Kwame, a 34-year-old farmer, presents to a district hospital in Brong-Ahafo with a 3-day history of high fever, rigors, and headache. He has no cough, dysuria, or neck stiffness. On examination, tempe…
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A 38-year-old man is brought to the regional hospital A&E by relatives with a 3-day history of fever, confusion, and reduced urine output. On assessment: temperature 39.4°C, respiratory rate 24 breath…
Ama, a 60-year-old woman with diabetes, is brought to the Korle Bu emergency centre confused and febrile. Her temperature is 38.8°C, respiratory rate 24 breaths/min, and blood pressure 88/56 mmHg. Bed…
Adwoa, a 32-year-old nurse, presents to the regional hospital A&E with a 1-day history of fever, severe headache, neck stiffness, and photophobia. She vomited twice on the way to hospital. On examinat…
Mohammed, a 52-year-old man with known haematological malignancy on chemotherapy, is brought to Korle Bu emergency centre with a 1-day history of fever and rigors. Temperature is 38.6°C, heart rate 10…
A 2-year-old boy, Kwame, is brought to the district hospital A&E in Brong-Ahafo with a 3-day history of fever and progressive lethargy. On examination, he is unresponsive to voice, has a temperature o…
A 5-year-old boy, Yaw, is brought to Korle Bu emergency centre with a 2-day history of fever. His mother says he looks pale and has been sleeping excessively. On examination, he is febrile at 39.2°C, …
An 8-year-old boy, Mensah, is brought to a regional hospital A&E in Ashanti with 3 days of fever and is now confused and difficult to rouse. His temperature is 39.6°C, and he does not open his eyes to…
A 7-year-old girl, Akua, is brought to the Komfo Anokye ED with 2 days of high fever, severe headache, and vomiting. On examination she is febrile (40.1°C), photophobic, and has a stiff neck. A non-bl…
An 18-month-old girl, Abena, is brought to the A&E of a district hospital in Volta Region with a 3-day history of fever, diarrhoea, and reduced urine output. On examination, she is lethargic, has a ca…
A 14-month-old girl, Ama, is brought to a district hospital in the Upper East Region with fever and a bulging anterior fontanelle. She is irritable and cries inconsolably when handled. Her temperature…
A 6-month-old girl, Akua, is brought to Komfo Anokye ED by her mother who reports that the baby has been feverish for 2 days and is now refusing all feeds. On examination, the infant is irritable, has…
A 5-year-old boy, Kofi, is brought to a regional hospital A&E with 4 days of fever, poor feeding, and progressive weakness. On examination he is febrile (38.9°C), pale, and deeply jaundiced. His conju…
A 3-year-old boy, Kwame, is brought to the district hospital A&E in Brong-Ahafo by his mother who says he has had fever for 3 days and 'is not himself'. On examination he is febrile (39.2°C), lethargi…
A 4-year-old boy, Kofi, is brought to the regional hospital A&E in Ashanti with a 1-day history of high fever, vomiting, and a rapidly spreading rash. On examination, his temperature is 39.5°C, he is …
Ama, a 58-year-old woman with a long history of NSAID use for knee pain, presents to a regional hospital A&E with three episodes of black, tarry, foul-smelling stool over the past 24 hours. She denies…
A 48-year-old man, Kwabena, presents to the regional hospital A&E in Cape Coast with haematemesis and melaena. He has a history of epigastric pain for 3 months and has been taking over-the-counter ant…
Yaa, a 60-year-old woman with known liver cirrhosis from hepatitis B, presents to Korle Bu emergency centre with haematemesis and melaena. Her blood pressure is 80/50 mmHg and pulse is 126 beats per m…
A 45-year-old woman, Yaa, with known liver cirrhosis presents to Korle Bu emergency centre with massive haematemesis. She is resuscitated with IV fluids and blood. After initial stabilisation, the tea…
Kwabena, a 55-year-old man with a history of heartburn and dysphagia, presents to a district hospital in Brong-Ahafo with haematemesis and epigastric pain. He takes no regular medications. Examination…
Akua, a 40-year-old woman, presents to Komfo Anokye ED with two episodes of haematemesis. She is pale and diaphoretic. Her blood pressure is 90/60 mmHg, pulse is 120 beats per minute, and respiratory …
A 38-year-old woman, Akua, is brought to the district hospital A&E in Brong-Ahafo with a 2-day history of passing black, tarry, foul-smelling stools. She takes ibuprofen regularly for chronic knee pai…
A 70-year-old woman, Adwoa, is admitted to the regional hospital A&E with melaena and haematemesis. Her haemoglobin on admission is 6.8 g/dL. She has a background of ischaemic heart disease and is on …
A 47-year-old man, Yaw, with known liver cirrhosis presents to the Komfo Anokye ED with massive haematemesis. He is resuscitated with IV fluids. BP is now 96/64 mmHg, HR 110 bpm. You suspect variceal …
A 52-year-old man, Kwame, is brought to the regional hospital A&E by relatives after vomiting approximately 400 mL of fresh blood at home. He has a history of heavy alcohol use. On examination: BP 88/…
Kofi, a 52-year-old man with known alcohol-related liver cirrhosis, is brought to the regional hospital A&E by relatives after two episodes of haematemesis. On examination he is jaundiced, has visible…
A 52-year-old man, Kwame, presents to the regional hospital A&E in Kumasi with a 6-hour history of vomiting bright red blood. He has a known history of alcohol excess and his abdomen reveals splenomeg…
Kwame, a 45-year-old man, is brought to the Komfo Anokye ED after vomiting two large volumes of bright red blood. He has a history of heavy alcohol use and his abdomen shows dilated superficial veins …
A 60-year-old man, Mensah, is brought to the regional hospital A&E in Tamale with haematemesis and haemodynamic instability. His blood pressure is 80/50 mmHg and pulse is 130 bpm. He is confused and p…
A 61-year-old man is assessed in the Korle Bu emergency centre after an episode of haematemesis. He is haemodynamically stable. You calculate his Glasgow-Blatchford Score as 2 (haemoglobin 13.8 g/dL, …