A 21-year-old with type one diabetes is brought to the emergency department due to feeling unwell for the past few days. Upon examination, his blood glucose level is found to be 25.7 mmol/l and his ketone level is 5.8 mmol/l. What is the expected result of the arterial blood gas test?
A 65-year-old male is admitted to the respiratory ward for severe community-acquired pneumonia and is being treated with amoxicillin. He has a medical history of a heart attack 2 years ago, hypertension, and type 2 diabetes. His current medications include aspirin 75 mg, atorvastatin 40 mg, ramipril 5mg, bendroflumethiazide 5mg, and metformin 500 mg BD. On the third day of treatment, the medical team noticed that the patient’s creatinine levels increased from a baseline of 67 micromol/litre to 190 micromol/litre. His eGFR is found to be 25 ml/min, and he is diagnosed with acute kidney injury. Which of the patient’s current medications can he continue taking in his current condition?
A 54-year-old man visits his doctor with a complaint of erectile dysfunction. He reports no recent stressors or changes in his lifestyle or diet. He has a medical history of type 2 diabetes mellitus, hypertension, gastroesophageal reflux disease (GORD), and osteoarthritis. His current medications include gliclazide, indapamide, metformin, omeprazole, and paracetamol. The doctor suspects that one of his medications is responsible for his erectile dysfunction. Which medication is the most likely culprit?
A 28-year-old female presents with a two-day history of right loin and supra-pubic pain, dysuria, and swinging fevers. She has a past medical history of urinary tract infections. Upon examination, she is febrile with a temperature of 39.2°C, her blood pressure is 100/60 mmHg, and her pulse is 94 bpm and regular. She appears unwell, and right renal angle and supra-pubic pain are confirmed. Laboratory tests show an elevated white blood cell count and a creatinine level of 125 µmol/L. What is the most appropriate imaging test for this patient?
You perform a home visit for an 80-year-old man diagnosed with terminal bronchial carcinoma. The patient has palliative care support in place, including anticipatory medications should he develop end-of-life symptoms. He is lucid and eating well, although unfortunately has developed shortness of breath and worsening pains from his metastases. The patient is a smoker and has a background of hypertension, ischaemic heart disease, and stage 4 chronic kidney disease.
Which medication would be the most suitable to relieve his symptoms?
A 25-year-old man comes to his doctor complaining of painful urination and a discharge from the tip of his penis for the past week. He denies having any fever, abdominal pain, joint pain, or blood in his urine. He is sexually active and has had intercourse with three different women in the last two months. On examination, there are no abnormalities noted in his genital area. What is the most suitable investigation for the most probable diagnosis?
An aged man with aortic stenosis is evaluated. What could potentially decrease the intensity of his ejection systolic murmur?
A 70-year-old man visits his doctor with complaints of fatigue and lower back pain. Upon conducting a thorough examination and taking a complete medical history, the physician orders blood tests. The results are as follows:
– Hemoglobin (Hb): 101 g/L (normal range for males: 135-180; females: 115-160)
– Platelets: 138 * 109/L (normal range: 150-400)
– White blood cells (WBC): 4.9 * 109/L (normal range: 4.0-11.0)
– Sodium (Na+): 132 mmol/L (normal range: 135-145)
– Potassium (K+): 3.7 mmol/L (normal range: 3.5-5.0)
– Bicarbonate: 27 mmol/L (normal range: 22-29)
– Urea: 8.4 mmol/L (normal range: 2.0-7.0)
– Creatinine: 142 µmol/L (normal range: 55-120)
– Calcium: 3.2 mmol/L (normal range: 2.1-2.6)
– Phosphate: 1.4 mmol/L (normal range: 0.8-1.4)
– Magnesium: 1.0 mmol/L (normal range: 0.7-1.0)
What is the recommended first-line imaging for this patient?
An 80-year-old man comes to the clinic with his son. The son reports that his father’s memory has been declining for the past 8 months and he has been experiencing fluctuations in attention and consciousness. The patient has also reported seeing dogs and children running around in his living room. The patient has a medical history of resting tremors, rigidity, and shuffling gait for the past 10 years. However, there is no history of mood swings or urinary or bowel incontinence. On examination, there are no postural changes in his blood pressure. What is the most likely diagnosis?
A 40-year-old woman visits her primary care physician with complaints of occasional double vision that occurs during the day. She reports that her vision returns to normal after taking a break. The symptoms have been worsening over the past six months, and she has already consulted an optometrist who could not identify a cause. There have been no indications of muscle or peripheral nerve issues. What medication is typically attempted as a first-line treatment for the suspected diagnosis?