Acquired Haemophilia A as a cause of acute upper gastrointestinal haemorrhage Can you answer the questions below? 1. How would you manage coagulopathy in a patient with gastrointestinal haemorrhage? 2. How would you diagnose an underlying disorder of coagulation? 3. What is the pathophysiology of Haemophilia A? If you don’t know the answers or want […]
Latest articles
The case of the ‘not-so-simple’ fracture
Not just a fracture We have some very interesting images for you but, can you answer the questions below? 1. What is the significance of a child not being able to weight bear on a leg? 2. What do figures 1 and 2 show? 3. What are the typical abnormalities in Type 1 Neurofibromatosis? If you […]
The case of chylous ascites
Chylous ascites as a consequence of idiopathic pancreatitis We have some very interesting images for you but, can you answer the questions below? 1. What are the causes of chylous ascites? 2. What is the pathophysiology? 3. How would you manage this case? If you don’t know the answers or want to know […]
The case of chest pain
A Trojan Horse Saddle stuck in the Lung We have a very interesting image for you but, can you answer the questions below? 1. What is your differential diagnosis for chest pain and dyspnoea? 2. What abnormality is seen on the CT scan and ECG? 3.What is the gold standard for investigation of this condition? […]
Alveolar Ethmoidal Rhabdomyosarcoma in a Young Adult Male
A very well written case, which would be of interest to many specialties, with a clear discussion and relevant references. It may be useful for readers to highlight that rhabdomyosarcoma is most common in the paediatric population and thereby making the presentation of this type of tumour in this case more unusual. Also mention of the reasoning behind […]
An Unusual Posterior Fossa Tumour in a Young Child
The authors describe the case of a 23-month old child with a posterior fossa tumour, which was removed and turned out to be a choroid plexus papilloma. As they state, choroid plexus papilloma is encountered commonly in the first two years of life, but very rarely in the posterior fossa. It is more common in […]
Chiari malformation and central sleep apnoea: successful therapy with adaptive pressure support servo-ventilation following surgical treatment
This is a well written manuscript. The case is of interest to general physicians and highlights an important associations. The therapy described is of innovative nature and allows the reader to be familiarized with this novel mode of therapy. The case also discusses important, to general physicians, Chiari malformation. In my opinion this is a […]
Three cases of severely disseminated Staphylococcus aureus infection in patients treated with tocilizumab
These cases illustrate a number of important points of relevance to acute and general medical physicians as well as in specialties such as Rheumatology. Firstly, patients who are on anti-IL-6 medications may present in a different and less florid way when infected systemically with Staphylococcus aureus than immunocompetent patients. Secondly, they provide a reminder to […]
Hypertrophic Pulmonary Osteoarthropathy and Congenital Heart Disease
Secondary Hypertrophic osteoarthropathy in cyanotic congenital heart disease is a well known complication but its awareness is coming down. Though its prevalence may have come down thanks to total correction and better palliation during childhood it has not totally disappeared. Awareness about its presentation and x-ray findings is must for a timely diagnosis and management […]
Failure of anti-TNF therapy to reactivate previously septic prosthetic joints
There are many problems and alarms arising from anti-TNF therapy employed by biological drugs and infections. On the other hand, the medical behavior on this issue is usually personal and medical decisions are made on a case-by-case. In this case, the elapsed time from the previous infections is really considerable and it is also reasonable […]