A 50-year-old man presents to his GP with concerns about erectile dysfunction. He has been experiencing this for the past year and is feeling embarrassed and anxious about it, as it is causing issues in his marriage. On examination, the GP notes that the patient is overweight with a BMI of 27 kg/m2, but does not find any other abnormalities. The GP orders HbA1c and lipid tests. What other steps should the GP take at this point?
A 53-year-old man presents to the GUM clinic with a swollen, tender, and red glans penis that he has been experiencing for the past five days. He is unable to retract his foreskin fully and is experiencing pain while urinating. He has no sexual activity. This is his fourth presentation for balanitis in the last year, and he has tested negative for sexually transmitted infections and bacterial infections on each occasion. He has been successfully managed with saline baths and topical clotrimazole. He has a medical history of diabetes mellitus.
After treating this acute episode with saline baths and topical clotrimazole, what is the most appropriate next step in management?
Sarah is a 23-year-old female who has been brought to the emergency department via ambulance after a car accident. On arrival, her Glasgow Coma Score (GCS) is E2V2M4. Due to concerns about her airway, the attending anaesthetist decides to perform rapid sequence induction and intubation. The anaesthetist administers sedation followed by a muscle relaxant to facilitate intubation. Shortly after, you observe a series of brief muscle twitches throughout Sarah’s body, followed by complete paralysis. Which medication is most likely responsible for these symptoms?
A 28-year-old male patient visits his GP complaining of a painless lump in his scrotum. He admits to not regularly performing self-examinations and reports no other symptoms. Upon examination, his left testicle is enlarged. The GP orders a two-week-wait ultrasound scan of the testicles, which reveals a cystic lesion with mixed solid echoes in the affected testicle. What tumor marker is linked to this condition?
A 70-year-old man comes to you with complaints of painful and itchy white spots on his penis. Upon examination, you notice hyperkeratotic lesions in various locations on his foreskin and glans. He also reports dysuria and reduced sensation in the glans. Based on your assessment, you suspect Balanitis Xerotica Obliterans. What are some possible associations with this condition?
A 67-year-old woman comes in with a lesion on her left breast. Upon examination, there is a weeping, crusting lesion on the left nipple, but the areolar region is unaffected. No palpable mass is found in the breast, but there is a palpable lymph node in the axillary region. The patient’s doctor attempted to treat the lesion with 1% hydrocortisone cream, but it was unsuccessful. What is the probable diagnosis?
A 45-year-old man is recovering on the surgical ward three days after a laparotomy and right hemicolectomy for cancer. You are asked to see him as he has developed a temperature of 38.5ºC and is tachycardic at 120 bpm and tachypnoeic at 25 breaths per minute. On examination his abdomen is soft and not distended but tender around his midline wound. There is some discharge seeping through the dressing. His chest is clear and he has no signs of a deep vein thrombosis.
What is the most probable cause of this man’s elevated temperature?
An 81-year-old man has fallen off his bike and hit his head. His friend at the scene reports that he was unconscious for less than a minute. The man was cycling slowly on a path beside a canal. Upon initial assessment, he has some bruising on his upper and lower limbs, a Glasgow coma score (GCS) of 15, and no neurological deficit. He has not experienced vomiting or seizures since the accident and was able to describe the incident. He takes antihypertensives but has no significant medical history. What would be the most appropriate next step?
A 7-year-old boy arrives at the emergency department with his mother complaining of a painful penile erection that has lasted for 4 hours. The mother reports that the boy has a history of sickle cell disease. What is the most appropriate initial course of action?
An 80-year-old man arrives at the emergency department with his partner following a fall. A collateral history is obtained, revealing that he tripped over a loose rug and fell, hitting his head on the ground and losing consciousness for 2 minutes. Upon examination, there is bruising on his upper limbs, but no neurological deficits are observed, and his Glasgow coma score (GCS) is 15. The patient himself can recall events leading up to and after the fall, and has not experienced vomiting or seizures since the incident. Additionally, there are no indications of a skull fracture. The patient has a medical history of hypertension that is managed with amlodipine. What is the most appropriate next step?