A 15-year-old girl presents to her GP with her father, reporting a rash and fatigue. She has been feeling generally unwell for the past week since returning from a trip to Europe. During the examination, a circular rash is observed, with a more pronounced appearance in the center and edges. The rash is warm and red but does not cause any pain. What possible illnesses should be considered in this patient?
A 20-year-old male patient visits his GP clinic with a complaint of painful blisters and ulcers on his glans, accompanied by pain during urination. He is sexually active and does not use protection during intercourse. His last unprotected sexual encounter was a week ago. What medication would be beneficial for this patient?
A 32-year-old female sex worker presents to the emergency department complaining of a high fever and severe headache. During the physical examination, you observe neck stiffness and mild photophobia, prompting you to perform a lumbar puncture. The results of the lumbar puncture reveal the presence of a yeast and a capsule in the CSF stained with India ink.
What is the most probable diagnosis?
A 65-year-old woman presents to the emergency department with a 6 cm erythematous skin lesion on her upper arm after experiencing a high fever of 39ºC, headache, and vomiting for the past 48 hours. A skin biopsy revealed a beta-haemolytic group A streptococcal infection in the upper dermis. What is the most appropriate term to describe this condition?
A 55-year-old rancher presents to the ER with his spouse. He is experiencing a high fever and excessive sweating. During the examination, multiple black blisters are observed, which are producing a malodorous discharge. What is the typical microorganism linked to this ailment?
A 26-year-old man presents to the GUM clinic with penile discharge and dysuria for the past 5 days. Urethral swabs are taken and microscopy reveals the presence of diplococci. Sensitivities are not yet available, and he is diagnosed with gonorrhoea. What is the recommended initial treatment?
A 67-year-old man presents to the emergency department with a productive cough of green sputum. He has a history of COPD and is an active smoker. Upon examination, he is wheezy bilaterally and saturating at 94% on room air. A chest X-ray shows no signs of consolidation. The following blood tests were obtained:
CRP 26 mg/L (< 5)
Na+ 133 mmol/L (135 – 145)
K+ 3.6 mmol/L (3.5 – 5.0)
Bicarbonate 34 mmol/L (22 – 29)
Urea 6 mmol/L (2.0 – 7.0)
Creatinine 100 µmol/L (55 – 120)
What is the most likely causative organism for this clinical presentation?
A 67-year-old woman presents with a 2-week history of frequent loose stools, left iliac fossa discomfort and fever without rectal bleeding.
Three months ago she was treated for confirmed Clostridium difficile infection with oral vancomycin, with a resolution of symptoms.
On examination, her heart rate is 90 bpm, respiratory rate of 18 breaths/min, temperature 37.6ºC and blood pressure of 130/86 mmHg. Her abdomen is generally mildly tender, without guarding.
A repeat stool culture confirms Clostridium difficile infection.
What is the most appropriate treatment for this patient?
A 45-year-old woman visits her primary care physician after being bitten by a tick. She explains that the tick was removed by her husband using tweezers and is worried about the potential for Lyme disease. She reports no symptoms such as rash, headache, fever, lethargy, or joint pain. Her vital signs are normal and a full physical examination reveals no abnormalities. What is the best course of action for management?
You are taking the history of an Emergency Department patient who was assaulted. The victim is a 20-year-old female who has a deep laceration on her thigh caused by a rusty machete. The wound has exposed tendon, muscle, and subcutaneous fat. According to her medical records, she received all her childhood immunizations on schedule, including 5 doses of tetanus vaccine, with the last one administered when she was 16 years old.
What is the appropriate management for tetanus risk in this patient?