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Email enquiry from GP: This 49 year old man had an abdominal CT as part of an emergency assessment for ?appendicitis. No explanation for the pain was found, but he was noted to have multiple simple cortical cysts in his … Continue reading
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A 36 year old soldier developed a flu-like illness (fever, chills, headache, myalgia) 4 days after returning to Jakarta, Indonesia, from a 1 year posting to Papua New Guinea. He was known to have chronic hepatitis B infection, with chronically … Continue reading
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A 36 year old seamstress from Port Harcourt, Nigeria, presents at 35 weeks of her 6th pregnancy. 3 pregnancies went to term and she has 2 surviving children. She has had hypertension in previous pregnancies, and preterm labour with Caesarian … Continue reading
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A 34 year old man presents to Queen Elizabeth Central Hospital, Blantyre with a 2 day history of frontal headaches and generalized tonic clonic seizures. His guardians report that he has had multiple nodules all over his body since childhood … Continue reading
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Via email advice line from primary care: This man was diagnosed with interstitial nephritis secondary to mesalazine (prescribed for ulcerative colitis) in 2009. His eGFR has remained stable since and is currently 42. Last year he was started on lisinopril … Continue reading
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They are concerned about the renal function of a 43 year old woman who is day 26 post allogenic stem cell transplant for relapsed Acute Myeloid Leukaemia (conditioning with alemtuzumab, melphalan and fludarabine). Her pre-transplant renal function was normal (creatinine … Continue reading
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A 36 year old alcoholic man was admitted to hospital with obtunding, jaundice and cachexia. In addition to deranged LFTs, anaemia and thrombocytopenia, all thought to be related to cirrhosis, he had Creat 194 (eGFR 36), Na 138, K 2.6. … Continue reading
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A 22 year old plumber has a 1 day history of a painful vesicular rash on his right buttock and posterior thigh. He feels unwell with fever.This case contributed by Levie Mwale and Ann Sergeant Questions What is the most … Continue reading
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A healthy 4 year old boy is brought to the Dermatology clinic at Queen Elizabeth Central Hospital, Blantyre by his parents. He has been scratching his head, and they have recently noticed that he has developed several small scaly areas … Continue reading
A 53 year old woman presents with a 2 day history of drowsiness, diarrhoea and vomiting. Her past medical history includes hypertension, diabetes, and recently diagnosed breast cancer. On examination she is dehydrated, BP 95/60, pulse 120/min, temp 38°C, O2 … Continue reading
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A 42 year old man attends the dermatology clinic in Queen Elizabeth Central Hospital, Blantyre in 2012 with an ulcer on the sole of his right foot. He says that it has been present since 2004 but that he underwent … Continue reading
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A 19 year old young woman from Blantyre, Malawi, attends with a scaly lesion which has been present on her right cheek for 3 months. Thanks to Dr Ann Sergeant for this case. Questions Can you describe what you see? … Continue reading
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A 56 year old farmer who lives in a village near Blantyre, Malawi, presents with painful oral ulceration which is making eating difficult. On further questioning he also admits that he has pain on micturition as he has painful penile … Continue reading
A call from orthopaedics: a 68 year old retired hospital cook had been admitted electively for total knee replacement 4 days previously. She has a background of longstanding rheumatoid arthritis, treated hypertension, and CKD Stage 3 for which she no … Continue reading
The Hepatology junior doctor has been asked to ring due to concerns on the morning ward round about worsening renal function – specifically, do we think this is hepato-renal syndrome? The patient is a 56 year old man with history … Continue reading
An 86 year old woman who is resident in a local nursing home is known to have stage 3 CKD, hypertension, peripheral vascular disease, eczema, osteoporosis, and moderate Alzheimer’s disease. She is usually independent in dressing and eating and drinking. … Continue reading
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A 39 year old subsistence farmer is referred to the dermatology clinic at QE Hospital Blantyre, Malawi, with massive left leg swelling that has been present for several years. His main complaint is of “leaking” and malodour, and he is … Continue reading
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A 20 year old man complains of 3 weeks of cough and fever, and 4 days of oedema of his feet. On examination he is breathless. There is marked engorgement of his neck veins, JVP higher than ears, ascites, 2+ … Continue reading
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A 25 year old woman is referred with a 6 month history of fatigue, joint pain, pleuritic chest pain and facial rash. Three months ago at another hospital she was found to be unwell with a Creatinine of 500 micromol/l, … Continue reading