100 Diagnostic Dilemmas in Clinical Medicine

Kerry Layne, Consultant in Acute Medicine Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.

Preface. Acknowledgements. List of Abbreviations. Reference Ranges for Common Investigations. Confusion and Persistent Fever. Painful Upper Limb Swelling. An Unusual Infection. A Teenager with Falls. A Case of Intrapartum Fever. Jaundice and Diarrhoea. Erratic Behaviour. A Young Woman with Fever and Chest Pain. An Enlarged Tongue. A Young Man with an Abnormal Chest X-ray. Visual Loss and Confusion. Left-Eye Pain. Spontaneous Bleeding. A Young Man with a Rash and Hearing Impairment. Recurrent Loss of Consciousness. Visual Loss and Anuria. Abdominal Pain and Weight Loss. Worsening Shortness of Breath and Cough. Fatigue and Constipation. An Upper Limb Mass. A Teenager with a Rash and Fever. Hepatitis in a Nightshift Worker. Yellow Blood. An Unusual Method of Deliberate Self-Harm. Coffee Ground Vomiting. A Case of Parotitis Followed by Acute Hearing Loss. A Purpuric Rash. An Elderly Patient Admitted with a Fall. A Young Mother with Constipation. Hyperpigmented Skin Lesions. It’s All in Your Head. A Right Upper Quadrant Pain Puzzle. Arthritis, Miscarriage and Drowsiness. A Confused Traveller. A Pleural Effusion on a Background of Knee Pain. A Hypertensive Patient with Carpal Spasms. A Patient with HIV and Personality Change. Unilateral Facial Weakness. Chest Pain with a Gynaecological Cause. A First Fit. Collapse in the Corridor. ITP or Not ITP?. Recurrent Haemothorax. Hepatosplenomegaly. Cutaneous Ulceration in a Patient with Rheumatoid Arthritis. An Elderly Man with Confusion. Severe Sepsis Following Tonsillitis. A Farmer with Abdominal Pain. Recurrent Episodes of Acute Kidney Injury. A Sauna Cleaner with Shortness of Breath. A Hypernatraemic Patient. Recurrent Abdominal Pain and Diarrhoea. A Teenager with a Rash. Bilateral Foot Weakness. Hepatomegaly in a Patient with Newly Diagnosed Diabetes Mellitus. A Teenager with Palpitations. A Patient with Sickle Cell Disease and Flu-Like Symptoms. Vomiting without Gastrointestinal Pathology. Seizures and Hand Lesions. New Confusion in a Patient with Bipolar Affective Disorder. A Blistering Rash. Heart and Lungs. Sudden Onset Headache. A Febrile Canoeist. Chest Pain and an Abnormal Blood Film. Numb Fingers and Eosinophilia. Fevers and Cough (Part 1). Fever and Cough (Part 2). Fevers, Night Sweats and Lymphadenopathy. Unconscious outside a Club. A Relentless Rash. Bleeding Gums. Chest Pain after Bad News. HIV and Seizures. A Patient with Crohn’s Disease and Worsening Diarrhoea. Bilateral Hip Pain. A Young Woman with Chest Pain. A Heavy Smoker with Proximal Weakness. Collapse Following Influenza. Diarrhoea and Proximal Weakness. Haemoptysis and Renal Failure. A Young Patient with a Chronic Cough. Abdominal Pain and Bloody Diarrhoea. Nocturnal Enuresis and Back Pain. Shivering at the Station. Loss of Vision and Ophthalmitis. A Pregnant Woman with Loss of Vision. Rash, Fevers and Headache. Haemoptysis and Diplopia. Post-Partum Auditory Hallucinations. Rapidly Progressive Dementia. A Hillwalker with Fever and Chest Pain. Fever, Weight Loss and Night Sweats. Painless Jaundice. A Young Man with Chest Pain. An Unusual Cause of Haematemesis. TB or Not TB?. Headache at the Cattle Farm. Recurrent Lower Respiratory Infections Following a Renal Transplant. An Unsolved Mystery. Index.