A clinical trial compared the effectiveness of two anti-anginal medications in reducing stable angina pain while walking on flat ground. The study found that 65% of patients who took drug A and 60% of patients who took drug B achieved the primary outcome.
If a patient wants to avoid stable angina pain while walking on flat ground, how many more patients need to be treated with drug A compared to drug B?
In a randomized controlled trial evaluating the effectiveness of a new antihypertensive medication compared to conventional therapy for secondary stroke prevention in elderly patients, the researchers found a 0.5% reduction in the annual incidence of stroke. The cost of the new treatment is £100 more per patient per year than the conventional therapy. What is the cost per stroke prevented with the implementation of the new therapy?
A 68-year-old man with extensive peripheral vascular disease has sudden-onset severe abdominal pain with cramping and bloody stools. An arterial blood gas shows a pH of 6.9.
Which one of the following would you most likely find in this patient?
The arterial blood gas results are as follows: pH of 7.6 (normal range: 7.35-7.45), pO2 of 13.3 kPa (normal range: 10.5-13.5 kPa), pCO2 of 5.6 kPa (normal range: 4.6-6.0 kPa), HCO3 of 32 mmol/l (normal range: 24-30 mmol/l), and SaO2 of 97% on room air. Based on these results, which clinical scenario is the most likely explanation for these findings?
A 55-year-old woman comes to her primary care physician complaining of ongoing lower back pain. She has a medical history of type I diabetes mellitus since the age of 17 and hypertension. Upon examination, her total serum calcium level is found to be 3.5 (2.2–2.6 mmol/l), and her serum parathyroid hormone (PTH) level is significantly low. What is the most probable reason for these results?
A 58-year-old woman has developed hypotension and tachycardia, 3 hours after a laparoscopic partial gastrectomy for a distal gastric tumor. Her blood gas analysis shows:
Investigation Result Normal value
pH 7.28 7.35–7.45
pCO2 7.1 kPa 4.6–6.0 kPa
pO2 8.0 kPa 10.5–13.5 kPa
Bicarbonate 29 mmol/l 24–30 mmol/l
Base excess 5 mmol/l –2.0 to +2.0 mmol/l
What is the most probable diagnosis based on these findings?
A 78-year-old man is referred to rheumatology outpatients with increasing pain in the left leg. On examination, the left leg is slightly larger than the right and appears slightly deformed. An X-ray demonstrates cortical expansion and coarsening of trabeculae in keeping with Paget’s disease of bone.
What is likely to be found on serum biochemistry?
An 85-year-old woman presents in the Emergency Department with a 3-week history of increasing confusion and falls. Routine investigations reveal:
FBC: Hb 123 g/l, MCV 86 fl, WCC 7.9 × 109/l, platelets 478 × 109/l
U&Es: Na+ 109 mmol/l, K+ 4.9 mmol/l, urea 5.2 mmol/l, creatinine 76 μmol/l
Which of the following would clinically exclude a diagnosis of syndrome of inappropriate antidiuretic hormone (SIADH)?
A 47-year-old woman is brought into the Emergency Department after collapsing in a shopping mall. Her identity is unknown and she is unable to provide any medical history. The patient undergoes assessment and blood tests are taken, including an arterial blood gas (ABG). The ABG results reveal a metabolic acidosis with a normal anion gap.
What condition could potentially present with this ABG result in a 47-year-old woman?
A 28-year-old woman (an immigrant from India) complained of lower back and pelvic pain, as well as weakness when climbing stairs. Her physician suspects that she may have a vitamin D deficiency.
Which of the following blood tests would be most consistent with this diagnosis?