Medical Short Cases for Medical Students

This book is intended to help medical students with their preparations for medical short case examinations, and through this process enhance the depth and breadth of their knowledge of clinical medicine as well as their clinical skills. Though particularly useful to students sitting their final clinical exams, it will also be of interest to more junior students, particularly those who face medical short case clinical exams in their early clinical years. It aims to be useful whether the exam format is traditional or in more modern variations such as the Objective Structured Clinical Examination (OSCE).

Robert E. J. Ryder is the author of Medical Short Cases for Medical Students, published by Wiley. M. Afzal Mir is the author of Medical Short Cases for Medical Students, published by Wiley.

Preface

vii

Introduction

ix

Examine this patient's pulse

1

(8)

Irregular pulse

5

(1)

Slow pulse

6

(1)

Peripheral vascular disease

7

(2)

Examine this patient's heart

9

(23)

Raised jugular venous pressure

15

(1)

Mitral stenosis (lone)

16

(2)

Mitral incompetence (lone)

18

(2)

Mixed mitral valve disease

20

(2)

Aortic stenosis (lone)

22

(2)

Aortic incompetence (lone)

24

(2)

Mixed aortic valve disease

26

(2)

Tricuspid incompetence

28

(1)

Prosthetic valves

29

(1)

Ventricular septal defect

30

(1)

Coarctation of the aorta

31

(1)

Examine this patient's chest

32

(19)

Dullness at the lung base

38

(2)

Fibrosing alveolitis

40

(1)

Bronchiectasis

41

(1)

Chest infection/ consolidation/ pneumonia

42

(1)

Chronic bronchitis and emphysema

43

(2)

Cor pulmonale

45

(1)

Carcinoma of the bronchus

46

(2)

Pneumonectomy/lobectomy

48

(2)

Pneumothorax

50

(1)

Examine this patient's abdomen

51

(23)

Hepatomegaly (without splenomegaly)

58

(1)

Splenomegaly (without hepatomegaly)

59

(2)

Hepatosplenomegaly

61

(1)

Chronic liver disease

62

(2)

Polycystic kidneys

64

(2)

Abdominal mass

66

(2)

Ascites

68

(2)

Primary biliary cirrhosis

70

(2)

Crohn's disease

72

(2)

Examine this patient's visual fields

74

(5)

Visual field defect

76

(3)

Examine this patient's cranial nerves

79

(9)

Bulbar palsy

85

(2)

Pseudobulbar palsy

87

(1)

Examine this patient's arms

88

(6)

Cerebellar syndrome

92

(2)

Examine this patient's legs

94

(29)

Spastic paraparesis

98

(1)

Paget's disease

99

(2)

Peripheral neuropathy

101

(2)

Hemiplegia

103

(3)

Cervical myelopathy

106

(2)

Diabetic foot

108

(2)

Motor neurone disease

110

(2)

Old polio

112

(1)

Absent ankle jerks and extensor plantars

113

(1)

Subacute combined degeneration of the cord

114

(1)

Charcot---Marie---Tooth disease

115

(2)

Swollen knee

117

(2)

Lateral popliteal (common peroneal) nerve palsy

119

(2)

Multiple sclerosis

121

(2)

Examine this patient's gait

123

(6)

Abnormal gait

126

(3)

Ask this patient some questions

129

(7)

Dysarthria

132

(1)

Dysphasia

133

(3)

Examine this patient's fundi

136

(14)

Diabetic retinopathy

139

(4)

Hypertensive retinopathy

143

(2)

Optic atrophy

145

(2)

Papilloedema

147

(2)

Retinitis pigmentosa

149

(1)

Examine this patient's eyes

150

(21)

Exophthalmos

152

(3)

Ocular palsy

155

(4)

Nystagmus

159

(3)

Myasthenia gravis

162

(3)

Ptosis

165

(3)

Cataracts

168

(2)

Argyll Robertson pupils

170

(1)

Examine this patient's face

171

(13)

Lower motor neurone VIIth nerve palsy

173

(3)

Systemic sclerosis/CRST syndrome

176

(2)

Osler---Weber---Rendu syndrome

178

(2)

Horner's syndrome

180

(2)

Systemic lupus erythematosus

182

(2)

Examine this patient's hands

184

(27)

Rheumatoid hands

189

(3)

Wasting of the small muscles of the hand

192

(3)

Psoriatic arthropathy/psoriasis

195

(3)

Ulnar nerve palsy

198

(2)

Clubbing

200

(2)

Osteoarthrosis

202

(2)

Carpal tunnel syndrome

204

(2)

Radial nerve palsy

206

(1)

Tophaceous gout

207

(2)

Dystrophia myotonica

209

(2)

Examine this patient's skin

211

(15)

Vitiligo

214

(3)

Necrobiosis lipoidica diabeticorum

217

(2)

Neurofibromatosis (von Recklinghausen's disease)

219

(2)

Pretibial myxoedema

221

(2)

Pemphigus/pemphigoid

223

(3)

Examine this patient's rash

226

(11)

Purpura

228

(3)

Xanthomata

231

(2)

Erythema nodosum

233

(2)

Herpes zoster

235

(2)

Examine this patient's neck

237

(7)

Goitre

240

(3)

Generalized lymphadenopathy

243

(1)

Examine this patient's thyroid status

244

(10)

Graves' disease

247

(4)

Hypothyroidism

251

(3)

What is the diagnosis?

254

(20)

Acromegaly

257

(3)

Parkinson's disease

260

(3)

Addison's disease

263

(2)

Cushing's syndrome

265

(3)

Ankylosing spondylitis

268

(2)

Turner's syndrome

270

(2)

Gynaecomastia

272

(2)

Appendices

274

(23)

1/Checklists

275

(4)

2/Short cases in the final MB in UK medical schools in 1996/97

279

(1)

3/Glossary

280

(15)

4/Pocket Snellen's chart

295

(2)

Index

297

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Medical Short Cases for Medical Students

Summary

Author Biography

Table of Contents

Supplemental Materials