A 50 year-old man presents to the Emergency Department with a three day history of se

Discussion in 'Plab 1 and 2 forum' started by Santosh Jadhav, Oct 23, 2013.

  1. Santosh Jadhav

    Santosh Jadhav Active Member

    A 50 year-old man presents to the Emergency Department with a three day history of severe headache associated with vomiting. There is no significant past medical history. On examination blood pressure is 98/62 mmHg, pulse is 108 bpm and the temperature is 37.0ºC. There is mild neck stiffness and a partial third nerve palsy of the left eye. Blood results are as below.

    Hb 13.8 g/dl
    Plt 373 * 109/l
    WBC 13.6 * 109/l

    Na+ 132 mmol/l
    K+ 5.2 mmol/l
    Urea 4.2 mmol/l
    Creatinine 99 µmol/l

    Free T4 9 pmol/l
    (range 10-22)

    What is the most likely diagnosis?

    A-Subarachnoid haemorrhage
    B-Cavernous sinus thrombosis
    C-Meningitis
    D-Pituitary apoplexy
    E-Lateral sinus thrombosis

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