A 68-year-old man comes to his General Practitioner complaining of painless, gradual, one-sided swelling in his right leg. He reports that this is more noticeable in the evenings. During clinical examination, the right leg is swollen, but there is no redness or excessive warmth upon touch. He is in good health otherwise. He had undergone surgery in the past to treat prostate cancer.
What is the initial investigation that should be performed to confirm the diagnosis?
A 60-year-old man was brought into the Emergency Department with sudden onset of severe back pain lasting 20 min. The pain was constant and not exacerbated by coughing or sneezing. On examination, the patient was in shock, with a palpable 8-cm mass deep in the epigastrium above the umbilicus. His past medical history includes a 6-cm abdominal aortic aneurysm diagnosed 2 years ago at the time of cholecystectomy. The patient is a non-smoker and drinks 2 pints of beer a week.
Which is the most probable diagnosis?
A 35-year-old pregnant woman comes to the clinic with a complaint of a burning sensation in her legs. She reports that her legs are very sore and uncomfortable. Upon examination, there is a hard, tender, bulging of veins in both her thighs and the calf region, with hyperpigmentation and eczema of both the legs and an ulcer over the medial malleolus. What would prevent radiofrequency ablation from being performed as an initial treatment for this patient?
A 45-year-old man, who is a heavy smoker, was seen in the Surgical Outpatient Clinic, complaining of severe pain in both legs, even at rest. On examination, he had chronic ulceration of his toes.
Which of the following conditions is he most likely to have?
A 50-year-old woman had a traditional high tie, strip and avulsion procedure for her varicose veins in the distribution of the long and short saphenous veins. She experienced difficulty walking after the surgery because she could not dorsiflex or evert her foot. The surgeon had warned her beforehand that nerve damage was a possibility.
What nerve was affected during the patient’s varicose vein surgery?
A 72-year-old woman presents to the General Practitioner complaining of ‘bulging blue veins’ on her legs. While examining the patient’s legs, you note the presence of tortuous, dilated veins, accompanied by brown patches of pigmentation and dry, scaly plaques of skin. A diagnosis of varicose veins is made.
Which vein is most likely to be affected?
A 30-year-old man comes to the clinic with a testicular lump that has been present for a few weeks and is gradually getting bigger. He has no history of trauma and is not experiencing any other symptoms. He has no significant medical history or regular medications. During the examination, a solid 3 cm mass is found in the left testicle, along with widespread lymphadenopathy. The following are his blood test results:
Alpha-fetoprotein (αFP): 0.1 ng/ml (0-10 ng/ml)
Beta-human chorionic gonadotrophin (βHCG): 4,500 IU/l
Lactate dehydrogenase (LDH): 375 IU/l
What is the most probable diagnosis?
A 15-year-old presents with a tender, pea-sized lump in the upper pole of his left testis. He says it has developed gradually over the last 24 hours. His mum states that his grandfather died of testicular cancer at just 45 years of age. Other than pain from the lump, he says he feels generally well in himself. On examination, the lump does not transilluminate and feels regular. There is no associated oedema or erythema.
What is the most likely diagnosis?
A 28-year-old man and his 26-year-old wife visit their GP for a follow-up appointment regarding their difficulty in conceiving. The couple has been trying to conceive for the past year without success. The wife has a regular menstrual cycle and no previous gynaecological issues. An ovulation test measuring her progesterone level showed normal ovulation. The GP advises the couple that the husband needs to undergo tests to determine if there is any cause on his side contributing to the infertility. Both the man and the woman have no history of sexually transmitted infections. The man has been smoking one to two cigarettes a day since he was 16 years old. What is the best next investigation for this patient?
You are asked to place a catheter in a pediatric patient for urinary retention. You select a 6-Fr catheter.
Which of the following is the most accurate description of the size of this catheter?