Typical exam stem
A young adult with sickle cell disease presents with severe limb pain and fever. How would you assess and manage the patient?
Active exam mode
Plan the case before reading, then mark sections, reveal pearls and self-rate the viva.
1. Sixty-second answer plan
1:00Before reading the notes, say or write your assessment, investigations and management structure.
2. Section checklist
Mark each section only after you can explain its main decision points without reading.
3. Exam-pearl flashcards
Try to predict the pearl before revealing it.
4. Viva drill
Answer aloud before rating yourself. Anything marked “review” stays visible in your progress.
What is acute chest syndrome?
Progress is saved on this device. Use “Reset session” when you want a fresh attempt.
Treat the presentation as an acute medical problem
A painful vaso-occlusive episode is common, but the examiner expects you to actively search for complications that can rapidly become life-threatening. Ask about chest pain, breathlessness, fever, neurological symptoms, priapism, abdominal pain and recent transfusion. Assess oxygen saturation, respiratory rate, temperature, haemodynamic state and pain severity.
Do not miss acute chest syndrome
- Suspect acute chest syndrome when new respiratory symptoms or fever accompany a new pulmonary infiltrate.
- Provide oxygen when hypoxaemic, adequate analgesia, careful hydration, antibiotics according to local protocol and early specialist review.
- Escalating hypoxaemia, respiratory distress or falling haemoglobin may require transfusion support and critical-care input.
- Infection can trigger crisis and should be investigated promptly when fever or systemic illness is present.
Painful crisis management
Provide prompt, effective analgesia and reassess frequently. Hydration should correct dehydration without causing fluid overload. Encourage mobilisation and supportive care when safe. Investigate only as indicated by the presentation; uncomplicated pain does not require extensive testing simply because the patient has sickle cell disease.
Guideline source for further reading
This page is an original exam-revision summary. For clinical decisions, use current local protocols and the primary guidance below.