Medicine

A 61-year-old man is brought to the emergency department after fainting and passing a large amount of bright red blood. His blood pressure is now 102/70 mmHg af…

A 58-year-old man with established alcohol-related cirrhosis presents with two episodes of black, offensive stool and light-headedness. His blood pressure is 10…

A 32-year-old woman shares a bedroom with her partner, who has been admitted with laboratory-confirmed meningococcal meningitis. She has no fever or rash and fe…

A 41-year-old man undergoes urgent debridement for a necrotising infection of the calf. Initial broad-spectrum treatment has been given, and deep tissue culture…

A 35-year-old woman at 35 weeks of pregnancy presents with vomiting, malaise and jaundice. She is normotensive, has no proteinuria and has mild right upper quad…

A 42-year-old woman has 18 months of fatigue, pruritus and intermittent discomfort beneath the right costal margin. Alkaline phosphatase is 410 U/L (30–110), al…

A 52-year-old man attends for a health assessment. He does not smoke, has no diabetes, chronic kidney disease or established cardiovascular disease, and his fat…

A 46-year-old woman has a body mass index of 32 kg/m² and treated hypertension. Her mother developed type 2 diabetes at 58 years of age. She has no polyuria, po…

A 68-year-old man taking gliclazide modified release for type 2 diabetes is found drowsy with a blood glucose concentration of 2.1 mmol/L. He improves after int…

A 24-year-old woman with type 1 diabetes presents with abdominal pain, vomiting and deep breathing. Her blood glucose concentration is 24 mmol/L, venous pH is 7…

A 3-year-old boy who previously used short sentences has stopped speaking over the past six weeks. His parents also report that he no longer understands familia…

A 72-year-old woman with newly diagnosed multiple myeloma presents with confusion, constipation and weakness. Her serum calcium is 4.18 mmol/L (2.10–2.60), crea…

A 29-year-old woman presents with headache, confusion and reduced urine output. She is pale and has scattered petechiae; investigations show haemoglobin 78 g/L…

A 35-year-old primigravida at 37 weeks’ gestation is found to have blood pressure readings of 148/96 and 146/94 mmHg 4 hours apart. Urine protein is 2+, platele…

A 31-year-old woman at 34 weeks’ gestation presents with a severe frontal headache and flashing lights. Her blood pressure is 176/114 mmHg on two measurements 1…

A 68-year-old man with a recent transurethral resection of a bladder tumour presents with worsening suprapubic pain and inability to pass urine. He has passed b…

A 29-year-old woman at 25 weeks of pregnancy presents with right flank pain, rigors and vomiting. Her temperature is 39.2°C, pulse 132/min and blood pressure 92…

A 78-year-old man presents with a lesion on the sun-exposed forearm that has enlarged from a pinpoint mark to 18 mm over seven weeks. It is a firm, smooth, red-…

A 35-year-old woman is referred for a brown plaque on the upper back that has slowly enlarged over nine years. It was initially flat, but several firm reddish-b…

A 63-year-old man has a brown papule on the bridge of his nose that has slowly enlarged over two years and occasionally leaves a spot of blood on his handkerchi…