NPMCN Primary case studies
NPMCN Primary · Put your knowledge to work in context.
The NPMCN Primary Examination is the entry gate to postgraduate specialist training under the National Postgraduate Medical College of Nigeria. It is sat by medical graduates who already hold a recognised MBBS (or equivalent) and who intend to pursue fellowship training in a clinical or laboratory specialty. The NPMCN Primary case studies are 5 cases and about 5,183 words.
1A mechanical mitral valve, a dental infection and an INR of 6.8
Mr A, a 58-year-old retired teacher in Enugu, has a mechanical mitral valve prosthesis and has taken warfarin 5 mg daily for two years, with his INR stable between 2.7 and 3.2. He attends the dental clinic with a five-day history of a painful, swollen lower molar and is prescribed co-trimoxazole 960 mg twice daily for seven days.
1,012 words, about 5 min2Watery diarrhoea after a funeral feast in a rural Kano community
A rural community of about 1,400 people in Kano State reports 52 cases of acute watery diarrhoea over four days, and two elderly women have died. Forty-seven of the 52 patients attended a funeral feast three days before falling ill; 210 people attended that feast.
1,062 words, about 5 min3A 15-year-old, severe anaemia and her parents' refusal of blood
A 15-year-old girl is carried into the accident and emergency unit of a tertiary hospital in Ibadan by her parents. She has a three-day history of fever and vomiting and is drowsy but rousable, with deep, rapid breathing, temperature 39.4 °C, pulse 132/min and oxygen saturation 96% on room air.
1,063 words, about 5 min4A liver mass, an AFP of 1,240 and only money for one more test
A 52-year-old farmer from a village near Ilorin presents to a surgical outpatient clinic with six weeks of right upper quadrant pain, 7 kg of weight loss and early satiety. He has known he is HBsAg-positive since 2011 and has never taken antiviral drugs; his father died of 'liver cancer'.
1,069 words, about 5 min5Reading a 120-patient malaria trial for a formulary decision
A randomised trial run in two Nigerian teaching hospitals compares intravenous artesunate with intramuscular artemether in 120 adults with severe falciparum malaria, 60 per arm. The primary outcome is mean parasite clearance time.
977 words, about 5 min