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Case report 10/01/2012

Too quick to clear the spine

Too quick to clear the spine

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Twenty-eight-year-old Miss T was a pillion passenger on her boyfriend’s motorbike going at high speed on a motorway. He lost control of the vehicle and tried to regain it by braking, which threw them both over the handles, landing some distance away. Unfortunately, Miss T’s boyfriend was certified dead at the scene of the accident.

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Case report 10/01/2012

Too many records spoil the notes

Too many records spoil the notes

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Mr M, a 51-year-old primary school teacher, was referred to ophthalmologist Mrs C, following a letter sent by an optometrist to his GP. The optometrist had found Mr M to have an abnormal right optic disc, slightly raised intraocular pressures and significant defects in the visual fields of his right eye with suspected glaucoma.

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Case report 10/01/2012

Symptoms that don’t add up

Symptoms that don’t add up

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Mr B was a 30-year-old garage manager who had just returned from a long trip abroad with his wife. After the flight he developed some chest tightness. This showed no signs of improvement after ten days so Mr B made an appointment with his GP, Dr W.

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Case report 01/05/2011

An inflammatory situation

An inflammatory situation

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Mrs D was a 47-year-old school teacher with two children. She noticed a lump in her right breast while she was in the shower. The lump was tender when she pressed it and she became concerned that it could be something serious. One of her aunts had had breast cancer at about her age and this added to her concerns. She booked an appointment to see her GP the following day.

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Case report 01/05/2010

An unexpected, painful end

An unexpected, painful end

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Fifty-five-year-old lorry driver Mr Q was involved in a road traffic accident, sustaining severe injuries to both legs. He was taken to the local hospital where, following initial assessment and stabilisation by the emergency medicine team, he was referred to the orthopaedic department.

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Case report 01/01/2010

A takeaway lesson

A takeaway lesson

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Mr U, a 39-year-old print worker, attended his local Emergency Department (ED) one evening with a six-hour history of vomiting and abdominal discomfort. The symptoms had come on shortly after eating a takeaway meal. He was seen by Dr A, a doctor-in-training on the emergency medicine rotation. Dr A documented a detailed abdominal examination which showed no evidence of an acute abdomen. Dr A diagnosed acute gastritis or early gastroenteritis and advised Mr U to go home, rest, and see his GP the next day if things had not settled down.

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Case report 01/01/2009

Send her in

Send her in

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Mrs E was an overweight school cook in her 50s who had type 2 diabetes and smoked 20 cigarettes a day. She developed a cough on the flight home from a holiday in Cyprus and, one week later, went to see her GP, Dr R. The cough had become productive of green sputum and she said she was also feeling extremely tired and generally unwell.

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Case report 01/01/2008

A sticky situation

A sticky situation

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Mr R was a healthy 17-year-old student who suffered with a severe form of palmar hyperhidrosis. Mr R’s GP referred him to Mr F, a cardiothoracic surgeon. Following discussion about possible alternative treatment, Mr R was very keen on the surgical option, so Mr F placed him on the waiting list for a right-sided transthoracic endoscopic sympathectomy.

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Case report 01/09/2007

Troublesome chest pain

Troublesome chest pain

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Mr F was a 46-year-old accountant who lived with his wife and two children. He booked an appointment with his GP, Dr P, in an emergency surgery, the morning after experiencing some chest pain. He had been running for a train on the way back from a meeting.

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Case report 01/09/2007

The not-so-unlikely diagnosis

The not-so-unlikely diagnosis

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Three months after returning to the UK after a holiday in Gambia, Miss N, a 27-year-old care assistant, telephoned her GP practice for advice and spoke to Dr T. She told him that she was feeling generally unwell and slightly feverish and had noted that her urine was unusually dark.

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Case report 01/09/2007

Assume nothing

Assume nothing

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K was an active 14-year-old boy, keen on skateboarding and football. When he came home after a day’s skateboarding complaining of intense pain in his groin and abdomen, his father was alarmed and took him directly to his local A&E department. Four years earlier, K had developed testicular torsion resulting in the loss of his left testis; his father was understandably fearful that now K’s remaining testicle was also at risk.

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Case report 01/01/2007

A problem with the system, not the patient

A problem with the system, not the patient

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Mr C, a 47-year-old self-employed electrician, was admitted for a routine arthroscopic menisectomy of the knee. He was in good health and did not take any regular medication. His past medical history was unremarkable. He was keen to resume his active lifestyle, and return to work as soon as possible since he was the sole breadwinner. Preoperative assessment confirmed that he was healthy and fit for the procedure.

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Case report 01/11/2005

Ultrasound, antibiotic prophylaxis and endocarditis

Ultrasound, antibiotic prophylaxis and endocarditis

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Mrs N had a complex medical history; in her early twenties she had a splenectomy, chemotherapy and radiotherapy for treatment of Hodgkin’s disease. This caused ovarian failure and she then developed a pelvic abscess which left her fallopian tubes occluded.

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Case report 01/05/2005

An aspiration to gain compensation

An aspiration to gain compensation

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Mr W, a 30-year-old unemployed factory worker, was admitted to hospital for an elective intra-oral surgical procedure. His preoperative anaesthetic questionnaire was unremarkable except for a history of chronic mood disorder treated with carbamazepine and lithium.

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Case report 01/05/2005

Scarred for life?

Scarred for life?

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Rachel broke her left clavicle when she was an infant. Unfortunately, it healed poorly and became a malunited pseudarthrosis. In 1997, aged 16, she was tired of the pain, swelling and unsightliness this caused her and she saw Mr C, specialist orthopaedic surgeon.

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Case report 01/05/2005

A crushing oversight

A crushing oversight

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In the late 1990s, Mr M, a stockbroker in his fifties, was referred by his GP to see Dr J, specialist physician and cardiologist. Mr M had been feeling generally ‘not right’. He had suffered a transient left-sided loss of limb power a year earlier, diagnosed as a stroke.

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