Case of the Month

A 35-Year-Old Woman with Epistaxis

A 35-Year-Old Woman with Epistaxis

A 35-year-old woman presents with epistaxis. She has a history of menorrhagia and frequent nose bleeds. She is prescribed a medication to help with this but cannot recall its name or why she takes it. She states that her father and brother also suffer with the same...

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Arterial Line Insertion

Arterial Line Insertion

A doctor currently working in the intensive care unit has been asked to insert an arterial line into a patient that has just been reviewed on the ward round. 1. What are the main indications for inserting an arterial line?The two main indications for the insertion of...

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A 73-Year-Old Man with Lumps on His Neck

A 73-Year-Old Man with Lumps on His Neck

A 73-year-old man presents complaining of lumps on his neck. On examination, you note the presence of several large, non-tender cervical lymph nodes. You organise for some blood tests to be performed, and the results show that he has a lymphocytosis of 16 x...

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A 59-Year-Old Man with a Headache

A 59-Year-Old Man with a Headache

A 59-year-old gentleman presents to the Emergency Department complaining of a headache. He has had similar headaches over the last few weeks and also some blurring of his vision. His initial observations are as follows: HR 92 bpm, BP 210/132 mmHg, SaO2 99% on air, BM...

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A Patient with a Suspected Pulmonary Embolus

A Patient with a Suspected Pulmonary Embolus

A 52-year-old man presents to the emergency department with chest pain. He has recently returned from Australia and has a history of a painful swollen right calf over the last couple of days. He is otherwise usually fit and well and has no known allergies. You suspect...

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A 40-Year-Old Man with a Dry Cough and a Fever

A 40-Year-Old Man with a Dry Cough and a Fever

A 40-year-old man presents with a dry cough and a fever for the past few days. His cough is non-productive. Today he has also had several episodes of diarrhoea and has developed bilateral pleuritic chest pain. He states that he is short of breath, most notably on...

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Chickenpox Exposure in Pregnancy

Chickenpox Exposure in Pregnancy

You review a 31-year-old patient who is 14 weeks pregnant. She is worried as she was exposed to chickenpox two days ago. She cannot remember whether she has had chickenpox as a child.1. If the mother were to contract chickenpox, what would the principal risk to the...

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Needle Cricothyroidotomy

Needle Cricothyroidotomy

A 24-year-old man has been involved in a road traffic accident and suffered facial and thoracic injuries. The anaesthetist has been unable to intubate the patient and is going to attempt a needle cricothyroidotomy. 1. What are the anatomical landmarks for this...

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Stroke Management

Stroke Management

A 73-year-old woman presents with new-onset left-sided hemiplegia. A CT head scan is undertaken, which confirms the diagnosis of an ischaemic stroke. She is currently in resus, and the nurse in charge informs you that her BP is very high, with the most recent...

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A 50-Year-Old man with a Painful, Swollen Leg

A 50-Year-Old man with a Painful, Swollen Leg

A 50-year-old man presents with a painful, red, swollen lower left leg that started a few days after he suffered a small abrasion to his ankle working in his garage. The area is warm to the touch, and he currently has a temperature of 38.2°C. He has no other past...

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