A 55-year-old man presented with almost one year history of heat intolerance, mild palpitation and significant weight loss. Free T3 and T4 were elevated with normal TSH. Patient had suboptimal response to carbimazole therapy.
A 73-year-old man presented with 1 week’s history of progressive epigastric pain. The pain was dull in nature and the patient reported no vomiting or radiation of pain. On presentation, the patient was found to have a low-grade fever (temperature, 37.8°C). There was no tea-coloured urine. The patient had enjoyed good past health except for a previous surgery for spinal injury.
Dr. Yiting Fan, Yiqun Zhang, Dr. Xingwei Zhang, Dr. Alex Pui-Wai Lee, 20160812000000
A 74-year-old man with a history of paroxysmal non-valvular atrial fibrillation (AF) and transient ischaemic attack (TIA) despite oral anticoagulation was referred for catheter-based left atrial appendage (LAA) occlusion.
This case scenario was presented at a grand round in the Department of Medicine, The University of Hong Kong. Unlike traditional grand rounds that directly or indirectly deal with clinical challenges posed by patients, this one was equally about doctors and how they care for their charges. All doctors who tend patients dread being implicated on the receiving end of medico-legal proceedings. This topic is therefore intimately linked to the professionalism of doctors, their standing in the community, and the ethical aspects of how they interact with patients and relatives.