100 cases in clinical medicine - download pdf or read online

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 method to study medication is to determine sufferers. it's more straightforward to remember details in keeping with a true individual than a web page in a textbook. one other vital point within the retention of data is the intensity of studying. studying that seeks to appreciate difficulties is likely to be available later than superficial real accumulation. this can be the foundation of problem-based  Read more...

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How would you investigate and manage this patient? 39 100 Cases in Clinical Medicine ANSWER 15 This patient has a monoarthropathy, a rash and red eyes. Investigations show a raised white cell count and ESR. The diagnosis in this man was postinfective inflammatory mucositis and arthritis, often shortened to reactive arthritis, and also known as Reiter’s syndrome. This disease classically presents with a triad of symptoms (although all three may not always be present): • seronegative arthritis affecting mainly lower limb joints • conjunctivitis • non-specific urethritis (NSU).

He denies any intravenous drug abuse. He drinks around 14 units of alcohol each week. He has taken no other medication except for malaria prophylaxis. He denies any homosexual contacts. He has had a number of heterosexual contacts each year but says that all had been with protected intercourse. He had returned from Nigeria 3 weeks earlier and was finishing off his prophylactic malaria regime. He had been in Nigeria for 6 weeks as part of his job working for an oil company and had no illnesses while he was there.

The fluid should be sent for culture and inspection with a specific request for inspection for crystals. A high white cell count would be expected in an acute inflammatory arthritis. The diagnosis is made from the needle-like crystals of uric acid, which are negatively birefringent under polarized light, unlike the positively birefringent crystals of calcium pyrophosphate. In this case the pain in the joint was partly relieved by the aspiration. Treatment with a nonsteroidal anti-inflammatory drug should be covered by a proton pump inhibitor in view of her history of heartburn and indigestion.

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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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