A 57-year-old man arrives at the emergency department complaining of pleuritic chest pain, dyspnoea and pyrexia. He has a history of alcohol abuse and emits a strong smell of alcohol. While in the department, he begins to cough up currant jelly sputum. He is admitted and given the appropriate antibiotics. The sputum is cultured and the causative agent is identified. What other condition is associated with this organism?
A 29-year-old woman with a history of sickle cell disease visits her GP complaining of sudden fatigue, palpitations, and shortness of breath during physical activity. She has always been healthy before this. However, her daughter has been sick with a fever, fatigue, and a rash on her face for the past few days.
The patient’s blood test results from three months ago showed a hemoglobin level of 116 g/L (normal range for females: 115-160 g/L), platelets at 178 * 109/L (normal range: 150-400 * 109/L), and a white blood cell count of 6.3 * 109/L (normal range: 4.0-11.0 * 109/L).
Today’s blood test results show a significant drop in hemoglobin levels to 71 g/L, platelets at 110 * 109/L, and a white blood cell count of 4.1 * 109/L. The reticulocyte count is also low at 0.1% (normal range: 0.5-1.5%).
What is the most likely complication that has arisen in this case?
A 32-year-old male presents to the outpatient department with symptoms of fever and headache after returning from a trip to central America. He has no significant medical history or regular medications. Upon investigation, he is diagnosed with Plasmodium vivax and completes a course of acute treatment without adverse effects. It is confirmed that he has no allergies. What is the appropriate treatment to initiate at this point?
A 67-year-old man presents to a rural medical assessment unit with recurrent episodes of syncope. He is admitted into the hospital in the cardiology ward for a work-up.
After two hours of admission, he experiences dizziness and mild disorientation. Upon examination, his airway is clear, he is breathing at a rate of 15 breaths per minute, his oxygen saturation is 96% on air, his blood pressure is 90/50 mmHg, and his heart rate is 40 beats per minute. It is noted that he has a documented anaphylactic allergy to atropine.
What is the most appropriate management option?
A 65-year-old male presents to his primary care physician with a 2-month history of fatigue and difficulty concentrating. He experiences shortness of breath when walking short distances, which was not previously an issue. Upon examination, he appears pale and there are no notable findings in his cardiorespiratory or neurological exams. Blood tests reveal the following results: Hb 100 g/L (Male: 135-180, Female: 115-160), Platelets 165* 109/L (150-400), WBC 4.2* 109/L (4.0-11.0), and a blood film with hypersegmented polymorphs. His Vitamin B12 level is 110 ng/L (>200) and his Folate level is 1.5 ng/mL (2-10). What is the most appropriate management option for this patient?
A 26-year-old man presents to the gastroenterology clinic with symptoms of intermittent diarrhoea, abdominal distention, and unintentional weight loss. His investigations reveal low Hb, ferritin, and vitamin B12 levels, as well as complete villous atrophy and crypt hyperplasia on endoscopy and biopsy. The IgA tissue transglutaminase level is also elevated. What dietary recommendations should be given to this patient?
A 79-year-old man arrives at the emergency department with sudden onset of weakness in his right arm and leg accompanied by blurred vision. He has a medical history of hypertension and type 2 diabetes and is currently taking ramipril and metformin. During examination, the left pupil is dilated with absent consensual and direct light reflexes, while the right pupil has intact reflexes. Bilateral upper and lower limb power is 3/5. Based on this presentation, where is the most likely location of the patient’s stroke?
A 63-year-old man comes to the emergency department complaining of ‘flutters in his chest’ for the past 24 hours. He is aware of when his symptoms started and mentions having had 2 non-ST-elevation myocardial infarctions before. He has hypertension, which is controlled with perindopril monotherapy, and hypercholesterolaemia treated with atorvastatin. He has no other relevant medical history.
During the examination, the patient is alert and oriented. His blood pressure is 135/90 mmHg, heart rate is 112 beats per minute, temperature is 37.3ºC, and respiratory rate is 16 breaths per minute. An ECG shows an irregularly irregular rhythm. After discussing with the patient, a management plan is suggested.
What is the most likely management plan to be initiated for this patient based on his presentation?
A 54-year-old man visits his GP complaining of difficult-to-control hypertension for the past 6 years. Despite trying various medications, his blood pressure remains high. He also reports experiencing muscle weakness and nocturia for many years. The patient has no significant medical history. During the examination, the patient appears healthy, but his blood pressure is measured at 162/86 mmHg. Blood tests are conducted, and the results are as follows:
– Na+ 138 mmol/L (135 – 145)
– K+ 3.2 mmol/L (3.5 – 5.0)
– Urea 5.6 mmol/L (2.0 – 7.0)
– Creatinine 78 µmol/L (55 – 120)
– Aldosterone:renin ratio 42 ng/dl per ng/(ml·h) (2-17)
Based on the information provided, what is the most probable cause of the patient’s condition?
A 65-year-old patient in the emergency department waiting room suddenly collapses due to feeling unwell. Upon transfer to the resuscitation area, the patient’s heart rate is recorded at 38 bpm and blood pressure at 86/60mmHg. What is the initial step in managing this patient?