Picture quizzes
A man vomiting bright red blood
A 58 year old man was admitted to the emergency department after a sudden onset of vomiting bright red blood and an episode of black, tarry stools. His medical history included an appendicectomy 20 years ago and alcoholic liver disease. He took no regular drugs, drank 90 units of alcohol a week, and did not smoke. On examination his body temperature was normal (36.6°C), he was hypotensive (90/56 mm Hg), and he had tachycardia (110 beats/min). He also had palmar erythema, gynaecomastia, … Read this article >>
Transient respiratory distress and difficulty passing a nasogastric tube in a newborn baby
A baby was born at 30 weeks and 5 days’ gestation, by emergency caesarean section after onset of labour. It was a twin pregnancy, with an antenatal history of polyhydra… Read this article >>
Recognising the deteriorating patient
A 75 year old man is admitted to hospital with severe chest pain. The figure shows his observation chart. Observation chart of patient with severe chest infection Questions 1 What is the first sign o… Read this article >>
Beware the sarcoma
Six weeks previously a 67 year old man had undergone an unplanned excision of a presumed benign lipoma. During the surgery a lesion the size of a cricket ball was located just below his right scapula and removed. The lump had been increasing in size over a period of 18 months and was pai… Read this article >>
Ear discharge and hearing loss in an elderly woman
A 78 year old woman was referred by her general practitioner to the outpatient ear, nose, and throat clinic with a three week history of a discharging right ear (otorrhoea). She had difficulty hearing in both ears and normally used a hearing aid in her … Read this article >>