Nombre de la Materia

Medical English II

Nombre del Alumno (a)

Violeta Orona Ramirez. Matricula 1821338210

Nombre de la Tarea
Medical case

Nombre del Profesor (a)

Dr. Ana Paulina Nájera Soto

5th april 2022

 PAIN IN THE FOOT
Medical case

A 65-year-old man presents with an ulcer on the dorsum of his right foot. He noticed a sore area
on the right foot 3 weeks ago and this has extended to an ulcerated lesion which is not painful.
He has complained of pain in the legs for some months. This pain comes on when he walks and
settles down when he stops. He had an inguinal hernia repaired 2 years ago and he stopped
smoking then on the advice of the anaesthetist. Previously he smoked 20 cigarettes per day. He
drinks four pints of beer at weekends. His father died of a myocardial infarction aged 58 years.

Examination
His blood pressure is 136/84 mmHg. The respiratory, cardiovascular and abdominal systems
are normal. There is a 3 cm ulcerated area with a well-demarcated edge on the dorsum of the
right foot. The posterior tibial pulses are palpable on both feet, and the dorsalis pedis on the left.
The capillary return time is 4 s. On neurological examination there is some loss of light touch
sensation in the toes. Varicose veins are present in the long saphenous distribution on both
legs.

2. Annex for clinical case

1. The patient had an inguinal hernia repaired

A) A year ago
B) Two years ago
C) Four years ago
D) Ten years ago
ANSWER: B

2. The problem the patient presents is

A) A strong headache
B) A bleeding wound in the left foot
C) An ulcer on the dorsum of the right foot
D) An ulcer on the heal of the right foot
ANSWER: C

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3. The patient has complained of pain in the legs
A) For some months
B) Since last visit
C) For a year and half
D) During all his life
ANSWER: A
4. The patients’ age is
A) 67 y/o
B) 64 y/o
C) 65 y/o
D) 69 y/o
ANSWER: C

5. He noticed a sore area on the foot

A) A week ago
B) A month ago
C) Four weeks ago
D) Three weeks ago
ANSWER: D

6. The neurological examination shows

A) A complete loss of sensibility in the toes
B) Partial loss of sensibility in the toes
C) A complete sensibility in the right foot
D) A partial loss of sensibility in the left foot
ANSWER: B

7. The patient expresses that the pain

A) It’s always present
B) Stops when he sits down
C) Starts when he walks fast
D) Stops when he settles down
ANSWER: D

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8. The patient’s father dies at the age of
A) 58 y/o
B) 54 y/o
C) 52 y/o
D) 56 y/o
ANSWER: A

9. The cause of the patient’s father was

A) Heart disease
B) Pulmonary disease
C) Gastrointestinal disease
D) HIV
ANSWER: A

10. The patient stopped smoking as a recommendation of

A) The cardiologists
B) The Gastroenterologist
C) The Anaesthetist
D) The GP
ANSWER: C

Bibliografy:
clinical case given by the study unit. professor dra nájera