A Vomiting Medical Student

A Vomiting Medical Student

A 21-year-old medical student presents with severe retrosternal pain, pain on swallowing, and breathlessness. Over the weekend he went on a heavy drinking binge after finishing his exams and spent most of the previous evening vomiting and retching forcefully. You...
An Intravenous Drug User with Back Pain

An Intravenous Drug User with Back Pain

A known intravenous drug user of no fixed abode presents with very severe back pain, fever, and left leg weakness. He has been woken at night several times because of the pain and is having difficulty walking. On examination he has tenderness over the lower lumbar...
A Homeless Man with a Head Injury

A Homeless Man with a Head Injury

A 61-year-old man of no fixed abode suffers a head injury during a fall. You organise a full set of bloods and a CT scan of the head as part of his work up. The bloods show deranged liver function tests and a macrocytic anemia. The CT scan of the head is reported as...
Sudden Onset Severe Abdominal Pain

Sudden Onset Severe Abdominal Pain

A 68-year-old man with a history of rheumatoid arthritis presents with sudden onset severe abdominal pain. On examination his abdomen is rigid, with generalized tenderness, guarding and rebound tenderness. An erect chest X-ray is performed, which is shown below:   1....
Drug-Induced QT Prolongation

Drug-Induced QT Prolongation

A patient is discovered to have new onset QT prolongation when an ECG is performed as part of a cardiovascular assessment. He tells you that he was recently prescribed a new medication by his GP and wonders if that may be the cause. 1. What is a prolonged QT interval?...
A Student with a Sore Throat

A Student with a Sore Throat

A 19-year-old student presents with a one-week history of a sore throat, low-grade fever, and malaise. She states that a week ago she had a fine rash over her body that faded quickly. On examination you note the presence of mild splenomegaly. 1. What is the most...

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