Download e-book for iPad: 100 cases in clinical medicine by P John Rees, James Pattison, Visit Amazon's Christopher

By P John Rees, James Pattison, Visit Amazon's Christopher Kosky Page, search results, Learn about Author Central, Christopher Kosky,

ISBN-10: 1444174304

ISBN-13: 9781444174304

"Preface so much medical professionals imagine that the main memorable technique to examine drugs is to work out sufferers. it truly is more straightforward to remember info in keeping with a true individual than a web page in a textbook. one other vital aspect within the retention of data is the intensity of studying. studying that seeks to appreciate difficulties is likely to be obtainable later than superficial genuine accumulation. this can be the root of problem-based  Read more...

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Questions • What is the diagnosis? • What are the major differential diagnoses? • How would you investigate and manage this patient? 37 100 Cases in Clinical Medicine ANSWER 14 This woman’s generalized weakness is caused by myasthenia gravis. Myasthenia gravis is due to the presence of acetylcholine receptor antibodies causing impaired neuromuscular transmission. It characteristically affects the external ocular, bulbar, neck and shoulder girdle muscles. Weakness is worse after repetitive movements, which cause acetylcholine depletion from the presynaptic terminals.

Macrocytic anaemia can be due to dietary folate deficiency or the direct toxic action of alcohol on the bone marrow. The rise in bilirubin is insufficient to cause jaundice. The low serum albumin and raised international normalised ratio (INR) may be due to impaired synthetic function of clotting factors produced by the liver. Thrombocytopenia may be from platelet sequestration in an enlarged spleen as a result of portal hypertension from liver cirrhosis. However, his alcohol intake is too low to be consistent with the diagnosis of alcoholic liver disease.

She has noticed some abdominal discomfort and constipation which she has related to the medication for the back pain. She takes no other medicines and does not drink or smoke. Examination She looks a little pale. There is no abdominal tenderness. Bowel sounds are normal. She has tenderness locally over the lower thoracic spine. 0 mmol/L Questions • What is the most likely diagnosis? • What other investigations would you perform? 31 100 Cases in Clinical Medicine ANSWER 12 There are a number of clues here that there is a significant problem.

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100 cases in clinical medicine by P John Rees, James Pattison, Visit Amazon's Christopher Kosky Page, search results, Learn about Author Central, Christopher Kosky,

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