Author: Stephen Ojo / Editor: Steve Corry-Bass / Codes: ACCS LO 1, EnC6, SLO3 / Published: 24/07/2020
A 42-year-old male attends the emergency department with history of fever, feeling generally unwell and shortness of breath. He has been unwell for 3 days prior to presentation but was previously fit and well.
He describes an associated weakness of both lower limbs a few hours prior to presentation which made him panic and called the ambulance. He was FAST negative. He’s had no contact with anyone symptomatic for COVID-19.
On Examination, he looks unwell with evidence of Hyperthermia (Temp of 40.1), dehydration and mild respiratory distress.
His Respiratory rate is 28/min, pulse rate 142 bpm ( ECG shows Atrial Fibrillation with a fast ventricular response – not previously known) and his blood pressure is high at 190/120.
The rest of the respiratory and cardiovascular systems examination is unremarkable.His neurological examination is also normal but he has evidence of generalised muscle weakness on both lower limbs.
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Question 1 of 3
1. Question
Which of the following is the least likely possible differential diagnosis at this stage?
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Question 2 of 3
2. Question
The Investigation results show a slightly raised white cell count and a low potassium of 2.4 mmol/L (3.5-5.0)
The rest of his Full Blood Count, Biochemistry screen & CRP are normal.
The Chest Xray is reported as No suspicion of COVID-19 but there are features of Heart Failure.
What is the most likely cause of heart failure in this patient?
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Question 3 of 3
3. Question
The Investigation results show a slightly raised white cell count and a low potassium of 2.4 mmol/L (3.5-5.0)
The rest of his Full Blood Count, Biochemistry screen & CRP are normal.
The Chest Xray is reported as No suspicion of COVID-19 but there are features of Heart Failure.
What other investigation will be most relevant at this stage based on your thoughts regarding this patient's symptoms?
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