Cases for PACES

Foreword ix Preface x Acknowledgements xi Abbreviations xii Advice xv Station 1: Abdominal and Respiratory 1 Clinical mark sheet 1 Chronic liver disease and hepatomegaly 2 Haemochromatosis 5 Splenomegaly 7 Renal enlargement 9 The liver transplant patient 11 The renal patient 12 Pulmonary fibrosis 14 Bronchiectasis 16 Old tuberculosis 17 Surgical respiratory cases 18 Chronic obstructive airways disease 19 Pleural effusion 21 Lung cancer 22 Cystic fibrosis 24 Pneumonia 25 Station 2: History Taking 27 Clinical mark sheet 27 Introduction and advice 28 Case 1 32 Case 2 33 Case 3 34 Case 4 35 Case 5 36 Case 6 37 Case 7 38 Case 8 39 Case 9 40 Case 10 41 Case 11 42 Case 12 43 Station 3: Cardiology and Neurology 44 Clinical mark sheet 44 Aortic stenosis 45 Aortic incompetence 47 Mitral stenosis 49 Mitral incompetence 51 Tricuspid incompetence 53 Pulmonary stenosis 54 Prosthetic valves: aortic and mitral 55 Implantable devices 57 Pericardial disease 58 Other Common Congenital Defects 60 Atrial septal defect 60 Ventricular septal defect 61 Hypertrophic (obstructive) cardiomyopathy 63 Dystrophia myotonica 65 Cerebellar syndrome 67 Multiple sclerosis 69 Stroke 71 Lateral medullary (Wallenberg) syndrome 74 Spastic legs 75 Syringomyelia 77 Motor neurone disease 79 Parkinson’s disease 81 Hereditary sensory motor neuropathy 83 Friedreich’s ataxia 84 Facial nerve palsy 85 Myasthenia gravis 86 Tuberous sclerosis 88 Neurofibromatosis 89 Abnormal pupils 90 Optic atrophy 92 Retinal Patholo gy 93 Age]related macular degeneration (AMD) 93 Retinitis pigmentosa 94 Retinal artery occlusion 95 Retinal vein occlusion 96 Station 4: Ethics Law and Communication Skills 97 Clinical mark sheet 97 Ethics And Law In Medicine 98 Principles of medical ethics 98 Medico]legal system 99 Negligence 100 Competency and consent 101 Confidentiality 104 End of life decisions 105 Communication skills 107 Dealing with a difficult patient 108 Driving restrictions 109 Information delivery 110 Worked examples 111 Sample questions 116 Station 5: Brief Clinical Consultations 117 Clinical mark sheet 117 Chest pain 119 Headache 121 Swollen calf 123 Altered conscious state 124 Anaemia 125 Osler–Weber–Rendu syndrome (hereditary haemorrhagic telangiectasia) 127 Haemoptysis 128 Worsening mobility 129 Persistent fever 131 Dyspnoea 133 Syncope 135 Atrial fibrillation 137 Inflammatory bowel disease 139 Hypertension 141 Red rashes 143 Leg ulcers 146 Diabetes and the skin 148 Erythema nodosum 150 Henoch–Schonlein purpura 151 Skin malignancy 152 Skin and hyperextensible joints 154 Rheumatoid arthritis 156 Systemic lupus erythematosus 159 Systemic sclerosis 161 Ankylosing spondylitis 163 Marfan’s syndrome 164 Paget’s disease 165 Other joint problems 166 Diabetic retinopathy 168 Hyperthyroidism and Graves’ disease 171 Hypothyroidism 173 Acromegaly 174 Cushing’s disease 176 Addison’s disease 178 Sickle cell disease 180 Index 182