A 15-year-old patient, with learning difficulties and poorly controlled epilepsy, is admitted following a tonic−clonic seizure which resolved after the administration of lorazepam by a Casualty officer. Twenty minutes later, a further seizure occurred that again ceased with lorazepam. A further 10 minutes later, another seizure takes place.
What commonly would be the next step in the management of this patient?
A 72-year-old lady comes to the doctor with a gradual onset of bradykinesia, rigidity and tremor.
What is the most probable diagnosis?
A 32-year-old man is brought to the Emergency Department by air ambulance after being involved in a road traffic accident. According to witnesses this was a high-impact car crash and the other passenger in the car has unfortunately already passed away. The man is unconscious when he arrives, and initial assessment reveals a Glasgow Coma Scale (GCS) score of 9. He has some minor facial injuries and is bleeding from his nose.
What is the appropriate initial management for traumatic brain injury in this case?
A middle-aged woman reports to her general practitioner that she has noticed recent changes in her strength and endurance. Although she was active in her youth, she now reports weakness in her arms following formerly simple tasks. She no longer goes on long walks because of difficulty catching her breath on exertion. Her eyelids are droopy and she experiences difficulty holding her head upright.
What is the most likely disease?
A 58-year-old man visits his GP complaining of constant fatigue and frontal hair loss. He has a medical history of high blood pressure and asthma and takes salbutamol, amlodipine, and simvastatin. He appears to be in good health, and his neurological exam is unremarkable. The results of his auto-antibody screen are negative, but his creatine kinase (CK) level is 1,000 U/l, which is higher than the normal range of 22-198 U/l. What is the most likely cause of this man’s symptoms?
A 58-year-old man visits his GP complaining of constant fatigue and frontal hair loss. He has a medical history of high blood pressure and asthma and takes salbutamol, amlodipine, and simvastatin. He appears to be in good health, and his neurological examination is unremarkable. The auto-antibody screen is negative, and his creatine kinase (CK) level is 1,000 U/l (normal range: 22-198 U/l). What is the most likely cause of this man’s symptoms?
What are the reasons for having dilated pupils?
A 20-year-old farm worker presents with a two-day history of progressive weakness and tingling in all limbs. He had a recent episode of respiratory symptoms that resolved without treatment. On examination, he has decreased muscle strength in all extremities and absent deep tendon reflexes in the legs. Laboratory results show normal blood counts and electrolytes, as well as elevated CSF protein and normal glucose. What is the likely diagnosis?
A 75-year-old left-handed man with permanent atrial fibrillation comes to the clinic complaining of difficulty finding words and weakness in his right arm and leg. The symptoms appeared suddenly and have persisted for 24 hours. He reports no changes in his vision.
What is the probable diagnosis?
A 45-year-old woman with a history of schizophrenia resulting in multiple hospitalisations is referred to you in a psychiatry ward. She reports feeling generally unwell for several weeks, with increasing stiffness in her jaws and arms. She has been on haloperidol for the past few years with good symptom control. During examination, her temperature is 38.5°C and BP is 175/85 mmHg. What drug treatments would you consider for her condition?