A 35-year-old man visits the clinic seeking guidance. He has planned a long-distance trip to Australia and is worried about the risk of deep vein thrombosis (DVT). He has no significant medical history and is in good health.
What is the best advice to offer him?
A 35-year-old woman presents to the hospital with a painful and swollen right leg that has been bothering her for the past three days. She has a history of deep vein thrombosis in the same leg ten years ago after returning from her honeymoon in Australia. Additionally, she was treated for pleurisy three years ago by her general practitioner. She has been experiencing recurrent water infections for the past two years, with intermittent bouts of flank pain and dark urine in the morning. Her general practitioner has recently investigated this issue, but the ultrasound scan of her renal tract and intravenous pyelogram were normal. She works as a cashier in a building society and lives with her husband and two children. She does not have a recent history of travel, but she smokes 10 cigarettes daily and occasionally drinks alcohol. On examination, her right calf is swollen, red, and tender, but she appears otherwise well. Her blood tests show low hemoglobin, white cell count, and platelets, as well as elevated bilirubin and alkaline phosphatase. What is the most likely diagnosis?
A 50-year-old male has a history of severe rheumatoid arthritis for the past four years. Despite being compliant with therapy (NSAIDs and methotrexate), the disease remains poorly controlled. Recently, he has been experiencing extreme fatigue. Upon conducting an FBC, the following results were obtained:
– Haemoglobin 70 g/L (120-160)
– White cell count 1.5 ×109/L (4-11)
– Platelet count 40 ×109/L (150-400)
What could be the possible cause of his pancytopenia?
A 75-year-old woman who is in hospital for pneumonia begins to deteriorate on her third day of intravenous antibiotics. She develops purple bruises on her skin and on the inside of her mouth, and tells you that she feels short of breath and fatigued. Her platelet count has dropped from 165 × 109/l to 43 × 109/l over the last two days. She also complains of blurred vision in the last few hours.
Which of the following will form part of her initial management?
A 55-year-old male comes to the clinic complaining of pain in his right leg, five days after having a cholecystectomy. Upon examination, the right leg is swollen, tender, and warm, while the left leg appears normal. What is the most suitable test to confirm the diagnosis?
A 45-year-old patient presents with the following full blood count (FBC) result: Hb 105 g/L (130-180), RBC 4.5 ×1012/L, Hct 0.353 (0.4-0.52), MCV 75 fL (80-96), MCH 32.5 pg (28-32), Platelets 325 ×109/L (150-400), WBC 7.91 ×109/L (4-11), Neutrophils 6.15 ×109/L (1.5-7.0), Lymphocytes 1.54 ×109/L (1.5-4.0), Monocytes 0.33 ×109/L (0-0.8), Eosinophils 0.16 ×109/L (0.04-0.4), Basophils 0.08 ×109/L (0-0.1), Others 0.14 ×109/L. What would be the most appropriate initial investigation for this FBC result?
A 23-year-old female patient presents at the clinic for a check-up. She complains of irregular, heavy menstrual periods, has a BMI of 30 kg/m2, and experiences acne and excessive facial hair growth. She is not taking any medication. Her sister has been diagnosed with polycystic ovarian syndrome (PCOS), and she suspects that she may have the same condition.
During the physical examination, her blood pressure is 149/90 mmHg, and her pulse is regular at 78 bpm. She has excessive hair growth on her beard line and upper torso, and central obesity. However, the rest of her physical examination is normal.
Which blood test is the most diagnostic for PCOS?
These results were obtained on a 65-year-old male:
Hb 110 g/L (120-170)
RBC 4.8 ×1012/L (4.2-5.8)
Hct 0.365 (0.37-0.49)
MCV 75 fL (82-98)
MCH 33.2 pg (28-33)
Platelets 310 ×109/L (140-450)
WBC 8.21 ×109/L (4.5-11)
Neutrophils 6.45 ×109/L (1.8-7.5)
Lymphocytes 1.23 ×109/L (1.0-4.5)
Monocytes 0.28 ×109/L (0-0.8)
Eosinophils 0.18 ×109/L (0.02-0.5)
Basophils 0.09 ×109/L (0-0.1)
Others 0.18 ×109/L –
What could be the possible reason for these FBC results in a 65-year-old male?
A patient on the ward receiving a blood transfusion after knee replacement surgery is noted to have rigors.
On examination, their temperature is 39°C (baseline 36.5°C). They also complain of abdominal pain and their blood pressure is 90/55 mmHg (baseline 126/84 mmHg).
What is the next step in managing this patient?
A 10-year-old girl injures her leg while playing soccer at the park. Her mother takes her to the emergency doctor at their GP clinic later that day as the bleeding has not stopped. The cut is not very big and is on the girl’s calf. They immediately applied pressure to the wound and then a bandage, however on examination the wound is still bleeding a little bit. The girl’s mother knows that there is a bleeding disorder in her family.
What is the most suitable course of action for this patient, given the probable diagnosis?