack-years, presents to the emergency department with sudden chest pain. He describes the pain as starting in the center of his chest and then spreading to his back. The man lives alone, has a history of high blood pressure, and drinks 20 units of alcohol per week. On examination, he has a respiratory rate of 28 breaths per minute, a heart rate of 130 beats per minute, and a blood pressure of 88/65 mmHg. What is the most appropriate next step in managing this patient?
A 60-year-old male undergoes an abdominal ultrasound scan as part of the abdominal aortic aneurysm screening programme. The scan reveals an abdominal aortic aneurysm measuring 5.4 cm. After three months, a follow-up scan shows that the aorta width has increased to 5.5 cm. The patient remains asymptomatic.
What is the recommended course of action?
You are caring for a patient who has recently been diagnosed with prostate cancer and is currently considering treatment options. He asks you to explain the complications of surgery to remove the prostate. What is another common complication of radical prostatectomy?
A 28-year-old female patient presents to her GP with concerns about a lump in her right breast. The patient reports that she first noticed the lump about two months ago and it has remained persistent without any noticeable increase in size. Upon examination, the GP observes a smooth, mobile 2 cm lump in the Inferolateral quadrant without skin or nipple changes. The patient denies any family history of breast cancer and has no lumps in her axilla. What is the most suitable course of action for management?