Anaesthesiology

A 70 kg man requires debridement and suturing of an 18 cm laceration on his forearm in the emergency department. There is no adrenaline-containing local anaesth…

Mechanisms of disease · common

You are the intern covering an orthopaedic ward at 11 pm on the third night after a 78-year-old woman's hip hemiarthroplasty. The nurse says she has not slept,…

Pre-internship · middle twist

An 84-year-old woman is on the ward on the evening of the first day after hemiarthroplasty for a fractured neck of femur. She has a morphine patient-controlled…

Clinical rotations · middle twist

A 26-year-old woman is brought in three hours after taking about 40 alprazolam tablets with wine. She sleeps but rouses to a loud voice, gags on an oropharyngea…

Pre-internship · niche

A 74-year-old man on the orthopaedic ward is found drowsy six hours after his first dose of slow-release oxycodone for a fractured neck of femur. He rouses brie…

Pre-internship · middle twist

A 70 kg man has a 12 cm laceration across the extensor surface of his right forearm from a falling pane of glass. Tendon function through the full range of move…

Pre-internship · middle twist

A 24-year-old woman is brought in by ambulance after being found unrousable at home. She had swallowed six of her flatmate's morphine tablets, which he takes tw…

Pre-internship · middle twist

A 74-year-old woman is being discharged from the emergency department after a fall at home with an undisplaced pubic ramus fracture on radiography. She can weig…

Pre-internship · middle twist

A 26-year-old man is brought in after coming off a motorcycle at speed. He has an anterior dislocation of the left shoulder and fractures of the left pubic rami…

Clinical rotations · middle twist

A 63-year-old man with renal colic is receiving morphine 2.5 mg intravenously every 5 minutes on your instruction. He has now had 12.5 mg and says the pain has…

Pre-internship · middle twist

Which mechanism explains how antidepressants (e.g., amitriptyline, duloxetine) provide pain relief?

Clinical rotations · common

What is the primary mechanism of action of ketamine in pain management?

Clinical rotations · common