Short Cases in Clinical Medicine

Description

Front Cover......Page 1 Front matter......Page 2 Short cases in clinical medicine......Page 4 Copyright......Page 5 Dedication......Page 6 Preface to the 6th edition......Page 8 Preface to the 1st edition......Page 10 Acknowledgements......Page 12 Table of Contents......Page 14 SECTION A: SHORT CASES......Page 20 Introduction......Page 0 Physical examination......Page 24 General examination:......Page 25 Read the following topics in general examination......Page 27 Jaundice......Page 31 Read the following topics in jaundice......Page 32 Cyanosis......Page 35 Clubbing......Page 37 Read the following topics in relation to clubbing......Page 38 Read the following topics in relation to koilonychia......Page 42 Nail changes in different diseases......Page 43 Other different nail abnormalities......Page 44 Examination of hands......Page 49 Generalized oedema......Page 53 Read the following topics in relation to oedema......Page 54 Cervical lymphadenopathy......Page 55 Generalized lymphadenopathy......Page 59 Read the following topics in relation to generalized lymphadenopathy......Page 60 Gynaecomastia......Page 62 Read the following topics in relation to gynaecomastia......Page 69 Leprosy (hansen’s disease)......Page 72 Read the following topics in relation to leprosy......Page 78 Superior vena caval obstruction (superior vena caval syndrome)......Page 80 Read the following topics in relation to svc obstruction......Page 81 Inferior vena caval obstruction......Page 83 Hirsutism......Page 85 Read the following topics in relation to hirsutism......Page 86 Leg ulcer......Page 90 Read the following topics in relation to leg ulcer......Page 95 Pyoderma gangrenosum......Page 96 Read the following topics in relation to pyoderma gangrenosum:......Page 97 Diabetic foot......Page 99 Diabetic ulcer......Page 101 Unilateral or bilateral leg swelling......Page 104 Read the following topics in relation to leg oedema......Page 111 Angioedema......Page 114 Deep venous thrombosis (dvt)......Page 116 Read the following topics in relation to dvt......Page 117 Cellulitis......Page 121 Erysipelas......Page 123 Peripheral vascular disease......Page 125 Buerger’s disease (thromboangiitis obliterans)......Page 127 Bardet–biedl syndrome......Page 128 Tongue......Page 129 Read the following topics in relation to tongue......Page 130 Hairy leukoplakia......Page 133 Dupuytren’s contracture......Page 135 Paget’s disease......Page 137 Read the following topics in relation to paget’s disease......Page 138 Lupus pernio......Page 140 Read the following topics in relation to sarcoidosis......Page 141 2 Cardiovascular system......Page 144 Examination routine......Page 147 Inspection:......Page 148 Percussion:......Page 149 Pulse:......Page 150 Jvp:......Page 153 Heart sounds:......Page 156 Mitral stenosis......Page 159 Read the following topics in relation to mitral stenosis......Page 161 Brief note about myxoma of heart......Page 164 Mitral regurgitation......Page 166 Read the following topics in relation to mitral regurgitation......Page 167 Mitral valve prolapse (barlow’s syndrome or floppy mitral valve)......Page 169 Mitral stenosis with mitral regurgitation (mixed mitral valve disease)......Page 171 Aortic stenosis......Page 173 Read the following topics in relation to aortic stenosis......Page 174 Aortic regurgitation......Page 178 Read the following topics in relation to aortic regurgitation......Page 180 Aortic stenosis with aortic regurgitation (mixed aortic valve disease)......Page 184 Tricuspid regurgitation (tr)......Page 186 Pulmonary regurgitation (PR)......Page 188 Prosthetic heart valves......Page 194 Types of congenital heart diseases:......Page 198 Tetralogy of fallot (tof)......Page 200 Read the following topics in relation to tof......Page 201 Ventricular septal defect (vsd)......Page 204 Read the following topics in relation to vsd......Page 205 Atrial septal defect (asd)......Page 207 Read the following topics in relation to asd......Page 210 Patent ductus arteriosus (pda)......Page 213 Read the following topics in relation to pda......Page 214 Read the following topics in relation to coarctation of aorta......Page 216 Marfan’s syndrome......Page 220 Read the following topics in relation to marfan’s syndrome......Page 221 Dextrocardia......Page 224 Examination of pulse......Page 225 Read the following topics in relation to atrial fibrillation......Page 227 Slow pulse rate (complete heart block)......Page 232 Read the following topics in relation to chb......Page 233 Read the following topics in relation to takayasu’s disease......Page 235 Chronic constrictive pericarditis......Page 238 Read the following topics in relation to constrictive pericarditis......Page 242 Acute pericarditis......Page 244 Read the following topics in relation to acute pericarditis......Page 245 Rheumatic fever......Page 247 Read the following topics in relation to rheumatic fever......Page 248 Hypertrophic cardiomyopathy......Page 252 Read the following topics in relation to cardiomyopathy......Page 253 3 Respiratory system......Page 256 Examination routine......Page 259 Examination of the chest......Page 260 Respiratory rate:......Page 262 Shape of the chest (deformity or asymmetry):......Page 263 Reduction of movement of chest:......Page 264 Vocal fremitus:......Page 265 Auscultation:......Page 266 Added sounds:......Page 267 Crepitations:......Page 268 Drug induced lung disease......Page 269 Pleural rub or crepitations......Page 272 Pleural effusion......Page 274 Read the following topics in relation to pleural effusion......Page 278 Pneumothorax......Page 284 Read the following topics in relation to pneumothorax......Page 285 Bronchiectasis......Page 291 Read the following topics in relation to bronchiectasis......Page 293 Bronchiectasis with cystic fibrosis......Page 296 Dpld (previously called fibrosing alveolitis or ild)......Page 299 Read the following topics in relation to dpld......Page 300 Consolidation......Page 303 Read the following topics in relation to consolidation......Page 304 Collapse of lung......Page 312 Lung abscess......Page 315 Read the following topics in relation to lung abscess......Page 318 Chronic obstructive pulmonary disease (COPD)......Page 321 Read the following topics in relation to COPD......Page 322 Emphysema......Page 328 Read the following topics in relation to emphysema......Page 332 Lobectomy and pneumonectomy......Page 336 Rheumatoid lung......Page 346 4 Abdomen......Page 348 Examination routine (abdomen)......Page 351 Read the following important findings on inspection......Page 354 Splenomegaly (tropical splenomegaly syndrome)......Page 359 Hepatosplenomegaly (discussion about kala-azar)......Page 365 Post-kala-azar dermal leishmaniasis (pkdl)......Page 381 Hepatomegaly (isolated)......Page 383 Fitz–hugh–curtis syndrome......Page 386 Hepatomegaly (enlarged tender liver, viral hepatitis)......Page 387 Brief discussion about weil’s disease (leptospirosis)......Page 395 Tender hepatomegaly (discussion about liver abscess)......Page 397 Hepatomegaly (discussion about hydatid cyst)......Page 401 Ascites......Page 404 Read the following points in relation to ascites......Page 406 Chronic liver disease or cirrhosis of liver......Page 410 Read the following topics in relation to cld......Page 419 Spider angioma (spider naevi)......Page 420 Palmar erythema (liver palm)......Page 422 Flapping tremor (asterixis)......Page 423 Porto-systemic encephalopathy (discussion about pse or hepatic precoma)......Page 425 Hepatomegaly (discussion about primary biliary cirrhosis)......Page 429 Read the following topics in relation to pbc......Page 430 Hepatomegaly (discussion about haemochromatosis)......Page 434 Read the following topics in relation to haemochromatosis......Page 435 Abdominal mass......Page 438 Mass in epigastrium......Page 440 Mass in right iliac fossa......Page 441 Mass in left iliac fossa......Page 442 Mass in right hypochondrium......Page 443 Mass in left hypochondrium......Page 444 Mass in central abdomen......Page 445 Mass in flank (renal mass)......Page 446 Read the following topics in relation to carcinoma of stomach......Page 448 Gastric lymphoma......Page 451 Mass in the epigastrium (discussion about carcinoma of head of pancreas)......Page 452 Read the following topics in relation to carcinoma of head of pancreas......Page 453 Mass in the epigastrium (discussion about pancreatic pseudocyst)......Page 455 Mass in the epigastrium (discussion about aneurysm of aorta)......Page 457 Mass in right iliac fossa (discussion about crohn’s disease)......Page 461 Read the following topics in relation to crohn’s disease......Page 464 Carcinoma of colon......Page 470 5 Haematology......Page 474 Read the following topics in relation to lymphoma (hodgkin’s)......Page 478 Read the following topics in relation to lymphoma (non-hodgkin’s)......Page 483 Generalized lymphadenopathy (chronic lymphatic leukaemia)......Page 487 Read the following topics in relation to cll......Page 488 Read the following topics in relation to cml......Page 490 Purpura......Page 494 Read the following topics in relation to purpura......Page 497 Purpura (discussion about henoch–schönlein purpura)......Page 499 Read the following topics in relation to hsp......Page 502 Splenomegaly (hereditary haemolytic anaemia)......Page 505 Read the following topics in relation to thalassaemia......Page 507 Anaemia (iron deficiency anaemia)......Page 510 Read the following topics in relation to anaemia......Page 512 Splenomegaly (discussion about polycythaemia rubra vera)......Page 517 Splenomegaly (myelofibrosis)......Page 520 6 Endocrinology......Page 522 Examination of thyroid gland......Page 526 Face in thyroid disease (by looking at the face)......Page 529 Thyrotoxicosis (hyperthyroidism)......Page 531 Thyrotoxicosis in pregnancy......Page 537 Brief notes on post-partum thyroiditis......Page 538 Brief notes on de quervain’s thyroiditis......Page 539 Hypothyroidism......Page 540 Read the following topics in relation to hypothyroidism......Page 543 Hypothyroidism in pregnancy......Page 547 Brief notes on cretinism......Page 548 Graves’ disease......Page 550 Simple nodular goitre (solitary nodule)......Page 555 Simple multinodular goitre......Page 559 Toxic nodular or multinodular goitre......Page 560 Simple diffuse goitre......Page 562 Papillary carcinoma......Page 564 Lymphoma of thyroid......Page 565 Medullary carcinoma of thyroid (mct)......Page 566 Acromegaly......Page 567 Brief discussion about hyperprolactinaemia......Page 572 Cushing’s syndrome......Page 574 Read the following topics in relation to cushing’s syndrome......Page 576 Addison’s disease......Page 581 Tall stature......Page 587 Klinefelter’s syndrome......Page 588 Short stature......Page 591 Achondroplasia......Page 593 Diabetes mellitus......Page 594 Read the following topics in relation to diabetes mellitus......Page 596 Brief note about hyperglycaemic hyperosmolar state (hss)......Page 602 7 Nephrology......Page 604 Mass in flank (renal)......Page 608 Bilateral renal mass (polycystic kidney disease)......Page 610 Unilateral mass (renal cell carcinoma)......Page 613 Brief notes on wilms’ tumour (nephroblastoma)......Page 615 Mass in left or right iliac fossa (transplanted kidney)......Page 616 Nephrotic syndrome......Page 620 Brief notes on different glomerulonephritis causing nephrotic syndrome......Page 624 Read the following topics in relation to nephrology......Page 626 8 Neurology......Page 630 Introduction......Page 632 Neurological examination of lower limb......Page 634 Read the following topics carefully......Page 637 Spastic paraplegia (spinal cord compression)......Page 640 Multiple sclerosis (presenting as spastic paraplegia)......Page 647 Read the following topics in relation to multiple sclerosis......Page 649 Multiple sclerosis (presenting in other forms)......Page 652 Read the following topics in relation to transverse myelitis......Page 654 Guillain–barré syndrome (presenting as flaccid paraplegia)......Page 657 Monoplegia (brown–séquard syndrome)......Page 663 Old poliomyelitis (presenting as monoplegia)......Page 665 Polyneuropathy......Page 667 Read the following topics in relation to polyneuropathy......Page 669 Subacute combined degeneration (presenting as polyneuropathy)......Page 672 Read the following topics in relation to scd......Page 673 Motor neuron disease (mnd)......Page 676 Read the following topics in relation to mnd......Page 678 Friedreich’s ataxia......Page 683 Read the following topics in relation to friedrich’s ataxia......Page 684 Cerebellar lesion......Page 687 Read the following topics in relation to cerebellar lesion......Page 689 Parkinson’s disease......Page 691 Read the following topics in relation to parkinsonism......Page 695 Chorea......Page 700 Read the following topics in relation to chorea......Page 701 Read the following topics in relation to tremor......Page 704 Speech......Page 707 Dysarthria......Page 710 Examination of hands (wasting of small muscles of hands)......Page 716 Syringomyelia......Page 719 Read the following topics in relation to syringomyelia......Page 720 Myotonic dystrophy......Page 722 Myopathy (muscular dystrophy)......Page 725 Carpal tunnel syndrome (median nerve palsy)......Page 731 Radial nerve palsy......Page 734 Cranial nerves......Page 738 Facial (viith) nerve palsy......Page 742 Multiple cranial nerve palsy......Page 747 Cvd with hemiplegia......Page 751 Gait abnormality......Page 758 Orofacial dyskinesia......Page 760 Foot drop (common peroneal nerve palsy)......Page 762 Charcot–marie–tooth disease (peroneal muscle atrophy)......Page 764 Cervical myelopathy......Page 767 Cerebello-pontine (cp) angle lesion......Page 770 9 Rheumatology......Page 772 Introduction......Page 774 Systemic sclerosis......Page 776 Sclerodema......Page 782 Raynaud’s phenomenon or disease......Page 783 Rheumatoid hand......Page 786 Read the following topics in relation to rheumatoid arthritis......Page 788 Brief note about sjögren’s syndrome......Page 798 Knee joint arthritis (examination of knee joint)......Page 799 Read the following topics in relation to arthritis......Page 801 Juvenile idiopathic arthritis (jia/jca)......Page 803 Read the following topics in relation to jia......Page 804 Brief notes on adult still’s disease......Page 806 Haemophilic arthritis......Page 808 Read the following topics in relation to haemophilia......Page 813 Reiter’s syndrome (or, reactive arthritis)......Page 817 Psoriatic arthropathy......Page 820 Ankylosing spondylitis......Page 824 Read the following topics in relation to ankylosing spondylitis......Page 827 Dermatomyositis or polymyositis......Page 830 Proximal myopathy......Page 836 Gout......Page 839 Read the following topics in relation to gout......Page 841 Asymptomatic hyperuricaemia:......Page 843 Systemic lupus erythematosus (sle)......Page 844 Read the following topics in relation to sle......Page 845 Renal involvement in sle......Page 852 Pregnancy with sle......Page 853 Anti-phospholipid syndrome......Page 855 Vasculitis......Page 857 Osteoarthrosis......Page 861 Charcot’s joint......Page 864 10 Examination of the eye......Page 866 Optic atrophy......Page 868 Read the following topics in optic atrophy......Page 871 Papilloedema (pure)......Page 873 Read the following topics in papilloedema......Page 874 Diabetic retinopathy......Page 877 Read the following topics in relation to diabetic ocular complication......Page 887 Retinitis pigmentosa......Page 888 Ptosis......Page 890 Argyll robertson pupil (ar pupil)......Page 894 Holmes–adie pupil (myotonic pupil)......Page 897 Brief discussion about different types of pupil......Page 898 Exophthalmos......Page 900 Nystagmus......Page 903 Read the following topics in relation to nystagmus......Page 904 Retinal detachment......Page 907 Drusen......Page 912 Retinal artery occlusion......Page 914 Miscellaneous ocular abnormality......Page 916 Brief note on methanol poisoning......Page 918 11 Dermatology......Page 920 Introduction......Page 922 Psoriasis......Page 924 Read the following topics in relation to psoriasis......Page 926 Dermatitis herpetiformis......Page 929 Read the following topics in relation to dermatitis herpetiformis......Page 933 Herpes zoster (shingles)......Page 935 Acanthosis nigricans......Page 939 Read the following topics in relation to acanthosis nigricans......Page 940 Pemphigus vulgaris......Page 941 Pemphigoid (bullous)......Page 946 Arsenicosis (chronic arsenic toxicity)......Page 949 Scabies......Page 952 Lupus vulgaris......Page 955 Lichen planus......Page 958 Exfoliative dermatitis......Page 962 Alopecia......Page 966 Vitiligo......Page 969 Neurofibroma......Page 971 Mycosis fungoides......Page 974 Tuberous sclerosis......Page 976 Kaposi’s sarcoma......Page 978 Pityriasis versicolor (tinea versicolor)......Page 980 12 Miscellaneous......Page 982 Face in different diseases......Page 984 Wegener’s granulomatosis......Page 987 Butterfly rash......Page 988 Turner’s syndrome......Page 990 Down’s syndrome......Page 993 Bilateral parotid enlargement......Page 995 Xanthelasma......Page 997 Hereditary haemorrhagic telangiectasia......Page 999 Yellow nail syndrome......Page 1002 Basal cell carcinoma (bcc)......Page 1003 Malignant melanoma......Page 1004 Normal case......Page 1005 SECTION B: COMMON INTERPRETATIONS IN MEDICINE (Available Online)......Page 1006 13 DATA INTERPRETATION......Page 1008 NEPHROLOGY......Page 1012 NEUROLOGY......Page 1016 HAEMATOLOGY......Page 1020 RESPIRATORY......Page 1030 ENDOCRINE......Page 1032 14 X-RAY, CTAND MRI......Page 1042 14 X-RAY, CT AND MRI......Page 1044 MASS LESION......Page 1047 SOLITARY PULMONARY NODULE......Page 1049 MULTIPLE SECONDARIES IN LUNG......Page 1051 CONSOLIDATION......Page 1053 LUNG ABSCESS......Page 1054 PULMONARY TUBERCULOSIS......Page 1056 MILIARY TUBERCULOSIS......Page 1058 CALCIFICATION OF THE LUNG PARENCHYMA......Page 1059 EMPHYSEMA......Page 1060 BULLAE......Page 1061 SURGICAL EMPHYSEMA......Page 1062 PNEUMOTHORAX......Page 1063 HYDROPNEUMOTHORAX......Page 1065 COLLAPSE OF LUNG......Page 1066 RIB RESECTION......Page 1067 BILATERAL HILAR LYMPHADENOPATHY......Page 1068 SARCOIDOSIS......Page 1069 AZYGOS LOBE......Page 1070 CAVITY SUPERIMPOSED ON CARDIAC SHADOW......Page 1071 BRONCHIECTASIS......Page 1072 HOMOGENEOUS OPACITY OF ONE HEMITHORAX......Page 1074 MEDIASTINAL WIDENING......Page 1075 GAS UNDER THE DIAPHRAGM......Page 1076 SITUS INVERSUS......Page 1078 DEXTROCARDIA......Page 1079 MITRAL STENOSIS......Page 1080 VENTRICULAR ANEURYSM......Page 1082 ATRIAL SEPTAL DEFECT (ASD)......Page 1083 TETRALOGY OF FALLOT......Page 1084 CARDIOMEGALY......Page 1086 PERICARDIAL EFFUSION......Page 1087 PERICARDIAL CALCIFICATION......Page 1088 PULMONARY OEDEMA......Page 1090 PACEMAKER......Page 1091 METALLIC PROSTHETIC VALVE......Page 1093 ANKYLOSING SPONDYLITIS......Page 1095 POTT DISEASE......Page 1097 MULTIPLE MYELOMA......Page 1098 HEREDITARY HAEMOLYTIC ANAEMIA......Page 1099 ACROMEGALY......Page 1101 TOPHI......Page 1102 RHEUMATOID HAND......Page 1103 RESORPTION OF TERMINAL PHALANGES......Page 1105 RICKETS......Page 1106 SCURVY......Page 1108 AVASCULAR NECROSIS OF FEMORAL HEAD......Page 1109 ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY (ERCP)......Page 1110 ACHALASIA CARDIA......Page 1111 CARCINOMA OF OESOPHAGUS......Page 1112 CARCINOMA OF STOMACH......Page 1113 GASTRIC OUTLET OBSTRUCTION......Page 1114 PANCREATIC CALCIFICATION......Page 1115 POLYCYSTIC KIDNEY DISEASE......Page 1116 CT SCAN......Page 1117 MRI SCAN......Page 1118 FEW COMMON CT SCANS......Page 1119 15 ECG......Page 1126 BASIC CONCEPT OF ECG......Page 1128 LEADS......Page 1129 INTERPRETATION OF ECG......Page 1131 NORMAL ECG......Page 1133 DETAILS OF WAVES AND INTERVALS......Page 1134 RHYTHM OF HEART......Page 1142 CALCULATION OF HEART RATE......Page 1143 CARDIAC AXIS......Page 1144 SOME COMMON ECG TRACINGS......Page 1145 16 PICTURES......Page 1174 PICTURE 01: INFECTED SCABIES......Page 1176 PICTURE 02: PURPURA......Page 1178 PICTURE 03: RHEUMATOID ARTHRITIS......Page 1179 PICTURE 04: ARTHRITIS MUTILANS......Page 1180 PICTURE 05: GRAVES DISEASE......Page 1181 PICTURE 06: PSORIASIS......Page 1183 PICTURE 07: SYSTEMIC LUPUS ERYTHEMATOSUS......Page 1185 PICTURE 08: ERYTHEMA MULTIFORME......Page 1186 PICTURE 09: LEPROSY......Page 1188 PICTURE 10: STEVENS–JOHNSON SYNDROME......Page 1189 PICTURE 11: RING WORM......Page 1191 PICTURE 12: SUBCONJUNCTIVAL HAEMORRHAGE......Page 1192 PICTURE 13: BELL PALSY......Page 1193 PICTURE 14: RAMSAY HUNT SYNDROME......Page 1195 PICTURE 15: GOITROUS MYXOEDEMA......Page 1196 PICTURE 16: GONORRHOEA......Page 1198 PICTURE 17: HIRSUTISM......Page 1199 PICTURE 18: OSTEOARTHROSIS......Page 1201 PICTURE 19: PERIPHERAL VASCULAR DISEASE......Page 1202 PICTURE 20: HYPOPITUITARISM......Page 1203 PICTURE 21: HERPES ZOSTER......Page 1204 PICTURE 22: OBSTRUCTIVE JAUNDICE......Page 1206 PICTURE 23: WEGENER GRANULOMATOSIS......Page 1207 PICTURE 24: XANTHELASMA......Page 1208 PICTURE 25: BAKER CYST......Page 1209 PICTURE 26: PECTUS CARINATUM......Page 1210 PICTURE 27: CORNEAL ARCUS......Page 1211 PICTURE 28: ACROMEGALY......Page 1212 PICTURE 29: PRIMARY OPTIC ATROPHY......Page 1213 PICTURE 30: PAPILLOEDEMA......Page 1214 PICTURE 31: CENTRAL RETINAL VEIN OCCLUSION......Page 1215 17 INSTRUMENTS......Page 1216 INSTRUMENT 01: BONE MARROW ASPIRATION NEEDLE......Page 1218 INSTRUMENT 02: LUMBAR PUNCTURE NEEDLE......Page 1220 INSTRUMENT 03: LIVER BIOPSY NEEDLE......Page 1224 INSTRUMENT 04: PLEURAL BIOPSY NEEDLE......Page 1226 INSTRUMENT 05: ASPIRATION NEEDLE WITH RUBBER TUBE......Page 1227 INSTRUMENT 06: INTRAVENOUS CANNULA......Page 1230 INSTRUMENT 07: FOLEY CATHETER......Page 1231 INSTRUMENT 08: NASOGASTRIC TUBE (RYLE TUBE)......Page 1232 INSTRUMENT 09: AIRWAY TUBE......Page 1234 INSTRUMENT 10: ESR TUBE......Page 1235 INSTRUMENT 11: METERED-DOSE INHALER......Page 1237 INSTRUMENT 12: ACCUHALER......Page 1238 INSTRUMENT 13: EVOHALER......Page 1239 INSTRUMENT 14: PEAK FLOWMETER......Page 1240 INSTRUMENT 15: AMBU BAG......Page 1241 INSTRUMENT 16: TONGUE DEPRESSOR......Page 1242 ORAL REHYDRATION SALT......Page 1243 Bibliography......Page 1246 C......Page 1248 H......Page 1249 M......Page 1250 S......Page 1251 Z......Page 1252