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1466 matches for “Mahadevan” — showing 1111–1140
Endocrine emergencies · Adrenal crisis — steroid-induced HPA suppression and empirical hydrocortisone difficulty 3/5

A 52-year-old man, Joseph, is seen in a regional hospital A&E after a road traffic crash. He is haemodynamically stable but is noted to have a BP of 88/60 mmHg that has not responded to 1 litre of nor…

Endocrine emergencies · Phaeochromocytoma — recognition of classic triad difficulty 1/5

A 34-year-old woman, Afia, presents to Korle Bu emergency centre with episodic severe headache, diaphoresis, and palpitations over the past two months. Today she is brought in after a collapse. BP is …

Endocrine emergencies · Phaeochromocytoma: alpha-blockade before beta-blockade difficulty 3/5

A 44-year-old man, Kwame, presents to the Komfo Anokye ED with a severe throbbing headache, profuse sweating, and palpitations that began abruptly 30 minutes ago. BP is 228/136 mmHg, heart rate 108 bp…

Endocrine emergencies · Myxoedema coma — clinical recognition difficulty 2/5

A 48-year-old man, Yaw, presents to a regional hospital A&E with confusion, hypothermia (34.8°C), and a heart rate of 48 bpm. Examination reveals dry, thickened skin, a hoarse voice, and non-pitting o…

Endocrine emergencies · Thyroid storm — PTU vs carbimazole difficulty 2/5

A 55-year-old man, Kofi, is referred from a district hospital to Komfo Anokye ED with a three-day history of worsening thyrotoxic symptoms. He has been started on propranolol 40 mg orally eight-hourly…

Endocrine emergencies · Phaeochromocytoma: clinical recognition and BP management difficulty 2/5

A 44-year-old man, Kwame, presents to the Komfo Anokye ED with a severe headache and palpitations that started suddenly 30 minutes ago. His BP is 218/130 mmHg, heart rate 110 bpm, and he is sweating h…

Endocrine emergencies · Thyroid storm — mechanism of propranolol (T4-to-T3 inhibition) difficulty 3/5

A 45-year-old man, Kofi, presents to the Komfo Anokye ED with fever (38.9°C), severe agitation, heart rate 156 bpm in atrial fibrillation, and a palpable goitre. His Burch-Wartofsky score is calculate…

Endocrine emergencies · Myxoedema coma — resource-limited management and transfer difficulty 3/5

Adwoa, a 50-year-old woman with a history of Hashimoto's thyroiditis, is brought to the district hospital A&E in the Volta Region. She is obtunded (GCS 9/15), bradycardic at 36 bpm, and hypothermic at…

Endocrine emergencies · Myxoedema coma — concurrent hydrocortisone with levothyroxine difficulty 2/5

Fatima, a 42-year-old woman known to have hypothyroidism, is brought to Komfo Anokye ED with a three-day history of confusion and increasing drowsiness. Her temperature is 33.5°C, BP 80/50 mmHg, HR 38…

Endocrine emergencies · Hypothyroidism - constipation as a presenting feature difficulty 2/5

Ama, a 35-year-old woman, presents to the Komfo Anokye ED with a three-week history of constipation, weight gain, and fatigue. She reports feeling cold all the time and her hair has been falling out. …

Endocrine emergencies · Phaeochromocytoma — clinical recognition difficulty 2/5

A 29-year-old man, Kwesi, presents to a district hospital A&E with a severe headache, diaphoresis, and palpitations that started suddenly 30 minutes ago. BP is 210/130 mmHg, HR 122 bpm, and he is visi…

Environmental emergencies · Drowning — C-spine immobilisation and initial oxygen difficulty 2/5

A 19-year-old woman, Afia, is retrieved from a flooded gutter in Accra after heavy rains. Bystanders report she was submerged for approximately 3 minutes. She is now conscious and breathing spontaneou…

Environmental emergencies · Moderate hypothermia rewarming difficulty 2/5

A 19-year-old student, Esi, is brought to a district hospital in the Northern Region after being found unconscious in a cold storage facility. Her core temperature is 32°C, she is drowsy but responds …

Environmental emergencies · Hypothermia rewarming by severity difficulty 2/5

A 55-year-old woman, Adwoa, is brought to a regional hospital A&E in the Northern Region after being found unresponsive in a cold harmattan night. Her core temperature is 30°C. She is breathing sponta…

Environmental emergencies · Electrical injury — hidden deep tissue burns and renal protection difficulty 2/5

A 35-year-old electrician, Kofi, is brought to a regional hospital A&E after accidentally contacting a live 240 V domestic supply. He is conscious with a small entry wound on his right palm and an exi…

Environmental emergencies · Lightning injury recognition difficulty 1/5

A 30-year-old woman, Akua, presents to the Korle Bu emergency centre after being struck by lightning during a storm in Accra. She was thrown 2 metres and was briefly unconscious. She is now awake but …

Environmental emergencies · Drowning resuscitation mechanism difficulty 2/5

A 22-year-old man, Mohammed, is retrieved from a river near Tamale after being submerged for approximately 5 minutes. He is unresponsive with no palpable pulse and is not breathing. Bystanders had alr…

Environmental emergencies · Hypothermia — staged rewarming strategy difficulty 3/5

A 60-year-old fisherman is brought to a district hospital in the Northern Region after being found unconscious in a cold storage facility. His core temperature (rectal) is 30°C. He is bradycardic at 3…

Environmental emergencies · Cold-water drowning — resuscitation and the 'not dead until warm' principle difficulty 3/5

A 10-year-old girl, Adwoa, is brought to a district hospital in the Volta Region after falling into a river. She was submerged for approximately 8 minutes before rescue. On arrival she is unresponsive…

Environmental emergencies · Drowning - ventilation priority in cardiac arrest difficulty 2/5

A 45-year-old fisherman, Mensah, is rescued from Lake Volta after his canoe capsized. He was submerged for an estimated 8 minutes and is unresponsive when pulled from the water. He has no palpable pul…

Environmental emergencies · Severe hypothermia recognition difficulty 2/5

A 45-year-old fisherman, Yaw, is rescued from the Volta Lake after his boat capsized during a cold harmattan night. He is brought to a regional hospital A&E unresponsive, with barely palpable pulses a…

Ethics and end-of-life issues · Palliative symptom control — pain difficulty 2/5

Adwoa, a 45-year-old woman with advanced cervical cancer, presents to the Korle Bu emergency centre in severe pain, rated 9/10. She is alert and oriented. Her husband says she 'should not be given mor…

Ethics and end-of-life issues · Family conflict resolution difficulty 3/5

A 78-year-old man, Mohammed, with severe dementia is brought to the regional hospital A&E from a nursing home in respiratory failure. He has no documented advance directive. His daughter, who holds no…

Ethics and end-of-life issues · Palliative symptom control — dyspnoea difficulty 2/5

Mensah, a 75-year-old man with metastatic lung cancer, is admitted to the Korle Bu emergency centre with increasing breathlessness at rest. He is on a recognised palliative pathway. His oxygen saturat…

Ethics and end-of-life issues · Capacity assessment difficulty 3/5

A 30-year-old woman, Fatima, is brought to the district hospital A&E following a large paracetamol overdose. She is conscious and tearful, saying she took the tablets deliberately and does not want tr…

Ethics and end-of-life issues · Family conflict resolution difficulty 2/5

A 60-year-old man, Kofi, is admitted to Komfo Anokye ED with advanced hepatocellular carcinoma and is in obvious distress. His son insists on full resuscitation including CPR if his heart stops, stati…

Ethics and end-of-life issues · Breaking bad news — SPIKES protocol difficulty 1/5

The emergency physician at a district hospital in the Eastern Region is about to inform Mohammed, a 55-year-old man, that his CT scan has revealed a large inoperable brain tumour. Mohammed is accompan…

Ethics and end-of-life issues · Palliative symptom control — secretions difficulty 2/5

Kofi, a 62-year-old man with end-stage hepatocellular carcinoma, is brought to a district hospital in Brong-Ahafo. He is agitated, with noisy, gurgling respirations ('death rattle') and is unresponsiv…

Ethics and end-of-life issues · Palliative symptom control — secretions difficulty 2/5

Fatima, a 65-year-old woman with end-stage cervical cancer, is in the resus bay at a regional hospital A&E. She is unconscious and actively dying. Her family report she had previously expressed a wish…

Ethics and end-of-life issues · Withholding vs withdrawing treatment difficulty 3/5

A 72-year-old man, Joseph, has end-stage renal disease and metastatic prostate cancer. He is admitted to Korle Bu emergency centre in respiratory distress and is intubated by the night team before his…