10 Scenarios contain the text: ' wrist' |
| Title | Description |
|---|---|
| Forearm / wrist injury | A 24 year old male Māori forestry worker presents with severe and worsening left forearm and wrist pain after his arm was crushed between two heavy logs of wood at work. An X-ray shows comminuted mid-shaft fractures of the radius and ulna. He develops compartment syndrome. This is not diagnosed immediately and despite surgical decompression he goes on to suffer serious disability. D/O: Musculoskeletal System (•••), Orthopaedics (•••) PTT: Musculoskeletal |
| Personality disorder | You are on your Emergency Medicine placement. You see a 36 year old single NZ European man who is a frequent attender at the Emergency Department. He has presented following multiple cuts to both wrists; a repeated presentation. He reports that his mood is low but this is not consistent with his affect. He appears irritable and sensitive at times. Poor relationships existed with his parents and three siblings; he states ‘they have given up on me’. He was inconsistent when asked about his personal safety, suggesting admission would be safest. He had a history of childhood sexual abuse by an uncle. He reported problematic alcohol use. Current medications include antidepressant, mood stabiliser and antipsychotic medications. Attendance at community clinics has been erratic with multiple non-attendances. With the patient's consent, you contact his parents who are relieved to have received the phone call. They had been worried about their inability to contact him; they report extensive involvement and support of their son. D/O: Psychiatry/Health Psychology (•••), General Practice (••), Emergency Medicine (•) PTT: Mental health |
| Rash on extensor surfaces and joint pains | An 45 year old NZ European man, who is obese, hypertensive, and smokes cigarettes, goes to see his GP about a rash. It has been present for some 20 years on his elbows and knees but is now becoming widespread. This rash bothers him a lot as he feels it is unsightly. On further questioning it becomes apparent that he experiences joint pains of the fingers, wrists and ankles. D/O: Dermatology (•••), Rheumatology (•••), Immunology (••) PTT: Musculoskeletal, Skin |
| Swollen and tender joints | A 40 year old Fijian Indian woman presents to her GP with a several week history of painful, stiff joints in her hands and feet. It takes her over an hour in the morning to 'get going'. She is feeling much more tired than usual and has lost 3 kg in weight over the last 2 months. Clinical examination revealed 22 swollen joints (all the MCP, PIP and wrist joints) and 22 tender joints (all the MCP, PIP and wrist joints). The metatarsal squeeze test was positive. D/O: Musculoskeletal System (•••), Rheumatology (•••) PTT: Musculoskeletal |
| Hand injury | A 19 year old NZ European male presents with a swollen, painful right hand after falling whilst intoxicated. There is swelling over the back of his hand and he has two small wounds over his 4th and 5th knuckles. He appears angry and gives little extra history. D/O: Musculoskeletal System (•••), Orthopaedics (•••), Plastic Surgery (•••), Ethics (••) PTT: Musculoskeletal |
| Child with abnormal gait | A Somali woman brings her 2 year old son to the GP, because her husband is concerned about the way he is walking. His mother wears a veil for religious reasons. D/O: Musculoskeletal System (•••), Orthopaedics (•••), Paediatrics (•••), General Practice (••) PTT: Musculoskeletal |
| Dislocated joint | A 23 year old Samoan man attends the Emergency Department after dislocating his shoulder playing rugby. His friend who is a doctor has tried unsuccessfully to relocate the shoulder. The emergency nurse practitioner is managing the case and you are helping them. D/O: Emergency Medicine (•••), Musculoskeletal System (•••), Orthopaedics (•••) PTT: Musculoskeletal |
| Osteomyelitis | A ten year old Niuean child presents with a 2 day history of limp from a painful knee. He had chicken pox over a week ago, weighs 70 kg and is 140 cm tall. D/O: Infectious Diseases (•••), Microbiology (•••), Musculoskeletal System (•••), Orthopaedics (•••), Paediatrics (••) PTT: Musculoskeletal |
| Painful hands in the cold | A 37 year old NZ European woman presented to her GP with a recent history of painful 'weak' hands. She has also been quite lethargic the last few weeks, complains of low mood and aches all over her body. She has had Raynaud's phenomenon since her early teens which she manages by avoiding cold exposure and she is not prescribed any regular medications. On examination she has a positive Tinel's sign bilaterally. D/O: Musculoskeletal System (•••), Rheumatology (•••) PTT: Musculoskeletal |
| Rest home resident with itching and rash | You have been asked to visit an 81 year old NZ European man with dementia in hospital level care. The nursing staff report that he has become agitated in the last 3 months and has developed an extensive rash that is most severe on the trunk and in the inguinal flexures. D/O: Dermatology (•••), General Practice (•••), Infectious Diseases (•••) PTT: Skin |
| Title | Description |
