You are requested to assess a 43-year-old male patient who has been admitted to the acute medical unit due to anaemia. The patient has a history of sickle cell anaemia. According to his blood test results, his Hb level is 37 g/l, and his reticulocyte count is 0.4%. Normally, his Hb level is 70 g/l. What is the probable diagnosis?
A 45-year-old man has been referred to the hepatology clinic by his GP due to concerns of developing chronic liver disease. The patient reports feeling increasingly fatigued over the past few years, which he attributes to poor sleep and low libido causing relationship problems with his partner. During examination, the hepatologist notes the presence of gynaecomastia, palmar erythema, and grey skin pigmentation. Blood tests are ordered to investigate the underlying cause.
The following results were obtained:
Bilirubin: 18 µmol/L (3 – 17)
ALP: 110 u/L (30 – 100)
ALT: 220 u/L (3 – 40)
γGT: 90 u/L (8 – 60)
Albumin: 37 g/L (35 – 50)
Ferritin: 1,250 ng/mL (20 – 230)
What is the initial treatment that should be offered to this patient?
A 68-year-old man with chronic kidney disease (CKD) visits his doctor for routine blood tests. The following results are obtained:
Hb 140 g/L Male: (135-180)
Female: (115 – 160)
Platelets 135 * 109/L (150 – 400)
WBC 6.4 * 109/L (4.0 – 11.0)
Na+ 130 mmol/L (135 – 145)
K+ 6.0 mmol/L (3.5 – 5.0)
Bicarbonate 16 mmol/L (22 – 29)
Urea 11.4 mmol/L (2.0 – 7.0)
Creatinine 186 µmol/L (55 – 120)
Calcium 1.2 mmol/L (2.1-2.6)
Phosphate 4.5 mmol/L (0.8-1.4)
Magnesium 0.8 mmol/L (0.7-1.0)
Question: Which of the above results indicates a chronic disease course in this patient, rather than an acute one?
Which of the following features is least likely to be observed in Henoch-Schonlein purpura?
An elderly woman, aged 72, is admitted to the hospital with chest pain and diagnosed with a non-ST elevation myocardial infarction. She has a medical history of hypertension, type 2 diabetes, and chronic kidney disease (CKD2). Her current medications include metformin 1 g twice daily, ramipril 2.5 mg daily, and aspirin 75 mg daily. What therapeutic intervention is necessary to prepare for the upcoming contrast angiogram?
A 55-year-old man of black African origin presents to his GP for a review of his home blood pressure monitoring diary. The diary shows an average blood pressure of 140/90 mmHg, while his clinic reading today is 145/92 mmHg. The patient has a medical history of type two diabetes mellitus (T2DM) and takes metformin. He has no allergies and is not on any other medications. What is the best course of action for managing his blood pressure?
A 56-year-old male has presented to the GP diabetic clinic for a medication and blood result review. He has been well-controlled on metformin 1g twice-a-day for his type 2 diabetes. However, his recent HbA1c result is 60 mmol/mol. The patient has a history of heart failure and the GP emphasizes the significance of lifestyle and dietary advice.
What would be the most suitable course of action for managing this patient?
A 26-year-old man visits his GP complaining of watery diarrhoea that has persisted for a few days. The patient had received IM ceftriaxone for gonorrhoeae treatment the previous week. He has not traveled recently and has maintained his regular diet. This is the first time the patient has encountered diarrhoea in his life. The GP conducted some tests and found that the patient is positive for C.difficile toxin. What is the best course of action to take?
A 70-year-old man visits his doctor complaining of leg pains. He has been suffering from diabetic neuropathy in both legs for the last 6 years and has tried various medications such as amitriptyline, duloxetine, and gabapentin. He inquires if there are any additional measures that can be taken to alleviate his pain in the long run. What would be the most suitable answer?
A 70-year-old woman presents to the emergency department with symptoms of chest pain, palpitations, shortness of breath and dizziness. She has a medical history of depression, poorly controlled COPD and allergies. Recently, she has been taking medications such as salbutamol, sertraline, erythromycin, gentamicin and promethazine.
During the physical examination, her heart rate is 120 beats/min and her blood pressure is 83/50 mmHg. An ECG reveals ventricular tachycardia with prolonged QT intervals and rapid polymorphic QRS complexes.
Based on this information, which medication is most likely responsible for her presentation?