Online Clinical Case Study (July 2010)
The content of the Office Cardiology Series is provided by: Dr. LI Siu Lung, Steven FHKAM (Med), FRCP (Glasg), FRCP (Edin), FRCP (Lond), Specialist in Cardiology. Dr. WONG Shou Pang, Alexander FRCP, FHKAM (Med.), FHKCP, Specialist in Cardiology 臨床心臟科個案研究之內容誠蒙李少隆醫生及王壽鵬醫生提供。
A 32-year-old gentleman was admitted for moderate to severe chest pain that he experienced for one day. He is a non-smoker and has no known diabetes, hyperlipidaemia or hypertension. He has no history of effort angina and he exercises regularly with no problems. His chest pain was unexertional, relieved by sitting and was worse with deep breathing. Physical examination showed no evidence of heart failure. A rubbing sound was heard on auscultation. His ECG is shown in the Figure.
Figure. ECG taken during examination.
Answer Sheet
Clinical Cardiology Series臨床心臟科個案研究
1. What are the major abnormalities on the ECG? a. ST depression b. Diffuse ST elevation c. Atrial fibrillation
2. What is your diagnosis? a. Acute myocardial infarction b. Atrial fibrillation c. Pericarditis
3. What investigations would you arrange? a. Blood tests for troponin levels b. Echocardiogram c. CT coronary angiogram d. Serial ECG monitoring
4. What is the underlying cause? a. Viral infection b. Atherosclerosis c. Auto-immune response
5. What is the treatment? a. Antibiotics b. Thrombolytics c. Anti-viral treatment d. NSAIDs
A 35-year-old male developed a mildly itchy skin rash on his lower limbs over a period of one year. Physical examination revealed well-demarcated erythema plaques on his right knee. Silvery-white scales were more prominent after scraping. A similar rash was found on the left side. His rash had improved with topical treatment prescribed by another doctor but it relapsed after a few months.
Dermatology Series 皮膚科病例研究
1. What is the diagnosis?
2. What other parts of the body will you examine?
3. What are the aggravating factors for this dermatosis?
4. What are the treatments?
5. He complained that his previous doctor had not cured his dermatosis. How would you advise him?
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