Case of the Month
A 70-Year-Old Man with Acute Shortness of Breath
A 70-year-old man with a history of stable angina and hypertension develops sudden onset breathlessness at night. He is unable to lie flat and appears, sweaty and anxious. He is brought into the resus area and the sister in charge has sat him upright and commenced...
An 80-Year-Old Woman with an Itchy, Blistering Rash
An 80-year old woman presents with an itchy, blistering rash affecting her arms and trunk. She is systemically well, and her observations are normal. The rash is mainly localised to her right arm and is shown below: 1. What is the most likely diagnosis?Bullous...
A 50-Year-Old Woman with an Itchy, Blistering Rash
A 50-year-old woman presents with a painful, blistering rash affecting her face, limbs and trunk. She initially noticed painful blisters in her mouth, but these subsequently spread to the skin a few weeks later. The blisters, where present are large and flaccid. Most...
A 22-Year-Old Man with a Nasal Injury
A 22-year-old man has been struck on the bridge of the nose during an altercation outside a nightclub last night. He had a brief episode of epistaxis at the time, which stopped after pressure was applied to the nose. He is complaining of a painful, deformed nose and...
A 25-Year-Old Woman with a Nosebleed
A 25-year-old woman presents with a nosebleed that started after blowing her nose 30 minutes ago. She is currently catching the drips in a bowl and you have been asked to see her urgently by the triage nurse. Her observations are normal, and she has no haemodynamic...
A 53-Year-Old Woman with Hypertension and Hypokalaemia
A 53-year-old woman has been visiting her GP with symptoms of tiredness, muscle weakness and headaches. She is known to be hypertensive and takes amlodipine to control this. Her blood results today show that her potassium level is low at 3.0 mmol/L, and her sodium...
A 40-Year-Old Woman with Intermittent Hypertension and Sweating
A 40-year-old woman presents with intermittent episodes of severe sweating, palpitations and an associated feeling of panic and anxiety. She measured her blood pressure at home during one of these episodes and found it to be 196/118 mmHg. You measure it today and find...
A 34-Year-Old Man with Hyperkalaemia
A patient with a history of renal problems generalised weakness, palpitations and chest pain. His serum potassium levels are measured and come back at 8.2 mmol/L. An ECG is performed, and it shows some very alarming changes. 1. What is the definition of...
A 74-Year-Old Man with Sudden Cognitive Decline
A 74-year-old man presents having suffered an episode of left arm and leg weakness that resolved after a few hours. His relatives have noticed that he has suddenly become very forgetful over the past week and is forgetting the names of people and places and having...
A 21-Year-Old Football Player with a Severely Painful Elbow
A 21-year-old football player presents with a deformed, severely painful elbow following a fall onto his right arm. An X-ray is performed, which is shown below. 1. What is the diagnosis?This patient has a posterolateral elbow dislocation. Elbow dislocations are...
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