A 25-year-old ice hockey player was tackled by a member of the opposite team and fell on the ice, hitting the right side of his head. He was disoriented but was able to continue the game. The following evening, his roommate tried to wake him but found him unconscious in a pool of vomit.
What is the most probable finding in a CT scan of his head?
A 14-year-old boy presents to his family physician complaining of headaches, delayed puberty, growth retardation, and difficulty with spatial awareness. Upon visual field testing, a bitemporal hemianopia is observed. What is the most probable diagnosis?
A 72-year-old man presents to the Emergency Department with a headache after being referred by his General Practitioner (GP). The GP referral letter mentions that the patient presented with a history of fluctuating consciousness levels for the past week. The wife reports that her husband had a fall about a week ago and since then, he seemed to be a different man. The patient mentions that he has been experiencing a dull headache which did not respond to regular paracetamol. He denies nausea, vomiting and photophobia.
On examination, the vital signs are stable, the patient is apyrexial and there are no rashes. The patient has a past medical history of alcohol dependence, liver cirrhosis, gout and hypertension. A computed tomography (CT) scan of the patient’s head shows a crescent-shaped area of haemorrhage with midline shift of the brain structures.
What is the best next management step for this patient?
A 76-year-old man is brought unconscious to the Emergency Department by the paramedics. His daughter reported that her father had been having slurred speech since he woke up and that he had fallen out of bed 2 days previously. Upon radiological examination, it was determined that the patient suffered from a subdural haematoma.
If untreated, which of the following will most likely be a complication?
A 32-year-old man presents with sudden-onset severe occipital headache and neck stiffness. His wife helped him into bed but had to call an ambulance after he became increasingly confused and drowsy. He is currently under investigation for chronic renal failure. On examination, his Glasgow Coma Score (GCS) is 6 and his blood pressure is elevated at 192/100 mmHg. There are bilateral ballotable renal masses on abdominal palpation.
Investigations:
Investigation Result Normal value
Haemoglobin 131 g/l 135–175 g/l
White cell count (WCC) 9.1 × 109/l 4–11 × 109/l
Platelets 189 × 109/l 150–400 × 109/l
Sodium (Na+) 139 mmol/l 135–145 mmol/l
Potassium (K+) 4.9 mmol/l 3.5–5.0 mmol/l
Creatinine 195 μmol/l 50–120 µmol/l
Which of the following is the most likely diagnosis?
A 38-year-old man comes to the emergency department with a sudden-onset severe headache and vomiting that started an hour ago. He has no significant medical history but is a smoker and drinks socially. The doctor suspects a subarachnoid haemorrhage and wants to perform the most appropriate first-line investigation to confirm the diagnosis.
What is the most suitable initial test to confirm the suspected diagnosis in this patient?
A 32-year-old man is currently in the Neurosurgical Intensive Care Unit (ICU) following a subarachnoid haemorrhage. He had surgery to manage occlusive hydrocephalus that arose as a result of his bleed. He has an intraventricular pressure monitor in place to monitor his intracranial pressure.
What is a true statement about intracranial pressure?
A 28-year-old man presents to his GP with complaints of abnormal sensations in his right hand and forearm. He reports experiencing numbness and tingling in the back of his hand, particularly around his thumb, index, and middle finger. Additionally, he has noticed weakness in his elbow and wrist. Upon examination, the GP observes reduced power in elbow and wrist extension on the right side. The patient denies any history of trauma to the arm and does not engage in extreme sports. He works as a security agent and often sleeps in a chair during his night shifts. X-rays of the right wrist, elbow, and shoulder reveal no apparent fractures. What is the most probable diagnosis for this individual?
A 38-year-old woman presents to her general practitioner with new lower back pain. The pain started yesterday when she was lifting a heavy item at her workplace. She is otherwise fit and well, and not on any regular medications.
Which of the following features would suggest an urgent hospital admission should be arranged?
A 38-year-old male patient presents with sudden-onset severe headache and vomiting. He has a family history of subarachnoid haemorrhage.
Which of the following statements is true?