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A 34-year-old woman is reviewed after treatment with single-dose intramuscular methotrexate for a confirmed, unruptured tubal ectopic pregnancy. She remains wel…
A 24-year-old woman at 10 weeks of pregnancy has vomited repeatedly for three weeks and has lost 7 kg. She is alert, with a pulse of 104 beats/minute and blood…
A 27-year-old woman with a desired pregnancy presents at 8 weeks with mild vaginal bleeding but no pain. Transvaginal ultrasonography shows an intrauterine gest…
A 29-year-old woman has 6 weeks of amenorrhoea and two days of increasing right iliac fossa pain. Transvaginal ultrasonography shows a 30-mm right tubal gestati…
A 32-year-old woman presents at 7 weeks of pregnancy with left lower abdominal pain and light vaginal bleeding. The pregnancy followed in-vitro fertilisation, a…
A 34-year-old woman is reviewed 18 hours after an emergency caesarean section complicated by a 1.6 L postpartum haemorrhage. The bleeding has been controlled fo…
Nine days after a vaginal birth, a woman presents with recurrent bleeding, a temperature of 38.3°C and lower abdominal pain. The uterus is tender and larger tha…
Immediately after delivery, a woman becomes pale and hypotensive and reports severe pelvic pain. A smooth, dark-red mass is visible at the introitus; the placen…
A woman develops ongoing haemorrhage during an emergency caesarean section for uterine atony. After 3 units of red blood cells and 2 units of fresh frozen plasm…
Thirty-five minutes after a vaginal birth, the placenta has not separated and the woman has lost 900 mL of blood. The uterus is firm, the placenta is palpable a…
A 29-year-old woman has a 1.4 L haemorrhage after an uncomplicated vaginal birth. The placenta is complete and there is no vaginal or cervical tear. Despite ute…
A 48-year-old woman taking sotalol for paroxysmal atrial fibrillation has two brief episodes of collapse. The ECG monitor records recurrent bursts of polymorphi…
A 72-year-old woman with severe chronic obstructive pulmonary disease is admitted with worsening breathlessness. Her pulse is irregular at 118 beats per minute.…
A 67-year-old man with a previous anterior myocardial infarction develops palpitations while being monitored in hospital. He is alert, has a blood pressure of 1…
A 29-year-old man presents with palpitations and light-headedness. His pulse is irregular at 190 beats per minute and the blood pressure is 126/74 mmHg. The ECG…
A 32-year-old woman presents seven days after an uncomplicated delivery with five sudden, severe headaches over 48 hours. Each begins abruptly during bathing or…
A 38-year-old man develops left-sided neck pain and a new unilateral headache after forceful neck stretching. He has a mild left ptosis and a smaller left pupil…
A 49-year-old man develops abrupt retro-orbital pain and vomiting while exercising. In the next hour he becomes drowsy and develops left ptosis with limitation…
A 72-year-old woman has developed a new unilateral temporal headache over three weeks. She reports pain when chewing and two recent episodes in which vision in…
A 29-year-old woman presents with 10 days of progressive daily headache and brief episodes of greying vision. She is six weeks postpartum and takes a combined o…