Results for “anticoagulation”

An 84-year-old man with mild Alzheimer disease is brought to the emergency department by his daughter. For two days he has been drowsy after lunch and then agit…

Psychiatry · Pre-internship · middle twist

A 26-year-old woman with a history of childhood sexual abuse collapses in the emergency department waiting room and develops generalised shaking. Twelve minutes…

Psychiatry · Pre-internship · niche

You are the intern on a geriatric ward. An 84-year-old woman admitted six days ago with pneumonia was disorientated and inattentive for her first three days; sh…

Psychiatry · Pre-internship · middle twist

Police bring a 54-year-old man to the emergency department at 2 am after he shouted at passing cars and swung at an officer. He is known to the mental health se…

Psychiatry · Pre-internship · middle twist

A 79-year-old woman is brought to the emergency department at 2 am by police, having been found walking along a main road in her nightdress. She is pleasant and…

Psychiatry · Pre-internship · middle twist

A 71-year-old man says the vision in his right eye switched off ninety minutes ago, without pain. He can count fingers only on that side. The right pupil dilate…

Ophthalmology · Pre-internship · middle twist

A 62-year-old man with treated hypertension develops severe pain between his shoulder blades while carrying a bag of potting mix. It was as bad in the first few…

Acute Care · Clinical rotations · middle twist

A 79-year-old woman is admitted with ongoing lower gastrointestinal bleeding and a haemoglobin concentration of 72 g/L (reference range 115–155). She is receivi…

Cardiovascular · Pre-internship · middle twist

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…

Cardiovascular · Clinical rotations · common

A 42-year-old woman has a second proximal deep vein thrombosis while taking rivaroxaban as prescribed. She has no interacting medicines, normal renal function a…

Cardiovascular · Clinical rotations · middle twist

A 68-year-old man with metastatic oesophageal cancer develops a symptomatic proximal deep vein thrombosis. He completed treatment for melaena from the tumour tw…

Cardiovascular · Clinical rotations · middle twist

A 76-year-old man with persistent atrial fibrillation develops sudden severe abdominal pain and vomiting. He is pale and distressed, but his abdomen is initiall…

Emergency and Toxicology · Clinical rotations · middle twist

A 71-year-old man receiving an unfractionated heparin infusion for a recent pulmonary embolus develops recurrent haematemesis and hypotension. The infusion is s…

Cardiovascular · Clinical rotations · common

A 70-year-old woman is recovering from a small ischaemic stroke and is found to have persistent atrial fibrillation. She has normal renal function and no eviden…

Cardiovascular · Clinical rotations · common

A 31-year-old woman developed a proximal deep vein thrombosis at 32 weeks gestation and has received therapeutic low-molecular-weight heparin since diagnosis. S…

Obstetrics and Gynaecology · Clinical rotations · common

A 66-year-old man with metastatic gastric adenocarcinoma develops a symptomatic proximal deep vein thrombosis. He has a friable gastric lesion with recent occul…

Cardiovascular · Clinical rotations · middle twist

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…

Obstetrics and Gynaecology · Pre-internship · common

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…

Obstetrics and Gynaecology · Pre-internship · middle twist

A 74-year-old woman presents with severe pain in her left leg that began abruptly two hours ago while she was sitting watching television. She walks to the shop…

Cardiovascular · Clinical rotations · common

A 76-year-old woman taking warfarin for atrial fibrillation attends for a routine INR check, which returns at 11.0 (target 2.0–3.0). She recently completed a co…

Cardiovascular · Clinical rotations · middle twist