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Case report 26/10/2017

Failure to follow specialist advice

Failure to follow specialist advice

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Following a hospital admission for status epilepticus, which was attributed to a previous cerebral insult, Mr G, a 35-year-old clerical officer, was started on an anticonvulsant regime of phenytoin and sodium valproate.

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Case report 26/10/2017

Problematic Anaesthetic

Problematic Anaesthetic

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Mrs B was a 57-year-old lady with a past history of breast cancer treated with mastectomy and adjuvant therapy. She re-presented to her consultant breast surgeon, Mr F, three years after the original surgery with a worrying 2cm lump in the vicinity of her mastectomy scar.

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Case report 26/10/2017

A hidden problem

A hidden problem

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Mr T, a 40-year-old accountant, attended a private health check under his employer’s healthcare scheme. Blood and protein were noted on urinalysis and his eGFR was found to be 45 ml/min/1.73 m2. He was asked to make an appointment with his GP and was given a letter highlighting the abnormal results to take with him.

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Case report 26/10/2017

A friend in need

A friend in need

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Ms N, a 33-year-old female accountant, presented to Mr X, a consultant orthopaedic surgeon, with severe lower back pain radiating to both legs.

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Case report 26/10/2017

Unforeseeable complications?

Unforeseeable complications?

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Mr M, a 45-year-old lawyer with a substantial income, consulted Dr L, an ophthalmologist, for the management of deteriorating keratoconus. He had become intolerant of contact lenses and was experiencing visual difficulties.

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Case report 26/10/2017

No news is not always good news

No news is not always good news

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Child J, a one-week-old baby girl, was noticed to have a clicking right hip when she was seen by the community midwife. A referral to the orthopaedic clinic was requested and Child J was reviewed by orthopaedic junior doctor, Dr M, three weeks later. Dr M confirmed that there was no relevant family history and examined Child J.

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Case report 26/10/2017

Reported abuse

Reported abuse

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Mrs X asked her GP to refer her eightyear-old daughter, Child F, to be assessed by a consultant psychiatrist in child and adolescent mental health. The GP referral letter stated that Child F had reported to her teacher that her father frequently touched her genitalia.

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Case report 26/10/2017

Back to basics

Back to basics

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Mr B, a 42-year-old builder, attended his GP, Dr S, with a three-week history of back pain and left sided sciatica. Dr S found nothing of concern on further questioning or examination, so made a referral for physiotherapy and recommended ibuprofen.

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Case report 26/10/2017

Lost in translation

Lost in translation

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Mrs S, a 27-year-old Romanian woman who lived with her husband in the UK, became pregnant and presented to her local GP surgery to commence antenatal care. Mrs S did not speak English and usually brought a family member with her to interpret.

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Case report 26/10/2017

Repeating the risk

Repeating the risk

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Mrs L, a teacher, was first prescribed the oral contraceptive pill microgynon by her GP, Dr G, when she was 17. Her blood pressure was taken and recorded as normal. At this time, no other mention was made in the records of her risk profile or family history.

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Case report 26/10/2017

Elbow Arthroscopy radial nerve injury

Elbow Arthroscopy radial nerve injury

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Mr P, a right-handed project manager, developed a stiff right elbow following a previous injury, and had reached the limit of his progress with physiotherapy. X-rays showed degenerative changes and he was referred to an orthopaedic consultant, Mr A, who diagnosed osteoarthritis of his elbow.

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