Cases for PACES (eBook)

Stephen Hoole is Consultant Cardiologist, Papworth Hospital, Cambridge Andrew Fry is Consultant Nephrologist and Acute Physician, Addenbrooke's Hospital, Cambridge Rachel Davies is Consultant Respiratory Physician, Hammersmith Hospital, London

Foreword ix

Preface x

Acknowledgements xi

Abbreviations xii

Advice xv

Station 1: Abdominal and Respiratory 1

Clinical mark sheet 1

Chronic liver disease and hepatomegaly 2

Haemochromatosis 5

Splenomegaly 7

Renal enlargement 9

The liver transplant patient 11

The renal patient 12

Pulmonary fibrosis 14

Bronchiectasis 16

Old tuberculosis 17

Surgical respiratory cases 18

Chronic obstructive airways disease 19

Pleural effusion 21

Lung cancer 22

Cystic fibrosis 24

Pneumonia 25

Station 2: History Taking 27

Clinical mark sheet 27

Introduction and advice 28

Case 1 32

Case 2 33

Case 3 34

Case 4 35

Case 5 36

Case 6 37

Case 7 38

Case 8 39

Case 9 40

Case 10 41

Case 11 42

Case 12 43

Station 3: Cardiology and Neurology 44

Clinical mark sheet 44

Aortic stenosis 45

Aortic incompetence 47

Mitral stenosis 49

Mitral incompetence 51

Tricuspid incompetence 53

Pulmonary stenosis 54

Prosthetic valves: aortic and mitral 55

Implantable devices 57

Pericardial disease 58

Other Common Congenital Defects 60

Atrial septal defect 60

Ventricular septal defect 61

Hypertrophic (obstructive) cardiomyopathy 63

Dystrophia myotonica 65

Cerebellar syndrome 67

Multiple sclerosis 69

Stroke 71

Lateral medullary (Wallenberg) syndrome 74

Spastic legs 75

Syringomyelia 77

Motor neurone disease 79

Parkinson's disease 81

Hereditary sensory motor neuropathy 83

Friedreich's ataxia 84

Facial nerve palsy 85

Myasthenia gravis 86

Tuberous sclerosis 88

Neurofibromatosis 89

Abnormal pupils 90

Optic atrophy 92

Retinal Patholo gy 93

Age?]related macular degeneration (AMD) 93

Retinitis pigmentosa 94

Retinal artery occlusion 95

Retinal vein occlusion 96

Station 4: Ethics Law and Communication Skills 97

Clinical mark sheet 97

Ethics And Law In Medicine 98

Principles of medical ethics 98

Medico?]legal system 99

Negligence 100

Competency and consent 101

Confidentiality 104

End of life decisions 105

Communication skills 107

Dealing with a difficult patient 108

Driving restrictions 109

Information delivery 110

Worked examples 111

Sample questions 116

Station 5: Brief Clinical Consultations 117

Clinical mark sheet 117

Chest pain 119

Headache 121

Swollen calf 123

Altered conscious state 124

Anaemia 125

Osler-Weber-Rendu syndrome (hereditary haemorrhagic telangiectasia) 127

Haemoptysis 128

Worsening mobility 129

Persistent fever 131

Dyspnoea 133

Syncope 135

Atrial fibrillation 137

Inflammatory bowel disease 139

Hypertension 141

Red rashes 143

Leg ulcers 146

Diabetes and the skin 148

Erythema nodosum 150

Henoch-Schonlein purpura 151

Skin malignancy 152

Skin and hyperextensible joints 154

Rheumatoid arthritis 156

Systemic lupus erythematosus 159

Systemic sclerosis 161

Ankylosing spondylitis 163

Marfan's syndrome 164

Paget's disease 165

Other joint problems 166

Diabetic retinopathy 168

Hyperthyroidism and Graves' disease 171

Hypothyroidism 173

Acromegaly 174

Cushing's disease 176

Addison's disease 178

Sickle cell disease 180

Index 182