Short Cases in Clinical Medicine 6th Edition by Abdullah 9788131250013 8131250016

SECTION A. SHORT CASES

1.  General examination

Introduction

Jaundice

Cyanosis

Clubbing

Koilonychia

Examination of hands

Generalized oedema

Cervical lymphadenopathy

Generalized lymphadenopathy

Pigmentation

Erythema ab igne

Gynaecomastia

Erythema nodosum

Leprosy (Hansen’s disease)

Superior vena caval obstruction (superior vena caval syndrome)

Inferior vena caval obstruction

Hirsutism

Polycystic ovarian syndrome

Leg ulcer

Pyoderma gangrenosum

Diabetic foot

Diabetic ulcer

Diabetic amyotrophy

Lipodystrophy of thigh

Necrobiosis lipoidica diabeticorum

Unilateral or bilateral leg swelling

Angioedema

Deep venous thrombosis (DVT)

Cellulitis

Erysipelas

Peripheral vascular disease

Buerger’s disease (thromboangiitis obliterans)

Bardet–Biedl syndrome

Tongue

Hairy leukoplakia

Dupuytren’s contracture

Paget’s disease

Lupus pernio

2.  Cardiovascular system

Introduction

Mitral stenosis

Mitral regurgitation

Mitral valve prolapse (Barlow’s syndrome or Floppy mitral valve)

Mitral stenosis with mitral regurgitation (mixed mitral valve disease)

Aortic stenosis

Aortic regurgitation

Aortic stenosis with aortic regurgitation (mixed aortic valve disease)

Tricuspid regurgitation (TR)

Tricuspid stenosis (TS)

Pulmonary stenosis (PS)

Pulmonary regurgitation (PR)

Prosthetic heart valves

Congenital heart disease

Tetralogy of fallot (TOF)

Ventricular septal defect (VSD)

Eisenmenger’s syndrome

Atrial septal defect (ASD)

Patent ductus arteriosus (PDA)

Coarctation of aorta

Marfan’s syndrome

Dextrocardia

Examination of pulse

Atrial fibrillation (irregular pulse)

Slow pulse rate (complete heart block)

Absent pulse (Takayasu’s disease)

Pericardial effusion

Chronic constrictive pericarditis

Acute pericarditis

Rheumatic fever

Hypertrophic cardiomyopathy

3.  Respiratory system

Introduction

Pleural rub or crepitations

Pleural effusion

Pneumothorax

Bronchiectasis

Bronchiectasis with cystic fibrosis

DPLD (previously called fibrosing alveolitis or ILD)

Consolidation

Collapse of lung

Fibrosis of lung

Lung abscess

Chronic obstructive pulmonary disease (COPD)

Chronic bronchitis

Emphysema

Mass lesion in lung (bronchial carcinoma)

Lobectomy and pneumonectomy

Rheumatoid lung

4.  Abdomen

Introduction

Splenomegaly (not hepatomegaly)

Splenomegaly (tropical splenomegaly syndrome)

Hepatosplenomegaly

Hepatosplenomegaly (discussion about malaria)

Hepatosplenomegaly (discussion about kala-azar)

Post-kala-azar dermal leishmaniasis (PKDL)

Hepatomegaly (isolated)

Hepatomegaly (discussion about hepatoma)

Hepatomegaly (enlarged tender liver, viral hepatitis)

Tender hepatomegaly (discussion about liver abscess)

Hepatomegaly (discussion about hydatid cyst)

Ascites

Ascites (discussion about tuberculous peritonitis)

Chronic liver disease or cirrhosis of liver

Porto-systemic encephalopathy (discussion about PSE or hepatic precoma)

Hepatomegaly (discussion about primary biliary cirrhosis)

Hepatomegaly (discussion about haemochromatosis)

Abdominal mass

Mass in different sites of abdomen

Mass in the epigastrium (discussion about carcinoma of stomach)

Mass in the epigastrium (discussion about carcinoma of head of pancreas)

Mass in the epigastrium (discussion about pancreatic pseudocyst)

Mass in the epigastrium (discussion about aneurysm of aorta)

Mass in right iliac fossa (discussion about ileo-caecal tuberculosis)

Mass in right iliac fossa (discussion about Crohn’s disease)

Carcinoma of colon

5.  Haematology

Introduction

Generalized lymphadenopathy (hodgkin’s lymphoma)

Generalized lymphadenopathy (chronic lymphatic leukaemia)

Splenomegaly (chronic myeloid leukaemia)

Purpura

Purpura (discussion about idiopathic thrombocytopenic purpura)

Purpura (discussion about henoch–schönlein purpura)

Splenomegaly (hereditary haemolytic anaemia)

Anaemia (iron deficiency anaemia)

Splenomegaly (discussion about polycythaemia rubra vera)

Splenomegaly (myelofibrosis)

6.  Endocrinology

Examination of thyroid gland

Face in thyroid disease (by looking at the face)

Thyrotoxicosis (hyperthyroidism)

Thyroid disorders in pregnancy

Hypothyroidism

Hypothyroidism in pregnancy

Graves’ disease

Goitre

Thyroid malignancy

Acromegaly

Cushing’s syndrome

Addison’s disease

Tall stature

Klinefelter’s syndrome

Short stature

Diabetes mellitus

7.  Nephrology

Mass in flank (renal)

Bilateral renal mass (Polycystic Kidney disease)

Unilateral mass (renal cell carcinoma)

Mass in left or right iliac fossa (transplanted kidney)

Nephrotic syndrome

8.  Neurology

Introduction

Neurological examination of lower limb

Spastic paraplegia (spinal cord compression)

Multiple sclerosis (presenting as spastic paraplegia)

Multiple sclerosis (presenting in other forms)

Transverse myelitis (presenting as spastic paraplegia)

Flaccid paraplegia

Guillain–barré syndrome (presenting as flaccid paraplegia)

Monoplegia (brown–séquard syndrome)

Old poliomyelitis (presenting as monoplegia)

Polyneuropathy

Subacute combined degeneration (presenting as polyneuropathy)

Motor neuron disease (MND)

Friedreich’s ataxia

Cerebellar lesion

Parkinson’s disease

Chorea

Tremor

Speech

Dysphasia

Dysarthria

Examination of hands (wasting of small muscles of hands)

Syringomyelia

Myotonic dystrophy

Myopathy (muscular dystrophy)

Carpal tunnel syndrome (median nerve palsy)

Ulnar nerve palsy

Radial nerve palsy

Cranial nerves

Facial ((VIITH) nerve palsy

Vith nerve palsy

Multiple cranial nerve palsy

CVD with hemiplegia

Gait abnormality

Orofacial dyskinesia

Foot drop (common peroneal nerve palsy)

Charcot–marie–tooth disease (peroneal muscle atrophy)

Cervical myelopathy

Cerebello-pontine (CP) angle lesion

9.  Rheumatology

Introduction

Systemic sclerosis

Raynaud’s phenomenon or disease

Rheumatoid hand

Knee joint arthritis (examination of knee joint)

Juvenile idiopathic arthritis (JIA/JCA)

Septic arthritis

Haemophilic arthritis

Reiter’s syndrome (or, reactive arthritis)

Psoriatic arthropathy

Ankylosing spondylitis

Dermatomyositis or polymyositis

Proximal myopathy

Gout

Systemic lupus erythematosus (sle)

Vasculitis

Osteoarthrosis

Charcot’s joint

10.  Examination of the eye

Introduction

Optic atrophy

Papilloedema (pure)

Retinal vein occlusion (central and branch retinal vein occlusion)

Hypertensive retinopathy

Retinal haemorrhage

Diabetic retinopathy

Retinitis pigmentosa

Ptosis

Horner’s syndrome

Argyll robertson pupil (ar pupil)

Holmes–adie pupil (myotonic pupil)

Brief discussion about different types of pupil

Exophthalmos

Nystagmus

Subhyaloid haemorrhage

Choroido-retinitis

Retinal detachment

Drusen

Retinal artery occlusion

Miscellaneous ocular abnormality

11.  Dermatology

Introduction

Psoriasis

Erythema multiforme and stevens–johnson syndrome

Dermatitis herpetiformis

Herpes zoster (shingles)

Acanthosis nigricans

Ichthyosis

Pemphigus vulgaris

Pemphigoid (bullous)

Arsenicosis (chronic arsenic toxicity)

Scabies

Lupus vulgaris

Lichen planus

Exfoliative dermatitis

Alopecia

Vitiligo

Neurofibroma

Mycosis fungoides

Tuberous sclerosis

Kaposi’s sarcoma

Pityriasis versicolor (tinea versicolor)

12.  Miscellaneous

Face in different diseases

Wegener’s granulomatosis

Butterfly rash

Turner’s syndrome

Down’s syndrome

Bilateral parotid enlargement

Xanthelasma

Sturge–weber’s syndrome

Hereditary haemorrhagic telangiectasia

Yellow nail syndrome

Skin cancers

Normal case

SECTION B. COMMON INTERPRETATIONS IN MEDICINE (Available Online)

   Data interpretation

Hepatology

Nephrology

Neurology

Haematology

Respiratory

Endocrine

   X-ray, CT and MRI

Pleural effusion

Mass lesion

Solitary pulmonary nodule

Multiple secondaries in lung

Consolidation

Lung abscess

Pulmonary tuberculosis

Miliary tuberculosis

Calcification of the lung parenchyma

Emphysema

Bullae

Surgical emphysema

Pneumothorax

Hydropneumothorax

Collapse of lung

RIB resection

Bilateral hilar lymphadenopathy

Sarcoidosis

Azygos lobe

Cavity superimposed on cardiac shadow

Bronchiectasis

Homogeneous opacity of one hemithorax

Mediastinal widening

Gas under the diaphragm

Situs inversus

Dextrocardia

Mitral stenosis

Ventricular aneurysm

Atrial septal defect (ASD)

Tetralogy of fallot

Cardiomegaly

Pericardial effusion

Pericardial calcification

Pulmonary oedema

Pacemaker

Metallic prosthetic valve

Ankylosing spondylitis

Pott disease

Multiple myeloma

Hereditary haemolytic anaemia

Acromegaly

Tophi

Rheumatoid hand

Resorption of terminal phalanges

Rickets

Scurvy

Avascular necrosis of femoral head

Endoscopic retrograde cholangiopancreatography (ERCP)

Achalasia cardia

Carcinoma of oesophagus

Carcinoma of stomach

Gastric outlet obstruction

Pancreatic calcification

Polycystic kidney disease

CT scan

MRI scan

Few common CT scans

   ECG

Basic concept of ECG

Interpretation of ECG

Normal ECG

Details of waves and intervals

Rhythm of heart

Calculation of heart rate

Cardiac axis

ECG 01: Atrial fibrillation

ECG 02: Atrial flutter

ECG 03: Ventricular tachycardia

ECG 04: Acute myocardial infarction

ECG 05: Old myocardial infarction

ECG 06: First-degree AV block

ECG 07: Second-degree AV block (mobitz type I)

ECG 08: Second-degree AV block (mobitz type II)

ECG 09: Complete heart block

ECG 10: Left bundle branch block

ECG 11: Right bundle branch block

ECG 12: Left ventricular hypertrophy

ECG 13: Right ventricular hypertrophy

ECG 14: P mitrale

ECG 15: P pulmonale

ECG 16: Pulsus bigeminy

ECG 17: Acute pericarditis

ECG 18: Pacemaker

ECG 19: Sinus tachycardia

ECG 20: Sinus bradycardia

ECG 21: Supraventricular tachycardia

ECG 22: Ventricular premature beat

ECG 23: Ventricular fibrillation

ECG 24: Hyperkalaemia

   Pictures

Picture 01: Infected scabies

Picture 02: Purpura

Picture 03: Rheumatoid arthritis

Picture 04: Arthritis mutilans

Picture 05: Graves disease

Picture 06: Psoriasis

Picture 07: Systemic lupus erythematosus

Picture 08: Erythema multiforme

Picture 09: Leprosy

Picture 10: Stevens–johnson syndrome

Picture 11: Ring worm

Picture 12: Subconjunctival haemorrhage

Picture 13: Bell palsy

Picture 14: Ramsay hunt syndrome

Picture 15: Goitrous myxoedema

Picture 16: Gonorrhoea

Picture 17: Hirsutism

Picture 18: Osteoarthrosis

Picture 19: Peripheral vascular disease

Picture 20: Hypopituitarism

Picture 21: Herpes zoster

Picture 22: Obstructive jaundice

Picture 23: Wegener granulomatosis

Picture 24: Xanthelasma

Picture 25: Baker cyst

Picture 26: Pectus carinatum

Picture 27: Corneal arcus

Picture 28: Acromegaly

Picture 29: Primary optic atrophy

Picture 30: Papilloedema

Picture 31: Central retinal vein occlusion

   Instruments

Instrument 01: Bone marrow aspiration needle

Instrument 02: Lumbar puncture needle

Instrument 03: Liver biopsy needle

Instrument 04: Pleural biopsy needle

Instrument 05: Aspiration needle with rubber tube

Instrument 06: Intravenous cannula

Instrument 07: Foley catheter

Instrument 08: Nasogastric tube (ryle tube)

Instrument 09: Airway tube

Instrument 10: ESR tube

Instrument 11: Metered-dose inhaler

Instrument 12: Accuhaler

Instrument 13: Evohaler

Instrument 14: Peak flowmeter

Instrument 15: Ambu bag

Instrument 16: Tongue depressor