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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
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
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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.
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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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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Limit of Liability/Disclaimer of WarrantyThe contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting scientific method, diagnosis, or treatment by physicians for any particular patient. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. While the publisher and authors have used their best efforts in preparing this work, they make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of merchantability or fitness for a particular purpose. No warranty may be created or extended by sales representatives, written sales materials or promotional statements for this work. This work is sold with the understanding that the publisher is not engaged in rendering professional services. The advice and strategies contained herein may not be suitable for your situation. You should consult with a specialist where appropriate. The fact that an organization, website, or product is referred to in this work as a citation and/or potential source of further information does not mean that the publisher and authors endorse the information or services the organization, website, or product may provide or recommendations it may make. Further, readers should be aware that websites listed in this work may have changed or disappeared between when this work was written and when it is read. Neither the publisher nor authors shall be liable for any loss of profit or any other commercial damages, including but not limited to special, incidental, consequential, or other damages.
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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
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
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