A 30-year-old female is being evaluated before an elective cholecystectomy due to two severe episodes of biliary colic. She has a BMI of 28 kg/m² and smokes 2-3 cigarettes daily, but has no other medical conditions. She inquires about when she should discontinue her oral contraceptive pill. What is the recommended protocol?
A 30-year-old woman is preparing for an elective laparoscopic cholecystectomy with general anesthesia and inquires about when she should discontinue her combined oral contraceptive pill. What is the best recommendation?
A 28-year-old male has come for his pre-operative assessment before his tonsillectomy due to recurrent tonsillitis. During the assessment, the anaesthetist asks about his family history and he reveals that his father and paternal grandfather both had malignant hyperthermia after receiving general anaesthesia. However, his mother and paternal grandmother have never had any adverse reactions to general anaesthesia. What is the likelihood of this patient experiencing a similar reaction after receiving general anaesthesia?
You are the surgical F1 on call and are bleeped to go and review Mrs. Smith, a 64-year-old who underwent a right sided total hip replacement 6 hours previously. She has type 2 diabetes mellitus but is otherwise healthy. The nursing staff are concerned as her catheter output has steadily declined and has been 40ml over the last two hours. She has also been drowsy since returning to the ward. The urine is very concentrated but is draining slowly.
Examination reveals: heart rate 131/min, blood pressure 92/71 mmHg, temperature 36.8C, BM 8.7 and a central cap refill of 2/3 seconds. Her abdomen is soft, non-tender and you see no obvious signs of acute bleeding. She had a spinal anaesthetic during the procedure and is written up for PRN oramorph (5mg 2-4 Hourly). A 1 L bag of Hartmann’s is running over 8 hours. What is the most appropriate course of action?
A 67-year-old man presents for an abdominal aortic aneurysm (AAA) screening at his GP’s office. During the ultrasound, it is discovered that he has a supra-renal aneurysm measuring 4.9 cm in diameter. The patient reports no symptoms. What is the appropriate management plan for this individual?
A 26-year-old woman weighing 70kg is brought to the emergency department with burns covering 25% of her body surface area.
Using the Parkland formula, calculate the volume of Hartmann’s solution that is recommended to be given in the first 8 hours after the burn.
You are consulting with a 30-year-old male who is experiencing difficulties with his erections. He is generally healthy, a non-smoker, and consumes 8-10 units of alcohol per week. He has been in a committed relationship for 3 years, but this issue is beginning to impact their intimacy.
Before providing advice, you proceed to gather a complete psychosexual history. What information from the following list would indicate a physical rather than psychological origin for his condition?
A patient is brought into resus following a seizure, she has a nasopharyngeal airway (NPA) in situ. A nasopharyngeal airway would be contraindicated in?
A 56-year-old man comes to your GP office and expresses his anxiety about developing an abdominal aortic aneurysm (AAA) after his friend, who seemed healthy, passed away due to a ruptured AAA. During the physical examination, the patient’s vital signs are all normal, and his body mass index is 24 kg/m². Although you can feel his abdominal pulse, it is not expansile. As a result, you decide to educate the patient about the abdominal aortic aneurysm screening program.
What information would you provide to the patient during this discussion?
A 68-year-old male presents to the emergency department via ambulance with severe abdominal pain and vomiting. He has a history of similar but less severe episodes in the past. The patient has a medical history of gastro-oesophageal reflux, osteoarthritis, and COPD. He has a smoking history of 30 pack-years and drinks 40 units of alcohol per week. After stabilizing the patient using an ABCDE approach, investigations reveal moderately raised amylase, deranged liver function tests, and free air under the diaphragm on chest x-ray. What is the most likely diagnosis?