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100 Cases in Clinical Medicine
The successful 100 Cases in Clinical Medicine provides a novel learning and revision tool that works by guiding the student through clinical cases, imitating those that students and junior doctors are likely to meet in accident and emergency and outpatient departments, and in general practice.
272 pages, Kindle Edition
First published April 15, 2000
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June 25, 2020
*On the GIT
The history should try to distinguish between the small- and large-bowel origins of the diarrhea.
Large-bowel diarrhea tends to be maximal in the morning, pain is relieved by defecation, and blood and mucus may be present.
By contrast diarrhea of small-bowel origin does not occur at any particular time, and pain is not helped by defecation.
Typically a pale fatty stool without blood or mucus occurs in small-bowel disease. Other pathogens which cause small-bowel diarrhea include Campylobacter, rotavirus, Cryptosporidia and Strongyloides.
If small-bowel-type diarrhea persists, other non-infective causes of malabsorption should be considered such as tropical sprue, coeliac disease, and chronic pancreatitis.
Alcohol, dairy products and spices should be avoided during the recovery period.
*Diuretics and angiotensin converting enzyme (ACE) inhibitors are used to treat cardiac failure.
*On Arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder principally affecting joints in a peripheral symmetrical distribution.
The peak incidence is between 35 and 55 years in women and 40 and 60 years in men.
Early-morning stiffness of the joints is typical of rheumatoid arthritis.
*Ischaemic heart disease characteristically causes central rather than left-sided chest pain.
*Paracetamol overdose should be suspected in any patient admitted with deranged liver function tests and clotting, if no obvious alternative cause is apparent.
*Anorexia nervosa is a common cause of amenorrhoea in young women.
*Lymphadenopathy affecting two or more separate groups of nodes suggests lymphoma or a systemic infection.
*Colonic diverticula are small outpouchings which are most commonly found in the left colon. They are very common in the elderly Western population probably due to a deficiency in dietary fiber.
*Sickle cell disease occurs mainly in African black populations and sporadically in the Mediterranean and Middle East.
*Severe muscle damage causes a massively elevated serum creatine kinase level, and a rise in serum potassium and phosphate levels.
*Acute hyperkalaemia is a life-threatening emergency.
*A very high creatine kinase level is diagnostic of rhabdomyolysis.
*Stein–Leventhal Syndrome
This is a complex disorder characterized by excessive androgen production by the ovaries and/or adrenal cortex which interferes with ovarian follicular ripening.
Patients are usually obese with the adipose tissue converting androgens to estrogens, leading to high LH levels stimulated by positive feedback of estrogens on the pituitary, and low FSH levels due to negative feedback.
The low FSH level means that ovarian follicles do not mature normally. A large number of follicles develop abnormally leading to enlarged ovaries.
*True hirsutism is due to excessive androgens, whereas constitutional hirsutism is foundin certain ethnic groups.
*The association of menstrual irregularities and obesity is suggestive of true hirsutism and polycystic ovary syndrome.
*In transplant patients, the anti-rejection drug ciclosporin causes marked hirsutism.
*Excessive ingestion of barbiturates, alcohol and phenytoin all cause acute neurotoxicity manifested by vertigo, dysarthria, ataxia and nystagmus. In severe cases coma, respiratory depression and hypotension occur.
*Tension headaches occur mainly in those aged under 50, and patients often show features of depression.
*Tension headache should be diagnosed after other causes have been excluded.
*A nutritional history should be part of any clinical assessment, particularly in the elderly.
*Vitamin deficiencies can occur in patients on a poor diet in the absence of any problem with malabsorption.
*Hypothyroidism should be considered as a possible contributor to hypothermia.
*The diagnosis of hypothermia requires a thermometer capable of reading low temperatures.
*J-waves on the ECG are specific signs of hypothermia.
*Hypothermia in the elderly is treated by gradual passive rewarming.
*Patients with isolated hematuria aged above 50 years should be initially referred to a nephrologist.
*Patients with isolated hematuria aged below 50 years should be initially referred to a urologist for investigation, to exclude bladder or prostatic disease.
*Small elevations in serum/plasma creatinine indicate large loss in renal function.
*Liver damage from a high alcohol intake may occur with no obvious signs and symptoms.
*Bloody diarrhoea implies serious colonic pathology.
*Intrapartum hypertension must be followed up as it may indicate underlying renal disease and the beginning of chronic hypertension, primary or secondary.
*Patients with headache must always have their blood pressure checked.
*Avoid the term ‘malignant hypertension’!
*Drug overdose is the commonest cause of unconsciousness in young people, but other diagnoses must always be considered.
*Carboxyhaemoglobin levels should be measured in patients found unconscious indoors or in vehicles and after known exposure to smoke.
In carbon monoxide poisoning marked hypoxia may be present in the absence of cyanosis.
*Guillain–Barré syndrome presents with predominantly a motor neuropathy although sensory symptoms are usually present.
There is often a history of an infective illness in the previous 3 weeks, often Campylobacter jejuni.
*Parkinson’s disease is characterized by tremor, rigidity and hypokinesia.
Patient management is long term and multidisciplinary.
Benefits of levodopa treatment in Parkinson’s disease may lessen with time.
The history should try to distinguish between the small- and large-bowel origins of the diarrhea.
Large-bowel diarrhea tends to be maximal in the morning, pain is relieved by defecation, and blood and mucus may be present.
By contrast diarrhea of small-bowel origin does not occur at any particular time, and pain is not helped by defecation.
Typically a pale fatty stool without blood or mucus occurs in small-bowel disease. Other pathogens which cause small-bowel diarrhea include Campylobacter, rotavirus, Cryptosporidia and Strongyloides.
If small-bowel-type diarrhea persists, other non-infective causes of malabsorption should be considered such as tropical sprue, coeliac disease, and chronic pancreatitis.
Alcohol, dairy products and spices should be avoided during the recovery period.
*Diuretics and angiotensin converting enzyme (ACE) inhibitors are used to treat cardiac failure.
*On Arthritis
Rheumatoid arthritis is a chronic, systemic inflammatory disorder principally affecting joints in a peripheral symmetrical distribution.
The peak incidence is between 35 and 55 years in women and 40 and 60 years in men.
Early-morning stiffness of the joints is typical of rheumatoid arthritis.
*Ischaemic heart disease characteristically causes central rather than left-sided chest pain.
*Paracetamol overdose should be suspected in any patient admitted with deranged liver function tests and clotting, if no obvious alternative cause is apparent.
*Anorexia nervosa is a common cause of amenorrhoea in young women.
*Lymphadenopathy affecting two or more separate groups of nodes suggests lymphoma or a systemic infection.
*Colonic diverticula are small outpouchings which are most commonly found in the left colon. They are very common in the elderly Western population probably due to a deficiency in dietary fiber.
*Sickle cell disease occurs mainly in African black populations and sporadically in the Mediterranean and Middle East.
*Severe muscle damage causes a massively elevated serum creatine kinase level, and a rise in serum potassium and phosphate levels.
*Acute hyperkalaemia is a life-threatening emergency.
*A very high creatine kinase level is diagnostic of rhabdomyolysis.
*Stein–Leventhal Syndrome
This is a complex disorder characterized by excessive androgen production by the ovaries and/or adrenal cortex which interferes with ovarian follicular ripening.
Patients are usually obese with the adipose tissue converting androgens to estrogens, leading to high LH levels stimulated by positive feedback of estrogens on the pituitary, and low FSH levels due to negative feedback.
The low FSH level means that ovarian follicles do not mature normally. A large number of follicles develop abnormally leading to enlarged ovaries.
*True hirsutism is due to excessive androgens, whereas constitutional hirsutism is foundin certain ethnic groups.
*The association of menstrual irregularities and obesity is suggestive of true hirsutism and polycystic ovary syndrome.
*In transplant patients, the anti-rejection drug ciclosporin causes marked hirsutism.
*Excessive ingestion of barbiturates, alcohol and phenytoin all cause acute neurotoxicity manifested by vertigo, dysarthria, ataxia and nystagmus. In severe cases coma, respiratory depression and hypotension occur.
*Tension headaches occur mainly in those aged under 50, and patients often show features of depression.
*Tension headache should be diagnosed after other causes have been excluded.
*A nutritional history should be part of any clinical assessment, particularly in the elderly.
*Vitamin deficiencies can occur in patients on a poor diet in the absence of any problem with malabsorption.
*Hypothyroidism should be considered as a possible contributor to hypothermia.
*The diagnosis of hypothermia requires a thermometer capable of reading low temperatures.
*J-waves on the ECG are specific signs of hypothermia.
*Hypothermia in the elderly is treated by gradual passive rewarming.
*Patients with isolated hematuria aged above 50 years should be initially referred to a nephrologist.
*Patients with isolated hematuria aged below 50 years should be initially referred to a urologist for investigation, to exclude bladder or prostatic disease.
*Small elevations in serum/plasma creatinine indicate large loss in renal function.
*Liver damage from a high alcohol intake may occur with no obvious signs and symptoms.
*Bloody diarrhoea implies serious colonic pathology.
*Intrapartum hypertension must be followed up as it may indicate underlying renal disease and the beginning of chronic hypertension, primary or secondary.
*Patients with headache must always have their blood pressure checked.
*Avoid the term ‘malignant hypertension’!
*Drug overdose is the commonest cause of unconsciousness in young people, but other diagnoses must always be considered.
*Carboxyhaemoglobin levels should be measured in patients found unconscious indoors or in vehicles and after known exposure to smoke.
In carbon monoxide poisoning marked hypoxia may be present in the absence of cyanosis.
*Guillain–Barré syndrome presents with predominantly a motor neuropathy although sensory symptoms are usually present.
There is often a history of an infective illness in the previous 3 weeks, often Campylobacter jejuni.
*Parkinson’s disease is characterized by tremor, rigidity and hypokinesia.
Patient management is long term and multidisciplinary.
Benefits of levodopa treatment in Parkinson’s disease may lessen with time.
February 23, 2020
كتاب جيد جداً يتناول 100 حالة شائعة في الداخلية في مختلف فروعها (العصبية والهضمية و..).
تبدأ كل حالة بقصة سريرية ومن ثم تلخيص للفحص السريري وبعض الفحوصات والتحاليل المخبرية والشعاعية الأساسية متبوعةً بأسئلة عن التشخيص والتدبير، يجاب عنها مع شرح جيد للحالة وتُختَتم بمعلومات أساسية (مفتاحية) تخص كل حالة.
أنصح به لطلاب الطب
A very good book with 100 common cases in internal medicine (gastroenterology, neurology etc).
Each case starts with a history followed by physical examination and some basic laboratory tests and radiographs. Then, questions on diagnosis and management, answered with good explanation. Finally, some key facts concerning each case.
I recommend it for medical students
تبدأ كل حالة بقصة سريرية ومن ثم تلخيص للفحص السريري وبعض الفحوصات والتحاليل المخبرية والشعاعية الأساسية متبوعةً بأسئلة عن التشخيص والتدبير، يجاب عنها مع شرح جيد للحالة وتُختَتم بمعلومات أساسية (مفتاحية) تخص كل حالة.
أنصح به لطلاب الطب
A very good book with 100 common cases in internal medicine (gastroenterology, neurology etc).
Each case starts with a history followed by physical examination and some basic laboratory tests and radiographs. Then, questions on diagnosis and management, answered with good explanation. Finally, some key facts concerning each case.
I recommend it for medical students
Displaying 1 - 2 of 2 reviews