Medicine

A 56-year-old man with alcohol-related cirrhosis presents with profuse vomiting of blood. He is agitated, intermittently drowsy and repeatedly coughing while bl…

A 63-year-old man is admitted with fever, hypotension and rapidly progressive cellulitis of the forearm. He had been licked on an excoriated hand by his daughte…

A 21-year-old university student notices yellowing of his eyes after several days of restricted food intake during examinations. He is otherwise well and has no…

A 24-year-old woman with asthma remains breathless after repeated nebulised salbutamol and ipratropium, intravenous hydrocortisone and oxygen. She can speak onl…

A 78-year-old woman becomes agitated and repeatedly pulls at her intravenous line on the second night after hip surgery. She alternates between asking where she…

A 29-year-old man is brought in shortly after his partner administered naloxone for suspected heroin overdose. He is yawning repeatedly, has abdominal cramps, d…

A 46-year-old man is found vomiting beside an open container of an automotive fluid. He has tachypnoea, flank pain and oliguria; arterial blood gas analysis sho…

A 24-year-old woman is brought to the emergency department after drinking approximately 8 L of water during a long-distance event. She is drowsy and has a serum…

A 68-year-old man with chronic kidney disease presents with weakness after spironolactone was added to his medicines. His serum potassium is 7.0 mmol/L (3.5–5.2…

A 74-year-old man is referred after three falls over two months. He describes a brief feeling of faintness after rising from a chair, without spinning sensation…

A 59-year-old man suddenly develops difficulty speaking and weakness of the right arm while driving. His wife reports that, immediately beforehand, the right si…

A 63-year-old woman has three sudden episodes over two days of dizziness followed by double vision, slurred speech and veering to the left; each episode lasted…

A 70-year-old woman vomits during a generalised seizure and becomes cyanosed. One hour later her temperature is 38.4°C, oxygen saturation is 88% on room air and…

A 5-month-old boy is brought to hospital with 2 days of nasal congestion, cough and reduced breastfeeds. He is alert but has subcostal recession and widespread…

A 42-year-old man is brought to hospital 45 minutes after taking an unknown number of amitriptyline tablets. He is drowsy, has a blood pressure of 78/46 mmHg an…

A 29-year-old woman presents with three days of worsening unilateral throat pain, fever and difficulty swallowing. She cannot open her mouth fully, her voice is…

A 7-year-old boy has complained of pain in both thighs and an intermittent limp for one month. He is pale but afebrile, and there is no joint swelling; both hip…

A 13-year-old boy with obesity has had aching pain in his left knee for three weeks. He suddenly develops severe groin pain while rising from a chair and cannot…

A 24-year-old university student presents with three days of migratory joint pain involving both knees and one wrist. He has a temperature of 38.1°C and a small…

A 71-year-old man presents with three days of dyspnoea. CT pulmonary angiography shows bilateral pulmonary emboli and right ventricular enlargement; his blood p…