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Case report 26/10/2017

A hidden problem

A hidden problem

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Mr T, a 40-year-old accountant, attended a private health check under his employer’s healthcare scheme. Blood and protein were noted on urinalysis and his eGFR was found to be 45 ml/min/1.73 m2. He was asked to make an appointment with his GP and was given a letter highlighting the abnormal results to take with him.

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Case report 26/10/2017

A friend in need

A friend in need

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Ms N, a 33-year-old female accountant, presented to Mr X, a consultant orthopaedic surgeon, with severe lower back pain radiating to both legs.

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Case report 26/10/2017

No news is not always good news

No news is not always good news

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Child J, a one-week-old baby girl, was noticed to have a clicking right hip when she was seen by the community midwife. A referral to the orthopaedic clinic was requested and Child J was reviewed by orthopaedic junior doctor, Dr M, three weeks later. Dr M confirmed that there was no relevant family history and examined Child J.

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Case report 26/10/2017

Reported abuse

Reported abuse

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Mrs X asked her GP to refer her eightyear-old daughter, Child F, to be assessed by a consultant psychiatrist in child and adolescent mental health. The GP referral letter stated that Child F had reported to her teacher that her father frequently touched her genitalia.

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Case report 26/10/2017

Back to basics

Back to basics

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Mr B, a 42-year-old builder, attended his GP, Dr S, with a three-week history of back pain and left sided sciatica. Dr S found nothing of concern on further questioning or examination, so made a referral for physiotherapy and recommended ibuprofen.

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Case report 26/10/2017

Lost in translation

Lost in translation

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Mrs S, a 27-year-old Romanian woman who lived with her husband in the UK, became pregnant and presented to her local GP surgery to commence antenatal care. Mrs S did not speak English and usually brought a family member with her to interpret.

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Case report 26/10/2017

Repeating the risk

Repeating the risk

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Mrs L, a teacher, was first prescribed the oral contraceptive pill microgynon by her GP, Dr G, when she was 17. Her blood pressure was taken and recorded as normal. At this time, no other mention was made in the records of her risk profile or family history.

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Case report 26/10/2017

Elbow Arthroscopy radial nerve injury

Elbow Arthroscopy radial nerve injury

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Mr P, a right-handed project manager, developed a stiff right elbow following a previous injury, and had reached the limit of his progress with physiotherapy. X-rays showed degenerative changes and he was referred to an orthopaedic consultant, Mr A, who diagnosed osteoarthritis of his elbow.

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Case report 26/10/2017

Failing to act on tonsillar cancer

Failing to act on tonsillar cancer

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Mr K was a 36-year-old man who ran a pub. Mr K smoked and drank heavily. Mr K’s dentist had noticed a painless swelling on the right side of his neck during a routine check-up and asked him to see his GP.

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Case report 26/10/2017

Death by Diarrhoea

Death by Diarrhoea

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Mrs B was a 27-year-old secretary with a ten-year-old daughter. She had just enjoyed a trip to Pakistan where she had been visiting relations. Three days after her return she developed profuse, watery diarrhoea.

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Case report 26/10/2017

Contraception and a cardiac arrest

Contraception and a cardiac arrest

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Miss F, an 18-year-old university student, had been taking the combined oral contraceptive pill microgynon for 18 months for dysmenorrhoea, when she presented to her GP Dr K worried about acne on her back.

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Case report 25/10/2017

Living up to expectations

Living up to expectations

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Mr G was a 62-year-old office worker; he was overweight (BMI 29) and suffered from exercise-related angina. Mr G had several risk factors for ischaemic heart disease including smoking, diabetes mellitus and hypercholesterolaemia. Following a positive exercise test, a coronary angiography confirmed triple vessel coronary artery disease with a left ventricular ejection fraction of 45%. He was referred to Mr F, a consultant cardiothoracic surgeon, for consideration of coronary artery bypass graft (CABG) surgery.

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Articles and features 24/10/2017

Case study - Missed critical limb ischaemia

Case study - Missed critical limb ischaemia

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Mr S was a 60-year-old lorry driver. He was overweight and smoked, and couldn’t walk far because he suffered with pain in his calves. This became so severe that he attended the out-of-hours service that evening.

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Articles and features 24/10/2017

Case study - An early presentation

Case study - An early presentation

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Baby T was eight weeks old when his mother brought him to his GP’s morning surgery.

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Articles and features 24/10/2017

Case study - Cauda Equina Syndrome

Case study - Cauda Equina Syndrome

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When Mrs C, a keen golfer in her early 40s, began to experience constant pain in her lower back, she consulted a GP at her local surgery.

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