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Medicine at a Glance E-Book

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Beschreibung

The market‐leading at a Glance series is popular among healthcare students and newly qualified practitioners, for its concise and simple approach and excellent illustrations.

Each bite‐sized chapter is covered in a double‐page spread with clear, easy‐to‐follow diagrams, supported by succinct explanatory text.

Covering a wide range of topics, books in the at a Glance series are ideal as introductory texts for teaching, learning and revision, and are useful throughout university and beyond.

Everything you need to know about Medicine… at a Glance!

A learning resource containing 250+ cases with self-assessment exercises to aid understanding and test student knowledge

Written to complement the bestselling Medicine at a Glance, Fifth Edition, this newly revised and updated Second Edition of Medicine at a Glance: Core Cases contains more than 250 cases with self-assessment exercises that aid understanding and test your knowledge. Following the structure of the main textbook, each chapter presents several clinical cases based on the chapter’s content.

The use of text, images, and diagrams in answer explanations caters for different learning styles and provides intuitive, targeted information to support the decision-making process in selecting answers.

Medicine at a Glance: Core Cases is an essential learning aid for students preparing for exams and clinical practice. This text is also fully updated for the UK AKT.

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Veröffentlichungsjahr: 2025

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Table of Contents

Cover

Table of Contents

Title Page

Copyright Page

Preface

List of Contributors

List of Abbreviations

1 Cardiovascular: Cases and Questions

Case 1: A patient with high blood pressure

Case 2: A patient with xanthelasma

Case 3: A patient with severe central chest pain

Case 4: A patient with dizzy spells and a history of angina

Case 5: A woman with sudden shortness of breath and palpitations

Case 6: A 72‐year‐old patient with shortness of breath

Case 7: A patient in cardiac arrest on the ward

Case 8: A patient in cardiac arrest

Case 9: A fit woman with shortness of breath and flu‐like symptoms

Case 10: A patient with shortness of breath and chest tightness

Case 11: A drug user with a cough and chest pain

Case 12: A patient with angina and raised blood pressure

Case 13: A pregnant woman with left‐sided chest pain

Case 14: A patient with calf pain and loss of appetite

Case 15: A patient with hypertension and chest pain

Case 16: A patient with new onset chest pain

Case 17: Severe chest pain in a man with diabetes

Case 18: A man with blackouts

Cardiovascular: Cases and Answers

Case 1: A patient with high blood pressure

Case 2: A patient with xanthelasma

Case 3: A patient with severe central chest pain

Case 4: A patient with dizzy spells and a history of angina

Case 5: A woman with sudden shortness of breath and palpitations

Case 6: A 72‐year‐old patient with shortness of breath

Case 7: A patient in cardiac arrest on the ward

Case 8: A patient in cardiac arrest

Case 9: A fit woman with shortness of breath and flu‐like symptoms

Case 10: A patient with shortness of breath and chest tightness

Case 11: A drug user with a cough and chest pain

Case 12: A patient with angina and raised blood pressure

Case 13: A pregnant woman with left‐sided chest pain

Case 14: A patient with calf pain and loss of appetite

Case 15: A patient with hypertension and chest pain

Case 16: A patient with new onset chest pain

Case 17: Severe chest pain in a man with diabetes

Case 18: A man with blackouts

2 Respiratory: Cases and Questions

Case 1: A patient with sudden‐onset breathlessness

Case 2: A patient with a recent history of breathlessness

Case 3: A patient admitted with generalised abdominal pain

Case 4: An asthmatic patient with dyspnoea and wheeze

Case 5: A patient with fever and dry cough

Case 6: A patient with persistent cough

Case 7: A patient with a painful shin rash

Case 8: A smoker with dyspnoea

Case 9: A patient with chronic obstructive pulmonary disease and recent breathlessness

Case 10: A patient with cough and limb weakness

Case 11: A patient with headache and worsening breathlessness

Case 12: Lung function testing in a patient with breathlessness

Case 13: A patient with sleep apnoea

Case 14: A man with gradual‐onset breathlessness

Case 15: A man with cough and fever

Respiratory: Cases and Answers

Case 1: A patient with sudden‐onset breathlessness

Case 2: A patient with a recent history of breathlessness

Case 3: A patient admitted with generalised abdominal pain

Case 4: An asthmatic patient with dyspnoea and wheeze

Case 5: A patient with fever and dry cough

Case 6: A patient with persistent cough

Case 7: A patient with a painful shin rash

Case 8: A smoker with dyspnoea

Case 9: A patient with chronic obstructive pulmonary disease and recent breathlessness

Case 10: A patient with cough and limb weakness

Case 11: A patient with headache and worsening breathlessness

Case 12: Lung function testing in a patient with breathlessness

Case 13: A patient with sleep apnoea

Case 14: A man with gradual‐onset breathlessness

Case 15: A man with cough and fever

3 Gastroenterology: Cases and Questions

Case 1: An ex‐smoker with weight loss

Case 2: A woman with diabetes and weight loss

Case 3: A man with a history of constipation

Case 4: A woman with difficulty defaecating

Case 5: A man with a 6‐week history of diarrhoea

Case 6: A man with frequent loose stools

Case 7: A man with ‘coffee‐ground’ vomiting

Case 8: A man with vomiting and Crohn's disease

Case 9: An orthopaedic patient who has passed a melaena stool

Case 10: A man who has vomited blood

Case 11: A man with rectal bleeding

Case 12: A man with rectal bleeding of increasing frequency

Case 13: A man with difficulty in swallowing

Case 14: A patient with sudden‐onset upper abdominal pain

Case 15: A patient with worsening upper abdominal pain

Case 16: A heavy drinker with jaundice

Case 17: A patient with lower abdominal pain, diarrhoea and weight loss

Case 18: A patient with abdominal distension

Case 19: A patient with large‐volume ascites

Case 20: A patient with bloody diarrhoea

Case 21: A patient with community‐acquired pneumonia and diarrhoea

Case 22: A patient with a 6‐month history of indigestion

Case 23: A man with abnormal liver blood tests

Case 24: A woman with abnormal liver blood tests

Case 25: A patient with epigastric pain and vomiting

Case 26: A man with acute pancreatitis

Case 27: A former drug user on a methadone programme

Case 28: A jaundiced woman with profound fatigue

Case 29: A man with no symptoms whose brother has haemochromatosis

Case 30: A woman who drinks heavily and has had a seizure

Gastroenterology: Cases and Answers

Case 1: An ex‐smoker with weight loss

Case 2: A woman with diabetes and weight loss

Case 3: A man with a history of constipation

Case 4: A woman with difficulty defaecating

Case 5: A man with a 6‐week history of diarrhoea

Case 6: A man with frequent loose stools

Case 7: A man with ‘coffee‐ground’ vomiting

Case 8: A man with vomiting and Crohn's disease

Case 9: An orthopaedic patient who has passed a melaena stool

Case 10: A man who has vomited blood

Case 11: A man with rectal bleeding

Case 12: A man with rectal bleeding of increasing frequency

Case 13: A man with difficulty in swallowing

Case 14: A patient with sudden‐onset upper abdominal pain

Case 15: A patient with worsening upper abdominal pain

Case 16: A heavy drinker with jaundice

Case 17: A patient with lower abdominal pain, diarrhoea and weight loss

Case 18: A patient with abdominal distension

Case 19: A patient with large‐volume ascites

Case 20: A patient with bloody diarrhoea

Case 21: A patient with community‐acquired pneumonia and diarrhoea

Case 22: A patient with a 6‐month history of indigestion

Case 23: A man with abnormal liver blood tests

Case 24: A woman with abnormal liver blood tests

Case 25: A patient with epigastric pain and vomiting

Case 26: A man with acute pancreatitis

Case 27: A former drug user on a methadone programme

Case 28: A jaundiced woman with profound fatigue

Case 29: A man with no symptoms whose brother has haemochromatosis

Case 30: A woman who drinks heavily and has had a seizure

4 Renal: Cases and Questions

Case 1: A patient with polyuria

Case 2: A patient with oliguria

Case 3: A patient with dysuria

Case 4: A patient with haematuria

Case 5: A patient with diabetes and anaemia

Case 6: A patient with hyperkalaemia

Case 7: A patient with hyponatraemia

Case 8: A patient with a disorder of acid–base balance

Case 9: A patient with a urinary calculus

Case 10: A patient with nephrotic syndrome

Case 11: A patient with glomerulonephritis

Case 12: A man with heavy proteinuria and low serum protein

Case 13: A patient with red cells in his urine

Case 14: A patient with general aches and nosebleeds

Case 15: A patient with a possible hereditary renal disorder

Case 16: A patient with tubulointerstitial disease

Case 17: A patient with acute renal failure

Case 18: A patient with chronic renal failure and dialysis

Case 19: A patient with a renal transplant

Case 20: Drugs and renal failure

Case 21: A patient with benign prostatic hypertrophy

Renal: Cases and Answers

Case 1: A patient with polyuria

Case 2: A patient with oliguria

Case 3: A patient with dysuria

Case 4: A patient with haematuria

Case 5: A patient with diabetes and anaemia

Case 6: A patient with hyperkalaemia

Case 7: A patient with hyponatraemia

Case 8: A patient with a disorder of acid–base balance

Case 9: A patient with a urinary calculus

Case 10: A patient with nephrotic syndrome

Case 11: A patient with glomerulonephritis

Case 12: A man with heavy proteinuria and low serum protein

Case 13: A patient with red cells in his urine

Case 14: A patient with general aches and nosebleeds

Case 15: A patient with a possible hereditary renal disorder

Case 16: A patient with tubulointerstitial disease

Case 17: A patient with acute renal failure

Case 18: A patient with chronic renal failure and dialysis

Case 19: A patient with a renal transplant

Case 20: Drugs and renal failure

Case 21: A patient with benign prostatic hypertrophy

5 Endocrinology: Cases and Questions

Case 1: A patient with a thyroid mass

Case 2: A tired patient with an enlarged thyroid gland

Case 3: A patient with an irregular heartbeat

Case 4: A patient with confusion, weight loss and agitation

Case 5: A young man with anxiety attacks

Case 6: A tired patient with weakness and dizziness

Case 7: A patient with possible Cushing's syndrome

Case 8: A woman with possible acromegaly

Case 9: A patient with amenorrhoea

Case 10: A patient with hypercalcaemia

Case 11: A patient with excess hair growth

Case 12: A patient with type 2 diabetes mellitus

Case 13: A patient with possible diabetes mellitus

Case 14: A patient with confusion and vomiting

Endocrinology: Cases and Answers

Case 1: A patient with a thyroid mass

Case 2: A tired patient with an enlarged thyroid gland

Case 3: A patient with an irregular heartbeat

Case 4: A patient with confusion, weight loss and agitation

Case 5: A young man with anxiety attacks

Case 6: A tired patient with weakness and dizziness

Case 7: A patient with possible Cushing's syndrome

Case 8: A woman with possible acromegaly

Case 9: A patient with amenorrhoea

Case 10: A patient with hypercalcaemia

Case 11: A patient with excess hair growth

Case 12: A patient with type 2 diabetes mellitus

Case 13: A patient with possible diabetes mellitus

Case 14: A patient with confusion and vomiting

6 Infectious Disease: Cases and Questions

Case 1: A red and sore peripheral cannula site

Case 2: A young man with a sore throat and dark urine

Case 3: A patient with flu‐like symptoms and a rash

Case 4: A young patient with fever and heart murmur

Case 5: A patient with presumed infection

Case 6: A patient with presumed infection and confusion

Case 7: A man in hospital with a temperature

Case 8: A young man with a fever of unknown origin

Case 9: A drowsy patient with a fever and rash

Case 10: A patient with a fever and a rash on the lower limbs

Case 11: An HIV‐infected patient with fever

Case 12: A patient with a fever, sore throat and rash

Case 13: A traveller with diarrhoea and fever

Case 14: A traveller with jaundice

Case 15: A patient with fever and joint pain

Case 16: A patient with vaginal discharge

Case 17: A patient with malaise and fever following a tick bite

Case 18: A farmer with night sweats and a large spleen

Case 19: A febrile traveller returning from the Gambia

Case 20: A young man returning from sub‐Saharan Africa unwell and drowsy

Case 21: A patient with asthma and a fever

Case 22: An HIV‐positive patient with vomiting and fever

Case 23: A refugee with night sweats and haemoptysis

Case 24: A patient with abdominal pain and vomiting

Case 25: A patient with a blistering rash

Case 26: A breathless patient with HIV

Case 27: An HIV‐positive patient with a right hemiparesis

Case 28: Recurrent infections in a 49‐year‐old woman

Case 29: A patient with cough and lymphocytosis

Infectious Disease: Cases and Answers

Case 1: A red and sore peripheral cannula site

Case 2: A young man with a sore throat and dark urine

Case 3: A patient with flu‐like symptoms and a rash

Case 4: A young patient with fever and heart murmur

Case 5: A patient with presumed infection

Case 6: A patient with presumed infection and confusion

Case 7: A man in hospital with a temperature

Case 8: A young man with a fever of unknown origin

Case 9: A drowsy patient with a fever and rash

Case 10: A patient with a fever and a rash on the lower limbs

Case 11: An HIV‐infected patient with fever

Case 12: A patient with a fever, sore throat and rash

Case 13: A traveller with diarrhoea and fever

Case 14: A traveller with jaundice

Case 15: A patient with fever and joint pain

Case 16: A patient with vaginal discharge

Case 17: A patient with malaise and fever following a tick bite

Case 18: A farmer with night sweats and a large spleen

Case 19: A febrile traveller returning from the Gambia

Case 20: A young man returning from sub‐Saharan Africa unwell and drowsy

Case 21: A patient with asthma and a fever

Case 22: An HIV‐positive patient with vomiting and fever

Case 23: A refugee with night sweats and haemoptysis

Case 24: A patient with abdominal pain and vomiting

Case 25: A patient with a blistering rash

Case 26: A breathless patient with HIV

Case 27: An HIV‐positive patient with a right hemiparesis

Case 28: Recurrent infections in a 49‐year‐old woman

Case 29: A patient with cough and lymphocytosis

7 Haematology: Cases and Questions

Case 1: A patient with shortness of breath

Case 2: A patient needing a blood transfusion after a road traffic accident

Case 3: A patient with an intracranial haemorrhage

Case 4: A pregnant woman with a generalised seizure

Case 5: A patient with fatigue and mild jaundice

Case 6: A tired patient with lumps

Case 7: A patient with intermittent abdominal pain and mild jaundice

Case 8: A patient with lower back pain

Case 9: A patient with shortness of breath and purulent sputum

Case 10: A patient with increasing fatigue and mild jaundice

Case 11: A patient with intermittent palpitations

Case 12: A patient with increasing breathlessness

Case 13: A patient with a nosebleed and bruising

Case 14: A patient with shortness of breath and cough

Case 15: A patient with a rapidly enlarging neck lump

Case 16: A patient with headache and blurred vision

Case 17: A patient with burning pains in her fingers

Case 18: A patient with lower back pain

Case 19: A patient with increasing nausea

Case 20: A patient with macrocytosis and thrombocytopaenia

Case 21: A patient who has suffered a collapse

Case 22: A patient with heavy periods

Case 23: A patient who has undergone a coronary artery bypass

Case 24: A patient who has had a total hip replacement

Case 25: A patient with easy bruising and heavy periods

Haematology: Cases and Answers

Case 1: A patient with shortness of breath

Case 2: A patient needing a blood transfusion after a road traffic accident

Case 3: A patient with an intracranial haemorrhage

Case 4: A pregnant woman with a generalised seizure

Case 5: A patient with fatigue and mild jaundice

Case 6: A tired patient with lumps

Case 7: A patient with intermittent abdominal pain and mild jaundice

Case 8: A patient with lower back pain

Case 9: A patient with shortness of breath and purulent sputum

Case 10: A patient with increasing fatigue and mild jaundice

Case 11: A patient with intermittent palpitations

Case 12: A patient with increasing breathlessness

Case 13: A patient with a nosebleed and bruising

Case 14: A patient with shortness of breath and cough

Case 15: A patient with a rapidly enlarging neck lump

Case 16: A patient with headache and blurred vision

Case 17: A patient with burning pains in her fingers

Case 18: A patient with lower back pain

Case 19: A patient with increasing nausea

Case 20: A patient with macrocytosis and thrombocytopaenia

Case 21: A patient who has suffered a collapse

Case 22: A patient with heavy periods

Case 23: A patient who has undergone a coronary artery bypass

Case 24: A patient who has had a total hip replacement

Case 25: A patient with easy bruising and heavy periods

8 Oncology: Cases and Questions

Case 1: A patient with back pain, cough and breathlessness

Case 2: A patient with back pain and weight loss

Case 3: A patient with worsening back pain and weight loss

Case 4: A patient who has requested a prostate‐specific antigen (PSA) test

Case 5: An elderly patient with back pain

Case 6: A man with prostate cancer

Case 7: A distressed woman with shortness of breath

Case 8: A patient with shortness of breath and swollen face and neck

Case 9: A woman with metastatic breast cancer

Case 10: A man with prostate cancer and leg weakness

Case 11: A woman with advanced ovarian cancer

Case 12: A man with cancer and constant back pain

Case 13: A man with painless haematuria

Case 14: A woman with a familial history of cancer

Oncology: Cases and Answers

Case 1: A patient with back pain, cough and breathlessness

Case 2: A patient with back pain and weight loss

Case 3: A patient with worsening back pain and weight loss

Case 4: A patient who has requested a prostate‐specific antigen (PSA) test

Case 5: An elderly patient with back pain

Case 6: A man with prostate cancer

Case 7: A distressed woman with shortness of breath

Case 8: A patient with shortness of breath and swollen face and neck

Case 9: A woman with metastatic breast cancer

Case 10: A man with prostate cancer and leg weakness

Case 11: A woman with advanced ovarian cancer

Case 12: A man with cancer and constant back pain

Case 13: A man with painless haematuria

Case 14: A woman with a familial history of cancer

9 Neurology: Cases and Questions

Case 1: An elderly patient who has had a fall in the night

Case 2: A patient with speech disturbance and difficulty walking

Case 3: A patient with double vision

Case 4: A young woman with facial pain

Case 5: A patient with loss of leg control

Case 6: A patient with weakness of the hands and arms

Case 7: A patient suffering from dizziness

Case 8: A patient with acute‐onset shoulder pain

Case 9: A patient with weakness and wasting of the hand

Case 10: A patient with double vision

Case 11: A patient with a worsening tremor

Case 12: A patient with possible depression

Case 13: A pregnant patient with a stiff neck

Case 14: A patient who has had an episode of altered awareness

Case 15: A patient with possible epilepsy

Case 16: A patient with right hemiplegia

Case 17: A patient with a thunderclap headache

Case 18: A patient who has collapsed after an occipital headache

Case 19: An elderly patient with a decline in mobility

Case 20: A patient with memory difficulties

Case 21: A patient with rapidly progressive unsteadiness

Case 22: A young woman having tonic–clonic seizures

Case 23: A patient with blurred vision in one eye

Case 24: A patient with unsteadiness following childbirth

Case 25: A patient with weight loss, low‐grade fever and headache

Case 26: A patient with drowsiness and confusion

Case 27: A patient with weight loss, anorexia and fatigue

Case 28: A patient with new‐onset daily headache

Case 29: A patient with gait ataxia

Case 30: A patient who cannot move his legs after an operation

Case 31: A patient with gait disturbance and back pain

Case 32: A patient with diminishing walking distance

Case 33: A patient with double vision

Case 34: A patient with a progressive decline in mobility

Case 35: A patient with suspected Parkinson's disease

Case 36: A patient with obsessive‐compulsive disorder and a tremor

Case 37: A patient with abnormal movements

Case 38: A patient with a poorly localised headache

Case 39: A patient with increasing headache

Neurology: Cases and Answers

Case 1: An elderly patient who has had a fall in the night

Case 2: A patient with speech disturbance and difficulty walking

Case 3: A patient with double vision

Case 4: A young woman with facial pain

Case 5: A patient with loss of leg control

Case 6: A patient with weakness of the hands and arms

Case 7: A patient suffering from dizziness

Case 8: A patient with acute‐onset shoulder pain

Case 9: A patient with weakness and wasting of the hand

Case 10: A patient with double vision

Case 11: A patient with a worsening tremor

Case 12: A patient with possible depression

Case 13: A pregnant patient with a stiff neck

Case 14: A patient who has had an episode of altered awareness

Case 15: A patient with possible epilepsy

Case 16: A patient with right hemiplegia

Case 17: A patient with a thunderclap headache

Case 18: A patient who has collapsed after an occipital headache

Case 19: An elderly patient with a decline in mobility

Case 20: A patient with memory difficulties

Case 21: A patient with rapidly progressive unsteadiness

Case 22: A young woman having tonic–clonic seizures

Case 23: A patient with blurred vision in one eye

Case 24: A patient with unsteadiness following childbirth

Case 25: A patient with weight loss, low‐grade fever and headache

Case 26: A patient with drowsiness and confusion

Case 27: A patient with weight loss, anorexia and fatigue

Case 28: A patient with new‐onset daily headache

Case 29: A patient with gait ataxia

Case 30: A patient who cannot move his legs after an operation

Case 31: A patient with gait disturbance and back pain

Case 32: A patient with diminishing walking distance

Case 33: A patient with double vision

Case 34: A patient with a progressive decline in mobility

Case 35: A patient with suspected Parkinson's disease

Case 36: A patient with obsessive‐compulsive disorder and a tremor

Case 37: A patient with abnormal movements

Case 38: A patient with a poorly localised headache

Case 39: A patient with increasing headache

10 Ophthalmology: Cases and Questions

Case 1: A patient with a painful, red eye

Case 2: A patient with a painful red eye, aching joints and nosebleeds

Case 3: A patient with a sore red eye and worsening vision

Case 4: An elderly patient with general malaise and headache

Case 5: A patient with deteriorating vision in one eye

Case 6: A patient who sees flashes of light in one eye

Case 7: A child with a headache and swollen eyelids

Case 8: A patient who has vision difficulties while driving at night

Case 9: A patient who has difficulty seeing out of one eye

Case 10: A patient with constant double vision

Ophthalmology: Cases and Answers

Case 1: A patient with a painful, red eye

Case 2: A patient with a painful red eye, aching joints and nosebleeds

Case 3: A patient with a sore red eye and worsening vision

Case 4: An elderly patient with general malaise and headache

Case 5: A patient with deteriorating vision in one eye

Case 6: A patient who sees flashes of light in one eye

Case 7: A child with a headache and swollen eyelids

Case 8: A patient who has vision difficulties while driving at night

Case 9: A patient who has difficulty seeing out of one eye

Case 10: A patient with constant double vision

11 Rheumatology: Cases and Questions

Case 1: A patient with an unusual red rash

Case 2: An elderly patient with mobility difficulties

Case 3: A patient with osteoarthritis in one hip

Case 4: A young patient with rheumatoid arthritis

Case 5: A patient with lethargy and weight loss

Case 6: A patient with fatigue and aching joints

Rheumatology: Cases and Answers

Case 1: A patient with an unusual red rash

Case 2: An elderly patient with mobility difficulties

Case 3: A patient with osteoarthritis in one hip

Case 4: A young patient with rheumatoid arthritis

Case 5: A patient with lethargy and weight loss

Case 6: A patient with fatigue and aching joints

12 Dermatology: Cases and Questions

Case 1: A patient with an itchy skin eruption

Case 2: A patient with a pigmented lesion on her arm

Case 3: A patient with a pruritic rash

Case 4: A child with hair loss

Case 5: A patient with a chronic ulcer

Case 6: A patient with blisters on the backs of the hands

Case 7: A patient with atopic dermatitis and worsening itch and rash

Case 8: A patient with recurrent hives

Case 9: A patient with hand eczema

Case 10: A patient with a psoriasiform rash

Case 11: A patient with facial redness

Case 12: A patient with café‐au‐lait macules

Case 13: A patient with depigmented patches

Case 14: A patient with skin darkening on the face and hands

Case 15: An elderly patient with generalised skin blisters

Case 16: A patient with itching and diarrhoea

Case 17: A patient with targetoid lesions on the hands and feet

Dermatology: Cases and Answers

Case 1: A patient with an itchy skin eruption

Case 2: A patient with a pigmented lesion on her arm

Case 3: A patient with a pruritic rash

Case 4: A child with hair loss

Case 5: A patient with a chronic ulcer

Case 6: A patient with blisters on the backs of the hands

Case 7: A patient with atopic dermatitis and worsening itch and rash

Case 8: A patient with recurrent hives

Case 9: A patient with hand eczema

Case 10: A patient with a psoriasiform rash

Case 11: A patient with facial redness

Case 12: A patient with café‐au‐lait macules

Case 13: A patient with depigmented patches

Case 14: A patient with skin darkening on the face and hands

Case 15: An elderly patient with generalised skin blisters

Case 16: A patient with itching and diarrhoea

Case 17: A patient with targetoid lesions on the hands and feet

13 Other Emergencies: Cases and Questions

Case 1: A patient with dyspnoea and weight loss

Case 2: A patient with abdominal pain and weight loss

Case 3: A patient who has bumped his head getting out of the car

Case 4: A woman who has taken a drug overdose

Case 5: A man who has taken a drug overdose

Case 6: A man with acute confusional state

Case 7: A woman with acute confusional state

Case 8: A patient with progressive confusion

Case 9: A patient with reduced consciousness following a seizure

Case 10: A patient with coma

Case 11: A patient with recurrent tongue swelling

Case 12: A patient who has collapsed after eating a take‐away

Case 13: An asthmatic patient with breathlessness

Case 14: A patient with light‐headedness and faintness

Case 15: A patient with a peanut allergy

Case 16: A patient with a widespread itchy rash

Case 17: A patient with hayfever

Case 18: A baby with severe pneumonia

Case 19: A patient with severe headache, vomiting and photophobia

Other Emergencies: Cases and Answers

Case 1: A patient with dyspnoea and weight loss

Case 2: A patient with abdominal pain and weight loss

Case 3: A patient who has bumped his head getting out of the car

Case 4: A woman who has taken a drug overdose

Case 5: A man who has taken a drug overdose

Case 6: A man with acute confusional state

Case 7: A woman with acute confusional state

Case 8: A patient with progressive confusion

Case 9: A patient with reduced consciousness following a seizure

Case 10: A patient with coma

Case 11: A patient with recurrent tongue swelling

Case 12: A patient who has collapsed after eating a take‐away

Case 13: An asthmatic patient with breathlessness

Case 14: A patient with light‐headedness and faintness

Case 15: A patient with a peanut allergy

Case 16: A patient with a widespread itchy rash

Case 17: A patient with hayfever

Case 18: A baby with severe pneumonia

Case 19: A patient with severe headache, vomiting and photophobia

14 The Acutely Unwell Patient: Cases and Questions

Case 1: A patient with chest pain following a fall

Case 2: A hospitalised patient who develops neutropenia and a temperature

Case 3: A patient with septic shock

Case 4: A feverish patient with a productive cough

Case 5: A patient with haematemesis

Case 6: A patient with a severe asthma attack

The Acutely Unwell Patient: Cases and Answers

Case 1: A patient with chest pain following a fall

Case 2: A hospitalised patient who develops neutropenia and a temperature

Case 3: A patient with septic shock

Case 4: A feverish patient with a productive cough

Case 5: A patient with haematemesis

Case 6: A patient with a severe asthma attack

Index

End User License Agreement

List of Illustrations

Chapter 1

Figure 1.4.1

Figure 1.5.1

Figure 1.10.1

Figure 1.15.1

Figure 1.17.1

Figure 1.4.2 Physical findings in aortic valve disease.

Figure 1.6.1 Clinical features of mitral valve disease.

Figure 1.14.1 Clinical features of venous thrombosis.

Figure 1.16.1 Prevalence of coronary artery disease according to risk factor...

Figure 1.17.2 Value of specific components of the chest pain history for the...

Figure 1.17.3 Relationship between number of leads showing ST elevation and ...

Figure 1.17.4 The outcome for STEMI related to TIMI score.

Figure 1.18.1 Forms of vasomotor syncope.

Figure 1.18.2 The utility of the inter‐attack ECG in syncope.

Chapter 2

Figure 2.3.1 Blood gas analysis.

Figure 2.4.1 Features of asthma.

Figure 2.5.1 Clinical features of pneumonia.

Figure 2.12.1 Spirometry in lung disease.

Figure 2.13.1 The Epworth score: to assess sleepiness and the probability of...

Chapter 3

Figure 3.4.1 Causes of constipation.

Figure 3.5.1 Truelove–Witts criteria for diagnosing severe ulcerative coliti...

Figure 3.7.1 Features of colonic carcinoma.

Figure 3.12.1 Staging of colonic cancer.

Figure 3.17.1 Features of diverticular disease.

Figure 3.22.1 Features of hiatus hernia and gastro‐oesophageal reflux.

Figure 3.25.1 Markers of severe pancreatitis.

Figure 3.29.1 Features of haemochromatosis.

Figure 3.30.1 Features of alcoholic liver disease.

Chapter 4

Figure 4.1.1 Features and causes of polyuria.

Figure 4.2.1 Clinical features of oliguria.

Figure 4.5.1 Relationship between GFR and creatinine.

Figure 4.5.2 Stages of chronic kidney disease. Use the suffix (p) to denote ...

Figure 4.6.1 ECG features of hypo‐ and hyperkalaemia.

Figure 4.8.1 Acid–base balance.

Figure 4.9.1 Causes of renal colic.

Figure 4.10.1 Causes of nephrotic syndrome in adults.

Figure 4.12.1 Causes of proteinuria.

Chapter 5

Figure 5.2.1 Clinical features of hypothyroidism.

Figure 5.3.1 Features of thyroid eye disease.

Figure 5.3.2 Clinical features of thyrotoxicosis.

Figure 5.6.1 Features of Addison's disease.

Figure 5.7.1 Features of Cushing's syndrome.

Figure 5.8.1 Features of acromegaly.

Figure 5.9.1 Features of hyperprolactinaemia.

Figure 5.10.1 Features of hypercalcaemia.

Chapter 6

Figure 6.23.1

Figure 6.25.1

Figure 6.27.1

Figure 6.6.1 CSF findings in different forms of meningitis.

Figure 6.17.1 Features of Lyme disease.

Figure 6.19.1 Life cycle of

plasmodium

species.

Figure 6.20.1 Features of falciparum malaria.

Figure 6.21.1 Clinical features of allergic bronchopulmonary aspergillosis....

Figure 6.24.1 Features of extra‐pulmonary TB.

Figure 6.26.1 Kaposi's sarcoma.

Figure 6.28.1 Clinical features of antibody deficiencies.

Chapter 7

Figure 7.5.1 The peripheral blood film.

Figure 7.1.1 Classification of anaemia according to red cell size.

Figure 7.4.1 Anaemia with red cell fragments in the blood.

Figure 7.5.2 Different forms of autoimmune haemolytic anaemia.

Figure 7.6.1 Causes and consequences of non‐Hodgkin's lymphoma.

Figure 7.7.1 Consequences of haemolysis.

Figure 7.7.2 Hereditary spherocytosis peripheral blood film.

Figure 7.11.1 Investigation of suspected iron deficiency anaemia.

Figure 7.12.1 Features of paroxysmal nocturnal haemoglobulinuria.

Figure 7.14.1 Superior vena cava obstruction.

Figure 7.14.2 Features of Hodgkin's disease.

Figure 7.22.1 Causes of thrombocytopenia.

Chapter 8

Figure 8.8.1

Figure 8.8.2

Figure 8.9.1

Figure 8.5.1 Features of prostate cancer.

Figure 8.6.1 Causes and consequences of spinal cord compression.

Figure 8.9.2 Features of hypercalcaemia.

Figure 8.10.1 Mechanisms of malignant spinal cord compression.

Figure 8.12.1 The analgesic ladder.

Figure 8.13.1 Chemical factors in carcinogenesis.

Chapter 9

Figure 9.1.1 Gaits in different neurological conditions.

Figure 9.5.1 Clinical features of anterior spinal artery thrombosis.

Figure 9.7.1 Classification of stroke.

Figure 9.9.1 Clinical features of motor neuron disease.

Figure 9.11.1 Tremor and movement disorders.

Figure 9.18.1 Causes of intracranial bleeding.

Figure 9.29.1 Intracranial neoplasia.

Figure 9.33.1 Mitochondrial diseases (prevalence is 10–15 per 100 000, i.e. ...

Figure 9.35.1 The different Parkinson's ‘Plus’ syndromes.

Figure 9.38.1 Clinical features of temporal arteritis.

Chapter 10

Figure 10.3.1

Figure 10.1.1 Causes of iritis.

Figure 10.2.1 Features of granulomatosis with polyangiitis (GPA).

Figure 10.5.1 Central retinal vein occlusion.

Figure 10.7.1 Differential diagnosis of orbital cellulitis.

Chapter 11

Figure 11.1.1 Features of inflammatory muscle disease.

Figure 11.5.1 Classification of the vasculitides.

Figure 11.5.2 Clinical features of vasculitis.

Figure 11.6.1 Presenting features of SLE.

Figure 11.6.2 Classic features of SLE.

Chapter 12

Figure 12.1.1 Causes of erythroderma.

Figure 12.2.1 Outcome in malignant melanoma related to depth of skin invasio...

Figure 12.6.1 Causes of porphyria cutanea tarda.

Figure 12.12.1 Features of neurofibromatosis.

Figure 12.15.1 Features of common blistering skin diseases.

Figure 12.17.1 Causes and features of erythema multiforme.

Chapter 13

Figure 13.2.1 The patient's observation chart.

Figure 13.3.1 Glasgow Coma Scale.

Figure 13.2.2 Early warning score to detect critical illness at an early sta...

Figure 13.19.1 Consequences of complement deficiency.

Chapter 14

Figure 14.4.1 Outcome in severe community‐acquired pneumonia.

Guide

Cover Page

Table of Contents

Title Page

Copyright Page

Preface

List of Contributors

List of Abbreviations

Begin Reading

Index

Wiley End User License Agreement

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Medicine at a Glance: Core Cases

Second Edition

Edited by

Patrick Davey

Consultant Cardiologist and Medical ExaminerNorthampton General Hospital NHS TrustNorthampton, UK

William Ries

Acute General MedicineOxford University HospitalsOxford, UK

Alex Pitcher

Consultant CardiologistOxford University HospitalsOxford, UK

This edition first published 2025© 2025 John Wiley & Sons Ltd

Edition History1e (2011) ‐ Wiley‐Blackwell

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Preface

When studying, it is always important to determine whether or not one has learnt the subject – clearly, this is as true in medicine as any other subject. Different people have very different styles of learning and of testing themselves as to whether they have learnt and understood the subject thoroughly. Some people go on a wing and a prayer, reading and hoping they have retained some information, without testing their knowledge. Some go to the other extreme, reading, shutting the reference book and then writing down that which they have retained. They may do this immediately after reading, or some time later, clearly testing different forms of memory. Yet others, after reading, shut the book, shut their eyes and try to recall mentally their knowledge of the subject. This is often a most enjoyable way of working out what one knows and what one doesn't. Perhaps a down side of this ‘shut‐eye’ mental‐testing approach is the degree of mental strength needed to prevent day dreams intruding into working thoughts and distracting us from our studies! Some will discuss the subject with their peers, working out what they know, testing their understanding logically (‘if this, then why not this?’) and having colleagues help fill in the gaps – this can be a compellingly enjoyable way to learn. In fact, it may be that one of the most important roles of medical student clubs and rooms within medical schools is to encourage this sort of interaction. Perhaps even the most important role of the medical school is to ensure this peer‐to‐peer bonding, one that allows you to trust colleagues' knowledge and judgement sufficiently to ask them questions to which you don't know the answer, sometimes simple questions and sometimes the apparently ‘stupid’ question, the one everyone has been meaning to ask, the one so obvious you have been frightened to ask, as you feel you should know the answer, but the one in fact which, more often than not, is the most pertinent and central question to the problem at hand. This ability to interact with colleagues in this fashion will be, probably, the most important aspect of your competence as a future learner and so as a clinician.

Perhaps in medicine the most potent way of learning and testing knowledge is around a case; students see a patient (‘clerk them in’) using a fairly rigid and stylised system, synthesise this data into a short presentation, so including all the pertinent positives and negatives, which is then presented to a more senior clinician. The key part of this is not so much the acquisition and presentation of the data, though these are all crucial skills for a competent clinician; rather it is the joy of understanding what the data means, what is the data telling us about the patient and their condition? Does it only mean one illness, and if so why? This seems unlikely, but sometimes is the case. Could there be a differential diagnosis (almost inevitably so)? Why? To understand the data, as well as to collect and present it, one needs a full knowledge of the subject of medicine. The data is tested against our knowledge of disease processes, allowing us to reject or accept possible diagnoses. Do all the symptoms fit? Do the investigations support our possible diagnoses? If not, why not? What data needs to fit? What data can be rejected? This allows us to follow one diagnosis or another, reject it, find another, test it and so on. All clinicians are, to a greater or lesser extent medical detectives. All this sleuthing can be tremendous fun and is a most potent way to learn and, as importantly, to know that you have learnt and what still needs to be learnt.

Real‐life cases and real‐life clinicians, however, may not always be available and it is not possible to see representative examples of all the commonest and most serious conditions during a clinical course. Another way to learn, which addresses the breadth of cases one is likely to see in a long clinical career (and be tested on in examinations), is the case‐based approach from a textbook. This is the aim of this book, to introduce you to a case and then to test your understanding of that case, largely using multiple choice questions and answers. Each answer is followed by a detailed explanation, with supporting illustrations, and a reference to the relevant chapter in the supporting textbook, Medicine at a Glance, 5th edition http://www.wiley.com/go/medicine5e. Core Cases can be used as a stand‐alone volume, or in conjunction with the main textbook. There are different ways to test your knowledge using textbook‐based MCQs – one could read the question, mentally answer it, then look the answer up. I would suggest, however, that the best way is to read the question and write down the answer you think is right – this way, you commit yourself and so find the truth as to whether you know, or whether you only think you know! Every answer has a detailed explanation of what the answer is and why, and also a suggestion from Medicine at a Glance for further reading.

I hope you will enjoy this book and wish you every success in your endeavours. As always, we would be most pleased to have any feedback ([email protected]).

Patrick DaveyWilliam RiesAlex Pitcher

List of Contributors

Laura BenjaminWellcome Trust Clinical Research FellowLondon

Chris B. BunkerProfessor of Dermatology & Consultant DermatologistChelsea & Westminster, Royal Marsden Hospitals andImperial College School of MedicineLondon

Keith ChannonProfessor of Cardiovascular Medicine & Honorary ConsultantCardiologistDepartment of Cardiovascular MedicineUniversity of OxfordJohn Radcliffe HospitalOxford

Graham CollinsDepartment of HaematologyJohn Radcliffe HospitalOxford

Ophelia DadzieLocum Consultant Dermatopathologist and DermatologistSt John’s Institute of DermatologyGuy’s and St Thomas’ NHS Foundation TrustLondon

Patrick DaveyConsultant Cardiologist and Medical ExaminerNorthampton General Hospital NHS TrustNorthampton, UK

Suzanne DonnellyFormerly of Department of RheumatologySt George’s HospitalLondon

Peggy FrithConsultant Ophthalmic PhysicianThe Radcliffe InfirmaryOxford

Jonathan GleadleLecturer in NephrologyThe Wellcome TrustCentre for Human GeneticsOxford

Christopher HingstonSpR Intensive Care MedicineUniversity Hospital of WalesCardiff

Mark JuniperConsultant PhysicianGreat Western HospitalSwindon

David KeelingConsultant HaematologistOxford Haemophilia CentreThe Churchill HospitalOxford

David LallooReader in Tropical MedicineLiverpool School of Tropical MedicineLiverpool

Tim J. LittlewoodConsultant HaematologistDepartment of HaematologyJohn Radcliffe HospitalOxford

Andrew McLean‐TookeRoyal Victoria InfirmaryNewcastle‐upon‐Tyne

Faye MellingtonSpecialty Registrar (Ophthalmology)Oxford Eye HospitalOxford

Richard PensonDirector of Clinical Research in Medical GynecologicOncologyMassachusetts General HospitalBostonUSA

Alex PitcherConsultant CardiologistOxford University HospitalsOxford, UK

Anna RathmellOxford

William RiesAcute General MedicineOxford University HospitalsOxford

Jeremy ShearmanConsultant GastroenterologistDepartment of GastroenterologyWarwick HospitalWarwick

Gavin SpickettConsultant in Clinical Immunology, Allergy & General MedicineRegional Department of ImmunologyRoyal Victoria InfirmaryNewcastle‐upon‐Tyne

David SprigingsConsultant CardiologistNorthampton General HospitalNorthampton

Jeremy SteeleConsultant in Medical OncologySt Bartholomew’s HospitalLondon

Catherine StroudConsultant ImmunologistRoyal Victoria InfirmaryNewcastle‐upon‐Tyne

Kevin TalbotMRC Clinician ScientistDepartment of Human Anatomy & Genetics, andHonorary Consultant Neurologist

Department of Clinical NeurologyUniversity of OxfordThe Radcliffe InfirmaryOxford

Laura TookmanAcademic Clinical Fellow in OncologyInstitute of CancerBarts and The London School of Medicine and DentistryLondon

Helen E. TurnerConsultant EndocrinologistEndocrinology DepartmentThe Radcliffe InfirmaryOxford

Katherine WhybrewGeneral PractitionerBristol

Matt WiseConsultant in Intensive Care MedicineUniversity Hospital of WalesCardiff

Paul WordsworthProfessor of RheumatologyNuffield Orthopaedic CentreOxford

List of Abbreviations

AAA

AAION

abdominal aortic aneurysm arteritic anterior ischaemic optic neuropathy

Ab

antibody

ABG

arterial blood gas

ABPA

allergic bronchopulmonary aspergillosis

AC

acromioclavicular

ACE

AChR

angiotensin‐converting enzyme acetylcholine receptors

ACS

acute coronary syndrome

ACTH

adrenocorticotrophic hormone

ADH

antidiuretic hormone

ADP

adenosine diphosphate

ADPKD

autosomal dominant polycystic kidney disease

AF

atrial fibrillation

AFB

acid‐fast bacilli

α

‐FP

α‐fetoprotein

Ag

AIDP

antigen acute inflammatory demyelinating polyradiculoneuropathy

AIDS

acquired immune deficiency syndrome

AIH

autoimmune hepatitis

AIHA

autoimmune haemolytic anaemia

AION

ALI

anterior ischaemic optic neuropathy acute lung injury

ALL

acute lymphoid leukaemia

ALP

alkaline phosphatase

ALT

alanine transaminase

AMA

antimitochondrial antibody

AML

acute myeloid leukaemia

ANA

antinuclear antibody

ANCA

antineutrophil cytoplasmic antibody

ANF

antinuclear factor

APC

activated protein C

APKD

APML

adult polycystic kidney disease acute promyelocytic leukaemia

APS

antiphospholipid syndrome

APTT

activated partial thromboplastin time

AR

aortic regurgitation

ARDS

adult respiratory distress syndrome

AS

ankylosing spondylitis

ASD

atrial septal defect

ASO

antistreptolysin O

AST

aspartate transaminase

α

1

‐AT

α

1

‐antitrypsin

ATLL

adult T‐cell lymphoma/leukaemia

ATN

acute tubular necrosis

ATP

adenosine triphosphate

AV

atrioventricular

AVNRT

atrioventricular nodal re‐entrant tachycardia

AVRT

atrioventricular re‐entrant tachycardia

AXR

abdominal X‐ray

BAL

bronchoalveolar lavage

BBV

blood‐borne viruses

BCC

basal cell carcinoma

BCE

basal cell epithelioma

BCG

bacilli Calmette–Guérin

BCSP

bowel cancer screening programme

bd

bis die

(twice a day)

BDZ

benzodiazepine

BE

base excess

BLS

basic life support

BMD

bone marrow density

BMI

body mass index

BMZ

basement membrane zone

BNF

British National Formulary

BOOP

bronchiolitis obliterans organising pneumonia

BP

blood pressure

BRVO

branch retinal vein occlusion

CABG

coronary artery bypass graft

CAD

coronary artery disease

CAH

congenital adrenal hyperplasia

CBD

common bile duct, cortico‐basal degeneration

CBT

cognitive behavioural therapy

CCDC

consultant in communicable disease control

CCP

cyclic citrullinated peptide

CCU

coronary care unit

CGD

chronic granulomatous disease

CEA

carcinoembryonic antigen

CF

cystic fibrosis

CFA

cystic fibrosis alveolitis

CFS

chronic fatigue syndrome

CFTR

cystic fibrosis transmembrane conductance regulator

cGMP

cyclic guanosine monophosphate

CHAD

cold haemagglutinin disease

CHART

continuous hyperfractionated accelerated radiotherapy

CHD

congenital heart disease

CIDP

chronic idiopathic demyelinating polyneuropathy

CIDP

chronic inflammatory demyelinating neuropathy

CJD

Creutzfeldt–Jakob disease

CK

CKD

creatine kinase chronic kidney disease

CLL

chronic lymphoblastic leukaemia

CMC

carpometacarpal

CML

chronic myeloid leukaemia

CMV

cytomegalovirus

CNS

central nervous system

CO

2

carbon dioxide

COAD

chronic obstructive airway disease

COPD

chronic obstructive pulmonary disease

COX

cyclo‐oxygenase

cP

centipoise

CPAP

continuous positive airway pressure

CPK

CPM

creatine phosphokinase central pontine myelinolysis

CPR

cardiopulmonary resuscitation

CREST

calcinosis, Raynaud's, oesophagitis, sclerodactyly telangiectasia

CRH

corticotrophin‐releasing hormone

CRP

C‐reactive protein

CRVO

central retinal vein occlusion

CS

Churg–Strauss

CSM

carotid sinus massage

CSF

cerebrospinal fluid

CT

computed tomography

CTPA

computerised tomographic pulmonary angiography

CVA

cerebrovascular accident

CVID

common variable immunodeficiency

CVP

central venous pressure

CWP

coal worker's pneumoconiosis

CXR

chest X‐ray

CYP

cytochrome P450

D&V

diarrhoea and vomiting

DC

direct current

ddAVP

deamino‐D‐arginine vasopressin

DEXA

dual emission X‐ray absorptiometry

DH

dermatitis herpetiformis

DHEA

dehydroepiandrosterone

DHF/DSS

dengue haemorrhagic fever/dengue shock syndrome

DIC

disseminated intravascular coagulation

DIF

direct immunofluorescence

DIP

desquamative interstitial pneumonia, distal interphalangeal

DKA

diabetic ketoacidosis

DLB

dementia with Lewy bodies

DM

dermatomyositis, diabetes mellitus

DMARD

disease‐modifying antirheumatic drug

DMSA

[

99m

Tc] mercaptosuccinic acid

DNA

deoxyribonucleic acid

DNAR

‘do not attempt resuscitation’

dsDNA

DOAC

double‐stranded DNA direct oral anticoagulant

DU

duodenal ulcer

DVT

deep venous thrombosis

EAA

extrinsic allergic alveolitis

EBV

Epstein–Barr virus

ECG

electrocardiogram

EEG

electroencephalograph

EGFR

eGPA

epidermal growth factor receptor eosinophilic granulomatosis with polyangiitis

ELISA

enzyme‐linked immunosorbent assay

EM

electron microscopy

EMA

endomysial antibodies, eosin 5‐maleimide

EMG

electromyography

EN

erythema nodosum

ENT

ear, nose, throat

EPAP

EPO

expiratory positive airway pressure erythropoietin

ER

endoplasmic reticulum

ERA

enteric reactive arthritis

ERCP

endoscopic retrograde cholangiopancreatography

ESR

erythrocyte sedimentation rate

ESRF

end‐stage renal failure

ET

essential thrombocythaemia

EUS

endoscopic ultrasound

EVL

endoscopic variceal ligation

FAB

French–American–British classification

FBC

full blood count

FDP

fibrin degradation product

FEV

1

forced expiratory volume in 1s

FFA

free fatty acid

FFP

fresh frozen plasma

FNAC

fine needle aspiration cytology

FOB

faecal occult blood

FPG

fasting plasma glucose

FRC

functional residual capacity

FSGS

focal segmental glomerulosclerosis

FSH

follicle‐stimulating hormone

FTD

frontotemporal dementia

5FU

5‐fluorouracil

FUO

fever of unknown origin

FVC

forced vital capacity

G6PD

glucose‐6‐phosphate dehydrogenase

GABA

γ‐aminobutyric acid

GBM

glomerular basement membrane

GCS

Glasgow Coma Scale

GFR

GGT

glomerular filtration rate gamma‐glutamyl transferase

GH

GHRH

growth hormone GH‐releasing hormone

GI

gastrointestinal

GN

glomerulonephritis

GnRH

gonadotrophin‐releasing hormone

GORD

gastro‐oesophageal reflux disease

GP

GPA

general practitioner granulomatosis with polyangiitis

GPI

glycosyl‐phosphatidylinositol

γ

‐GT

γ‐glutamyl transferase

GTN

glyceryl trinitrate

GU

genitourinary

HAART

highly active anti‐retroviral therapy

HAV

hepatitis A virus

Hb

HBOC

haemoglobin hereditary breast and ovarian cancer

HBsAg

hepatitis B surface antigen

HBV

hepatitis B virus

HCC

hepatocellular carcinoma

hCG

human chorionic gonadotrophin

Hct

haematocrit

HCV

hepatitis C virus

HD

Huntington's disease

HDL

high‐density lipoprotein

HFE

HHS

haemochromatosis gene hyperosmolar hyperglycaemic state

HHV

human herpes virus

5‐HIAA

5‐hydroxyindoleacetic acid

HIB

Haemophilus influenzae

B

HIT

heparin‐induced thrombocytopenia

HIV

human immunodeficiency virus

HLA

human leukocyte antigen

HMG‐CoA

hydroxymethyl‐glutaryl coenzyme A

HMSN

hereditary motor and sensory neuropathy

HNPCC

hereditary non‐polyposis colon cancer

HOCM

hypertrophic obstructive cardiomyopathy

HPV

human papillomavirus

HR

heart rate

HRCT

high‐resolution computed tomography

HRT

hormone replacement therapy

HSP

Henoch–Schönlein purpura

HSV

herpes simplex virus

HSV

highly selective vagotomy

5‐HT

5‐hydroxytryptamine (serotonin)

HTLV

human T‐cell leukaemia virus

HUS

haemolytic uraemic syndrome

IBD

inflammatory bowel disease

IBS

inflammatory bowel syndrome

ICD

implantable cardioverter defibrillator

Ig

immunoglobulin

IGF

IGRA

insulin growth factor interferon gamma release assay

IHD

ischaemic heart disease

IL

interleukin

IM

intramuscular

INR

international normalised ratio

IOP

intraocular pressures

IPAP

inspiratory positive airway pressure

IPPV

intermittent positive pressure ventilation

IPSS

inferior petrosal sinus sampling

ITP

immune thrombocytopenic purpura

ITU

intensive therapy unit

IV

intravenous

IVC

inferior vena cava

IVIG

intravenous immunoglobulin

IVU

intravenous urogram

JVP

jugular venous pressure

KCl

potassium chloride

KOH

potassium hydroxide

KS

Kaposi's sarcoma

LA

left artery

LAD

LBD

left anterior descending (coronary artery) Lewy body dementia

LDH

lactate dehydrogenase

LDL

low‐density lipoprotein

LFT

liver function test

LH

luteinising hormone

LMW

low molecular weight

LMWH

low‐molecular‐weight heparin

LN

lymph nodes

LP

lumbar puncture

LSD

lysergic acid diethylamide

LTOT

long‐term oxygen therapy

LUQ

left upper quadrant

LV

LVF

left ventricle, left ventricular left ventricular failure

LVH

left ventricular hypertrophy

MAC

Mycobacterium avium‐intracellulare

complex

MALT

MAP

mucosa‐associated lymphoid tissue mean arterial pressure

MCA

middle cerebral artery

MCP

metacarpophalangeal

M,C&S

microscopy, culture and sensitivity

MCV

mean cell volume

MDS

myelodysplastic syndrome

MDT

multidisciplinary team

ME

myalgic encephalomyelitis

MELAS

mitochondrial encephalopathy, lactic acidosis, stroke‐like episodes

MEN

multiple endocrine neoplasia

MET

medical emergency team

MGUS

monoclonal gammopathy of uncertain significance

MHC

major histocompatibility complex

MI

myocardial infarction

MMSE

mini mental state examination

MND

motor neuron disease

MODY

maturity‐onset diabetes in the young

MPS

myocardial perfusion scan

MR

MRC

mitral regurgitation Medical Research Council

MRCP

magnetic resonance cholangiopancreatography/cholangiogram

MRI

magnetic resonance imaging

MRSA

methicillin‐resistant

Staphylococcus aureus

MS

multiple sclerosis

MSA

multiple system atrophy

MSU

midstream urine

MTC

medullary thyroid cancer

MTP

metatarsophalangeal

MUS

MuSK

medically unexplained symptom muscle‐specific tyrosine kinase receptors

MV

mechanical ventilation

MVP

NAAION

NAAT

mitral valve prolapse non‐arteritic anterior ischaemic optic neuropathy nucleic acid amplification testing

NaCl

sodium chloride

NADPH

reduced nicotinamide adenine dinucleotide phosphate

NG

nasogastric

NGU

non‐gonococcal urethritis

NHL

non‐Hodgkin's lymphoma

NHS

NILS

National Health Service non‐invasive liver screen

NIV

non‐invasive ventilation

NO

nitric oxide

nocte

at night

NPV

negative pressure ventilation

NSAID

non‐steroidal anti‐inflammatory drug

OA

osteoarthritis

OCD

obsessive compulsive disorder

OCP

oral contraceptive pill

od

omni die

(once a day)

OGD

oesophago‐gastroduodenoscopy

OGTT

oral glucose tolerance test

OSA

obstructive sleep apnoea

PAN

p‐ANCA

polyarteritis nodosa perinuclear staining antineutrophil cytoplasmic antibodies

PBC

primary biliary cirrhosis

PCI

percutaneous coronary intervention

PCOS

polycystic ovary syndrome

PCP

phencyclidine,

Pneumocystis carinii

pneumonia

PCR

PCT

PCWP

polymerase chain reaction porphyria cutanea tarda pulmonary capillary wedge pressure

PD

Parkinson's disease

PDA

patent ductus arteriosus

PE

pulmonary embolism

PEA

pulseless electrical activity

PEEP

positive end‐expiratory pressure

PEFR

peak expiratory flow rate

PEG

percutaneous endoscopic gastrostomy

PEG

polyethylene glycol

PET

positron emission tomography

PION

posterior ischaemic optic neuropathy

PIP

proximal interphalangeal

PM

polymyositis

PML

progressive multifocal leukoencephalopathy

PMR

polymyalgia rheumatica

PNH

paroxysmal nocturnal haemoglobinuria

PNS

po

peripheral nervous system

per os

(by mouth)

PPAR‐

γ

peroxisome proliferator‐activated receptor γ

PPI

proton pump inhibitor

PR

per rectum

PRL

prolactin

PRV

polycythaemia rubra vera

PS

psychoactive substance

PSA

prostate‐specific antigen

PSC

PSP

primary sclerosing cholangitis progressive supranuclear palsy

PT

prothrombin time

PTCA

percutaneous transluminal coronary angioplasty

PTH

PTLD

parathyroid hormone post‐transplant lymphoproliferative disorder

PUVA

psoralens and ultraviolet A

PV

polycythaemia vera, plasma viscosity

QDS

quater die sumendum

(4 times a day)

RA

rheumatoid arthritis, right atrium

RBBB

right bundle branch block

RBC

red blood cell

RCC

red cell count

RCT

randomised controlled trial

REM

rapid eye movement

RF

rheumatoid factor

RNA

ribonucleic acid

RP

retinitis pigmentosa

RPGN

rapidly progressive glomerulonephritis

RR

respiratory rate

RUQ

right upper quadrant

RV

right ventricle, right ventricular

RVH

right ventricular hypertrophy

SACD

subacute combined degeneration of the cord

SAH

subarachnoid haemorrhage

SARA

sexually acquired reactive arthritis

SBE

subacute bacterial endocarditis

SBP

spontaneous bacterial peritonitis

SCC

squamous cell carcinoma

SCID

severe combined immunodeficiency

SCLC

small cell lung cancer

SDH

SGLT2

subdural haemorrhage sodium‐glucose co‐transporter 2

SIADH

SIMV

syndrome of inappropriate antidiuretic hormone secretion synchronised intermittent mandatory ventilation

SLA

soluble liver antigen

SLE

systemic lupus erythematosus

SMA

smooth muscle actin antibody

SOB

shortness of breath

SPB

spontaneous bacterial peritonitis

SRH

stigmata of recent haemorrhage

SSRIs

selective serotonin reuptake inhibitors

STD

sexually transmitted disease

STEMI

ST segment elevation myocardial infarction

SVC

superior vena cava

SVCO

superior vena cava obstruction

SVR

sustained viral response

SVT

supraventricular tachyarrhythmia, supraventricular tachycardia

T3

triiodothyronine

T4

thyroxine

TB

tuberculosis

tds

ter die sumendus

(3 times a day)

TED

thyroid eye disease

TEN

toxic epidermal necrolysis

TGF

transforming growth factor

TIA

transient ischaemic attack

TIBC

total iron‐binding capacity

TIMI

thrombolysis in myocardial infarction

TIPSS

transjugular intrahepatic portosystemic shunt

TLC

TLCO

total lung capacity transfer factor of the lung for carbon monoxide

TMJ

temporomandibular joint

TNF

tumour necrosis factor

tPA

tissue plasminogen activator

TPN

TRALI

total parenteral nutrition transfusion‐related acute lung injury

TRUS

transrectal ultrasonography

TSH

TST

thyroid‐stimulating hormone tuberculin skin test

TT

thrombin time

TTE

transthoracic echocardiogram

TTP

thrombotic thrombocytopenic purpura

TURP

transurethral resection of the prostate

U&Es

urea and electrolytes

UC

ulcerative colitis

UFC

urinary free cortisol

UFH

unfractionated heparin

UIP

usual interstitial pneumonia

URTI

upper respiratory tract infection

US

ultrasound

UTI

urinary tract infection

UVA

ultraviolet A

UVB

VAP

ultraviolet B ventilator‐associated pneumonia

VC

vital capacity

VEGF

vascular endothelium growth factor

VEP

visual evoked potential

VF

ventricular fibrillation

VHL

Von Hippel–Lindau syndrome

VIN

vulval intraepithelial neoplasia

VIP

vasoactive intestinal peptide

VLDL

very‐low‐density lipoprotein

V/Q

ventilation/perfusion

VSD

ventricular septal defect

VT

ventricular tachycardia

VWD

von Willebrand's disease

vWF

von Willebrand's factor

VZV

varicella‐zoster virus

WCC

white cell count

WHO

World Health Organization

WoB

work of breathing

WPW

Wolff–Parkinson–White