Archives: BETs

A 45 year old male came to A&E with sever upper abdominal pain, and upon examination there is signs pf peritonism and elevated serum amylase more than 4 folds in addition to elevated CRP, WBC and fever.Within two days, he developed signs of acute severe necrotisig pancreatitis with Cullin and Turner signs and AKI for that we kept him on conservative treatment for more than 10 days

A 20-Year-old female front seat passenger with the seat belt on sustained a neck injury from a frontal collision car Accident that left her with a fronto-parietal scalp laceration; presented to the Emergency Room with cervical spine precautions. Primary survey demonstrated a non-disabling local neck pain and tenderness. The neurologic examination was normal with no disabilities, and no cranial nerve involvement. Glasgow coma scale was 15/15. Past medical history is unremarkable with no previous incident. An X-Ray, Computed Tomography (CT) scan and MRI of the neck revealed only a Jefferson fracture with a 12 mm widening of the lateral mass of C1. The Anterior Atlanto-Dens Interval (ADI) was normal (2mm) and the Space Available for the Cord was 17mm.

A 44 year old woman with recurrent episodes of benign paroxysmal peripheral vertigo (BPPV) presents to the ED. You perform a successful Epley manoeuvre but are unsure if there is anything you can prescribe her for residual dizziness as an outpatient.

74 year old man presents to emergency department with a 1 day history of dizziness, sensation of vertigo and imbalance. He has nystagmus on clinical exam. His head CT is negative for cerebellar infarct. Does he need an MRI to exclude cerebellar stroke?

A 13 year old female presents with self-inflicted lacerations on her wrists. It is revealed she has a history of physical and emotional abuse, and a child protection plan is in place. You wonder if deliberate self-harm is a predictor for being subject to a child protection plan?

A 40 year old male attends the emergency department with a persistent dry cough and fever. He tested positive for COVID-19 infection five days ago and has been isolating ever since. On examination his heart rate is 120 beats per minute, respiratory rate is 20 and his oxygen saturations are 94% on room air. Would measuring his serum lactate help you to risk stratify this patient and determine his requirement for medical intervention?

Mrs. Majorie Knowsbleed is a 75 year old woman, with history of avalvular atrial fibrillation, on Apixaban, presenting to the ED for 2 hours of atraumatic epistaxis. In your arsenal of epistaxis management, you consider the utility of topical tranexamic acid to stop the bleeding.

You see a 32-year-old man in the rapid assessment zone of your emergency department with acute neck pain a few hours after helping his friends move to their new apartment. There was no direct trauma and he has no neurological deficits and no bony tenderness. He has tried acetaminophen and ibuprofen but he continues to have limited range of motion and significant pain on the left side of his neck.

10 year girl present in A&E with 2 day history of fever, right sided back pain and dysuria. She had urine dip done which showed 3+ leucocytes, 1+ blood and nitrates positive. The registrar seeing the patient wants her to be immediately started on IV antibiotics for suspected pyelonephritis. The SHO questions why is IV required when the patient can tolerate oral?

A 40 year old male presents to the emergency department in septic shock. He is given fluid and vasopressor therapy. Can serial serum lactate measurements be used as a predictor of mortality?

A 12 year old boy has sustained a head injury at a school rugby match. The coach takes him off the pitch, but the player is keen to finish the game. He is told he needs an assessment for traumatic head injury before he can continue to play. As the team doctor you perform the head injury assessment but wonder if it is useful for predicting outcome and guiding further management in mild traumatic brain injury (TBI).