Clincher
Clincher
Clincher
VERSION 1.5
CLINCHER
Oesophageal Stent
Mass
compressing
middle third of
oesophagus
causing
dysphagia
Oesophageal stent
PLABABLE
Acoustic Neuroma
PLABABLE
Spironolactone
Vitals → Normal
Investigations
Low albumin
Ascitic tap → Ascitic fluid amylase
around 50% of serum amylase
PLABABLE
Haematemesis
Hypertensive retinopathy
PLABABLE
Drug Overdose
Vitals normal
Investigations:
● ECG normal
● FBC, LFT, UnE normal
PLABABLE
Xanthelasma
Xanthelasma
Xanthos → Yellow
Elasma → Beaten metal plates (plaques)
PLABABLE
Hypertension
PLABABLE
Phobia
Agoraphobia
PLABABLE
Cataract
Cataract
PLABABLE
Heart Block
Permanent pacemaker
PLABABLE
Breast Lump
Fibroadenoma
PLABABLE
Pneumonia
Doxycycline or clarithromycin
Bladder retraining
PLABABLE
Breast Pathology
PLABABLE
Halitosis
USE
PLABABLE
Fractures In Children
Non-accidental injury
PLABABLE
Post Cholecystectomy
Next step?
Intravenous naloxone
PLABABLE
Foreign Body
Foreign body
PLABABLE
Hypertension
PLABABLE
Fetal Movements
Next step?
PLABABLE
TURP
Hyponatremia
PLABABLE
Paracetamol Overdose
Administer N-acetylcysteine
immediately
This patient meets the following criteria:
AND
PLABABLE
Anorexia Nervosa
PLABABLE
Shingles
OldP
Pregnant woman came in contact with 50
year old man with shingles
CT brain
PLABABLE
Hypertension
Lisinopril
PLABABLE
Hearing Tests
PLABABLE
Vomiting
PLABABLE
Testicular Cancer
USG scan of
scrotum
PLABABLE
Chest Pain
Chest X-ray
PLABABLE
Prolactinoma
Prolactin is elevated
Cabergoline
PLABABLE
Myocardial Infarction
Myocardial infarction
PLABABLE
Fracture
Closed reduction
Followed by
PLABABLE
Syphilis
PLABABLE
PCOS
PCOS
PLABABLE
Bone Pain
Bone metastasis
Radiotherapy
PLABABLE
Guillain-Barre Syndrome
PLABABLE
Irregular Menstrual Cycles
TSH - Normal
Prolactin - Normal
FSH - Raised
PLABABLE
Penile Ulcers
PLABABLE
Recurrent Infections
Reassure
Centor score: 0 → Viral tonsillitis
Viral tonsillitis is self limiting and does not
require further treatment or investigation
Isotretinoin
PLABABLE
Hyperthyroidism
Graves’ Disease
PLABABLE
Panic attacks
PLABABLE
Menopause
PLABABLE
BPPV
PLABABLE
Contraception
Progestogen-only pill
Dantrolene
PLABABLE
Recurrent Falls
● Apixaban
● Atorvastatin
● Duloxetine
● Denosumab
● Clozapine
Duloxetine (SNRI)
PLABABLE
Parkinson’s Disease
Substantia nigra
PLABABLE
Nerve Injury
PLABABLE
Status Epilepticus
Status epilepticus
IV phenytoin
PLABABLE
Weakness
Functional weakness
PLABABLE
Nerve Injury
Phrenic nerve
PLABABLE
Nerve Injury
Hypoglossal nerve
PLABABLE
Breast Cancer
Lymphoedema
PLABABLE
Skin Lesions
Impetigo (uncomplicated)
What is the most appropriate medication to
prescribe?
PLABABLE
Diabetes
Diabetic ketoacidosis
What is the most appropriate/initial
investigation?
PLABABLE
Hypoglycaemia
IM glucagon 1mg
PLABABLE
Hypoglycaemia
PLABABLE
Bloating
PLABABLE
Asthma
PLABABLE
Carbon Monoxide Poisoning
Oxygen
PLABABLE
Cough
Parapneumonic effusion
PLABABLE
Asthma
Salmeterol inhalers
Salmeterol is a LABA
PLABABLE
Haemoptysis
Components of disease
Nasal ● Saddle nose deformity
● Sinusitis
● Bloody rhinorrhoea
Lower ● Haemoptysis
respiratory
Kidney ● Haematuria
Skin ● Subcutaneous nodules
● Purpura
PLABABLE
Urinary Leakage
Vesicovaginal fistula
PLABABLE
Tiredness
PLABABLE
Hyperthyroidism
Carbimazole
In pregnancy:
● 1st trimester → Propylthiouracil
● 2nd/3rd trimester → Switch to carbimazole
PLABABLE
Breast Discharge
Prolactin levels
PLABABLE
Diabetes
PLABABLE
Polyuria
Diabetes insipidus
Urine osmolality
PLABABLE
Hypothyroidism
Subclinical hypothyroidism
PLABABLE
PEG Tube Care
PLABABLE
Urinary Tract Infection
PLABABLE
Urinary Tract Infection
Vaginal oestrogen
PLABABLE
Hyperglycaemia
PLABABLE
Diabetes
PLABABLE
Hyperparathyroidism
Primary hyperparathyroidism
Parathyroidectomy
PLABABLE
Urinary Tract Infection
UTI
Nitrofurantoin
Ultrasound scan
In children >3 years old →
“M.C.U.Gee
Never pick over three!”
PLABABLE
Urinary Tract Infections
DMSA scan
In children >3 years old →
“M.C.U.Gee
Never pick over three!”
PLABABLE
Ulcers
Venous ulcer
PLABABLE
Haematuria
Cystourethroscopy
PLABABLE
Osteoporosis
Bisphosphonates
PLABABLE
Benign Prostatic Hyperplasia
Tamsulosin
PLABABLE
Haematuria
CT urogram
PLABABLE
MORE COMING SOON
PLABABLE
Image Attributions
https://commons.wikimedia.org/wiki/File:Xanthelasma.jpg
Klaus D. Peter, Gummersbach, Germany
CC BY 3.0 DE
https://commons.wikimedia.org/wiki/File:Cataract_(28464844371).png
National Eye Institute, National Institutes of Health
Public Domain
PLABABLE