Short Cases in Clinical Medicine

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