MCI GUIDELINES

#Its Time 82 y/o male came with altered mental status and acute renal failure, PMH includes atrial fibrillation, type 2 DM, CT scan of the head and MRI of the brain revealed multiple lesions located in the left cerebellum, in bilateral frontal lobe, and in the inferior parietal lobe on the left. MRI attached. What would you advice?

63 y/o female with no significant past medical history except discoid lupus complaining of new firm skin spots on left cheek for a few months (progressing). Non-tender. Non-pruritic. No pus or discharge noted. No new use of skin products or skin procedures. Has decent daily sun exposure but uses sunscreen. Patient is wondering if likely nothing or worth a biopsy? Could this be discoid lupus flare developing? (prior lesions on scalp and behind the ear). Denies fevers, chills, nausea, vomiting, or diarrhea.

30 year old male, 10 day history of diarrhoea and reduced oral intake, presented with lethargy and ongoing abdominal cramps. No respiratory symptoms, but O2 sats noted to be on the lower side, exertional O2 sats dropped to 86%. No past medical history of note, normal white cell count, not lymphopenic, urea 18.9 mmol/L, creatinine: 489 µmol/L, amylase 600 (30-118), ALT: 65, CRP: 100, Trop I 267 (0-46). Chest X-ray as shown. What do you think the patient is suffered from?

#ItsTime A 35 yr old admitted with intermittent moderate fever without any chills and rigor and yellowish discoloration of both eyes for last 1month and generalized swelling of abdomen for same duration. Patient had history of intermittent cough with sputum production in the past.No history of respiratory distress, abdominal pain, haemoptysis. Her pulse rate was 102/min, BP-110/70 mm of Hg, with mild pallor. USG of the abdomen showed mild splenomegaly and hepatomegaly with normal echo texture of the liver without any other abnormalities. X-ray was normal. CT of abdomen showed only a mildly enlarged liver without any other mass or lymphadenopathy. What is this case about?

50+ male patient, asthmatic, returning from a COVID-19-affected European country a few days earlier. Started to feel unwell before departure with fever and shortness of breath. No wheeze, hypoxia, tachypnea or tachycardia on assessment, only pyrexial with persistent dry cough. Arterial blood gas readings are all within range. Would you admit this patient? Would you swab this patient for the virus? Does the fact that he is asthmatic make a difference to your decision making? Would you prescribe antibiotics?