A 45-year-old woman with a history of schizophrenia and multiple hospitalisations presents in a psychiatry ward with a few weeks of feeling unwell and stiffness in her jaws and arms. She has been on haloperidol for symptom control. Her temperature is 38.5°C and BP is 175/85 mmHg. What is the most crucial investigation to conduct?
An 80-year-old retired teacher complains of headache and scalp tenderness. She reports experiencing blurred vision for the past three days. What signs suggest a possible diagnosis of giant cell arthritis?
A 60-year-old woman visits her GP with a complaint of hoarseness in her voice for a few weeks. She underwent a thyroidectomy a decade ago. During the examination, the doctor observed decreased breath sounds in the left upper lobe. The patient has a smoking history of 75 pack years and quit five years ago. A chest X-ray revealed an opacity in the left upper lobe. Which cranial nerve is likely to be impacted?
A 5-year-old boy is brought to his General Practitioner as his parents are worried about his walking. Up until four months ago, he was developing normally. However, they have now noticed he has difficulty getting up from the floor or climbing stairs. During the examination, the doctor observes Gowers’ sign and the boy has large, bulky calf muscles. His mother remembers having an uncle who died at a young age but cannot recall the cause of death. What is the probable reason for his walking difficulties?
A 16-year-old student presents to the Emergency Department with complaints of headache, neck stiffness, and photophobia. During the examination, a purpuric rash is observed on the trunk and limbs.
What condition is this patient at risk for?
A 54-year-old man with a history of acromegaly presents for a check-up. He reports experiencing pins and needles in his hands in the early morning hours, and a positive Tinel’s sign. Which muscle is most likely to be weak?
A father brings his 7-year-old daughter to the Emergency Department following three events which occurred earlier in the day. The father describes multiple events throughout the day whereby his daughter has been sitting on the floor and suddenly stops what she is doing, becoming somewhat vacant. She would not respond to anything that he said. He describes the events lasting for around five seconds and they end quite rapidly. She is not aware of these events and cannot recall any odd feelings. The father is very worried and is sure that this is not normal.
What is the most likely diagnosis?
What brain structure is likely affected in a 72-year-old man who suddenly experiences paralysis on the left side of his body and oculomotor nerve dysfunction on the right side?
A 27-year-old female patient presents to the Emergency Department complaining of a severe headache that has been progressively worsening over the past two to three months. She also reports experiencing blurred vision. The patient has a history of depression, which she attributes to her weight problem and bad skin. However, she has been actively trying to address these issues by joining Weight Watchers and receiving treatment for her acne from her GP for the past four months. On examination, the patient is overweight and has moderately severe acne. She is afebrile, and there are no signs of nuchal rigidity. The oropharynx is benign, and the neurological examination is normal, except for blurred disc margins bilaterally and a limited ability to abduct the left eye. What is the most likely diagnosis?
A 20-year-old female patient with a prolonged history of sinusitis complains of fever and headache accompanied by a change in personality. During fundal examination, papilloedema is observed. What is the most probable diagnosis?