A 30-year-old man comes to you complaining of severe anal pain that has been bothering him for a day, especially during defecation. Upon further inquiry, he reveals that he has been experiencing constipation more frequently lately and had a minor incident of fresh red blood on the toilet paper a week ago. During the examination, you observe a tender, bulging nodule just outside the anal opening. What is the probable diagnosis?
A 50-year-old man comes in with an episode of alcoholic pancreatitis. He shows gradual improvement and is assessed at his 6-week follow-up. He has a bloated feeling in his upper abdomen and a fluid collection is discovered behind his stomach on imaging. His serum amylase levels are slightly elevated. What is the most probable cause?
You encounter a 50-year-old man who confides in you about his personal issue. He has been experiencing difficulties with achieving and maintaining erections for the past year, and it has been progressively worsening. This patient seldom visits healthcare providers and has no prior medical conditions.
What is the predominant organic etiology for this symptom?
A 65-year-old woman undergoes a right hemicolectomy for colon cancer and four days later presents with vomiting, a distended abdomen, and absent bowel sounds. Her blood results show a CRP of 124 mg/l and a WBC count of 5.2 * 109/l. Nursing notes reveal no bowel movements since surgery. What is the probable cause of her clinical presentation?
A 50-year-old male construction worker presents to the Emergency Department with new onset frank haematuria. He has been passing blood and clots during urination for the past three days. He denies any dysuria or abdominal pain. His vital signs are stable with a heart rate of 80 bpm and blood pressure of 130/80 mmHg. Upon examination, his abdomen is soft without tenderness or palpable masses in the abdomen or renal angles. He has a 30 pack-year history of smoking. What is the most appropriate initial investigation to determine the cause of his haematuria?
You are summoned to the ward by nursing staff to assess a 79-year-old man who has been admitted with acute urinary retention. Despite a well-functioning catheter, he is experiencing pain in his penis. Upon examination, his abdomen appears normal, but his penis is swollen with a tight constricting band located just proximal to the glans penis. What is the probable diagnosis?
A 42-year-old man comes to the emergency department complaining of severe abdominal pain. The pain is concentrated in the epigastric region and is relieved by leaning forward. He has vomited twice, but there was no blood in the vomit.
Upon examination, he appears unwell and sweaty. His heart rate is 90 beats per minute, blood pressure is 100/72 mmHg, respiratory rate is 22 breaths per minute, and temperature is 39.2 ºC.
Given his complex medical history and multiple daily medications, which medication is most likely causing his symptoms?
A 16-year-old boy comes to the emergency department complaining of severe pain in his left testicle. The pain started about an hour ago and he rates it as 10/10. He has experienced this pain three times before, but he has never sought medical attention as it usually goes away within an hour. Upon examination, there is swelling and redness of the scrotum.
After being admitted, the pain and swelling begin to subside.
What treatment should be administered in this case based on his presentation?
A 35-year-old woman who is a heavy smoker presents with recurring infections in her right breast. During examination, an indurated area is found at the lateral aspect of the nipple areolar complex. Imaging reveals no mass lesions. What is the probable diagnosis?
An 80-year-old male is admitted to the urology ward with acute urinary retention. He is catheterised successfully with a large retention volume of 1.5 litres and therefore kept on the ward for observation. Over the next 24 hours, the patient has a urine output of 200 ml/hour and develops increasing confusion. His blood results are as follows:
Hb 130 g/L Male: (135-180)
Platelets 280 * 109/L (150 – 400)
WBC 9 * 109/L (4.0 – 11.0)
Na+ 136 mmol/L (135 – 145)
K+ 4.5 mmol/L (3.5 – 5.0)
Urea 8 mmol/L (2.0 – 7.0)
Creatinine 130 µmol/L (55 – 120)
CRP 3 mg/L (< 5) What could be the possible reason for the patient’s confusion?