100 Cases in Clinical Medicine

Respiratory CASE 3: CHRONIC COUGH History A 19-year-old boy has a history of repeated chest infections. He had problems with a c ...

ANSWER 3 The chest X-ray shows abnormal shadowing throughout both lungs, more marked in both upper lobes with some ring shadows ...

CASE 4: SHORTNESS OF BREATH History A 26-year-old teacher has consulted her general practitioner (GP) for her persistent cough. ...

ANSWER 4 The peak flow pattern shows a degree of diurnal variation. This does not reach the diag- nostic criteria for asthmabut ...

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Abdomen CASE 5: ACUTE ABDOMINAL PAIN History A 56-year-old woman presents to the emergency department complaining of abdominal p ...

Figure 5.1Plain abdominal X-ray. Questions What is the most likely diagnosis? How would you manage this patient? ...

ANSWER 5 This woman has acute cholecystitis. Cholecystitis is most common in obese, middle-aged women, and classically is trigge ...

CASE 6: WEIGHT LOSS History A 66-year-old woman, a retired nurse, consults her general practitioner (GP) with a 4-month history ...

ANSWER 6 The microcytic, hypochromic anaemia and the altered bowel habit, the only symptom referable to the gastrointestinal tra ...

Liver CASE 7: NAUSEA AND WEIGHT LOSS History A man of 45 consults his general practitioner (GP) with a 6-month history of reduce ...

ANSWER 7 This man has abnormal liver function tests which indicate hepatic failure; the hypopro- teinaemia has caused the ascite ...

CASE 8: ANOREXIA AND FEVER History A 22-year-old man presented with malaise and anorexia for 1 week. He vomited on one occasion, ...

ANSWER 8 The diagnosis is likely to be acute viral hepatitis. The biochemical results show abnormal liver function tests with a ...

Renal CASE 9: TIREDNESS History An 85-year-old woman is investigated by her general practitioner (GP) for increasing tired- ness ...

ANSWER 9 This patient presents with the typical symptoms of end-stage renal failure, namely anorexia, nausea, weight loss, fatig ...

CASE 10: BACK PAIN History A 27-year-old woman is admitted to the emergency department complaining of pain across her back. She ...

ANSWER 10 This woman has the symptoms and signs of acute pyelonephritis. Acute pyelonephritis is much more common in women than ...

Endocrinology CASE 11: WEIGHT GAIN History A 64-year-old man goes to his general practitioner (GP) because he has become increas ...

ANSWER 11 The symptoms and signs of proximal myopathy, striae and truncal obesity are features of Cushing’s syndrome. The hyperg ...