MRCEM EXAM SUCCESS INTERMEDIATE RECALLS (DEMO)

Explanation:

ECG suggests extensive Anterior STEMI (acute)
• ST elevation in V1-6 plus I and aVL (most marked in V2-4)
• Minimal reciprocal ST depression in III and aVF
• Q waves in V1-2, reduced R wave height (a Q-wave equivalent) in V3-4

• In anterior MI occluded coronary artery is LAD

Explanation:

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 Peri-lunate dislocation
• It is the posterior dislocation of carpal bones while the lunate maintains its position with respect to the distal radius.
• 60% of peri-lunate dislocations associated with a scaphoid fracture

  Clinical features: Generalized swelling, pain, and tenderness of the wrist.

  Diagnosis: lateral view of radiograph will reveal the three C’s sign which is disrupted with the capitate, represented by the third C, displaced dorsal to the lunate. The lunate retains its contact with the radius.

  Management: Give analgesia and refer to orthopedic for reduction

Explanation: