Clinical Cases
A Step-by-Step Approach
Andrew Solomon, Julia Anstey, Liora Wittner
- 224 Seiten
- English
- ePUB (handyfreundlich)
- Über iOS und Android verfügbar
Clinical Cases
A Step-by-Step Approach
Andrew Solomon, Julia Anstey, Liora Wittner
Über dieses Buch
It is vitally important for medical students and junior doctors to grasp an understanding of 'real-life medicine'. This innovative book of cases shows how a particular presentation may progress, and the different complications that may arise and emerge over time, which may be missed by the 'snapshot in time' approach taken by many problem-based volumes. The content reflects the average length of stay for a patient in hospital, in which their situation can change in a multitude of ways, and the management of chronic conditions may also need to be adapted as complications arise.
- Demonstrates the real bedside experiences that medical students can expect, in whichever simple or complex way that they may present
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- Cases selected from a range of sub-specialties for comprehensive coverage across the curriculum
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- Illustrates the complicated, progressive problems that will be seen while practicing as a doctor with detailed diagrams and diagnostic imagery to aid understanding
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- Shows, with timepoints, how differential diagnoses may change as more information becomes available and new symptoms arise
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- Describes a typical initial hospital stay, and subsequent presentations to the general practitioner and hospital readmission
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The Authors
Andrew Solomon, BM BCH MA(Hons) DM FRCP, is a Consultant Physician, East and North Hertfordshire NHS Trust, Stevenage, UK.
Julia Anstey, BSc (Hons) MBBS, is a Foundation Doctor, Somerset NHS Foundation Trust, Taunton, UK.
Liora Wittner, MBBS BSc, is a Resident in Internal Medicine, Shamir Medical Centre, Be'er Ya'akov, Israel.
With contributions from
Priti Dutta, MBBS BSc FRCR, Consultant Radiologist, Royal Free London NHS Foundation Trust, London, UK.
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Information
Case 1
Timepoint 1
- Respiratory rate: 14/min
- Oxygen saturations: 99% on room air
- Temperature: 36.8°C
- Blood pressure: 112/74 mmHg
- Heart rate: 72 bpm
What investigations should be arranged?
- Urinalysis
- Bladder scan
- Bloods – FBC, U&Es, ESR, CRP, Serum B12 and Folate
- Lumbar puncture (preceded by CT head)
- MRI spinal cord
- MRI brain
Venous blood results | |
Haemoglobin | 140 g/L |
White cell count | 6.0 × 109/L |
Platelets | 253 × 109/L |
Sodium | 139 mmol/L |
Potassium | 4.4 mmol/L |
Urea | 6.1 mmol/L |
Creatinine | 90 μmol/L |
Lumbar puncture results | |
CSF fluid | Clear |
CSF protein | 1.2 g/L |
CSF glucose | 4.1 mmol/L |
CSF cell count | High |
Plasma glucose | 4.8 mmol/L |
Gram stain | No organisms |
What are the diagnostic criteria for transverse myelitis?
- Development of sensory, motor or autonomic dysfunction attributable to the spinal cord
- Bilateral signs and/or symptoms (though not necessarily symmetric)
- Clearly defined sensory level
- Exclusion of extra-axi...