By John Rees, James Pattison, Gwyn Williams
This article covers middle fabric in scientific medication. overlaying the most important platforms in 15 sections, every one part comprises 8 situations. those situations reflect these which scholars and condo officials will meet in outpatients and common perform. conceal; e-book identify; Contents; Preface; Acknowledgements; Abbreviations; part 1: Systems-related instances; part 2: common self-assessment instances; Index
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Pseudogout is caused by deposition of calcium pyrophosphate crystals and would be expected to show calcification in the articular cartilage in the knee joint. The X-rays here show some joint space narrowing but no calcification in the articular cartilage. The fever, high white cell count and ESR are compatible with acute gout. The raised glucose may also be a side-effect of thiazide diuretics. If this remains after the acute arthritis has subsided then it may need further treatment. Precipitation of gout by thiazides is more likely in older women, particularly in the presence of renal impairment and diabetes.
The pain is colicky and accompanied by nausea and vomiting. He is taken to the emergency department. Examination The only physical abnormalities are pallor, sweating, and slight left loin tenderness. 0 mmol/L Urine: – protein; ϩϩϩ blood Questions • What is the likely diagnosis? • What other investigations would you perform? 31 ANSWER 12 The acute abdominal pain and the haematuria indicate ureteric colic due to a renal stone. The polyuria and polydipsia and the mental changes point to hypercalcaemia causing all three problems.
Her husband and friends have noticed that her voice has become quieter. She has lost about 3 kg in weight in the past 6 months. The woman has had no significant previous medical illnesses. She lives with her husband and three children. She is a non-smoker and drinks about 15 units of alcohol per week. She is taking no regular medication. Examination She looks well, and examination of the cardiovascular, respiratory and abdominal systems is normal. Power in all muscle groups is grossly normal but seems to decrease after testing a movement repetitively.
100 Cases in Clinical Medicine by John Rees, James Pattison, Gwyn Williams