A 25-year-old law student presents with visual loss in the right eye, accompanied by a constant headache for the past three months. She also reports not having had her menstrual cycle for six months. Upon examination, her visual acuity in the affected eye is 6/24, with slight constriction of both temporal visual fields. However, there are no other neurological deficits present. The patient is stable, without fever or hemodynamic abnormalities. What is the likely diagnosis?
A 65-year-old man with lung cancer was admitted to the Emergency department due to respiratory distress. Upon examination, his ECG revealed electrical alternans. What is the most probable diagnosis for this patient?
A 20-year-old male with sickle cell disease complains of severe abdominal pain. He has a blood pressure of 105/80 mmHg, heart rate of 110 bpm, and temperature of 38.0°C.
What would be your initial step?
What virus is described as a picornavirus with a single stranded RNA genome, transmitted through faecal-oral route, and has no chronic sequelae?
The following arterial blood gases (ABGs) were taken from an unconscious 50-year-old woman in the Emergency department on FiO2 of 21%:
pH 7.36 (7.36-7.44)
pO2 13.0 kPa (11.3-12.6)
pCO2 3.7 kPa (4.7-6.0)
HCO3− 15 mmol/L (20-28)
What is the correct interpretation of the ABG result?
As the foundation year doctor in general surgery, you are called to assess a patient who has suddenly become unresponsive at 4 am. The patient is a 45-year-old female who has been admitted for an elective cholecystectomy scheduled for 8 am.
Upon examination, the patient appears sweaty and clammy and is hypoventilating. She is only responsive to painful stimuli.
The patient’s vital signs are as follows: heart rate of 115, blood pressure of 110/70 mmHg, respiratory rate of 8, oxygen saturation of 99%, and blood glucose level of 1.1.
What would be your next step in initiating drug therapy?
A previously healthy 85-year-old woman presents to the surgical admissions unit after being referred by her GP due to a two-day history of increasing pain and swelling in the right groin area. Upon examination, there is a firm and red swelling that extends from the pubic tubercle downwards and outwards. What is the probable diagnosis?
A 60-year-old patient has been diagnosed with chronic hepatitis B through blood tests. The doctor explains that the patient is highly contagious and at a greater risk of long-term disease. Which of the following blood results is most likely to be seen in this patient?
HbSAg Anti-HBs IgM anti-HBc IgG anti-HBc HBeAg Anti-HBe
A + – + + + –
B – + – + – +
C + – – + + –
D + – – + – +
E – + – – – –
A 27-year-old female is found in a confused and drowsy state. Her friend discovered her this morning after a night of drinking, but also mentions that she was upset about her recent breakup. Upon examination, she has a Glasgow coma scale rating of 10/15, a blood pressure of 138/90 mmHg, a temperature of 37.5°C, large pupils that react slowly to light, a pulse of 120 beats per minute, a respiratory rate of 32/min, and exaggerated reflexes with Downgoing plantar responses. Additionally, a palpable bladder is found during abdominal examination. What substance is she most likely to have taken?
A 20-year old woman arrives at the Emergency department after a night out with her friends. According to her friends, she has been talking to herself about nonsensical things and appears agitated and restless. During the examination, it is noted that her reflexes are heightened and an electrocardiogram (ECG) reveals ventricular ectopics. What type of substance abuse is suspected in this case?