Oxford Cases in Medicine and Surgery

2015 ◽  
Author(s):  
Hugo Farne ◽  
Edward Norris-Cervetto ◽  
James Warbrick-Smith
Keyword(s):  
Chest Pain ◽  
Case History ◽  
Clinical Medicine ◽  
Real Life ◽  
General Medicine ◽  
Diagnostic Approach ◽  
History Taking ◽  
Presenting Symptoms ◽  
Essential Resource ◽  
Physiological Systems

Oxford Cases in Medicine and Surgery, second edition, teaches students a logical step-by-step diagnostic approach to common patient presentations. This approach mirrors that used by successful clinicians on the wards, challenging students with questions at each stage of a case (history-taking, examination, investigation, management). In tackling these questions, students understand how to critically analyse information and learn to integrate their existing knowledge to a real-life scenario from start to finish. Each chapter focuses on a common presenting symptom (e.g. chest pain). By starting with a symptom, mirroring real life settings, students learn to draw on their knowledge of different physiological systems - for example, cardiology, respiratory, gastroenterology - at the same time. All the major presenting symptoms in general medicine and surgery are covered, together with a broad range of pathologies. This book is an essential resource for all medicine students, and provides a modern, well-rounded introduction to life on the wards. Ideal for those starting out in clinical medicine and an ideal refresher for those revising for OSCEs and finals.

Pleural Effusions: Diagnostic Considerations

1995 ◽  
Vol 16 (2) ◽  
pp. 79-79
Author(s):  
Jeffrey M. Ewig
Keyword(s):  
Chest Pain ◽  
Pleural Space ◽  
Pleural Effusions ◽  
Pleuritic Chest Pain ◽  
Radiographic Appearance ◽  
Air Bubble ◽  
Presenting Symptoms ◽  
Breath Sounds ◽  
Costophrenic Angle ◽  
Pleural Involvement

The presence of fluid in the pleural space can be seen in a variety of disorders. Presenting symptoms include dyspnea, pleuritic chest pain, and ipsilateral shoulder pain if pleural involvement occurs at the central portion of the diaphragm. Physical examination findings include chest asymmetry, diminished breath sounds, dullness to percussion, and decreased tactile fremitus. In an upright patient, the radiographic appearance of pleural fluid includes blunting of the costophrenic angle, straightening or a more lateral peak of the hemidiaphragm contour, simulation of an elevated hemidiaphragm, or a distance of greater than 2 cm between the gastric air bubble and the lung.

Evaluation of noncardiac chest pain: diagnostic approach, coping strategies and quality of life

2006 ◽  
Vol 10 (1) ◽  
pp. 51-51 ◽  
Author(s):  
Daniela Husser ◽  
Andreas Bollmann ◽  
Christian Kühne ◽  
Jochen Molling ◽  
Helmut U. Klein
Keyword(s):  
Quality Of Life ◽  
Chest Pain ◽  
Coping Strategies ◽  
Diagnostic Approach ◽  
Noncardiac Chest Pain ◽  
Approach Coping

scholarly journals HRIDROGA – AN OUTLOOK THROUGH SAMANYA LAKSHANA

2021 ◽  
Vol 9 (9) ◽  
pp. 2084-2087
Author(s):  
Ashwini P K ◽  
Geetha B Markande ◽  
Prashanth Jain
Keyword(s):  
Chest Pain ◽  
Cardiovascular Diseases ◽  
Causes Of Death ◽  
Signs And Symptoms ◽  
Presenting Symptoms ◽  
Unique Approach ◽  
Cardiac Disorders ◽  
Proper Analysis

Hridroga (cardiovascular diseases) are the major causes of death globally, taking an estimated 17.9 million lives each year. In view of increasing incidence of cardiac disorders in the present era, there is a need to understand the disease more elaborately. Ayurveda has a unique approach towards understanding and diagnosing diseases. Diag- nosis must be done by proper analysis of presenting symptoms of a disease. By the thorough knowledge regarding these signs and symptoms, right diagnosis can be done before planning any treatment. Ayurveda has given utmost importance for diagnosis with due consideration of Lakshanas. Hritshoola (chest pain), Vaivarnya (cyanosis), Moorcha (syncope), Shwasa (dyspnea), Kasa (cough) are the cardinal features of Hridroga. By knowing the whole concept of Lakshanas, diagnosis can be done at an earlier stage. Keywords: Hridroga, Cardiovascular diseases, Samanya Lakshanas

Aortic dissection in children and young adults: diagnosis, patients at risk, and outcomes

2003 ◽  
Vol 13 (4) ◽  
pp. 341-344 ◽  
Author(s):  
Eli Zalzstein ◽  
Robert Hamilton ◽  
Nili Zucker ◽  
Samuel Diamant ◽  
Gary Webb
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Marfan Syndrome ◽  
Medical Condition ◽  
Young Patients ◽  
Diagnostic Tools ◽  
Cardiac Defects ◽  
Congenital Cardiac Defects ◽  
Ischemic Bowel ◽  
Presenting Symptoms

Objective: To heighten the awareness of pediatricians and pediatric cardiologists to aortic dissection, a potentially dangerous medical condition. Methods: We reviewed the charts of 13 patients, seen in four medical centers, who suffered acute or chronic aortic dissection over the period 1970 through 2000 whilst under the age of 25 years. Results: There were seven male and six female patients, with the mean age at diagnosis being 12.1 years, with a range from one day to 25 years. Congenital cardiac defects were present in five patients, and Marfan syndrome in four. In three of the patients with congenital cardiac defects, aortic dissection developed as a complication of medical procedures. In three patients, dissection followed blunt trauma to the chest. We could not identify any risk factors in one patient. The presenting symptoms included chest pain in four patients, abdominal pain and signs of ischemic bowel in two, non-palpable femoral pulses in one, and obstruction of the superior caval vein in one. Angiography and magnetic resonance imaging were the main diagnostic tools. Overall mortality was 38%. Only six patients had successful surgical outcomes. Conclusion: Due to the rarity of aortic dissection a high index of suspicion is required to reach the diagnosis in a timely manner. It should be considered in young patients complaining of chest pain in association with Marfan syndrome, anomalies of the aortic valve and arch, and chest trauma.

Dizziness

2021 ◽  
Author(s):  
Kevin A. Kerber ◽  
Robert W. Baloh
Keyword(s):  
Vestibular System ◽  
Clinical Medicine ◽  
Background Information ◽  
History Taking ◽  
Symptom Presentation ◽  
Anatomy And Physiology ◽  
Common Causes ◽  
History Of ◽  
Specific Disorders ◽  
Key Aspects

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 11 tables, and 69 references.

Dizziness

2021 ◽  
Author(s):  
Kevin A. Kerber ◽  
Robert W. Baloh
Keyword(s):  
Vestibular System ◽  
Clinical Medicine ◽  
Background Information ◽  
History Taking ◽  
Symptom Presentation ◽  
Anatomy And Physiology ◽  
Common Causes ◽  
History Of ◽  
Specific Disorders ◽  
Key Aspects

Dizziness is the quintessential symptom presentation in all of clinical medicine. It is a common reason that patients present to a physician. This chapter provides background information about the vestibular system, then reviews key aspects of history-taking and examination of the patient, then discusses specific disorders and common presentation types. Throughout the chapter the focus is on neurologic and vestibular disorders. Normal vestibular anatomy and physiology are discussed, followed by recommendations for history-taking and the physical examination. Specific disorders that cause dizziness are explored, along with common causes of non-specific dizziness. Common presentations are discussed, including acute severe dizziness, recurrent attacks, and recurrent positional vertigo. Finally, the chapter looks at laboratory investigations in diagnosis and management. Figures include population prevalence of dizziness symptoms, the anatomy of inner structures, primary afferent vestibular nerve activity, the head thrust test, the Dix-Hallpike maneuver, the supine positional test, the canalith repositioning procedure, and the barbecue roll maneuver. Tables list physiologic properties and clinical features of the components of the peripheral vestibular system, information to be acquired from history of the present illness, common symptoms patients report as dizziness, examination components, distinguishing among common peripheral and central vertigo syndromes, common causes of nonspecific dizziness, types of dizziness presentations, relevant imaging abnormalities on neuroimaging studies, vestibular testing components, and medical therapy for symptomatic dizziness. This review contains 8 highly rendered figures, 11 tables, and 69 references.

Identifying low-risk chest pain in the emergency department without troponin testing: a validation study of the HE-MACS and HEAR risk scores

2021 ◽  
pp. emermed-2021-211669
Author(s):  
Fraser Todd ◽  
James Duff ◽  
Edward Carlton
Keyword(s):  
Risk Factors ◽  
Chest Pain ◽  
Limit Of Detection ◽  
Controlled Trial ◽  
Statistical Significance ◽  
Low Risk ◽  
Risk Scores ◽  
Cardiac Events ◽  
Presenting Symptoms ◽  
Randomised Controlled

IntroductionPatients presenting to EDs with chest pain of possible cardiac origin represent a substantial and challenging cohort to risk stratify. Scores such as HE-MACS (History and Electrocardiogram-only Manchester Acute Coronary Syndromes decision aid) and HEAR (History, ECG, Age, Risk factors) have been developed to stratify risk without the need for troponin testing. Validation of these scores remains limited.MethodsWe performed a post hoc analysis of the Limit of Detection and ECG discharge strategy randomised-controlled trial dataset (n=629; June 2018 to March 2019; 8 UK hospitals) to calculate HEAR and HE-MACS scores. A <4% risk of major adverse cardiac events (MACE) at 30 days using HE-MACS and a score of <2 calculated using HEAR defined ‘very low risk’ patients suitable for discharge. The primary outcome of MACE at 30 days was used to assess diagnostic accuracy.ResultsMACE within 30 days occurred in 42/629 (7%) of the cohort. HE-MACS and HEAR scores identified 85/629 and 181/629 patients as ‘very low risk’, with MACE occurring in 0/85 and 1/181 patients, respectively. The sensitivities of each score for ruling out MACE were 100% (95% CI: 91.6% to 100%) for HE-MACS and 97.6% (95% CI: 87.7% to 99.9%) for HEAR. Presenting symptoms within these scores were poorly predictive, with only diaphoresis reaching statistical significance (OR: 4.99 (2.33 to 10.67)). Conventional cardiovascular risk factors and clinician suspicion were related to the presence of MACE at 30 days.ConclusionHEAR and HE-MACS show potential as rule out tools for acute myocardial infarction without the need for troponin testing. However, prospective studies are required to further validate these scores.

The spectrum of disorders associated with adult rheumatic and musculoskeletal diseases

2018 ◽  
pp. 205-240
Author(s):  
Gavin Clunie ◽  
Nick Wilkinson ◽  
Elena Nikiphorou ◽  
Deepak R. Jadon
Keyword(s):  
General Practitioners ◽  
Musculoskeletal Diseases ◽  
Real Life ◽  
General Medicine ◽  
Differential Diagnoses ◽  
Medical Comorbidities ◽  
Adult Disease ◽  
Adults And Children ◽  
Rheumatological Disease ◽  
Rheumatic Conditions

The Oxford Handbook of Rheumatology, 4th edition, takes the reader through a pragmatic and realistic way of assessing musculoskeletal and rheumatological disease presentation in its first four chapters. The text reflects real life, with differential diagnoses suggested as information becomes available through the details from history, then examination, then investigations. The chapters focus on patterns of, and focal regional, symptoms in adults and children. In this chapter, the book considers musculoskeletal and rheumatic conditions which occur in, or are closely associated with, other conditions of the skin, eye, heart, lung, kidney, and in hormonal, neurological, and gastrointestinal systems. Such an approach should help general practitioners and rheumatology trainees caring for their patients across their medical comorbidities and in general medicine. There is also a section on musculoskeletal–rheumatological features in patients with neoplasia. The chapter focuses primarily on adult disease.

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