A previously well 50 year old presents with sharp severe chest pain after a long haul flight from North America. A chest X-ray and ECG are performed and reveal no abnormalities
The Paradoxical Alternative
March 15, 2010 by 1 Comment
Consider a 49 year female old smoker with two weeks of increasing shortness of breath. She is being treated for pneumonia on the ward for three days but getting worse. An ICU review is performed on the ward and the following ECG is obtained.
A metabolic acidosis with hypernatremia
March 10, 2010 by Leave a Comment
A 20 year old male presents with 3 days of lethargy and generalised malaise. He is confused and looks very unwell. Can sort out this metabolic muddle?
A post-drainage problem with the lungs
February 3, 2010 by Leave a Comment
A 45 year old woman with metastatic ovarian cancer is admitted for VATS pleurodesis and drainage of bilateral pleural effusions. Her admission chest X-ray is shown below:
More green urine…
February 1, 2010 by Leave a Comment
You are looking after a 23 year old male who has a subarachnoid haemorrhage and the nurse calls because the patient has started to pass unusual urine:
Rapidly progressive respiratory failure
January 26, 2010 by Leave a Comment
A 30 year old male presents with a 3 day history of fevers and increasing breathlessness. On presentation he is noted to be severely hypoxic with sats of 80% on room air. The following chest X-ray is obtained:
Metabolic mayhem post-subacrachnoid hemorrhage
January 15, 2010 by 3 Comments
An 87 year old female presented with a subarachnoid haemorrhage. GCS 8/15. A nasogastric tube was unable to be placed due to patient agitation. As a consequence, the patient was fasted for five days due to concern about swallowing. Can you figure out her acid-base disturbance?
A Nasty Sore Throat
January 13, 2010 by 2 Comments
A 38 year old male with a background history of type 2 diabetes presents with fevers, rigors and pain on swallowing. There is no sign of impending airway compromise; however, marked trismus is noted. The following plain X-ray is obtained:
A Case of CO2 Narcosis
January 12, 2010 by Leave a Comment
A 67 year old gentleman with a BMI of 45 was waiting for his respiratory outpatient clinic appointment. While waiting, he fell asleep. A medical emergency was called because he could not be woken up. On arrival of the MET team the patient is found to have a blood pressure of 140/70, a heart rate of 100bpm and oxygen sats of 68% on room air. He is breathing spontaneously but requires airway support. His GCS is 3/15. Supplemental oxygen is applied and the following arterial blood gas is obtained.
Could it be renal colic?
December 29, 2009 by 1 Comment
Consider a 65-year-old male presenting with flank pain radiating to the groin. The following CT scan was taken to confirm a presumed diagnosis of renal colic
