Real life cases…
1- A young female with 1 year history of renal transplant . She presented with uncontrolled DM and HTN . The transplant was non tender and no signs of volume overload ( good functioning ) A diagnosis of steroid and tacrolimus side effects was made .
2- A young male with 25 tablet suicidal diazepam ingestion since 24 hours . He presented with apnea . We decided no need or benifit from flumazinil ( risk outweighs benifit ) . He was intubated and ventilated with supportive treatment for 3 days . He is due for discharge .
3- A middle aged man presented with exertional dyspnea . Examination and ECG showed bradycardia in the form of complete AV block . No reversible cause was found on investigation. A permanent pacemaker was decided .
4- A middle aged man presented with uncontrolled hypertension and there was typical symptoms and signs of left carpal tunnel syndrome ( numbness over lateral 3 fingers and wasting of thenar eminence ) . No signs or symptoms suggestive of acromegaly and his lab tests including thyroid function were normal .
5- A patient with prosthetic mitral valve and AF on warfarin therapy presented with TIA .The valve was clinically OK and with normal metallic sound .Echo was OK . CT was normal . INR was 1.2 . Warfarin dose was increased . Aspirin was already on .
6- A case of typical features of extrinsic allergic alveolitis with dyspnea and cough for the last few weeks , with low o2 sat and bilateral lung reticulonodular infiltrate and marvelous response to oral prednisolone therapy .