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

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 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 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 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 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…