By Kerry Layne, Henry Fok, Adam Nabeebaccus
A 32-year-old Caucasian woman used to be admitted to health center following a cave in on the fitness center. Her buddies defined the sufferer falling to the ground whereas exercise at the rowing computer, by way of twitching of her legs and arms and a interval of being unrousable. you're the medic on duty...
100 instances in Acute drugs offers a hundred acute stipulations in most cases obvious by way of clinical scholars and junior medical professionals within the emergency division, or at the ward, or locally environment. A succinct precis of the patient's historical past, exam, and preliminary investigations, together with images the place appropriate, is via questions about the prognosis and administration of every case. the reply features a specific dialogue of every subject, with additional representation the place applicable, delivering an important revision reduction in addition to a realistic advisor for college kids and junior doctors.
Making scientific judgements and selecting the easiest plan of action is without doubt one of the such a lot tough and hard components of educating to turn into a physician. those situations will train scholars and junior medical professionals to acknowledge very important medical signs and symptoms, and to strengthen their diagnostic and administration talents.
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Additional resources for 100 Cases in Acute Medicine (1st Edition)
24 CASE 13: SEVERE PAIN IN THE LEGS History A 22-year-old man has been admitted to hospital with severe pain in his legs. He is known to have sickle cell disease and says that his pain is typical of his sickle crises. He was initially given opiate analgesia and intravenous ﬂuids, and after 24 hours his pain has largely settled. He now complains of shortness of breath. Examination This young man is visibly dyspnoeic and has coarse crackles at both lung bases. His SaO2 is now 87 per cent on room air.
An autoimmune response is triggered, leading to GBS. A disconcerting feature of GBS is that it can ascend to involve the respiratory muscles. This can lead to paralysis of the diaphragm muscles and subsequent respiratory arrest. Patients should be monitored closely for signs of respiratory distress and bedside spirometry should be performed every 4 hours to record the vital capacity. Clinicians should have a low threshold for intubating patients with GBS as diaphragmatic paralysis can occur rapidly over a few hours, with catastrophic consequences.
Prompt treatment with antiviral agents, such as valganciclovir, could save a patient’s vision. • Patients with HIV who commence antiretroviral therapy are at risk of developing IRIS, where their immune system begins to recover and mounts a strong response against previously acquired infections. 52 CASE 27: RECURRING DIZZINESS WITH EXERCISE History An 84-year-old woman has been brought to hospital after collapsing in the street. She describes walking quickly and feeling very dizzy, then waking up a few moments later on the pavement.
100 Cases in Acute Medicine (1st Edition) by Kerry Layne, Henry Fok, Adam Nabeebaccus