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Final clinical short case 46

Created: 9/10/2015
1. Latex allergy:
- What are the types of allergy?
- Who is susceptible?
- What would you ask when taking the history?
- How do you test for this allergy?
- How are radioallergosorbent test (RAST) and skin testing performed?
- How would you plan to give the anaesthetic?

2. Trauma case: A 19-year-old male is involved in a road traffic accident and has a compound tibial fracture, a Glasgow Coma Scale (GCS) of 13 and a linear skull fracture on a plain X-ray.
- What do you think of the GCS?
- How relevant is it?
- Discuss the GCS.
- How would you assess this patient?
- Discuss the clearance of the C-spine and whether it can be done in this case.
- How would you anaesthetise him?
- What type of analgesia would you administer postoperatively?

3. Chest X-ray: You are shown a chest X-ray from a young female from India with haemoptysis, shortness of breath and night sweats. She has a ruptured ectopic pregnancy.
- Comment on the chest X-ray (the mediastinum is shifted and there is an apical cavitating lesion).
- Is it active tuberculosis (TB)?
- Is her operation urgent?
- What are the problems with her needing an anaesthetic?
- What would you do postoperatively?
- How would do you manage her TB?
- Discuss the treatment of TB.

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