68 patients. You work out what is wrong.

A 66-year-old man's feet have felt numb for a few months, and they burn at night. He recently cut his foot in the garden and did not feel it.

A student presents with a severe, throbbing headache preceded by light flashes. She has experienced similar episodes over the past three months.

A 32-year-old mother of two comes to emergency because she has been unsteady on her feet for two days, worse at night and when she turns quickly. She had a cold about a week ago.

A 48-year-old supermarket worker can barely stand. His feet started feeling wrong four days ago, walking became difficult the next day, and now his feet hurt too. He had a stomach upset a month ago.

Her son says she was eating breakfast when her right hand dropped the cup and she could not get her words out. That was a little over an hour ago. He tells you what he saw.

At a quarter past seven he came out of the bathroom holding his head, vomited twice, and within minutes his left arm and leg went weak and his speech thickened. His wife says he is getting sleepier.

A frail 76-year-old woman had weakness of her right arm and leg with slurred speech while sitting with her husband. It all went within ten minutes. She has diabetes, high blood pressure and heart disease, and smokes.

For three days he has had a high fever with a pounding headache, pain behind his eyes and aches in every joint. Two neighbours in his lane fell ill this month, and a friend has told him to get a transfusion straight away.

An engineering student's temperature has climbed a little higher each day for nine days, with a headache, a dull ache in the belly and no appetite. A course of tablets from the chemist did nothing.

A 24-year-old man presents with three days of fever, intense rigors and malaise after returning from a six-week work trip to Nigeria. Blood tests show mild anaemia, thrombocytopenia and raised bilirubin.

Since last night she has had high fever with shaking chills, pain in her right side and back, and she has vomited twice. For three days before that, it burned when she passed urine.

A farm worker from the hills has had high fever, a pounding headache and aching all over for eight days, through the end of the monsoon. Paracetamol brings the fever down for a few hours only.

A young child presents with sudden onset of vomiting followed by profuse watery stools. Evaluate the severity of dehydration and determine the underlying cause.

A mother brings her 4-week-old son because the yellow colour in his eyes and face has not gone away.

Ten days ago his right knee became hot and swollen. That settled, then his left ankle swelled, and now it is his left wrist. He has been hot and unwell all along.

Her mother brings her after three days of cough and fever. Since this morning she has been breathing fast and won't take the breast or water.

A mother brings her son because his eyes have been puffy every morning for a week, and now his legs and scrotum are swollen too. He had a cold two weeks ago.

A 25-year-old accountant felt a sudden sharp pain in the right side of her chest while walking to work six hours ago, with breathlessness and a dry cough. The worst has settled, but it still hurts to breathe in deeply.

A 57-year-old taxi driver has been nodding off whenever he sits quietly for two years. He has twice fallen asleep at the wheel. He gets a full eight hours in bed every night.

An auto-rickshaw driver has had a cough for six weeks, evening fevers and night sweats, and has lost 6 kg. A course of antibiotics from a local clinic did not help, and last week he saw streaks of blood in his phlegm.

A thin 48-year-old man who stopped his antibiotics early for a chest infection is back with fever, loss of appetite, left-sided chest discomfort and breathlessness on exertion. He smokes and drinks heavily.

A 69-year-old man who gave up smoking 9 months ago has had a cough for years and is getting more and more breathless. His ankles have started to swell and his inhaler is not helping.

A 50-year-old man feels perfectly well and has come for a health check because his life insurance company asked for one.

A 48-year-old woman comes back with mid-back pain that has become worse and now wakes her at night. A couple of months ago her X-ray and blood tests were normal and she was treated for a muscle strain.

A 54-year-old woman presents with a painless, non-progressive neck swelling associated with difficulty swallowing, change in voice, and difficulty breathing on exertion.

A 79-year-old retired shopkeeper has been tired and generally unwell for 5 or 6 weeks and has lost interest in things. His daughter has brought him in.

A first-time mother at 37 weeks is brought to the labour room by her mother-in-law. Her head has hurt since morning and paracetamol has not touched it, her vision is blurred, and her face and hands have been swelling for five days.

A woman expecting her second baby, now at 28 weeks, has felt tired and breathless on walking for five days.

An hour after a long labour and a normal delivery, the staff nurse calls you: she has soaked two pads in ten minutes, she is pale and her pulse is climbing.

A young woman collapsed at her office after a day of pain low in her belly. Her colleagues brought her in; she is pale, sweaty and says her shoulder hurts too.

He has been itching for a month and it is worst at night, so he can't sleep. Two boys in his dormitory are scratching too. The cream from the chemist hasn't helped.

A previously healthy young man comes to emergency with a high fever, a painful rash on his face and body, red eyes, and raw sores on his lips and inside his mouth that have got worse fast. He was treated for a sore throat a few days ago.

Three light patches have appeared on his skin over eight months. They don't itch, a cream from the chemist did nothing, and last month he burnt one on a cooking pot without feeling it.

For eight months she has felt exhausted, put on 6 kg without eating more, and feels cold when everyone else is comfortable. Her periods have become heavy.

For two months he has been drinking glass after glass of water and getting up three or four times a night to pass urine. He has lost 3 kg although he eats well, and his father and brother have had the same trouble.

A 58-year-old teacher with three months of upper abdominal pain, now worse and going through to her back, has noticed yellow eyes, dark urine and pale stools. Her doctor referred her after a course of acid-reducing tablets did not help.

A 70-year-old woman has had upper abdominal pain for three days, with waves of worse pain and vomiting. Her eyes are yellow and her urine has been darker, which she thinks is a urine infection. She has had a few bad bouts of pain over the past five years.

The pain started around his navel late last night and has got steadily worse. He hasn't eaten anything since and has vomited twice.

A sore under the front of his right foot has been there for ten days. It does not hurt, so he kept working, but for three days it has been red and swollen and his wife saw pus on his sock.

Over the last day and a half, a 79-year-old man in a residential home has become sleepy, frightened and aggressive, accuses the staff of plotting against him, keeps falling and has become incontinent. The staff think he has dementia and want him moved. The nurse in charge gives you the story.

An 85-year-old man who lives alone has fallen again and cut his face. He has had about eight falls in the last 3 months and is dizzy each time.

A 49-year-old school teacher has had pain in her flank on and off for a while, and now she has seen blood in her urine.

Four days of loose motions and vomiting in the June heat, and now she can hardly stand. Her daughter says she has been taking painkillers for her knees.

He has been preparing for the civil services exam in Delhi for two years. His mother says he barely leaves his room now and hardly eats.

He stopped drinking yesterday morning after a fight at home. Since last night he hasn't slept, he is sweating, and his hands shake so much he can't hold a cup of tea.

The pain woke him at four this morning, in waves from his left side round to his groin. He can't keep still and has vomited twice. His urine looked pink.

He got off an overnight bus this morning and has not been able to pass water since. His lower belly is swollen and painful, and he keeps trying.

An older man presents with recurrent episodes of sudden dizziness and transient loss of consciousness. His pulse is markedly slow on examination.

A 36-year-old man is rushed in by his brother. He is struggling to breathe and feels faint.

Blood started running from his right nostril forty minutes ago while he was reading the paper. He has soaked a towel. He stopped his blood pressure tablets last month.

A 63-year-old woman presents with progressive tiredness, exertional breathlessness and headaches, along with numbness, unsteadiness and loss of sensation in her feet.

She slipped on the wet bathroom floor this morning and has not been able to stand since. Her son carried her to the car. Her right hip hurts badly when anyone moves her leg.