A 35-year-old woman arrives at the emergency department complaining of intense epigastric pain and non-bilious vomiting that has persisted for two days. She reports retching but no longer brings anything up. During the examination, the surgical registrar observes abdominal distension and widespread guarding and rigidity. The registrar requests the insertion of a nasogastric tube, but three attempts fail. What is the probable diagnosis?
A 65-year-old man comes to the GP with a recently discovered lump on his abdomen. During the examination, a solitary visible protrusion is observed 5 cm above the belly button in the center. It seems pink and is painless without indications of necrosis. Bowel sounds are audible.
What is the probable diagnosis?
An 80-year-old man arrives at the emergency department complaining of sudden pain in his left leg that has developed over the past two hours. During examination, the leg appears pale and the patient is unable to move it. The leg is also tender to the touch. The left foot is absent of dorsalis pedis and posterior tibial pulses, while the right foot has a palpable dorsalis pedis pulse. The patient’s medical history includes atrial fibrillation, and he mentions being less active in recent months. He has a family history of his father dying from a pulmonary embolus.
What is the initial management that should be taken for this patient’s most likely diagnosis?
A 72-year-old man presents to the emergency department after being referred by his primary care physician due to experiencing abdominal distension and difficulty passing stool or flatus for the past four days. The patient denies any nausea or vomiting, but reports irregular bowel movements with occasional bleeding and recent weight loss. During the examination, tinkling bowel sounds are heard and a digital rectal exam reveals the presence of hard feces. The patient also mentions that his mother had a history of recurrent bowel adhesions requiring multiple surgeries. What is the most probable cause of the patient’s symptoms?
A 6-month old boy is brought to his pediatrician by the parents. They request circumcision due to their religious beliefs. The doctor explains that this is not a service provided by the NHS unless there is a medical necessity, and it must be done at a private clinic. Before making a decision about performing the procedure, what should be ruled out?
A 6-week-old boy is brought to his pediatrician by his parents to discuss referral to private healthcare for a circumcision, which they want performed for cultural reasons. They do not report any concerns regarding his health. On examination, he appears to be developing normally and the external genitalia appear normal.
What is a contraindication to performing a circumcision?
What substances or factors prevent osteoclast activity?
A 67-year-old male is admitted to your surgical ward for an elective hemicolectomy tomorrow due to Duke’s B colonic cancer. During your admission assessment, you observe that his full blood count (FBC) indicates a microcytic anaemia with a haemoglobin level of 60 g/L. His previous FBC 4 months ago showed Hb 90 g/L. Haematinic blood tests reveal that the cause of the microcytosis is iron deficiency.
What would be the most suitable approach to manage his anaemia?
A 39-year-old man arrives at the emergency department complaining of intense pain in his lower back. The pain comes in waves and spreads to his groin area. He is unable to stay still due to the severity of the pain and has vomited multiple times since arriving at the hospital. The patient has no fever and is still able to urinate normally. A urine dipstick test shows the presence of blood but no signs of white blood cells or nitrites.
What is the initial treatment that should be administered to this patient?
What is a characteristic of a trident hand?