Note

💡❔ A 25 year old man presents to the emergency department with a 4-day history of chest pain and mild shortness of breath. He feels that the pain is worse on lying flat, coughing and deep breathing; it is relieved by sitting forwards and has improved with ibuprofen. He has no significant past medical history but was recently unwell with a non-specific viral infection. An ECG shows widespread saddle ST elevation. What is the most likely cause of the chest pain?

❔50 year old woman with type 2 diabetes presents to her family physician complaining of genital thrush, which has not settled with topical antifungal treatment. She had been started on a new oral hypoglycaemic drug 4 months earlier. Which of the following drugs is most likely to be responsible for her presentation?

A 65 year old man with type 2 diabetes of 20 years’ duration is referred to the specialist diabetes foot clinic by his family physician with an ulcer of the plantar surface of the right foot. The ulcer has been present for approximately 6 weeks and there is a history of peripheral diabetic neuropathy. On examination, there is a 2-cm diameter ulcer in proximity to the first metatarsal head. It has an offensive odour and discharge. The area around the ulcer is hot and erythematous. Which of the following features, if present, would most strongly indicate the presence of osteomyelitis (bone infection)?

72 year old man is admitted to hospital by his family physician for urgent investigation of weight loss. He has a progressive 3-month history of back pain, jaundice, dark urine and anorexia. He has lost approximately 15 kg in weight. In the last 4 weeks he has developed increased thirst and is drinking excessively. A random venous glucose is 16.0 mmol/L (288 mg/dL). Which investigation is most likely to reveal the cause of his diabetes?

A 29 year old woman with type 1 diabetes for 18 years attends clinic for routine review. She has poor glycaemic control with an HbA1c of 90 mmol/mol (10.4%). She is keen to embark on stricter glycaemic management in advance of planning pregnancy. Which of the following complications of diabetes would be the most likely to deteriorate significantly should her glycaemic control improve suddenly?

Performing both Rinne's and Weber's test allows differentiation of conductive and sensorineural deafness. ✔Rinne's test :tuning fork is placed over the mastoid process until the sound is no longer heard, followed by repositioning just over external acoustic meatus  💡air conduction (AC) is normally better than bone conduction (BC).... if BC > AC then conductive deafness ✔Weber's test : tuning fork is placed in the middle of the forehead equidistant from the patient's ears ,the patient is then asked which side is loudest 💡in unilateral sensorineural deafness, sound is localised to the unaffected side. 💡 in unilateral conductive deafness, sound is localised to the affected side.