Contents

Preface

Conveying abnormal test results

1. The 51-Year-Old Woman with a Possible Brain Tumour

2. The 22-Year-Old Woman with New Diagnosis of Type 1 Diabetes

3. The 28-Year-Old Woman with a Positive HIV Test Result

4. The 66-Year-Old Man with Advanced Pancreatic Cancer

5. The 74-Year-Old Man with Acute Myeloid Leukaemia

6. The 27-Year-Old Woman with Possible Coeliac Disease

7. The 30-Year-Old Woman with Tuberculosis

8. The 34-Year-Old Man with Hypertrophic Cardiomyopathy

Counselling on disease management

9. The 22-Year-Old Man with Recurrent Episodes of Fainting

10. Case 10 The 24-Year-Old Pregnant Woman with Suspected Pulmonary

11. Case 11 The 37-Year-Old Woman with Functional Dyspepsia

12. Case 12 The 46-Year-Old Man with Poorly Controlled Diabetes Mellitus

13. Case 13 The 78-Year-Old Woman with Hyponatremia

14. Case 14 The 26-Year-Old Woman who has had an Anaphylactic Reaction

15. Case 14 The 26-Year-Old Woman who has had an Anaphylactic Reaction

Capacity, consent and confidentiality

16. Case 16 The 28-Year-Old Woman with Possible Lupus Nephritis

17. Case 17 The 19-year-old Girl whose Father Objects to a Lumbar Puncture

18. Case 18 The 66-Year-Old Man who Does Not Wish to Start Dialysis

19. Case 19 The 33-Year-Old Man who is Refusing the HIV Test

20. Case 20 The 52-Year-Old Man who wants to get Discharged Against Medical Advice

Challenging patients and relatives

21. Case 21 The 77-Year-Old Man whose Daughter asks you Not to Reveal the Diagnosis of Cancer to him

22. Case 22 The 37-Year-Old Man with Gonorrhoea who asks you Not to Tell his Wife about his Diagnosis

23. Case 23 The 26-Year-Old Man who is asking to be tested for Huntington’s disease

24. Case 24 The 46-Year-Old Man who is Not Compliant with his Anti-Hypertensive Medication

25. Case 25 The 65-Year-Old Woman Who Wants to Try Herbal Treatment for her Lymphoma

26. Case 26 The 24-Year-Old Man with Difficult Asthma

27. Case 27 The 63-Year-Old Woman whose Husband asks you Not to Discharge Her

28. Case 28 The 42-Year-Old Man with Non-Specific Back Pain who Demands a Scan

When things go wrong

29. Case 29 The 47-Year-Old Man who is Demanding Strong Opioids for his Chronic Back Pain

30. Case 30 The 43-Year-Old Woman with No Diagnosis despite Extensive Evaluation

31. Case 31 The 66-Year-Old Man whose Sister Does Not Agree with your Diagnosis

32. Case 32 The 68-Year-Old Man whose Stroke was not Diagnosed in Time

33. Case 33 The 74-Year-Old Woman who has Suffered Harm because of a Medication Error

34. Case 34 The 78-Year-Old Man who Fell Off His Bed in the Ward

End-of-life issues

35. Case 35 The 73-Year-Old Man who was Exposed to COVID in Hospital

36. Case 36 The 27-Year-Old Woman with a Severe Allergic Reaction to Sulfasalazine

37. Case 37 The 69-Year-Old Woman whose Cord Compression was not Diagnosed in Time

38. Case 38 The 69-Year-Old Woman who wants to Make a Living Will

39. Case 39 The 82-Year-Old Woman for whom the Medical Team feels that CPR Should Not be Attempted

40. Case 40 The 68-Year-Old Man with Motor Neurone Disease who needs Artificial Feeding

41. Case 41 The 70-Year-Old Man with Acute Exacerbation of COPD

42. Case 42 The 81-Year-Old Man who is Terminally Ill

43. Case 43 The 45-Year-Old Man with Severe Brain Haemorrhage

44. Case 44 The 59-Year-Old Man who has just Died from Myocardial Infarction

45. Case 45 The 53-Year-Old Woman whose Death is Unexplained