Spit Happens, Clinical Case, NEW
NEW: Following exposure to a Hepatitis B positive source, what essential blood investigations are indicated for the exposed?
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#ClinicalCase
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RCEMLearning logo. Heading for trouble Clinical Case. UPDATE
UPDATE: A 14-year-old is brought into the emergency department (ED) with a headache that started 4 days ago. The headache came on gradually and he tells you it is about 4/10 in severity. Can you see any red flags?
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#ClinicalCase
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When ‘Normal’ isn’t Normal! Clinical Case NEW RCEMLearning
NEW: A 50-year-old man presents to the Emergency Department (ED) with left retro-orbital discomfort and a droopy left eyelid noticed by his wife this morning. He experienced one brief episode of dizziness that resolved.
#ClinicalCase
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Who decided to dip this child’s urine? Clinical Case, UPDATE
UPDATE: A 12-year-old girl is brought to your ED with abdominal pain and a urine dip is done.
What would your next course of action be? #ClinicalCase
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Cloudy Hypoxia After Foreign Travel. NEW. Clinical Case
NEW: Cloudy Hypoxia after foreign travel; a flashback of a pandemic or a rare home-grown complication of a childhood illness in an adult. #ClinicalCase
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🔎 Have a look at the Clinical Case of the Month: Severe CNI-Induced Hypertriglyceridemia with Neurological Hyperviscosity After HSCT ➡️ 🔗 ebmt.org/ebmt/news/cl...
#HCT #transplant #leukemia #clinicalcase
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A breathless boy with bruising. Clinical Case. UPDATE.
UPDATE: A 14-year-old boy presents with a one week history of lethargy, shortness of breath on minimal exertion such as climbing stairs, palpitations, recurrent spontaneous epistaxis lasting 10-15 minutes and easy bruising. #ClinicalCase
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A 45-year-old regular Emergency Department (ED) attender brought in by paramedics after being found unresponsive, GCS 11 (E2, M5 V4), in a lay-by near a local garage. The gentleman appears intoxicated. He does not smell of alcohol. Initial VBG indicates: pH 7.33, PaCO2 3.8, glucose 7.0, lactate 4.5, BE -5 Whilst waiting to be assessed the GCS drops to 9 and a repeat gas show pH 7.10, Lactate 6.2, BE -12. What is the most likely suspected cause of the abnormal VBG result?
UPDATE: Tis the season …. - #ClinicalCase
Regular attender is brought to ED with low GCS with suspicion of intoxication in cold winter season.
What is the most likely suspected cause of the abnormal VBG result?
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RCEMLearning, A Case of Muffled Hearing, Clinical Case, NEW
NEW: A 25-year-old Chinese male, who works in asset management, presents to the urgent care centre with a 5-day history of muffled hearing and tinnitus in the right ear.
What do you think is the most likely diagnosis? #ClinicalCase
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NEW: The Rash Decision: A Surprising Culprit behind a Sudden Eruption. Clinical Case.
NEW: A 55-year-old gentleman presents to the Emergency Department (ED) with a striking, itchy rash most noticeable on his torso, arms, and legs.
Which term best describes the rash? Find out more about the case: www.rcemlearning.co....
#ClinicalCase
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The Child with an Unbreakable Fever Clinical Case Which is the most likely diagnosis? NEW - RCEMLearning
NEW: A 4-year-old boy, previously well, presents to the emergency department (ED) with a 6-day history of high fever, unresponsive to paracetamol.
Which is the most likely diagnosis? #ClinicalCase
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on her right hand. She complains of tingling and numbness of the hand with new onset of right shoulder pain. On secondary survey, the palmar surface of right hand is erythematous. No entry or exit marks found. No collateral injury. #ClinicalCase
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Today's question! A patient with Dyskeratosis Congenita presents with hypoxia and intrapulmonary vascular dilatations on a bubble study. Can you identify the most likely diagnosis?
See the answer and explanation on the next slide!
#Hematology #BoneMarrowFailure #ClinicalCase #RareDiseases #HEMEHUB
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RCEMLearning logo. Sting on a Banjo String! Clinical Case. Update
On examination, a tiny bleeding point in the frenulum of the uncircumcised penis is revealed with no swelling, bruising or penile deformity. There is no difficulty in micturition. No injury elsewhere.
What is the most likely diagnosis? #ClinicalCase
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You can't see my hand? Clinical Case. UPDATE
A 21-year-old female presents to Emergency Department (ED) with 6 day history of occipital headache and seeing flashing lights. She has otherwise been well with no fevers or collapses. PMH: Mitochondrial 3243 A>G Mutation O/E: Left-sided homonymous hemianopia, otherwise normal. VBG: pH 7.37, Lactate 3.7
UPDATE: A 21-year-old female presents to Emergency Department (ED) with 6 day history of occipital headache and seeing flashing lights. She has otherwise been well with no fevers or collapses.
What is the most likely diagnosis? #ClinicalCase www.rcemlearning.co....
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A Minor Infection, a Major Interaction: Carbamazepine Toxicity Triggered by Clarithromycin. Clinical Case. UPDATE.
NEW: A 48-year-old man on carbamazepine developed acute ataxia and vomiting after starting clarithromycin for cellulitis, with toxic carbamazepine levels, highlighting a preventable drug–drug interaction [cont]. #ClinicalCase
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Can't keep it in. Clinical Case. UPDATE. RCEMLearning.
Mr Ship is a 94-year-old man, who lives alone in his home, and is fully independent for all his activities of daily living. He presents to the Emergency Department (ED) complaining of vomiting every time he eats. For the last 5 weeks Mr Ship has been complaining of vomiting after everything he eats. He is only able to keep a small amount of Weetabix down in the morning, and then has to survive on liquids from then on. He will still vomit small amounts of liquid. His vomit is clear with no blood. He also feels as though his trousers are starting to feel looser. He has put this down to poor oral intake. He has no abdominal pain, and his bowels continue to open every other day. He has had multiple ERCP’s for recurring cholangitis, and is on 30mg Lansoprazole for GORD following a recent presentation to the ED. On examination his abdomen is soft non tender, bowel sounds present, and his bloods are all normal. His past medical history includes hypertension, and barrettes oesophagus.
UPDATE: A 94-year-old man, who lives alone in his home, and is fully independent for all his activities of daily living. He presents to the Emergency Department complaining of vomiting every time he eats
What's the most likely cause? #ClinicalCase www.rcemlearning.co....
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Combined Beta Blocker and Calcium Channel Blocker Overdose. NEW. Clinical Case. RCEMLearning logo in white.
In addition to securing ABCs, which intervention should be performed first for this patient’s biochemical abnormality?
#ClinicalCase
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RCEMLearning logo in white. A boy looking out from a window. Vertigo: will it make your head spin?. Clinical Case. UPDATE
A 49-year-old man is brought to the Emergency Department (ED) by ambulance after waking this morning with severe vertigo. He is unable to move his head, sit or stand without feeling very nauseous and has, in fact, vomited a number of times. He has not noticed any alteration in his hearing or tinnitus. He has no other symptoms, in particular no visual or speech problems and no limb weakness. He was well yesterday and has not suffered any recent illness or injury. The patient is normally fit and well and doesn’t take any regular medication. He drinks little alcohol but he has smoked 10 cigarettes per day for the last 25 years. His initial observations are pulse 78 / minute and regular, BP 166/85, respiratory rate 14 / minute, oxygen saturation 96% on air. His temperature is 36.5oC.
UPDATE: A 49-year-old man is brought to the Emergency Department (ED) by ambulance after waking this morning with severe vertigo
What features of the history are typical of acute peripheral vertigo? #ClinicalCase www.rcemlearning.co....
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RCEMLearning logo in white. A picture of a man with a sore throat, holding it in pain. Post Tonsillitis Septic Shock. NEW. Clinical Case
NEW: A 39-year-old man presents with a 4–5-day history of fever, rigors, general malaise, and worsening shortness of breath.
#ClinicalCase www.rcemlearning.co....
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RCEMLearning logo in white. Non classic Chest Pain! Clinical Case. UPDATE. A picture of a ECG.
A 48-year-old male patient presents to the Emergency Department (ED) with central chest pain that woke him up at 2 am. He reports feeling short of breath, shivery with clamminess and sweatiness for about 40 minutes. He’s improved shortly after arriving in the hospital. The patient reports having a brief period of exertional chest pain for a few minutes and fainting episodes while he was exercising the same afternoon. However, he has no symptoms of collapse, cough, haemoptysis or any respiratory symptoms or contact with anyone known to have COVID-19. He also denies genitourinary or gastrointestinal symptoms. He is normally active with no past medical, drug or surgical history of significance. Initial observations: Temperature 38.5 degrees Celsius, HR 125, BP 134 /67, sat 99 % RR 18 /min. Cardiovascular and respiratory examination is unremarkable. Electrocardiogram (ECG): showed sinus tachycardia HR 130 per minute.
UPDATE: A 48-year-old male patient presents to the Emergency Department (ED) with central chest pain that woke him up at 2 am
What is the differential diagnosis of exertional syncope in this case? #ClinicalCase
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RCEMLearning logo in white. A child lying down in pain. Alt text: When a Rash Turns Dangerous. Clinical Case
A 10-year-old boy presents to the Emergency Department (ED) with his mother, reporting a 2-day history of fever, malaise, and rapidly spreading skin lesions. His mother states that the lesions initially appeared as small red spots on his trunk and face but quickly progressed into painful blisters and erosions. He also reports severe oral discomfort, making it difficult to eat or drink, along with painful swallowing and redness with irritation of both eyes. He describes mild sensitivity to light but denies any visual changes. He was commenced on oral amoxicillin seven days earlier for a mild cough and sore throat prescribed by his GP. There is no recent viral illness, vaccination, travel, or known exposure to infectious diseases. He is otherwise well, with nil past medical history of note. He has no known drug allergies, and family history is non-contributory. (cont. on RCEMLearning)
NEW: A 10-year-old boy presents with fever, malaise, and rapidly spreading painful skin lesions with oral and eye involvement, following a recent course of antibiotics.
What is the most likely underlying condition? #ClinicalCase
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RCEMLearning logo in white. An X-Ray of a persons bowels. Alt text: Blocked Bowels … but by what? Clinical Case. NEW
NEW: A 56-year-old lady with Williams syndrome, presents to the Emergency Department (ED) with mild abdominal pain and distension, reporting she is unsure if her last bowel movement was 2 weeks ago.
What is the most likely diagnosis? #ClinicalCase
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RCEMLearning logo in white. A picture of a large lake and forest in the background. Alt text: Eyelid Injury. Clinical Case
He had no focal limb neurology or extra-cranial injury. Check out our #ClinicalCase here: www.rcemlearning.co....
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RCEMLearning logo in white. A person touching a pregnant person's stomach. Alt Text: Resuscitative Hysterotomy. Clinical Case. NEW
NEW: A 34-year-old G2P1 IVF patient at 40+5 weeks presents with severe epigastric pain, bilateral leg swelling, hypertension and proteinuria. Despite initial management, she subsequently collapses #ClinicalCase
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RCEMLearning logo in white. A close up of acute anterior uveitis during eye examination. Alt text: Blinded by the Light. NEW Clinical Case.
[cont.] in the morning
On examination, you note the affected eye is red predominantly around the cornea, the pupil appears irregular and constricted, and the cornea has a slight haziness
What is the most likely diagnosis? #ClinicalCase
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RCEMLearning logo in white. Overdose of an Ancient Drug. Clinical Case. NEW. A picture of a man in distress.
NEW: An 83-year-old male is pre-alerted to your emergency department (ED) following an intentional overdose of one of his medications. On arrival, he admits to taking the medication around 12 hours ago with the intent to end his own life
#ClinicalCase www.rcemlearning.co....
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RCEMLearning logo in white. A picture of a medical practitioner holding an older person hand. Alt text: Never Make Diagnostic Assumptions! UPDATE. Clinical Case
...and increasingly bizarre behaviour, screaming, running impulsively from rooms and making pouting facial grimaces.
Read the rest of our #ClinicalCase here, what's the most likely diagnosis? www.rcemlearning.co....
#MentalHealth #Meningitis #encephalitis
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RCEMLearning logo in white. A Chest X-ray reveals figure 3 sign and rib notching. Alt text: NEW, A Persistent Hypertensive Colonel. Clinical Case.
Chest X-ray reveals figure 3 sign and rib notching. What is the most likely diagnosis? Read our #ClinicalCase to learn more
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NEW. A picture of a young man with a bulging bicep. The Case of the Bulging Bicep. Clinical Case. RCEMLearning logo in white.
NEW: A male presents with a large bulge to his bicep area after going to punch and then missing a punch bag in an arcade. Why does he now have such a big bicep? #ClinicalCase
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