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1466 matches for “Mahadevan” — showing 1381–1410
Sepsis and septic shock · Refractory shock — hydrocortisone difficulty 3/5

Yaw, a 60-year-old man, is in the Korle Bu emergency centre with septic shock secondary to a perforated appendix. He has received 30 mL/kg IV crystalloid, IV piperacillin-tazobactam, and is on noradre…

Sepsis and septic shock · SIRS criteria and sepsis definition difficulty 1/5

A 38-year-old woman named Yaa presents to a district hospital in the Volta Region with 2 days of fever, chills, and productive cough. Her temperature is 38.6°C, heart rate is 104 bpm, respiratory rate…

Sepsis and septic shock · Sepsis from soft tissue source — recognition difficulty 1/5

A 70-year-old man named Yaw presents to a regional hospital A&E with a 5-day history of worsening confusion, fever, and reduced oral intake. His daughter reports he has a chronic leg ulcer. On examina…

Sepsis and septic shock · Vasopressors — noradrenaline first-line difficulty 2/5

Fatima, a 42-year-old woman, is in the resus bay of a regional hospital A&E with confirmed septic shock secondary to an abdominal source. She has received 30 mL/kg IV Hartmann's solution and IV ceftri…

Sepsis and septic shock · SIRS criteria recognition difficulty 2/5

Fatima, a 34-year-old woman, presents to the regional hospital A&E with a 3-day history of dysuria, loin pain, and rigors. Her temperature is 38.8°C, heart rate 106 bpm, respiratory rate 24 breaths/mi…

Sepsis and septic shock · Lactate elevation mechanism in septic shock difficulty 2/5

A 62-year-old man named Yaw is brought to the Korle Bu emergency centre with a 3-day history of lower abdominal pain, vomiting, and fever. He is confused and diaphoretic. His blood pressure is 86/52 m…

Sepsis and septic shock · SIRS criteria recognition difficulty 2/5

A 60-year-old man named Mensah presents to the Komfo Anokye ED with a 2-day history of fever and productive cough. His temperature is 38.6°C, heart rate is 110 bpm, respiratory rate is 23 breaths/min,…

Shock · Hypovolaemic shock — immediate management difficulty 1/5

A 50-year-old woman, Adwoa, presents to the regional hospital A&E in the Volta Region with 3 days of profuse watery diarrhoea and vomiting. She appears sunken-eyed and lethargic, with a pulse of 122 b…

Shock · Obstructive shock — cardiac tamponade recognition difficulty 2/5

A 55-year-old woman, Yaa, is brought to the district hospital A&E with sudden onset severe chest pain and dyspnoea. On examination she is hypotensive at 80/50 mmHg, tachycardic at 128 bpm, and has mar…

Shock · Haemorrhagic shock classification — Class IV difficulty 2/5

A 40-year-old man, Mohammed, is brought to the Komfo Anokye ED after a road traffic accident with suspected pelvic fracture. He is confused, with a pulse of 140 bpm, blood pressure of 70/40 mmHg, and …

Shock · Hypovolaemic shock - immediate fluid resuscitation difficulty 1/5

Joseph, a 38-year-old man, presents to the district hospital A&E with a 3-day history of profuse watery diarrhoea and vomiting. He is lethargic and unable to stand. His blood pressure is 76/50 mmHg, p…

Shock · Haemorrhagic shock classification - Class III recognition difficulty 2/5

Adwoa, a 32-year-old woman, is brought to the Komfo Anokye ED after a motor vehicle collision. She is confused and agitated. Her pulse is 128 bpm, blood pressure is 84/60 mmHg, respiratory rate is 28 …

Shock · Lactate clearance as resuscitation endpoint difficulty 3/5

Yaw, a 50-year-old man, is admitted to the Tamale Teaching Hospital ED with septic shock secondary to a perforated viscus. After 2 litres of IV crystalloid, his BP has improved to 96/64 mmHg and his H…

Shock · Cardiogenic shock — vasopressor first-line difficulty 3/5

Kofi, a 62-year-old man with no prior cardiac history, presents to the Korle Bu emergency centre with sudden-onset central chest pain and diaphoresis. ECG shows anterior ST elevation. He rapidly deter…

Shock · Obstructive shock - massive pulmonary embolism recognition difficulty 3/5

Akua, a 50-year-old woman, is brought to the regional hospital A&E with sudden onset severe breathlessness and pleuritic chest pain 5 days after a caesarean section. Her blood pressure is 86/58 mmHg, …

Shock · Recognising shock at the bedside — mottling, capillary refill, mental status difficulty 2/5

A 45-year-old woman is brought to the district hospital A&E after a large post-partum haemorrhage. She has received 2 litres of IV crystalloid but remains hypotensive at 82/55 mmHg with HR 130 bpm. He…

Shortness of breath in adults · Differentiating cardiac vs pulmonary cause clinically difficulty 3/5

Mohammed, a 55-year-old man with no known lung disease, is brought to Korle Bu emergency centre with sudden-onset breathlessness and central chest tightness radiating to his left arm. His oxygen satur…

Shortness of breath in adults · COPD exacerbation — classical presentation difficulty 1/5

Yaw, a 72-year-old man with a 40 pack-year smoking history, presents to Komfo Anokye ED with a 2-day history of increased breathlessness, worsening productive cough with green sputum, and reduced exer…

Shortness of breath in adults · PE in pleuritic pain difficulty 3/5

Yaw, a 42-year-old man who returned from a long road journey from Accra to Tamale 5 days ago, presents to Tamale Teaching Hospital ED with sudden-onset right-sided pleuritic chest pain and breathlessn…

Shortness of breath in adults · Spontaneous pneumothorax — classical presentation difficulty 1/5

Kwabena, a 22-year-old tall, thin male student, presents to the district hospital A&E in the Eastern Region with sudden-onset left-sided chest pain and breathlessness that began 1 hour ago at rest. He…

Shortness of breath in adults · COPD exacerbation - classical presentation and oxygen therapy difficulty 2/5

Kofi, a 72-year-old man with a 40 pack-year smoking history, presents to a district hospital in Brong-Ahafo with a 3-day history of worsening breathlessness and increased production of green sputum. O…

Shortness of breath in adults · Acute pulmonary oedema - escalation to NIV difficulty 2/5

Mensah, a 65-year-old man with known ischaemic heart disease, is brought to Komfo Anokye ED with severe breathlessness, pink frothy sputum, and inability to lie flat. His blood pressure is 160/100 mmH…

Shortness of breath in adults · PE in pleuritic pain — recognising VTE risk in post-operative patient difficulty 3/5

Akosua, a 34-year-old woman, presents to the district hospital A&E with sudden-onset right-sided pleuritic chest pain and breathlessness that began 6 hours ago, one week after a caesarean section. Her…

Shortness of breath in adults · NIV indications difficulty 2/5

A 64-year-old woman named Adwoa with a 10-year history of COPD presents to a regional hospital A&E with acute breathlessness and a pH of 7.30, PaCO2 8.2 kPa on blood gas. She is alert, cooperative, an…

Shortness of breath in adults · Community-acquired pneumonia - immediate management difficulty 2/5

Abena, a 55-year-old woman with no prior cardiac history, presents to a district hospital in the Upper East Region with a 4-day history of fever, productive cough with rusty-coloured sputum, and worse…

Shortness of breath in adults · PE in pleuritic pain difficulty 2/5

A 28-year-old woman named Afia with no significant past medical history presents to a regional hospital A&E with a 2-hour history of acute breathlessness and right-sided pleuritic chest pain. She take…

Shortness of breath in adults · Community-acquired pneumonia — classical presentation difficulty 1/5

Mensah, a 45-year-old man, presents to the regional hospital A&E in Cape Coast with a 4-day history of fever, productive cough with rusty-coloured sputum, and right-sided pleuritic chest pain. On exam…

Sudden onset weakness · Stroke management — resource-limited setting difficulty 3/5

A 68-year-old hypertensive man named Joseph is brought to a district hospital A&E after suddenly developing weakness of his left arm and leg 90 minutes ago. He also has a left-sided facial droop. His …

Sudden onset weakness · Spinal cord compression — metastatic difficulty 3/5

A 52-year-old woman named Abena is brought to the regional hospital A&E with sudden onset severe back pain followed by progressive leg weakness over 6 hours. She has a known history of breast cancer. …

Sudden onset weakness · Transverse myelitis — diagnosis and initial treatment difficulty 3/5

Yaw, a 19-year-old man, presents to the Korle Bu Emergency Centre with a 4-day history of progressive bilateral leg weakness and difficulty walking. He had a febrile illness with sore throat 3 weeks a…