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Fellowship Mock Exam September 2019

This article focuses on the important differential diagnoses and initial investigations for an 78-year-old female presenting with lethargy and upper abdominal pain. Key considerations include AAA rupture, ACS/STEMI, mesenteric ischemia, bowel perforation/hollow viscus perforation, and pancreatitis/cholecystitis/cholangitis/pneumonia. Important initial investigations within the first 20 minutes of patient care include FBC, LFT, and upright CXR, with justifications provided.

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Fellowship Mock Exam September 2019

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  1. Fellowship Mock Exam September 2019

  2. Q4.(11 Marks) A 78 y/o lady presents to your Emergency Department with lethargy and upper abdominal pain since this morning.She has a PMH of HTN and type 2 D.M • On examination she is distressed with pain, her vital signs are: • HR: 84/bpm • BP:92/56 • Temp: 37.6 • RR: 18

  3. List five important ddx you need to consider in this patient (5 Marks) • AAA rupture • ACS/STEMI • Mesenteric ischemia • Bowel perforation/hollow viscus perforation • Pancreatitis/ cholecystitis/cholangitis/pneumonia

  4. Some of you wrote: • Biliary pathology??? • Peptic ulcer • Aortic dissection • IHD • HHS

  5. B.Complete the following table listing three important initial investigation in the first 20 minutes of this patient care.Give you justification for each.(6 Marks)

  6. Some of you wrote: • FBC • LFT • CT angiogram • BSL • CXR upright

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