Raftery / Lim / Ostor | Churchill's Pocketbook of Differential Diagnosis E-Book | E-Book | sack.de
E-Book

E-Book, Englisch, 622 Seiten

Reihe: Churchill Pocketbooks

Raftery / Lim / Ostor Churchill's Pocketbook of Differential Diagnosis E-Book


E-Book, Englisch, 622 Seiten

Reihe: Churchill Pocketbooks

ISBN: 978-0-7020-5404-4
Verlag: Elsevier HealthScience EN
Format: EPUB
 Kopierschutz: Adobe DRM (»Systemvoraussetzungen)

Making a correct diagnosis is one of the key aspects of every medical student's and junior doctor's clinical training, and problem-based learning is now widely used to focus on the causes behind the presentation of a clinical feature. The Fourth Edition of this best-selling book is packed full of information to help the reader move from a presenting problem to an accurate diagnosis.This Fourth Edition covers 127 common presenting problems in both medicine and surgery in a consistent format. Each topic includes a list of all potential causes of the condition, colour coded to indicate common, occasional or rare causes. Important geographical variations are also highlighted. Two sections cover the differential diagnosis of biochemical and haematological disorders which provide a ready check when reviewing abnormal results The text includes a targeted guide to the relevant general and specific follow-up investigations which should be carried out as appropriate. At the end of each topic a box highlights important learning points, or indicates symptom and signs suggestive of significant pathology which require urgent action. Eighty colour photographs of key clinical presentations have been added to assist symptom recognition. Two new chapters on Hypotension and Photophobia.
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Autoren/Hrsg.

Raftery, Andrew T
Lim, Eric Ks
Ostor, Andrew J K

Weitere Infos & Material

1;Front Cover;1
2;Churchill’s Pocketbook of Differential Diagnosis;4
3;Copyright Page;5
4;Preface;6
5;Acknowledgements;7
5.1;Figure Acknowledgements;7
6;How to Use this Book;8
7;Abbreviations;9
8;Contents;12
9;Section A: Clinical Presentations;14
9.1;Abdominal Pain;16
9.1.1;Causes;16
9.1.2;History;19
9.1.2.1;Age;19
9.1.2.2;Pain;19
9.1.2.3;Defecation;19
9.1.2.4;Fever;19
9.1.2.5;Past history;19
9.1.3;Examination;19
9.1.3.1;General;19
9.1.3.1.1;Pulse, temperature, respiration;20
9.1.3.1.2;Cervical lymphadenopathy;20
9.1.3.1.3;Chest;20
9.1.3.2;Abdomen;20
9.1.3.3;Rectal examination;20
9.1.3.4;Vaginal examination;20
9.1.4;General Investigations;20
9.1.5;Specific Investigations;21
9.2;Abdominal Swellings;23
9.2.1;Right Upper Quadrant;23
9.2.1.1;Causes;23
9.2.2;History;24
9.2.2.1;Liver;24
9.2.2.2;Gall bladder;24
9.2.2.3;Right colon;24
9.2.2.4;Right kidney;24
9.2.3;Examination;24
9.2.3.1;Liver;24
9.2.3.2;Gall bladder;25
9.2.3.3;Right colon;25
9.2.3.4;Right kidney;25
9.2.4;General Investigations;25
9.2.5;Specific Investigations;26
9.2.6;Left Upper Quadrant;26
9.2.6.1;Causes;26
9.2.7;History;26
9.2.7.1;Spleen;26
9.2.7.2;Stomach;26
9.2.7.3;Pancreas;27
9.2.7.4;Kidney;27
9.2.7.5;Colon;27
9.2.8;Examination;27
9.2.8.1;Stomach;27
9.2.8.2;Colon;27
9.2.9;General Investigations;27
9.2.10;Specific Investigations;27
9.2.11;Epigastrium;28
9.2.12;Causes;28
9.2.13;History;29
9.2.13.1;Abdominal wall;29
9.2.13.2;Stomach;29
9.2.13.3;Retroperitoneum;29
9.2.14;Examination;29
9.2.14.1;Abdominal wall;29
9.2.14.2;Retroperitoneum;29
9.2.15;General Investigations;30
9.2.16;Specific Investigations;30
9.2.17;Umbilical;30
9.2.17.1;Causes;31
9.2.18;History;31
9.2.18.1;Superficial;31
9.2.18.2;Hernia;31
9.2.18.3;Small bowel;32
9.2.19;Examination;32
9.2.19.1;Superficial;32
9.2.19.2;Hernia;32
9.2.19.3;Small bowel;32
9.2.20;General Investigations;32
9.2.21;Specific Investigations;32
9.2.22;Right and Left Lower Quadrants;33
9.2.22.1;Causes;33
9.2.23;History;34
9.2.23.1;Anterior abdominal wall;34
9.2.23.2;Large bowel;34
9.2.23.3;Small bowel;35
9.2.23.4;Spleen;35
9.2.23.5;Ovary/fallopian tube/uterus;35
9.2.23.6;Retroperitoneum;35
9.2.24;Examination;35
9.2.25;General Investigations;36
9.2.26;Specific Investigations;36
9.2.27;Suprapubic;37
9.2.27.1;Causes;37
9.2.28;History;37
9.2.28.1;Bladder;37
9.2.28.2;Uterus;37
9.2.28.3;Urachus;37
9.2.29;Examination;37
9.2.29.1;Uterus;38
9.2.30;General Investigations;38
9.2.31;Specific Investigations;38
9.3;Anorectal Pain;39
9.3.1;Causes;39
9.3.2;History;40
9.3.3;Examination;40
9.3.4;General Investigations;41
9.3.5;Specific Investigations;41
9.4;Arm Pain;42
9.4.1;Causes;42
9.4.2;History;43
9.4.3;Examination;44
9.4.4;General Investigations;44
9.4.5;Specific Investigations;45
9.5;Arm Swellings;46
9.5.1;Causes;46
9.5.2;History;46
9.5.3;Examination;46
9.5.4;General Investigations;47
9.5.5;Specific Investigations;47
9.6;Ascites;48
9.6.1;Causes;48
9.6.2;History;49
9.6.2.1;Symptoms;49
9.6.2.2;Onset;49
9.6.2.3;Past medical history;49
9.6.2.4;Associated symptoms;49
9.6.3;Examination;50
9.6.3.1;Inspection;50
9.6.3.2;Palpation;50
9.6.3.3;Auscultation;50
9.6.3.4;Percussion;50
9.6.3.5;Internal examination;50
9.6.4;General Investigations;50
9.6.4.1;Ascitic fluid;51
9.6.4.1.1;Appearance;51
9.6.4.1.1.1;Chylous;51
9.6.4.1.1.2;Bile-stained;51
9.6.4.1.1.3;Haemorrhagic;51
9.6.4.1.1.4;Straw-coloured;51
9.6.4.1.2;Biochemistry;51
9.6.4.1.2.1;Protein;51
9.6.4.1.2.2;Amylase;52
9.6.4.1.2.3;Glucose;52
9.6.4.1.2.4;Triglyceride;52
9.6.4.1.2.5;Bilirubin;52
9.6.4.1.3;Microbiology;52
9.6.4.1.4;Cytology;52
9.6.4.1.4.1;WCC;52
9.6.5;Specific Investigations;52
9.7;Axillary Swellings;53
9.7.1;Causes;53
9.7.2;History;53
9.7.2.1;Superficial;53
9.7.2.1.1;Acute abscess;53
9.7.2.1.2;Sebaceous cyst;53
9.7.2.1.3;Lipoma;53
9.7.2.1.4;Hidradenitis suppurativa;53
9.7.2.2;Deep;54
9.7.2.2.1;Lymphadenopathy (p. 321);54
9.7.2.2.2;Breast lumps;54
9.7.2.2.3;Lipoma;54
9.7.2.2.4;Chronic abscess;54
9.7.2.2.5;Axillary artery aneurysm;54
9.7.3;Examination;54
9.7.3.1;Superficial;54
9.7.3.1.1;Acute abscess;54
9.7.3.1.2;Lipoma;54
9.7.3.1.3;Sebaceous cyst;54
9.7.3.1.4;Hidradenitis suppurativa;55
9.7.3.2;Deep;55
9.7.3.2.1;Chronic abscess;55
9.7.3.2.2;Lymphadenopathy;55
9.7.3.2.3;Lipoma;55
9.7.3.2.4;Axillary artery aneurysm;55
9.7.3.2.5;Breast lumps;55
9.7.4;General Investigations;55
9.7.5;Special Investigations;55
9.8;Backache;57
9.8.1;Causes;57
9.8.2;History;59
9.8.2.1;Congenital;59
9.8.2.2;Acquired;59
9.8.2.2.1;General;59
9.8.2.2.2;Traumatic;59
9.8.2.2.3;Infective;59
9.8.2.2.4;Inflammatory;59
9.8.2.2.5;Neoplastic;60
9.8.2.2.6;Degenerative;60
9.8.2.2.7;Metabolic;60
9.8.2.2.8;Endocrine;60
9.8.2.2.9;Idiopathic;60
9.8.2.2.10;Psychogenic;60
9.8.2.2.11;Visceral;60
9.8.2.2.12;Vascular;61
9.8.2.2.13;Renal;61
9.8.2.2.14;Gynaecological;61
9.8.3;Examination;61
9.8.3.1;General;61
9.8.3.2;Congenital;61
9.8.3.3;Acquired;61
9.8.3.3.1;Traumatic;61
9.8.3.3.2;Infective;61
9.8.3.3.3;Inflammatory;62
9.8.3.3.4;Neoplastic;62
9.8.3.3.5;Degenerative;62
9.8.3.3.6;Metabolic;62
9.8.3.3.7;Endocrine;62
9.8.3.3.8;Idiopathic;62
9.8.3.3.9;Psychogenic;62
9.8.3.3.10;Visceral;63
9.8.3.3.11;Vascular;63
9.8.3.3.12;Renal;63
9.8.3.3.13;Gynaecological;63
9.8.4;General Investigations;63
9.8.5;Specific Investigations;64
9.9;Breast Lumps;65
9.9.1;Causes;65
9.9.2;History;66
9.9.3;Examination;66
9.9.3.1;Carcinoma;66
9.9.3.2;Phyllodes Tumour;66
9.9.3.3;Fibroadenoma;67
9.9.3.4;Cyst;67
9.9.3.5;Galactocele;67
9.9.3.6;Fat necrosis;67
9.9.3.7;Lipoma;67
9.9.3.8;Duct ectasia;67
9.9.3.9;Sebaceous cyst;67
9.9.3.10;Generalised swellings;67
9.9.3.11;Swellings behind the breast;67
9.9.4;General Investigations;67
9.9.5;Specific Investigations;68
9.10;Breast Pain;69
9.10.1;Causes;69
9.10.2;History;70
9.10.3;Examination;70
9.10.4;General Investigations;71
9.10.5;Specific Investigations;71
9.11;Chest Pain;72
9.11.1;Causes;72
9.11.2;History;73
9.11.2.1;Character;73
9.11.2.2;Location;73
9.11.2.3;Precipitating factors;73
9.11.2.4;Relieving factors;73
9.11.2.5;Trauma;73
9.11.2.6;Emotion;73
9.11.3;Examination;74
9.11.3.1;Temperature;74
9.11.3.2;Pulse;74
9.11.3.3;JVP;74
9.11.3.4;Palpation of the chest;74
9.11.3.5;Auscultation of the chest;74
9.11.3.6;Lower limbs;74
9.11.4;General Investigations;75
9.11.5;Specific Investigations;75
9.12;Clubbing;77
9.12.1;Causes;77
9.12.2;History;78
9.12.2.1;Duration;78
9.12.2.2;Respiratory symptoms;78
9.12.2.3;Gastrointestinal symptoms;79
9.12.2.4;Family history;79
9.12.3;Examination;79
9.12.3.1;Inspection;79
9.12.3.2;Temperature;79
9.12.3.3;Examination of the chest;80
9.12.3.4;Abdominal examination;80
9.12.4;General Investigations;80
9.12.5;Specific Investigations;80
9.13;Coma;82
9.13.1;Causes;82
9.13.2;History;83
9.13.2.1;Presentation;83
9.13.2.2;Onset;84
9.13.2.3;Trauma;84
9.13.2.4;Headache;84
9.13.2.5;Predisposing factors;84
9.13.3;Examination;85
9.13.3.1;Temperature;85
9.13.3.2;General examination;85
9.13.3.3;Neurological examination;85
9.13.4;General Investigations;86
9.13.5;Specific Investigations;87
9.14;Confusion;88
9.14.1;Causes;88
9.14.2;History;89
9.14.2.1;Onset;89
9.14.2.2;Past medical history;89
9.14.2.3;Drug history;89
9.14.2.4;Associated symptoms;89
9.14.3;Examination;89
9.14.3.1;Temperature;89
9.14.3.2;General;90
9.14.3.3;Systemic examination;90
9.14.3.4;Neurological examination;90
9.14.4;General Investigations;90
9.14.5;Specific Investigations;91
9.15;Constipation;92
9.15.1;Causes;92
9.15.2;History;93
9.15.2.1;Congenital;93
9.15.2.2;Acquired;93
9.15.2.2.1;Obstruction;93
9.15.2.2.2;Painful anus;93
9.15.2.2.3;Adynamic bowel;93
9.15.2.2.4;Endocrine;93
9.15.2.2.5;Drugs;93
9.15.2.2.6;Other;93
9.15.3;Examination;94
9.15.3.1;Obstruction;94
9.15.3.2;Painful anus;94
9.15.3.3;Adynamic bowel;94
9.15.3.4;Endocrine;94
9.15.4;General Investigations;94
9.15.5;Specific Investigations;95
9.16;Convulsions;96
9.16.1;Causes;96
9.16.2;History;97
9.16.2.1;Event;97
9.16.2.2;Precipitating factors;97
9.16.2.3;Headache;97
9.16.2.4;Associated neurology;97
9.16.2.5;Past medical and drug history;97
9.16.3;Examination;97
9.16.3.1;Temperature;97
9.16.3.2;General examination;98
9.16.3.3;Neurological examination;98
9.16.4;General Investigations;98
9.16.5;Specific Investigations;98
9.17;Cough;100
9.17.1;Causes;100
9.17.2;History;101
9.17.2.1;Onset and duration;101
9.17.2.2;Sputum;101
9.17.2.3;Smoking history;101
9.17.2.4;Associated symptoms;101
9.17.3;Examination;102
9.17.3.1;Temperature;102
9.17.3.2;Inspection and palpation;102
9.17.3.3;Auscultation;102
9.17.4;General Investigations;102
9.17.5;Specific Investigations;103
9.18;Cyanosis;104
9.18.1;Causes;104
9.18.2;History;104
9.18.2.1;Central cyanosis;104
9.18.2.1.1;Onset;104
9.18.2.1.2;Chest pain;104
9.18.2.1.3;Dyspnoea;105
9.18.2.2;Past medical history and drug history;105
9.18.2.3;Peripheral cyanosis;105
9.18.2.3.1;General history;105
9.18.3;Examination;105
9.18.3.1;Temperature;105
9.18.3.2;Inspection;105
9.18.3.3;Respiratory examination;105
9.18.4;General Investigations;106
9.18.5;Specific Investigations;106
9.19;Deafness;107
9.19.1;Causes;107
9.19.2;History;108
9.19.2.1;Duration;108
9.19.2.2;Onset;108
9.19.2.3;Pain;108
9.19.2.4;Precipitating factors;108
9.19.2.5;Associated symptoms;108
9.19.2.6;Drug history;108
9.19.3;Examination;108
9.19.3.1;Examination of the ear;108
9.19.3.2;Assessment of hearing;109
9.19.3.3;General examination;109
9.19.4;General Investigations;109
9.19.5;Specific Investigations;109
9.20;Diarrhoea;111
9.20.1;Causes;111
9.20.2;History;113
9.20.2.1;Infective enteritis;113
9.20.2.2;Inflammatory bowel disease;113
9.20.2.3;Malabsorption;113
9.20.2.4;Neoplastic;113
9.20.2.5;Other intestinal;114
9.20.2.6;Gastric;114
9.20.2.7;Pancreatic lesions;114
9.20.2.8;Endocrine disorders;114
9.20.2.9;Drugs;114
9.20.2.10;Other;114
9.20.3;Examination;115
9.20.3.1;Infective enteritis;115
9.20.3.2;Inflammatory bowel disease;115
9.20.3.3;Neoplastic;115
9.20.3.4;Other intestinal;115
9.20.3.5;Gastric;115
9.20.3.6;Pancreatic;115
9.20.3.7;Endocrine;115
9.20.4;General Investigations;116
9.20.5;Specific Investigations;116
9.21;Dizziness;118
9.21.1;Causes;118
9.21.2;History;118
9.21.2.1;General;118
9.21.2.2;Precipitating factors;119
9.21.2.3;Associated symptoms;119
9.21.2.4;Drug history;119
9.21.3;Examination;119
9.21.4;General Investigations;120
9.21.5;Specific Investigations;120
9.22;Dysphagia;122
9.22.1;Causes;122
9.22.2;History;123
9.22.2.1;Congenital;123
9.22.2.1.1;Oesophageal atresia;123
9.22.2.2;Acquired;124
9.22.2.2.1;In the lumen;124
9.22.2.2.2;In the wall;124
9.22.2.2.3;Outside the wall;124
9.22.2.2.4;Neuromuscular;125
9.22.2.2.5;Others;125
9.22.3;Examination;125
9.22.4;General Investigations;126
9.22.5;Specific Investigations;126
9.23;Dyspnoea;127
9.23.1;Causes;127
9.23.2;History;128
9.23.2.1;Onset;128
9.23.2.2;Precipitating factors;128
9.23.2.3;Relieving factors;129
9.23.2.4;Associated factors;129
9.23.3;Examination;129
9.23.3.1;Inspection;129
9.23.3.2;Pulse;129
9.23.3.3;JVP;129
9.23.3.4;Temperature;129
9.23.3.5;Trachea;130
9.23.3.6;Expansion;130
9.23.3.7;Percussion;130
9.23.3.8;Auscultation of the precordium;130
9.23.3.9;Breath sounds;130
9.23.3.10;Added sounds;130
9.23.4;General Investigations;130
9.23.5;Specific Investigations;132
9.24;Ear Disorders;134
9.24.1;Causes;134
9.24.2;History;135
9.24.2.1;Local;135
9.24.2.1.1;External ear;135
9.24.2.1.2;External auditory meatus;135
9.24.2.1.3;Middle ear;136
9.24.2.2;Referred pain;136
9.24.2.2.1;Neurological;136
9.24.3;Examination;136
9.24.3.1;Local;136
9.24.3.1.1;External ear;136
9.24.3.1.2;External auditory meatus;136
9.24.3.1.3;Middle ear;137
9.24.3.2;Referred pain;137
9.24.3.3;Neurological;137
9.24.4;General Investigations;137
9.25;Eye Disorders;139
9.25.1;Causes;139
9.25.2;History;140
9.25.2.1;Pain;140
9.25.2.2;Visual disturbance;140
9.25.2.3;Discharge;141
9.25.2.4;Past medical history;141
9.25.3;Examination;141
9.25.4;General Investigations;142
9.25.5;Specific Investigations;142
9.26;Facial Pain;143
9.26.1;Causes;143
9.26.2;History;144
9.26.2.1;Site;144
9.26.2.2;Character;144
9.26.2.3;Precipitating factors;144
9.26.2.4;Associated symptoms;145
9.26.3;Examination;145
9.26.3.1;Inspection;145
9.26.3.2;Palpation;145
9.26.4;General Investigations;146
9.26.5;Specific Investigations;146
9.27;Facial Swellings;147
9.27.1;Causes;147
9.27.2;History;148
9.27.2.1;Traumatic;148
9.27.2.2;Infective;148
9.27.2.3;Neoplastic;149
9.27.2.4;Vascular;149
9.27.2.5;Endocrine;149
9.27.2.6;Metabolic;149
9.27.2.7;Drugs;149
9.27.2.8;Other;149
9.27.3;Examination;150
9.27.3.1;Traumatic;150
9.27.3.2;Infective;150
9.27.3.3;Neoplastic;150
9.27.3.4;Vascular;150
9.27.3.5;Endocrine;150
9.27.3.6;Metabolic;150
9.27.3.7;Drugs;151
9.27.3.8;Other;151
9.27.4;General Investigations;151
9.27.5;Specific Investigations;151
9.28;Facial Ulcers;153
9.28.1;Causes;153
9.28.2;History;154
9.28.3;Examination;155
9.28.3.1;Benign ulcers;155
9.28.3.2;Malignant ulcers;155
9.28.3.3;Infective;155
9.28.4;General Investigations;155
9.28.5;Specific Investigations;156
9.29;Faecal Incontinence;157
9.29.1;Causes;157
9.29.2;History;158
9.29.3;Examination;158
9.29.4;General Investigations;158
9.29.5;Specific Investigations;158
9.30;Finger Lesions;160
9.30.1;Causes;160
9.30.2;History;161
9.30.2.1;Congenital;161
9.30.2.2;Acquired;161
9.30.2.2.1;Traumatic/degenerative;161
9.30.2.2.1.1;Dupuytren’s contracture;161
9.30.2.2.1.2;Implantation dermoid;161
9.30.2.2.1.3;Pyogenic granuloma;161
9.30.2.2.1.4;Trigger finger;162
9.30.2.2.1.5;Mallet finger;162
9.30.2.2.1.6;Swan-neck deformity;162
9.30.2.2.1.7;Boutonnière deformity;162
9.30.2.2.1.8;Heberden’s nodes;162
9.30.2.2.1.9;Mucous cyst;162
9.30.2.2.1.10;Calluses over knuckles (bulimia);162
9.30.2.2.2;Metabolic;162
9.30.2.2.2.1;Tophaceous gout;162
9.30.2.2.2.2;Ectopic calcification;162
9.30.2.2.3;Connective tissue disease;162
9.30.2.2.3.1;CREST syndrome;162
9.30.2.2.4;Neoplastic;162
9.30.2.2.4.1;Subungual melanoma;162
9.30.2.2.4.2;Enchondroma;163
9.30.3;Examination;163
9.30.3.1;Congenital;163
9.30.3.2;Acquired;163
9.30.3.2.1;Traumatic/degenerative;163
9.30.3.2.1.1;Dupuytren’s contracture;163
9.30.3.2.1.2;Implantation dermoid;163
9.30.3.2.1.3;Trigger finger;163
9.30.3.2.1.4;Mallet finger;163
9.30.3.2.1.5;Swan-neck deformity;163
9.30.3.2.1.6;Boutonnière deformity;163
9.30.3.2.1.7;Heberden’s nodes;163
9.30.3.2.1.8;Mucous cyst;164
9.30.3.2.2;Metabolic;164
9.30.3.2.2.1;Tophaceous gout;164
9.30.3.2.2.2;Ectopic calcification;164
9.30.3.2.3;Connective tissue disease;164
9.30.3.2.3.1;CREST syndrome;164
9.30.3.2.4;Neoplastic;164
9.30.3.2.4.1;Subungual melanoma;164
9.30.3.2.4.2;Enchondroma;164
9.30.4;General Investigations;164
9.31;Finger Pain;166
9.31.1;Causes;166
9.31.2;History;167
9.31.2.1;Traumatic;167
9.31.2.2;Inflammatory/infective;167
9.31.2.2.1;Paronychia;167
9.31.2.2.2;Pulp space infection;167
9.31.2.2.3;Tendon sheath infection;167
9.31.2.3;Neoplastic;168
9.31.2.3.1;Glomus tumour;168
9.31.2.3.2;Primary and secondary bone tumours;168
9.31.2.4;Degenerative;168
9.31.2.4.1;Rheumatoid arthritis;168
9.31.2.5;Vascular;168
9.31.2.5.1;Chilblains;168
9.31.2.5.2;Small vessel disease;168
9.31.2.6;Metabolic;168
9.31.2.6.1;Gout;168
9.31.2.7;Autoimmune;169
9.31.2.7.1;Scleroderma;169
9.31.2.8;Neurological;169
9.31.2.8.1;Carpal tunnel syndrome;169
9.31.2.8.2;Cervical lesions;169
9.31.3;Examination;169
9.31.3.1;Traumatic;169
9.31.3.2;Inflammatory/infective;169
9.31.3.2.1;Paronychia;169
9.31.3.2.2;Pulp space infection;169
9.31.3.2.3;Tendon sheath infection;169
9.31.3.3;Neoplastic;170
9.31.3.3.1;Glomus tumours;170
9.31.3.3.2;Primary and secondary tumours;170
9.31.3.4;Degenerative;170
9.31.3.4.1;Rheumatoid arthritis;170
9.31.3.5;Vascular;170
9.31.3.5.1;Chilblains;170
9.31.3.5.2;Small vessel disease;170
9.31.3.6;Metabolic;170
9.31.3.6.1;Gout;170
9.31.3.7;Autoimmune;170
9.31.3.7.1;Scleroderma;170
9.31.3.8;Neurological;171
9.31.3.8.1;Carpal tunnel syndrome;171
9.31.3.8.2;Cervical spondylosis;171
9.31.4;General Investigations;171
9.31.5;Specific Investigations;171
9.32;Foot Deformities;173
9.32.1;Causes;173
9.32.2;History;174
9.32.2.1;Talipes equinovarus;174
9.32.2.2;Metatarsus adductus;174
9.32.2.3;Pes planus;174
9.32.2.4;Pes cavus;174
9.32.2.5;Acquired talipes;174
9.32.2.6;Trauma;174
9.32.3;Examination;174
9.32.3.1;Talipes equinovarus;174
9.32.3.2;Metatarsus adductus;175
9.32.3.3;Pes planus;175
9.32.3.4;Pes cavus;175
9.32.3.5;Acquired talipes;175
9.32.3.6;Trauma;175
9.32.4;General Investigations;175
9.33;Foot Pain;176
9.33.1;Causes;176
9.33.2;History;177
9.33.2.1;Traumatic;177
9.33.2.2;Infective;177
9.33.2.3;Inflammatory;177
9.33.2.4;Vascular;177
9.33.2.5;Metabolic;178
9.33.2.6;Degenerative;178
9.33.2.7;Other;178
9.33.3;Examination;178
9.33.3.1;Traumatic;178
9.33.3.2;Infective;178
9.33.3.3;Inflammatory;178
9.33.3.4;Vascular;179
9.33.3.5;Metabolic;179
9.33.3.6;Degenerative;179
9.33.3.7;Other;179
9.33.4;General Investigations;179
9.33.5;Specific Investigations;179
9.34;Foot Ulcers;181
9.34.1;Causes;181
9.34.2;History;182
9.34.2.1;Vascular;182
9.34.2.2;Neuropathic;182
9.34.2.3;Neoplastic;182
9.34.2.4;Traumatic;183
9.34.2.5;Infective;183
9.34.3;Examination;183
9.34.3.1;Vascular;183
9.34.3.2;Neuropathic;183
9.34.3.3;Neoplastic;183
9.34.3.4;Traumatic;183
9.34.3.5;Infective;184
9.34.4;General Investigations;184
9.34.5;Specific Investigations;184
9.35;Gait Abnormalities;185
9.35.1;Causes;185
9.35.2;History;185
9.35.2.1;Duration;185
9.35.2.2;Associated symptoms;185
9.35.2.3;Past medical and drug history;186
9.35.3;Examination;186
9.35.3.1;The asymmetrical gait;186
9.35.3.2;The symmetrical gait;186
9.35.3.3;Orthopaedic examination;187
9.35.3.4;Neurological examination;187
9.35.3.5;Specific examination;187
9.35.4;General Investigations;187
9.35.5;Specific Investigations;188
9.36;Goitre;189
9.36.1;Causes;189
9.36.2;History;190
9.36.2.1;Simple hyperplastic goitre;190
9.36.2.2;Multinodular goitre;190
9.36.2.3;Toxic goitre;190
9.36.2.4;Autoimmune;190
9.36.2.5;Neoplastic goitre;191
9.36.2.6;Inflammatory (rare);191
9.36.3;Examination;191
9.36.3.1;Simple hyperplastic goitre;191
9.36.3.2;Multinodular goitre;191
9.36.3.3;Toxic goitre;191
9.36.3.4;Autoimmune;191
9.36.3.5;Neoplastic goitre;192
9.36.3.6;Inflammatory;192
9.36.4;General Investigations;192
9.36.5;Specific Investigations;193
9.37;Groin Swellings;194
9.37.1;Causes;194
9.37.2;History;195
9.37.2.1;Sebaceous cyst;195
9.37.2.2;Lipoma;195
9.37.2.3;Hernias;195
9.37.2.4;Imperfectly descended testis;195
9.37.2.5;Lipoma of the cord;195
9.37.2.6;Hydrocele of the cord;195
9.37.2.7;Hydrocele of the canal of Nuck;195
9.37.2.8;Lymph nodes;195
9.37.2.9;Saphena varix;196
9.37.2.10;Femoral artery aneurysm;196
9.37.2.11;Imperfectly descended testis;196
9.37.2.12;Neuroma of the femoral nerve;196
9.37.2.13;Synovioma of the hip joint;196
9.37.2.14;Obturator hernia;196
9.37.3;Examination;196
9.37.3.1;Sebaceous cyst;196
9.37.3.2;Lipoma;197
9.37.3.3;Hernias;197
9.37.3.4;Imperfectly descended testis;197
9.37.3.5;Lipoma of the cord;197
9.37.3.6;Hydrocele of the cord;198
9.37.3.7;Hydrocele of the canal of Nuck;198
9.37.3.8;Femoral hernia;198
9.37.3.9;Lymph nodes;198
9.37.3.10;Saphena varix;198
9.37.3.11;Femoral artery aneurysm;198
9.37.3.12;Imperfectly descended testis;199
9.37.3.13;Neuroma of the femoral nerve;199
9.37.3.14;Synovioma of the hip joint;199
9.37.3.15;Obturator hernia;199
9.37.3.16;Psoas abscess;199
9.37.4;General Investigations;199
9.37.5;Specific Investigations;200
9.38;Gum Disorders;201
9.38.1;Causes;201
9.38.2;History;202
9.38.3;Examination;202
9.38.3.1;Local;202
9.38.3.2;General;203
9.38.4;General Investigations;203
9.38.5;Specific Investigations;203
9.39;Gynaecomastia;204
9.39.1;Causes;204
9.39.2;History;205
9.39.3;Examination;205
9.39.3.1;Local;205
9.39.3.2;General;206
9.39.4;General Investigations;206
9.39.5;Specific Investigations;206
9.40;Haematemesis;208
9.40.1;Causes;208
9.40.2;History;209
9.40.2.1;Swallowed blood;209
9.40.2.2;Oesophagus;209
9.40.2.3;Stomach;209
9.40.2.4;Duodenum;210
9.40.2.5;Bleeding disorders;210
9.40.2.6;Drugs;210
9.40.2.7;Others;210
9.40.3;Examination;210
9.40.3.1;Swallowed blood;210
9.40.3.2;Oesophagus;211
9.40.3.3;Stomach;211
9.40.3.4;Duodenum;211
9.40.3.5;Bleeding disorders;211
9.40.3.6;Drugs;211
9.40.3.7;Others;211
9.40.4;General Investigations;211
9.40.5;Specific Investigations;212
9.41;Haematuria;213
9.41.1;Causes;213
9.41.2;History;214
9.41.3;Examination;215
9.41.4;General Investigations;215
9.41.5;Specific Investigations;216
9.42;Haemoptysis;217
9.42.1;Causes;217
9.42.2;History;218
9.42.2.1;Onset;218
9.42.2.2;Dyspnoea;218
9.42.2.3;Weight loss;218
9.42.2.4;Other sites of bleeding;218
9.42.2.5;Past medical and drug history;218
9.42.3;Examination;219
9.42.3.1;Inspection;219
9.42.3.2;Palpation;219
9.42.3.3;Percussion and auscultation;219
9.42.4;General Investigations;219
9.42.5;Specific Investigations;221
9.43;Halitosis;223
9.43.1;Causes;223
9.43.2;History;223
9.43.3;Examination;224
9.43.4;General Investigations;224
9.43.5;Specific Investigations;224
9.44;Hallucinations;226
9.44.1;Causes;226
9.44.2;History;227
9.44.3;Examination;227
9.44.4;General Investigations;227
9.44.5;Specific Investigations;227
9.45;Hand Deformities;229
9.45.1;Causes;229
9.45.2;History;230
9.45.2.1;Congenital;230
9.45.2.2;Acquired;230
9.45.2.2.1;Trauma and burns;230
9.45.2.2.2;Dupuytren’s contracture;230
9.45.2.2.3;Rheumatoid arthritis;230
9.45.2.2.4;Volkmann’s ischaemic contracture;230
9.45.2.2.5;Spinal cord lesions;231
9.45.2.2.6;Brachial plexus lesions;231
9.45.2.2.7;Peripheral nerve lesions;231
9.45.2.2.8;Ollier’s disease;231
9.45.3;Examination;231
9.45.3.1;Congenital;231
9.45.3.2;Acquired;231
9.45.3.2.1;Trauma and burns;231
9.45.3.2.2;Dupuytren’s contracture;231
9.45.3.2.3;Rheumatoid arthritis;231
9.45.3.2.4;Volkmann’s ischaemic contracture;232
9.45.3.2.5;Spinal cord lesions;232
9.45.3.2.6;Brachial plexus injuries;232
9.45.3.2.7;Peripheral nerve lesions;232
9.45.3.2.8;Ollier’s disease;232
9.45.4;General Investigations;232
9.46;Headache;234
9.46.1;Causes;234
9.46.2;History;235
9.46.2.1;Onset;235
9.46.2.2;Site;235
9.46.2.3;Character;235
9.46.2.4;Precipitating factors;236
9.46.2.5;Associated symptoms;236
9.46.3;Examination;236
9.46.3.1;Temperature;236
9.46.3.2;Inspection;236
9.46.3.3;Palpation;237
9.46.3.4;Neurological examination;237
9.46.4;General Investigations;237
9.46.5;Specific Investigations;237
9.47;Hemiplegia;239
9.47.1;Causes;239
9.47.2;History;239
9.47.2.1;Onset;239
9.47.2.2;Precipitating factors;239
9.47.2.3;Associated symptoms;240
9.47.3;Examination;240
9.47.4;General Investigations;241
9.47.5;Specific Investigations;241
9.48;Hepatomegaly;242
9.48.1;Causes;242
9.48.2;History;243
9.48.2.1;Hepatitis/infection;243
9.48.2.2;Congestion;244
9.48.2.3;Infiltration;244
9.48.2.4;Biliary tract disease;244
9.48.2.5;Malignancy;244
9.48.2.6;Metabolic;244
9.48.2.7;Others;244
9.48.2.7.1;Regular generalised enlargement without jaundice;245
9.48.2.7.2;Regular generalised enlargement with jaundice;245
9.48.2.7.3;Irregular generalised enlargement without jaundice;245
9.48.2.7.4;Irregular generalised enlargement with jaundice;245
9.48.2.7.5;Localised swellings;245
9.48.3;Examination;245
9.48.3.1;General;245
9.48.3.1.1;Congestion;246
9.48.3.1.2;Biliary tract disease;246
9.48.3.1.3;Storage disease;246
9.48.3.1.4;Malignancy;246
9.48.4;General Investigations;246
9.48.5;Specific Investigations;246
9.49;Hiccups;248
9.49.1;Causes;248
9.49.2;History;248
9.49.2.1;Respiratory history;248
9.49.2.2;Abdominal history;249
9.49.2.3;Neurological history;249
9.49.2.4;Others;249
9.49.3;Examination;249
9.49.4;General Investigations;250
9.49.5;Specific Investigations;250
9.50;Hirsutism;252
9.50.1;Causes;252
9.50.2;History;253
9.50.2.1;General;253
9.50.2.2;Menstrual history;253
9.50.2.3;Drug history;253
9.50.2.4;Associated symptoms;253
9.50.3;Examination;253
9.50.4;General Investigations;254
9.50.5;Specific Investigations;254
9.51;Hypertension;256
9.51.1;Causes;256
9.51.1.1;Other;257
9.51.2;History;257
9.51.3;Examination;258
9.51.3.1;Inspection;258
9.51.3.2;Palpation and auscultation;258
9.51.4;General Investigations;258
9.51.5;Specific Investigations;259
9.52;Impotence;261
9.52.1;Causes;261
9.52.2;Examination;262
9.52.2.1;Vascular;262
9.52.2.2;Neurological;262
9.52.2.3;Endocrine;262
9.52.2.4;Local painful conditions;263
9.52.2.5;Systemic disease;263
9.52.3;General Investigations;263
9.52.4;Specific Investigations;263
9.53;Intestinal Obstruction;265
9.53.1;Causes;265
9.53.2;History;266
9.53.2.1;Small bowel;266
9.53.2.2;Large bowel;266
9.53.2.3;Adynamic obstruction;267
9.53.3;Examination;267
9.53.3.1;Small bowel;267
9.53.3.2;Large bowel;267
9.53.3.3;Adynamic obstruction;267
9.53.4;General Investigations;267
9.53.5;Specific Investigations;268
9.54;Jaundice;269
9.54.1;Causes;269
9.54.2;History;271
9.54.2.1;General;271
9.54.2.2;Newborn;271
9.54.2.3;Prehepatic;271
9.54.2.4;Hepatocellular;271
9.54.2.5;Cholestatic;271
9.54.3;Examination;272
9.54.3.1;Prehepatic (haemolytic);272
9.54.3.2;Hepatic;272
9.54.3.3;Cholestatic;272
9.54.4;General Investigations;272
9.54.5;Specific Investigations;273
9.55;Jaw Pain and Swellings;275
9.55.1;Causes;275
9.55.2;History;276
9.55.2.1;Traumatic;276
9.55.2.2;Infective;276
9.55.2.3;Temporomandibular joint;276
9.55.2.4;Cystic;277
9.55.2.5;Neoplastic;277
9.55.2.6;Others;277
9.55.3;Examination;278
9.55.3.1;Traumatic;278
9.55.3.2;Infective;278
9.55.3.3;Temporomandibular joint;278
9.55.3.4;Cystic;278
9.55.3.5;Neoplastic;278
9.55.3.6;Other;279
9.55.3.7;General Investigations;279
9.55.4;Special Investigations;279
9.56;Joint Disorders;280
9.56.1;Causes;280
9.56.2;History;282
9.56.2.1;Congenital;282
9.56.2.2;Acquired;282
9.56.2.2.1;Infective;282
9.56.2.2.2;Inflammatory;282
9.56.2.2.3;Degenerative;283
9.56.2.2.4;Enteropathic;283
9.56.2.2.5;Endocrine;283
9.56.2.2.6;Metabolic;283
9.56.2.2.7;Neuropathic;283
9.56.2.2.8;Haematological;284
9.56.2.2.9;Drugs;284
9.56.2.2.10;Neoplastic;284
9.56.2.2.11;Other;284
9.56.3;Examination;284
9.56.3.1;Congenital;284
9.56.3.2;Acquired;284
9.56.3.2.1;Infective;284
9.56.3.2.2;Inflammatory;285
9.56.3.2.3;Degenerative;285
9.56.3.2.4;Enteropathic;285
9.56.3.2.5;Endocrine;285
9.56.3.2.6;Metabolic;285
9.56.3.2.7;Neuropathic;286
9.56.3.2.8;Haematological;286
9.56.3.2.9;Drugs;286
9.56.3.2.10;Neoplastic;286
9.56.3.2.11;Other;286
9.56.4;General Investigations;286
9.56.5;Specific Investigations;287
9.56.6;Individual Joints;288
9.56.7;Shoulder;288
9.56.7.1;Causes;288
9.56.8;History;289
9.56.8.1;Congenital;289
9.56.8.2;Acquired;289
9.56.8.2.1;Traumatic;289
9.56.8.2.2;Degenerative;289
9.56.8.2.3;Inflammatory;290
9.56.8.2.4;Infective;290
9.56.8.2.5;Neoplastic;290
9.56.8.2.6;Referred pain;290
9.56.8.2.7;Neurological;291
9.56.9;Examination;291
9.56.9.1;Congenital;291
9.56.9.2;Acquired;291
9.56.9.2.1;Traumatic;291
9.56.9.2.2;Degenerative;291
9.56.9.2.3;Inflammatory;291
9.56.9.2.4;Infective;291
9.56.9.2.5;Neoplastic;291
9.56.9.2.6;Referred pain;292
9.56.9.2.7;Neurological;292
9.56.10;General Investigations;292
9.56.11;Specific Investigations;292
9.56.12;Elbow;292
9.56.12.1;Causes;292
9.56.13;History;293
9.56.13.1;Traumatic;293
9.56.13.2;Degenerative;293
9.56.13.3;Inflammatory;294
9.56.13.4;Neurological;294
9.56.13.5;Other;294
9.56.14;Examination;294
9.56.14.1;Traumatic;294
9.56.14.2;Degenerative;295
9.56.14.3;Inflammatory;295
9.56.14.4;Neurological;295
9.56.14.5;Other;295
9.56.15;General Investigations;295
9.56.16;Specific Investigations;295
9.56.17;Wrist;296
9.56.17.1;Causes;296
9.56.18;History;296
9.56.18.1;Traumatic;296
9.56.18.2;Degenerative;297
9.56.18.3;Inflammatory;297
9.56.18.4;Other;297
9.56.19;Examination;297
9.56.19.1;Traumatic;297
9.56.19.2;Degenerative;297
9.56.19.3;Inflammatory;298
9.56.19.4;Other;298
9.56.20;General Investigations;298
9.56.21;Specific Investigations;298
9.56.22;Hip;299
9.56.22.1;Causes;299
9.56.23;History;299
9.56.23.1;Congenital;299
9.56.23.2;Acquired;300
9.56.23.2.1;Traumatic;300
9.56.23.2.2;Infective;300
9.56.23.2.3;Inflammatory;300
9.56.23.2.4;Degenerative;300
9.56.23.2.5;Neoplastic;300
9.56.23.2.6;Other;301
9.56.24;Examination;301
9.56.24.1;Congenital;301
9.56.24.2;Acquired;301
9.56.24.2.1;Traumatic;301
9.56.24.2.2;Infective;301
9.56.24.2.3;Inflammatory;301
9.56.24.2.4;Degenerative;302
9.56.24.2.5;Neoplastic;302
9.56.24.2.6;Other;302
9.56.25;General Investigations;302
9.56.26;Specific Investigations;302
9.56.27;Knee;303
9.56.27.1;Causes;303
9.56.28;History;304
9.56.28.1;Traumatic;304
9.56.28.2;Infective;304
9.56.28.3;Inflammatory;304
9.56.28.4;Degenerative;305
9.56.28.5;Metabolic;305
9.56.28.6;Neuropathic;305
9.56.28.7;Neoplastic;305
9.56.28.8;Other;305
9.56.28.8.1;Bursitis;305
9.56.28.8.2;Baker’s cyst;305
9.56.28.8.3;Disorders of alignment;305
9.56.28.8.4;Patellofemoral instability;306
9.56.28.8.5;Referred pain;306
9.56.28.8.6;Osteochondritis dissecans;306
9.56.28.8.7;Osgood–Schlatter’s disease;306
9.56.28.8.8;Chondromalacia patellae;306
9.56.29;Examination;306
9.56.29.1;Traumatic;306
9.56.29.2;Infective;307
9.56.29.3;Inflammatory;307
9.56.29.4;Degenerative;307
9.56.29.5;Metabolic;307
9.56.29.6;Neuropathic;307
9.56.29.7;Other;307
9.56.30;General Investigations;308
9.56.31;Specific Investigations;308
9.56.32;Ankle;309
9.56.32.1;Causes;309
9.56.33;History;309
9.56.33.1;Traumatic;309
9.56.33.2;Infective;309
9.56.33.3;Inflammatory;309
9.56.33.4;Degenerative;310
9.56.33.5;Others;310
9.56.34;Examination;310
9.56.34.1;Traumatic;310
9.56.34.2;Infective;310
9.56.34.3;Inflammatory;310
9.56.34.4;Degenerative;310
9.56.34.5;Others;310
9.56.35;General Investigations;311
9.56.36;Specific Investigations;311
9.57;Kidney Swellings;312
9.57.1;Causes;312
9.57.2;History;313
9.57.2.1;Congenital;313
9.57.2.2;Acquired;313
9.57.3;Examination;313
9.57.4;General Investigations;313
9.57.5;Specific Investigations;314
9.58;Leg Pain;315
9.58.1;Causes;315
9.58.2;History;316
9.58.2.1;Traumatic;316
9.58.2.2;Inflammatory;316
9.58.2.3;Infective;317
9.58.2.4;Degenerative;317
9.58.2.5;Vascular;317
9.58.2.6;Neurological;317
9.58.2.7;Metabolic;317
9.58.2.8;Neoplastic;318
9.58.2.9;Other;318
9.58.3;Examination;318
9.58.3.1;Traumatic;318
9.58.3.2;Inflammatory;318
9.58.3.3;Infective;318
9.58.3.4;Degenerative;318
9.58.3.5;Vascular;319
9.58.3.6;Neoplastic;319
9.58.3.7;Neurological;319
9.58.3.8;Metabolic;319
9.58.3.9;Other;319
9.58.4;General Investigations;319
9.58.5;Specific Investigations;320
9.59;Leg Swellings;321
9.59.1;Causes;321
9.59.2;History;322
9.59.3;Examination;322
9.59.4;General Investigations;323
9.59.5;Specific Investigations;324
9.60;Leg Ulcers;325
9.60.1;Causes;325
9.60.2;History;326
9.60.3;Examination;326
9.60.3.1;Site;326
9.60.3.2;Edge;327
9.60.3.3;Base;327
9.60.3.4;Surrounding tissues;327
9.60.4;General Investigations;327
9.60.5;Specific Investigations;328
9.61;Lip Lesions;329
9.61.1;Causes;329
9.61.2;History;330
9.61.2.1;Congenital;330
9.61.2.2;Acquired;330
9.61.2.2.1;Flat lesions;330
9.61.2.2.2;Raised lesions;330
9.61.2.2.3;Erosions;331
9.61.2.2.4;Swelling;331
9.61.2.2.5;Cheilitis;331
9.61.3;Examination;331
9.61.3.1;Congenital;331
9.61.3.2;Acquired;332
9.61.3.2.1;Flat lesions;332
9.61.3.2.2;Raised lesions;332
9.61.3.2.3;Erosions;332
9.61.3.2.4;Swellings and cheilitis;332
9.61.4;General Investigations;332
9.61.5;Specific Investigations;333
9.62;Lymphadenopathy;334
9.62.1;Causes;334
9.62.2;History;335
9.62.2.1;Infection;335
9.62.2.2;Primary malignancy;335
9.62.2.3;Secondary malignancy;335
9.62.2.4;Other conditions;335
9.62.3;Examination;335
9.62.4;General Investigations;336
9.62.5;Specific Investigations;336
9.63;Melaena;338
9.63.1;Causes;338
9.63.2;History;339
9.63.2.1;Swallowed blood;339
9.63.2.2;Oesophagus;339
9.63.2.3;Stomach;339
9.63.2.4;Duodenum;340
9.63.2.5;Small intestine;340
9.63.2.6;Other causes of dark stools;340
9.63.3;Examination;340
9.63.3.1;Swallowed blood;340
9.63.3.2;Oesophagus;340
9.63.3.3;Stomach;340
9.63.3.4;Duodenum;340
9.63.3.5;Small intestine;341
9.63.3.6;Bleeding disorders;341
9.63.4;General Investigations;341
9.63.5;Specific Investigations;341
9.64;Mouth Ulcers;342
9.64.1;Causes;342
9.64.2;History;343
9.64.2.1;Traumatic;343
9.64.2.2;Aphthous;343
9.64.2.3;Inflammatory;343
9.64.2.4;Infective;343
9.64.2.5;Neoplastic;344
9.64.2.6;Haematological disorders;344
9.64.2.7;Skin disease-associated;344
9.64.2.8;Connective tissue disease;344
9.64.2.9;Other;344
9.64.3;Examination;344
9.64.3.1;Traumatic;344
9.64.3.2;Aphthous;344
9.64.3.3;Inflammatory;344
9.64.3.4;Infective;345
9.64.3.5;Neoplastic;345
9.64.3.6;Haematological disorders;345
9.64.3.7;Skin disease-associated;345
9.64.3.8;Connective tissue disorders;345
9.64.3.9;Other;345
9.64.4;General Investigations;345
9.65;Muscle Weakness and Wasting;347
9.65.1;Causes;347
9.65.2;History;348
9.65.2.1;Onset;348
9.65.2.2;Site;348
9.65.2.3;Precipitating factors;348
9.65.2.4;Past medical history;348
9.65.2.5;Associated symptoms;348
9.65.3;Examination;349
9.65.4;General Investigations;349
9.65.5;Specific Investigations;350
9.66;Nail Abnormalities;351
9.66.1;Causes;351
9.66.2;History;352
9.66.2.1;Congenital;352
9.66.2.2;Acquired;352
9.66.2.2.1;Infections;352
9.66.2.2.2;Traumatic;352
9.66.2.2.3;Systemic illness;352
9.66.2.2.4;Dermatological;353
9.66.2.2.5;Other;353
9.66.3;Examination;353
9.66.3.1;Congenital;353
9.66.3.2;Acquired;353
9.66.3.2.1;Infections;353
9.66.3.2.2;Traumatic;353
9.66.3.2.3;Systemic illness;353
9.66.3.2.4;Dermatological;354
9.66.3.2.5;Other;354
9.66.4;General Investigations;354
9.66.5;Specific Investigations;354
9.67;Nasal Discharge;356
9.67.1;Causes;356
9.67.2;History;357
9.67.2.1;Congenital;357
9.67.2.2;Acquired;357
9.67.2.2.1;Infective;357
9.67.2.2.2;Allergic;357
9.67.2.2.2.1;Allergic rhinitis;357
9.67.2.2.3;Inflammatory;357
9.67.2.2.3.1;Vasomotor rhinitis;357
9.67.2.2.3.2;Nasal polyps;358
9.67.2.2.3.3;Non-eosinophilic vasomotor rhinitis;358
9.67.2.2.4;Neoplastic;358
9.67.2.2.4.1;Nasopharyngeal carcinoma;358
9.67.2.2.4.2;Carcinoma of the maxillary sinus;358
9.67.2.2.4.3;Malignant granuloma;358
9.67.2.2.5;Granulomatous disease;358
9.67.2.2.6;Traumatic;358
9.67.2.2.7;Degenerative;359
9.67.3;Examination;359
9.67.3.1;Choanal atresia;359
9.67.3.2;Infective;359
9.67.3.3;Allergic;359
9.67.3.4;Inflammatory;359
9.67.3.5;Neoplastic;359
9.67.3.6;Granulomatous disease;359
9.67.3.7;Traumatic;360
9.67.3.8;Degenerative;360
9.67.4;General Investigations;360
9.67.5;Specific Investigations;360
9.68;Neck Lumps;361
9.68.1;Causes;361
9.68.2;History;362
9.68.2.1;Symptoms;362
9.68.2.2;Past medical history;362
9.68.3;Examination;362
9.68.3.1;Sebaceous cyst;362
9.68.3.2;Lipoma;362
9.68.3.3;Dermoid cyst;363
9.68.3.4;Abscess;363
9.68.3.5;Lymphadenopathy;363
9.68.3.6;Thyroid;363
9.68.3.7;Thyroglossal cyst;363
9.68.3.8;Salivary gland;363
9.68.3.9;Branchial cyst;363
9.68.3.10;Carotid body tumour;363
9.68.3.11;Carotid aneurysm;364
9.68.3.12;Sternomastoid ‘tumour’;364
9.68.3.13;Cervical rib;364
9.68.3.14;Subclavian artery aneurysm;364
9.68.3.15;Pharyngeal pouch;364
9.68.3.16;Cystic hygromas;364
9.68.4;General Investigations;364
9.68.5;Specific Investigations;364
9.69;Neck Pain;366
9.69.1;Causes;366
9.69.2;History;367
9.69.2.1;Congenital;367
9.69.2.2;Acquired;367
9.69.2.2.1;Traumatic;367
9.69.2.2.2;Inflammatory;367
9.69.2.2.3;Infective;367
9.69.2.2.4;Degenerative;368
9.69.2.2.5;Neoplastic;368
9.69.2.2.6;Other;368
9.69.3;Examination;368
9.69.3.1;Congenital;368
9.69.3.2;Acquired;368
9.69.3.2.1;Traumatic;368
9.69.3.2.2;Inflammatory;368
9.69.3.2.3;Infective;369
9.69.3.2.4;Degenerative;369
9.69.3.2.5;Neoplastic;369
9.69.3.2.6;Other;369
9.69.4;General Investigations;369
9.69.5;Specific Investigations;369
9.70;Nipple Discharge;371
9.70.1;Causes;371
9.70.2;History;371
9.70.3;Examination;372
9.70.4;General Investigations;372
9.70.5;Specific Investigations;372
9.71;Oedema;374
9.71.1;Causes;374
9.71.2;History;375
9.71.2.1;Site and distribution;375
9.71.2.2;Precipitating factors;375
9.71.2.3;Past medical and drug history;376
9.71.2.4;Associated symptoms;376
9.71.2.4.1;Cardiac failure;376
9.71.2.4.2;Liver disease;376
9.71.2.4.3;Renal disease – nephrotic syndrome;376
9.71.2.4.4;Malabsorption;376
9.71.2.4.5;Venous thrombosis;376
9.71.3;Examination;377
9.71.3.1;Inspection;377
9.71.3.2;Cardiovascular system;377
9.71.3.3;Abdominal examination;377
9.71.3.4;Legs;377
9.71.4;General Investigations;377
9.71.5;Specific Investigations;378
9.72;Oliguria;379
9.72.1;Causes;379
9.72.2;History;379
9.72.2.1;Renal circulatory insufficiency;379
9.72.2.2;Renal causes;379
9.72.2.3;Post-renal;380
9.72.2.4;Others;380
9.72.2.5;Anuria;380
9.72.3;Examination;380
9.72.3.1;General;380
9.72.3.2;Specific;381
9.72.4;General Investigations;381
9.72.5;Specific Investigations;382
9.73;Palpitations;383
9.73.1;Causes;383
9.73.2;History;383
9.73.2.1;Additional features;384
9.73.3;Examination;384
9.73.4;Initial Investigations;384
9.73.4.1;12-lead ECG;384
9.73.5;Further Investigations;385
9.73.5.1;Ambulatory ECG monitoring;385
9.74;Penile Lesions;386
9.74.1;Causes;386
9.74.2;History;387
9.74.2.1;Foreskin and glans;387
9.74.2.1.1;Phimosis;387
9.74.2.1.2;Paraphimosis;387
9.74.2.1.3;Balanoposthitis;387
9.74.2.1.4;Balanitis xerotica obliterans;387
9.74.2.1.5;Herpes genitalis;387
9.74.2.1.6;Condylomata (warts);387
9.74.2.1.7;Trauma;388
9.74.2.1.8;Carcinoma;388
9.74.2.1.9;Erythroplasia of Queyrat;388
9.74.2.1.10;Syphilitic chancre;388
9.74.2.2;Shaft;388
9.74.2.2.1;Peyronie’s disease;388
9.74.2.2.2;Priapism;388
9.74.2.3;Urethra;388
9.74.2.3.1;Epispadias;388
9.74.2.3.2;Hypospadias;388
9.74.3;Examination;388
9.74.3.1;Foreskin and glans;388
9.74.3.1.1;Phimosis;388
9.74.3.1.2;Paraphimosis;389
9.74.3.1.3;Balanoposthitis;389
9.74.3.1.4;Balanitis xerotica obliterans;389
9.74.3.1.5;Herpes genitalis;389
9.74.3.1.6;Condylomata (warts);389
9.74.3.1.7;Trauma;389
9.74.3.1.8;Carcinoma;389
9.74.3.1.9;Erythroplasia of Queyrat;389
9.74.3.1.10;Syphilitic chancre;389
9.74.3.2;Shaft;390
9.74.3.2.1;Peyronie’s disease;390
9.74.3.2.2;Priapism;390
9.74.3.3;Urethra;390
9.74.4;General Investigations;390
9.74.5;Specific Investigations;390
9.75;Polyuria;392
9.75.1;Causes;392
9.75.2;History;393
9.75.2.1;General;393
9.75.2.2;Drug history;393
9.75.2.3;Past medical history;393
9.75.3;General Investigations;393
9.75.4;Specific Investigations;394
9.76;Popliteal Swellings;396
9.76.1;Causes;396
9.76.2;History;397
9.76.2.1;Superficial;397
9.76.2.1.1;Sebaceous cyst;397
9.76.2.1.2;Lipoma;397
9.76.2.1.3;Varix of the short saphenous vein;397
9.76.2.2;Deep;397
9.76.2.2.1;Lipoma;397
9.76.2.2.2;Lymphadenopathy;397
9.76.2.2.3;Semi-membranosus bursa;397
9.76.2.2.4;Baker’s cyst;397
9.76.2.2.5;Popliteal artery aneurysm;397
9.76.2.3;Bony;397
9.76.2.3.1;Exostoses;397
9.76.2.3.2;Osteogenic sarcoma;398
9.76.3;Examination;398
9.76.3.1;Superficial;398
9.76.3.1.1;Sebaceous cyst;398
9.76.3.1.2;Lipoma;398
9.76.3.1.3;Varix of the short saphenous vein;398
9.76.3.2;Deep;398
9.76.3.2.1;Lipoma;398
9.76.3.2.2;Lymphadenopathy;398
9.76.3.2.3;Semi-membranosus bursa;398
9.76.3.2.4;Baker’s cyst;398
9.76.3.2.5;Popliteal artery aneurysm;399
9.76.3.3;Bony;399
9.76.3.3.1;Exostoses;399
9.76.3.3.2;Osteogenic sarcoma;399
9.76.4;General Investigations;399
9.76.5;Specific Investigations;399
9.77;Pruritus;401
9.77.1;Causes;401
9.77.2;History;401
9.77.3;Examination;402
9.77.3.1;Inspection;402
9.77.4;General Examination;402
9.77.5;General Investigations;402
9.77.6;Specific Investigations;403
9.78;Pruritus Ani;404
9.78.1;Causes;404
9.78.2;History;405
9.78.2.1;Anal discharge;405
9.78.2.2;Faecal soiling;405
9.78.2.3;Skin diseases;405
9.78.2.4;Parasites;405
9.78.2.5;Psychogenic;406
9.78.3;Examination;406
9.78.3.1;Anal discharge;406
9.78.3.2;Faecal soiling;406
9.78.3.3;Skin diseases;406
9.78.3.4;Parasites;406
9.78.3.5;Psychogenic;406
9.78.4;General Investigations;406
9.79;Pyrexia of Unknown Origin;408
9.79.1;Causes;408
9.79.2;History;409
9.79.3;Examination;409
9.79.4;Investigations;409
9.79.5;General Investigations;409
9.79.6;Specific Investigations;410
9.80;Rectal Bleeding;412
9.80.1;Causes;412
9.80.2;History;413
9.80.2.1;Anus;413
9.80.2.1.1;Haemorrhoids;413
9.80.2.1.2;Fissure-in-ano;413
9.80.2.1.3;Carcinoma of the anal canal;414
9.80.2.1.4;Trauma;414
9.80.2.2;Colorectal;414
9.80.2.2.1;Carcinoma;414
9.80.2.2.2;Polyps;414
9.80.2.2.3;Diverticular disease;414
9.80.2.2.4;Inflammatory bowel disease;414
9.80.2.2.5;Ischaemic colitis;414
9.80.2.2.6;Angiodysplasia;414
9.80.2.2.7;Irradiation proctitis or colitis;414
9.80.2.2.8;Rectal prolapse;414
9.80.2.2.9;Solitary rectal ulcer;415
9.80.2.3;Small bowel;415
9.80.2.3.1;Meckel’s diverticulum;415
9.80.2.3.2;Intussusception;415
9.80.2.3.3;Mesenteric infarction;415
9.80.2.3.4;Aortoenteric fistula;415
9.80.2.4;Upper gastrointestinal tract;415
9.80.2.5;Others;415
9.80.2.5.1;Uraemia;415
9.80.3;Examination;416
9.80.3.1;Anus;416
9.80.3.1.1;Haemorrhoids;416
9.80.3.1.2;Fissure-in-ano;416
9.80.3.1.3;Carcinoma;416
9.80.3.1.4;Trauma;416
9.80.3.2;Colon and rectum;416
9.80.3.2.1;Carcinoma;416
9.80.3.2.2;Polyps;416
9.80.3.2.3;Diverticular disease;416
9.80.3.2.4;Inflammatory bowel disease;416
9.80.3.2.5;Ischaemic colitis;416
9.80.3.2.6;Angiodysplasia;417
9.80.3.2.7;Irradiation colitis or proctitis;417
9.80.3.2.8;Rectal prolapse;417
9.80.3.2.9;Solitary rectal ulcer;417
9.80.3.3;Small bowel;417
9.80.3.3.1;Meckel’s diverticulum;417
9.80.3.3.2;Intussusception;417
9.80.3.3.3;Mesenteric infarction;417
9.80.3.3.4;Aortoenteric fistula;417
9.80.3.4;Upper gastrointestinal tract;417
9.80.3.4.1;Massive haemorrhage;417
9.80.3.5;Others;417
9.80.4;General Investigations;418
9.80.5;Specific Investigations;418
9.81;Scalp Lesions;420
9.81.1;Causes;420
9.81.2;History;421
9.81.2.1;Traumatic;421
9.81.2.2;Sebaceous cyst;421
9.81.2.3;Neoplastic;421
9.81.2.4;Infective;422
9.81.2.5;Other;422
9.81.3;Examination;422
9.81.3.1;Traumatic;422
9.81.3.2;Sebaceous cyst;422
9.81.3.3;Neoplastic;422
9.81.3.4;Infective;422
9.81.3.5;Other;423
9.81.4;General Investigations;423
9.81.5;Specific Investigations;423
9.82;Scrotal Pain;424
9.82.1;Causes;424
9.82.2;History;425
9.82.2.1;Skin;425
9.82.2.2;Internal scrotal swellings;425
9.82.2.3;Referred pain;426
9.82.3;Examination;426
9.82.3.1;Skin;426
9.82.3.2;Internal scrotal swellings;426
9.82.3.3;Referred pain;427
9.82.4;General Investigations;427
9.82.5;Specific Investigations;427
9.83;Scrotal Swellings;428
9.83.1;Causes;428
9.83.2;History;429
9.83.2.1;Sebaceous cyst;429
9.83.2.2;Indirect inguinal hernia;429
9.83.2.3;Hydrocele;429
9.83.2.4;Epididymal cyst;429
9.83.2.5;Epididymo-orchitis;429
9.83.2.6;Testicular torsion;429
9.83.2.7;Testicular tumour;430
9.83.2.8;Varicocele;430
9.83.2.9;Haematocele;430
9.83.2.10;Sperm granuloma;430
9.83.2.11;TB;430
9.83.2.12;Gumma;430
9.83.3;Examination;430
9.83.3.1;Sebaceous cyst;430
9.83.3.2;Indirect inguinal hernia;430
9.83.3.3;Hydrocele;431
9.83.3.4;Epididymal cyst;431
9.83.3.5;Epididymo-orchitis;431
9.83.3.6;Testicular torsion;431
9.83.3.7;Testicular tumour;431
9.83.3.8;Varicocele;431
9.83.3.9;Haematocele;431
9.83.3.10;Sperm granuloma;432
9.83.3.11;Tuberculosis;432
9.83.3.12;Gumma;432
9.83.4;General Investigations;432
9.83.5;Specific Investigations;432
9.84;Shock;434
9.84.1;Causes;434
9.84.2;History;434
9.84.2.1;Trauma;434
9.84.2.2;Dyspnoea;435
9.84.2.3;Chest pain;435
9.84.2.4;Precipitating factors;435
9.84.3;Examination;435
9.84.3.1;Inspection;435
9.84.3.2;Temperature;435
9.84.3.3;Pulse;435
9.84.3.4;JVP;436
9.84.3.5;Auscultation;436
9.84.4;General Investigations;436
9.84.5;Specific Investigations;436
9.85;Splenomegaly;438
9.85.1;Causes;438
9.85.2;History;440
9.85.2.1;Infective;440
9.85.2.2;Inflammatory;440
9.85.2.3;Neoplastic;440
9.85.2.4;Haemolytic disease;441
9.85.2.5;Storage diseases;441
9.85.2.6;Deficiency diseases;441
9.85.2.7;Splenic vein hypertension;441
9.85.2.8;Non-parasitic cysts;441
9.85.3;Examination;441
9.85.3.1;General;441
9.85.3.2;Infective;441
9.85.3.3;Inflammatory;442
9.85.3.4;Neoplastic;442
9.85.3.5;Haemolytic disease;442
9.85.3.6;Storage diseases;442
9.85.3.7;Splenic vein hypertension;442
9.85.3.8;Non-parasitic cysts;442
9.85.4;General Investigations;442
9.85.5;Specific Investigations;443
9.86;Steatorrhoea;444
9.86.1;Causes;444
9.86.2;History;444
9.86.2.1;Abdominal pain;444
9.86.2.2;Associated symptoms;445
9.86.2.3;Past medical history;445
9.86.2.4;Drug history;445
9.86.3;Examination;445
9.86.4;General Investigations;446
9.86.5;Specific Investigations;446
9.87;Stridor;448
9.87.1;Causes;448
9.87.2;History;449
9.87.2.1;Onset;449
9.87.2.2;Precipitating factors;449
9.87.2.3;Associated symptoms;449
9.87.3;Examination;450
9.87.3.1;Inspection;450
9.87.3.2;Palpation and auscultation;450
9.87.4;General Investigations;450
9.87.5;Specific Investigations;451
9.88;Syncope;456
9.88.1;Causes;456
9.88.2;History;456
9.88.3;Examination;457
9.88.3.1;Appearance;457
9.88.3.2;Blood pressure;457
9.88.3.3;Pulse;457
9.88.3.4;Auscultation;458
9.88.4;General Investigations;458
9.88.5;Specific Investigations;458
9.89;Thirst;460
9.89.1;Causes;460
9.89.2;History;461
9.89.3;Examination;461
9.89.4;General Investigations;461
9.89.5;Specific Investigations;461
9.90;Throat Conditions;463
9.90.1;Causes;463
9.90.2;History;464
9.90.2.1;Infective;464
9.90.2.2;Inflammatory;464
9.90.2.3;Neoplastic;464
9.90.2.4;Neurological;464
9.90.2.5;Referred pain;464
9.90.2.6;Other;465
9.90.3;Examination;465
9.90.3.1;Infective;465
9.90.3.2;Inflammatory;465
9.90.3.3;Neoplastic;465
9.90.3.4;Neurological;465
9.90.3.5;Referred pain;465
9.90.3.6;Others;465
9.90.4;General Investigations;466
9.90.5;Specific Investigations;466
9.91;Tiredness;467
9.91.1;Causes;467
9.91.2;History;468
9.91.3;Examination;469
9.91.4;General Investigations;469
9.91.5;Specific Investigations;470
9.92;Toe Lesions;471
9.92.1;Causes;471
9.92.2;History;472
9.92.2.1;Nails;472
9.92.2.2;Deformities;473
9.92.2.3;Ulcers;473
9.92.2.4;Discoloration;473
9.92.3;Examination;473
9.92.3.1;Nails;473
9.92.3.2;Deformities;474
9.92.3.3;Ulcers;474
9.92.3.4;Discoloration;474
9.92.4;General Investigations;474
9.92.5;Specific Investigations;474
9.93;Tongue Disorders;476
9.93.1;Causes;476
9.93.2;History;477
9.93.2.1;Furring;477
9.93.2.2;Colour change;477
9.93.2.3;Swelling;478
9.93.2.4;Chronic superficial glossitis;478
9.93.2.5;Ulceration;478
9.93.2.6;Wasting;478
9.93.3;Examination;479
9.93.3.1;Furring;479
9.93.3.2;Colour change;479
9.93.3.3;Swelling;479
9.93.3.4;Chronic superficial glossitis;479
9.93.3.5;Ulceration;479
9.93.3.6;Wasting;480
9.93.4;General Investigations;480
9.93.5;Specific Investigations;480
9.94;Tremor;481
9.94.1;Causes;481
9.94.2;History;481
9.94.3;Examination;482
9.94.3.1;Tremor;482
9.94.3.2;General;482
9.94.4;General Investigations;482
9.94.5;Specific Investigations;483
9.95;Urethral Discharge;484
9.95.1;Causes;484
9.95.2;History;484
9.95.2.1;General;484
9.95.2.2;Prostatitis;484
9.95.2.3;Non-gonococcal urethritis;484
9.95.2.4;Gonorrhoea;485
9.95.2.5;Other bacterial;485
9.95.2.6;Reiter’s disease;485
9.95.2.7;Trauma;485
9.95.2.8;Chemical;485
9.95.2.9;Neoplastic;485
9.95.3;Examination;485
9.95.3.1;Prostatitis;485
9.95.3.2;Non-gonococcal urethritis;485
9.95.3.3;Gonorrhoea;486
9.95.3.4;Other bacterial;486
9.95.3.5;Reiter’s disease;486
9.95.3.6;Traumatic;486
9.95.3.7;Neoplastic;486
9.95.4;General Investigations;486
9.95.5;Specific Investigations;486
9.96;Urinary Incontinence;488
9.96.1;Causes;488
9.96.2;History;489
9.96.2.1;Stress incontinence;489
9.96.2.2;Urge incontinence;489
9.96.2.3;Overflow incontinence;489
9.96.2.4;Neurological;489
9.96.2.5;Anatomical;490
9.96.2.6;Other;490
9.96.3;Examination;490
9.96.3.1;Stress incontinence;490
9.96.3.2;Urge incontinence;490
9.96.3.3;Overflow incontinence;490
9.96.3.4;Neurological;490
9.96.3.5;Anatomical;490
9.96.4;General Investigations;490
9.96.5;Specific Investigations;491
9.97;Urinary Retention;492
9.97.1;Causes;492
9.97.2;History;493
9.97.2.1;Local;493
9.97.2.2;General;493
9.97.3;Examination;494
9.97.3.1;Local;494
9.97.3.2;General;494
9.97.4;General Investigations;494
9.97.5;Specific Investigations;494
9.98;Vaginal Discharge;496
9.98.1;Causes;496
9.98.2;History;497
9.98.3;Examination;497
9.98.4;General Investigations;497
9.98.5;Specific Investigations;497
9.99;Visual Problems;499
9.99.1;Causes;499
9.99.2;History;500
9.99.2.1;Visual disturbances;501
9.99.2.2;Blurring of vision;501
9.99.2.3;Loss of vision;501
9.99.3;Examination;502
9.99.3.1;Fundoscopy;502
9.99.4;General Investigations;502
9.99.5;Specific Investigations;503
9.100;Voice Disorders;504
9.100.1;Causes;504
9.100.2;History;505
9.100.2.1;Onset;505
9.100.2.2;Precipitating factors;505
9.100.2.3;Past medical history;505
9.100.2.4;Associated symptoms;505
9.100.3;Examination;506
9.100.4;General Investigations;506
9.100.5;Specific Investigations;506
9.101;Vomiting;507
9.101.1;Causes;507
9.101.2;History;509
9.101.2.1;General;509
9.101.2.1.1;Nature of the vomiting;509
9.101.2.1.2;Time of vomit;509
9.101.2.1.3;Relief of pain by vomiting;509
9.101.2.2;Central vomiting;509
9.101.2.3;Reflex vomiting;509
9.101.2.3.1;Gastrointestinal;509
9.101.2.3.2;CNS;509
9.101.2.3.3;Psychogenic;509
9.101.2.3.4;Others;510
9.101.3;Examination;510
9.101.3.1;Gastrointestinal;510
9.101.3.2;CNS;510
9.101.3.3;Psychogenic;510
9.101.3.4;Others;510
9.101.4;General Investigations;510
9.101.5;Specific Investigations;511
9.102;Weight Gain;513
9.102.1;Causes;513
9.102.2;History;514
9.102.2.1;General;514
9.102.2.2;Cushing’s syndrome;514
9.102.2.3;Hypothyroidism;514
9.102.2.4;Polycystic ovarian syndrome;514
9.102.2.5;Hypothalamic disease;515
9.102.2.6;Cardiac failure;515
9.102.2.7;Renal failure;515
9.102.3;Ascites;515
9.102.4;Examination;515
9.102.4.1;Inspection;515
9.102.4.2;Palpation and auscultation;515
9.102.5;General Investigations;516
9.102.6;Specific Investigations;516
9.103;Weight Loss;518
9.103.1;Causes;518
9.103.2;History;519
9.103.2.1;General;519
9.103.2.2;Cardiorespiratory system;519
9.103.2.3;Gastrointestinal system;520
9.103.2.4;Renal system;520
9.103.2.5;Haematological system;520
9.103.2.6;Endocrine system;520
9.103.2.7;Connective tissue diseases;520
9.103.3;Examination;520
9.103.3.1;Inspection;520
9.103.3.2;Palpation and auscultation;521
9.103.4;General Investigations;521
9.103.5;Specific Investigations;522
10;Section B: Biochemical Presentations;524
10.1;Hypercalcaemia;526
10.1.1;Causes;526
10.1.2;Symptoms and Signs;526
10.1.3;Investigations;526
10.2;Hyperglycaemia;528
10.2.1;Causes;528
10.2.2;Symptoms and Signs;528
10.2.3;Investigations;529
10.3;Hyperkalaemia;531
10.3.1;Causes;531
10.3.2;Symptoms and Signs;531
10.3.3;Investigations;531
10.4;Hypokalaemia;533
10.4.1;Causes;533
10.4.2;Symptoms and Signs;533
10.4.3;Investigations;533
10.5;Hypernatraemia;535
10.5.1;Causes;535
10.5.2;Symptoms and Signs;535
10.5.3;Investigations;536
10.6;Hyponatraemia;537
10.6.1;Causes;537
10.6.2;Symptoms and Signs;538
10.6.3;Investigations;538
10.7;Hypoglycaemia;539
10.7.1;Causes;539
10.7.2;Symptoms and Signs;539
10.7.3;Investigations;540
10.8;Hypocalcaemia;542
10.8.1;Causes;542
10.8.2;Symptoms and Signs;542
10.8.3;Investigations;542
10.9;Hypomagnesaemia;544
10.9.1;Causes;544
10.9.2;Symptoms and Signs;544
10.9.3;Investigations;544
10.10;Metabolic Acidosis;545
10.10.1;Causes;545
10.10.2;Symptoms and Signs;545
10.10.3;Investigations;545
10.10.3.1;Increased anion gap;546
10.11;Metabolic Alkalosis;547
10.11.1;Causes;547
10.11.2;Symptoms and Signs;547
10.11.3;Investigations;547
10.12;Respiratory Acidosis;548
10.12.1;Causes (Any Cause of Hypoventilation);548
10.12.2;Symptoms and Signs;548
10.12.3;Investigations;549
10.13;Respiratory Alkalosis;550
10.13.1;Causes (Any Cause of Hyperventilation);550
10.13.2;Symptoms and Signs;550
10.13.3;Investigations;551
10.14;Urea (Blood);552
10.14.1;Causes;552
10.14.2;Symptoms and Signs;552
10.14.3;Investigations;553
11;Section C: Haematological Presentations;554
11.1;Anaemia;556
11.1.1;Causes;556
11.1.2;Symptoms and Signs;557
11.1.2.1;Symptoms of anaemia;557
11.1.2.2;History of the underlying disorder;557
11.1.2.3;Dietary history;557
11.1.2.4;Past medical and drug history;557
11.1.2.5;Family history;558
11.1.3;Examination;558
11.1.4;Specific Investigations;558
11.1.4.1;Microcytic anaemia;558
11.1.4.2;Normocytic anaemia;559
11.1.4.3;Macrocytic anaemia;559
11.2;Clotting Disorders;561
11.2.1;Causes;561
11.2.2;Symptoms and Signs;561
11.2.2.1;Onset and duration;561
11.2.2.2;Past medical history;561
11.2.2.3;Drug history;562
11.2.3;Examination;562
11.2.4;General Investigations;562
11.2.5;Specific Investigations;563
11.3;Leucocytosis;564
11.3.1;Causes;564
11.3.2;Symptoms and Signs;566
11.3.3;Investigations;566
11.4;Leucopenia;568
11.4.1;Causes;568
11.4.2;Symptoms and Signs;569
11.4.3;Investigations;569
11.5;Polycythaemia;570
11.5.1;Causes;570
11.5.2;Symptoms and Signs;571
11.5.3;Investigations;571
11.6;Thrombocytopenia;573
11.6.1;Causes;573
11.6.2;Symptoms and Signs;573
11.6.3;Investigations;574
11.7;Thrombocytosis;575
11.7.1;Causes;575
11.7.2;Symptoms and Signs;575
11.7.3;Investigations;575
12;Index;578

Abbreviations
ABC airway, breathing and circulation ABGs arterial blood gases AC air conduction ACE angiotensin-converting enzyme ACTH adrenocorticotrophic hormone ADH antidiuretic hormone AF atrial fibrillation AFP alpha fetoprotein AIDS acquired immunodeficiency syndrome ANA antinuclear antibody ANCA antineutrophil cytoplasmic antibody ANF antinuclear factor anti-CCP anti-cyclic citrullinated peptide AP anteroposterior APTT activated partial thromboplastin time ARDS acute respiratory distress syndrome ARF acute renal failure AXR abdominal X-ray BC bone conduction BCG bacille Calmette–Guérin BPPV benign paroxysmal positional vertigo c-ANCA cytoplasmic-staining antineutrophil cytoplasmic antibody CAPD continuous ambulatory peritoneal dialysis CCF congestive cardiac failure CK-MB creatine kinase–myocardial type CMV cytomegalovirus CNS central nervous system COPD chronic obstructive pulmonary disease CRF chronic renal failure CREST calcinosis cutis–Raynaud’s phenomenon–esophageal hypomobility–sclerodactyly–telangiectasia CRP C-reactive protein C&S culture and sensitivity CSF cerebrospinal fluid CT computerised tomography CVA cerebrovascular accident CVP central venous pressure CXR chest X-ray DDAVP 1-deamino-8-D-arginine vasopressin DDH developmental dysplasia of the hip DHEA dehydroepiandrosterone DIC disseminated intravascular coagulation DIP distal interphalangeal DMSA dimercaptosuccinic acid DVT deep venous thrombosis EBV Epstein–Barr virus ECG electrocardiogram EEG electroencephalogram ELISA enzyme-linked immunosorbent assay EM electron microscope EMG electromyography EMSU early morning specimen of urine ENT ear nose throat ERCP endoscopic retrograde cholangiopancreatography ESR erythrocyte sedimentation rate FBC full blood count FEV1 forced expiratory volume (1 second) FNAC fine-needle aspiration cytology FSH follicle-stimulating hormone FVC forced vital capacity GBM glomerular basement membrane GCS Glasgow Coma Scale GH growth hormone GI gastrointestinal GORD gastro-oesophageal reflux disease G6PD glucose-6-phosphate dehydrogenase GTN glyceryl trinitrate GUM genito-urinary medicine Hb haemoglobin ßHCG ß-human chorionic gonadotrophin 5HIAA 5-hydroxyindoleacetic acid HIV human immunodeficiency virus IGF-1 insulin growth factor-1 Ig immunoglobulin IP interphalangeal ITP idiopathic thrombocytopenic purpura IVC inferior vena cava IVU intravenous urography JVP jugular venous pressure KUB kidney ureter bladder (plain X-ray) LDH lactate dehydrogenase LFTs liver function tests LH luteinising hormone LIF left iliac fossa LVF left ventricular failure MAG3 mercapto acetyl triglycine MCH mean corpuscular haemoglobin MCHC mean corpuscular haemoglobin concentration MCP metacarpophalangeal MCV mean corpuscular volume ME myalgic encephalomyelitis MEN multiple endocrine neoplasia MRA magnetic resonance angiography MRCP magnetic resonance cholangiopancreatography MRI magnetic resonance imaging MSU midstream specimen of urine MTP metatarsophalangeal NSAID non-steroidal anti-inflammatory drug NSTEMI non-ST elevation myocardial infarction OGD oesophagogastroduodenoscopy PAS periodic acid–Schiff PCR polymerase chain reaction PCV packed cell volume PIP proximal interphalangeal PR per rectum PSA prostate specific antigen PT prothrombin time PTC percutaneous transhepatic cholangiography PTH parathyroid hormone PV per vaginam RAST radio allergen sorbent test RBC red blood cell RDW red cell distribution...

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