By John Rees, James Pattison, Gwyn Williams
This article covers center fabric in scientific medication. overlaying the main structures in 15 sections, each one part contains 8 instances. those instances replicate these which scholars and condominium officials will meet in outpatients and normal perform. disguise; ebook name; Contents; Preface; Acknowledgements; Abbreviations; part 1: Systems-related situations; part 2: normal self-assessment instances; Index
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This article covers center fabric in medical medication. masking the key platforms in 15 sections, each one part contains 8 circumstances. those instances replicate these which scholars and apartment officials will meet in outpatients and common perform. conceal; publication identify; Contents; Preface; Acknowledgements; Abbreviations; part 1: Systems-related situations; part 2: common self-assessment situations; Index
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Additional info for 100 Cases in Clinical Medicine
In this case the pain in the joint was partly relieved by the aspiration. Treatment with a non-steroidal anti-inflammatory drug should be covered by a proton pump inhibitor in view of her history of heartburn and indigestion. The thiazide diuretic was changed to an angiotensin-converting enzyme inhibitor as treatment for her hypertension, and the blood glucose settled. KEY POINTS • A careful drug history is an essential part of the history. • Thiazide diuretics can precipitate diabetes and gout, especially in the elderly.
There is no other abnormality on cardiovascular or respiratory examination. In the hands there are Heberden’s nodes over the distal interphalangeal joints. The left knee is hot and swollen with evidence of effusion in the joint with a positive patellar tap. There is pain on flexion beyond 90 degrees. The right knee appears normal. 0 mmol/L An X-ray of the knees is performed and the result is shown in Fig. 1. 1 X-ray of both knees. Questions • What is the likely diagnosis? • What is the appropriate management?
1. 1 Chest X-ray. Questions • What is the diagnosis? • How would you investigate and manage this patient? 51 ANSWER 20 This patient has fever, marked weight loss and a leucoerythroblastic anaemia. The length of the symptoms makes infections such as malaria unlikely, although this should be checked since she arrived from Nigeria and combined infections are possible. A very important finding is that immature red and white cells are seen in the peripheral blood. This leucoerythroblastic anaemia indicates bone-marrow replacement by tumour or infection forcing immature cells out into the blood.
100 Cases in Clinical Medicine by John Rees, James Pattison, Gwyn Williams