A 35-year-old woman and her partner have come to seek advice from their GP on how to conceive as they are planning to start a family. The woman has a medical history of asthma and obesity with a BMI of 32 kg/m², while her partner has Crohn’s disease that is being managed with methotrexate. They have no significant family history and the woman hopes to have a vaginal birth. She has never been pregnant before. What is the primary advice that should be given?
A 56-year-old male with a history of hypertension, obesity, gout and hypercholesterolemia experiences an abrupt onset of diarrhea. Which medication is the most probable cause?
A 30-year-old man presents to the emergency department following a fall at home. He reports tripping over a rug and landing on his left knee, resulting in an audible crack and severe pain. The patient is unable to bear weight on the affected leg and experiences swelling and discoloration. Upon examination, the left knee is found to have significant haemarthrosis and limited range of motion due to pain. However, the patient is able to perform a straight leg raise successfully. Radiographs reveal a non-displaced patella fracture with joint effusion. What is the most appropriate course of action for managing this patient’s knee injury?
An 80-year-old man complains of lower back pain that worsens with walking. Upon obtaining a thorough medical history and conducting a neurological and vascular assessment, the possibility of spinal stenosis is considered. Following the prescription of pain relief medication, what would be the most suitable course of action?
A 39-year-old woman experiences lower back pain that travels down her left leg while doing DIY work. She reports a severe, sharp, stabbing pain that worsens with movement. During the clinical examination, a positive straight leg raise test is observed on the left side, but there are no other notable findings. The patient is given appropriate pain relief. What is the most appropriate next step in managing this condition?
A 65-year-old cancer survivor visits the GP complaining of back pain that began after playing golf last week. The pain intensifies when lying flat on the back at night, and taking paracetamol has provided little relief. The patient denies experiencing any bowel or bladder issues. During the examination, the doctor notes that the back pain is most prominent in the thoracic area, but there are no signs of neurological impairment. What is the most appropriate course of action for this individual?
A 68-year-old male comes to the clinic after tripping while walking his dog. He stumbled forward but managed to catch himself with his hands. He did not experience any head trauma or loss of consciousness.
Upon examination, he reports persistent discomfort in his left hand, and the pain intensifies when pressure is applied through the metacarpal of his thumb.
An X-ray shows an unsteady fracture in the proximal pole of a carpal bone.
What would be the most suitable course of action for managing this condition?
A 65-year-old woman complains of tingling in her left hand that sometimes disturbs her sleep. She usually shakes her hand to alleviate the symptoms, which disappear entirely. She has a history of uncontrolled type 2 diabetes and breast cancer. During the examination, there is no evidence of deformity or wasting, and she has good power throughout her hand. The symptoms are reproduced when forced wrist flexion is performed.
What is the best initial course of action?
A 75-year-old man complains of pain in his left thigh that has been progressively worsening for the past 10 months. Despite this, he is otherwise healthy. An x-ray reveals a radiolucency of the subarticular region suggestive of osteolysis, with some areas of patchy sclerosis. Blood tests show elevated levels of alkaline phosphatase and normal levels of calcium, phosphate, and prostate-specific antigen. What is the best course of action?
A 22-year-old female patient arrives at the emergency department complaining of wrist pain after falling off her bike and landing on her outstretched left hand earlier in the day. Upon examination, there is significant swelling in her left wrist, and she experiences pain when attempting to abduct her wrist. The anatomical snuffbox is the most tender area upon palpation, leading the physician to suspect a scaphoid fracture. An x-ray of the wrist is taken, but it appears normal.
What should be the next course of action in managing this patient’s condition?