Thread by @Dr_Hempenstall

1/ Primary Care Case of the Week 3

Each week I’d like to share a case for #MedStudents to continue developing their clinical reasoning, even though not on clinical placement at present.

All cases are factitious, but inspired by those seen in #PrimaryCare

#MedEd #MedTwitter

2/ 30yo crayfish diver presents to the clinic with sudden onset abdominal, back & chest pain. He looks sweaty & in significant discomfort.

🦞What’s in your list of differential diagnoses?

🦞What would you would like to know on history & exam?

#MedEd

3/ Irukandji Syndrome

📌Caused by sting of Carukia barnesi jellyfish found in coastal waters of tropical Australia

📌Envenomation thought to induce massive catecholamine release

📌Initial sting usually not felt!

4/ Clinical Presentation of Irukandji Syndrome

📌Local signs like a skin rash are often absent

📌Systemic symptoms develop about 1-2hrs after sting:
-severe whole body pain
-vomiting
-diaphoresis
-hypertension

📌Risk of hypertensive crisis, ICH, cardiogenic shock & APO

5/ Management
📌Vinegar first aid to deactivate nematocysts

📌Opioids for pain relief

📌Promethazine for nausea

📌 Glyceryl trinitrate for hypertension

📌IV magnesium suphate for pain refractory to opioids

📌No Antivenom currently available

6/ Thanks for playing @am_baker @lucierobson @MartinLow88 @char_durand @broomedocs @erw269 @banndoc 🤩

You can read more about Irukandji Syndrome here:
😀litfl.com/irukandji-synd…
😀digitallibrary.health.nt.gov.au/prodjspui/bits…