A Crashing Asthmatic

A Crashing Asthmatic

A 24-year-old woman with a history of brittle asthma is brought to the Emergency Department by her boyfriend. She is very short of breath and wheezy and her condition deteriorates rapidly. Following back to back nebs, hydrocortisone and IV magnesium sulphate, she is...
An Overdose with an Unknown Substance

An Overdose with an Unknown Substance

A 30-year-old woman presents having taken an overdose of an unknown substance. She is drowsy and slurring her speech. Her observations are as follows: HR 116, BP 91/57, SaO2 96% on air. GCS 11/15. The results of her arterial blood gas (ABG) on air are shown below:  ...
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....

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