A 30-year-old female patient visits the neurology clinic due to recurring headaches that happen once a month. She also reports experiencing peculiar flashes before the onset of pain. During an attack, she feels exhausted and finds relief by resting in a dark room. What is the most probable diagnosis, and what medication should be prescribed for symptom prevention?
A 70-year-old male comes to the clinic with a painful and swollen right calf. The doctor suspects a deep vein thrombosis (DVT). What test result would indicate an underlying condition that increases the risk of DVT?
A 75-year-old man has been experiencing abdominal discomfort and distension for the past two days. He has not had a bowel movement in a week and has not passed gas in two days. He seems sluggish and has a temperature of 35.5°C. His pulse is 56 BPM, and his abdomen is not tender. An X-ray of his abdomen reveals enlarged loops of both small and large bowel. What is the most probable diagnosis?
A 67-year-old patient visits his primary care physician complaining of a recent exacerbation of his chronic cough. He reports experiencing similar episodes in the past, during which his typically yellow sputum becomes thicker and slightly tinged with blood. The patient has a history of hypertension and bronchiectasis, and has received multiple courses of antibiotics for these exacerbations. Upon examination, the patient appears relatively healthy but continues to cough. Crackles are heard upon chest auscultation. Given the patient’s medical history and likely diagnosis, the physician decides to obtain a sputum sample. What organism is most likely to be observed upon culturing?
A 34-year-old woman is seeking preconception advice from her GP as she plans to start trying for a baby. Despite feeling relatively well, she has several pre-existing medical conditions. She is classified as grade 2 obese and has type 2 diabetes (which is managed with metformin), hypertension (treated with ramipril), gastro-oesophageal reflux (using ranitidine), and allergic rhinitis (taking loratadine). Additionally, she experiences back pain and takes paracetamol on a daily basis.
Which medication should she avoid during pregnancy?
A 35-year-old man has visited his doctor complaining of feeling unwell. He has been experiencing flu-like symptoms, nausea, and joint pain for the past 3 weeks. Additionally, he has noticeable yellowing of the skin. The patient recently returned from a trip to Mallorca, a Spanish island, 6 weeks ago. Although he did not engage in unprotected sex, he frequently dined at local seafood restaurants. He has no medical history. Upon examination, the doctor noted an enlargement of the liver and spleen. What is the most likely cause of this patient’s hepatosplenomegaly?
A 67-year-old woman is undergoing an OGD to investigate dysphagia related to her known achalasia. During the procedure, a mass is observed in the middle third of her oesophagus, without other abnormalities detected beyond this point. What type of cancer is most likely present?
A 75-year-old man in the respiratory ward is diagnosed with a left-sided pleural effusion after presenting to the emergency department with difficulty breathing. An ultrasound-guided pleural aspiration is performed and the fluid is sent to the lab for analysis. The results show a pleural fluid protein level of 30 g/L (normal value < 10 g/dL) and a pleural fluid lactate dehydrogenase (LDH) level of 220 IU/L (normal value <50% plasma concentration). Unfortunately, the serum protein and LDH levels are not available. Based on these findings, what is the most likely underlying diagnosis?
A 28-year-old junior doctor presents to the Emergency department with complaints of a severe headache and neck stiffness. He reports experiencing mild diarrhoea over the past few days and some coryzal symptoms. On examination, his blood pressure is 155/82 mmHg, his pulse is 85 and regular, and his temperature is 37.8℃. He displays signs consistent with severe meningism, but there are no skin rashes or other signs of vasculitis.
The following investigations were conducted:
– Haemoglobin: 138 g/L (135-177)
– White cells: 8.9 ×109/L (4-11)
– Platelet: 183 ×109/L (150-400)
– Sodium: 141 mmol/L (135-146)
– Potassium: 4.4 mmol/L (3.5-5)
– Creatinine: 92 µmol/L (79-118)
– Lumbar puncture: lymphocytosis, slightly raised protein, normal glucose.
What is the most likely diagnosis?
A 55-year-old man undergoes an arterial blood gas test and the results show the following while he is breathing room air:
pH 7.49
pCO2 2.4 kPa
pO2 8.5 kPa
HCO3 22 mmol/l
What is the most probable condition responsible for these findings?