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Clinical Cases & Pearls in Medicine
GS Sainani
PART 1: CLINICAL CASES IN MEDICINE
SECTION 1:
Gastroenterology
CASE 1: ACHALASIA CARDIA
SALIENT CLINICAL FEATURES
CASE 2: HIATUS HERNIA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
MANAGEMENT
Medical
Surgical
CASE 3: CIRRHOSIS OF LIVER
INTRODUCTION
ETIOLOGICAL CAUSES
CLINICAL FEATURES
HISTOPATHOLOGY
INVESTIGATIONS
COMPLICATIONS
PROGNOSIS
MANAGEMENT OF CIRRHOSIS LIVER
MANAGEMENT OF HEMATEMESIS
MANAGEMENT OF HEPATIC ENCEPHALOPATHY
CASE 4: PRIMARY BILIARY CIRRHOSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
MANAGEMENT
Drugs to Treat Pruritus
Drugs to Treat Primary Biliary Cirrhosis
CASE 5: WILSON'S DISEASE
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
Use Copper Chelating Agents
CASE 6: HEPATOMEGALY
CAUSES OF LIVER ENLARGEMENT
Congestive
Cirrhosis Liver (Posthepatitis, Biliary)
Blood Disorders
Toxic
Infiltrative Diseases
Tumors
Granulomas
INVESTIGATIONS
CASE 7: SPLENOMEGALY
CAUSES OF MILD SPLENIC ENLARGEMENT
CAUSES OF MODERATE TO SEVERE SPLENIC ENLARGEMENT
CAUSES OF MASSIVE (GROSS) SPLENOMEGALY
CASE 8: FELTY'S SYNDROME
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PROGNOSIS
MANAGEMENT
CASE 9: HEPATOSPLENOMEGALY
INTRODUCTION
PHYSICAL EXAMINATION
INVESTIGATIONS
CASE 10: ASCITES
INTRODUCTION
CAUSES OF ASCITES
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
PRINCIPLES OF TREATMENT
CASE 11: JAUNDICE
INTRODUCTION
CLASSIFICATION
SALIENT CLINICAL FEATURES
Abdomen Examination
INVESTIGATIONS
CASE 12: NONCIRRHOTIC PORTAL FIBROSIS (NCPF)
PREVALENCE
ETIOPATHOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 13: TUBERCULOSIS OF ABDOMEN
INTRODUCTION
Intestinal Tuberculosis
SALIENT CLINICAL FEATURES
Symptoms
Signs
Peritoneal Tuberculosis
Glandular Tuberculosis
INVESTIGATIONS IN A CASE OF TB ABDOMEN
DIAGNOSIS
MANAGEMENT
CASE 14: CROHN'S DISEASE
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
COMPLICATIONS
MANAGEMENT
CASE 15: ULCERATIVE COLITIS
PATHOPHYSIOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
Cancer
Systemic Complications of Inflammatory Bowel Disease (Ulcerative Colitis and Crohn's Disease)
MANAGEMENT
Ulcerative Colitis
CASE 16: AMEBIC LIVER ABSCESS
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
COMPLICATIONS
MANAGEMENT
CASE 17: HEMOCHROMATOSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
SECTION 2:
Respiratory System
CASE 1: BRONCHIAL ASTHMA
INTRODUCTION
ETIOLOGICAL FACTORS
SALIENT CLINICAL FEATURES
TYPES OF BRONCHIAL ASTHMA
INVESTIGATIONS
MANAGEMENT OF BRONCHIAL ASTHMA
MANAGEMENT OF STATUS ASTHMATICS
CASE 2: CHRONIC BRONCHITIS
DEFINITION
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
MANAGEMENT PRINCIPLES OF ACUTE EXACERBATION OF CHRONIC BRONCHITIS
CASE 3: EMPHYSEMA
DEFINITION
HISTORY
PHYSICAL EXAMINATION
INVESTIGATIONS
PRINCIPLES OF MANAGEMENT
CASE 4: CHRONIC OBSTRUCTIVE PULMONARY DISEASE
DEFINITION
CAUSES OF COR PULMONALE
Lung Diseases
Pulmonary Vascular Disorders
SALIENT PHYSICAL EXAMINATION
INVESTIGATIONS
COMPLICATIONS
PRINCIPLES OF MANAGEMENT
Medical
Surgery
CASE 5: BRONCHIECTASIS
DEFINITION
CAUSES OF BRONCHIECTASIS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS OF BRONCHIECTASIS
PRINCIPLES OF MANAGEMENT
Medical
Surgical
CASE 6: LUNG ABSCESS
ETIOLOGICAL CAUSES
CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
Medical
Surgical
CASE 7: PNEUMONIC CONSOLIDATION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
COMPLICATIONS OF PNEUMONIA
MANAGEMENT
CASE 8: COLLAPSE LUNG
TYPES OF COLLAPSE
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 9: PULMONARY FIBROSIS
ETIOLOGICAL FACTORS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PRINCIPLES OF TREATMENT
CASE 10: FIBROSING ALVEOLITIS (INTERSTITIAL PULMONARY FIBROSIS)
SALIENT CLINICAL FEATURES
Commonest Symptoms and Signs
PATHOLOGY OF FIBROSING ALVEOLITIS
IMPORTANT INVESTIGATIONS
PRINCIPLES OF MANAGEMENT
CASE 11: CYSTIC FIBROSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
Neonates
Children and Adults
INVESTIGATIONS
PROGNOSIS
MANAGEMENT
Respiratory
Gastrointestinal (Particularly Treatment of Steatorrhea)
CASE 12: PULMONARY TUBERCULOSIS
PRIMARY PULMONARY TUBERCULOSIS
POSTPRIMARY TUBERCULOSIS
INVESTIGATIONS
MANAGEMENT
Drugs
CASE 13: BRONCHOGENIC CARCINOMA
ETIOLOGY
WHO CLASSIFICATION OF HISTOPATHOLOGICAL TYPES
CLINICAL FEATURES
Nonmetastatic Manifestations (Paraneoplastic Manifestations)
ON EXAMINATION
INVESTIGATIONS
PROGNOSIS
TREATMENT
Small Cell Carcinoma
Nonsmall Cell Carcinoma
CASE 14: PLEURISY
INTRODUCTION
ETIOLOGICAL FACTORS
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
CASE 15: PNEUMOTHORAX
DEFINITION
TYPES AND CAUSES
Clinical Types
HISTORY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 16: HYDROPNEUMOTHORAX
INVESTIGATIONS
CASE 17: SARCOIDOSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
Chest X-ray Staging
Prognosis and Treatment
CASE 18: PICKWICKIAN SYNDROME (OBESITY HYPOVENTILATION SYNDROME)
PRESENTING COMPLAINTS
PHYSICAL EXAMINATION
INVESTIGATIONS
MANAGEMENT
Medical
Surgical Treatment
CASE 19: ACUTE RESPIRATORY DISTRESS SYNDROME
INTRODUCTION
PREDISPOSING CAUSES
PATHOGENESIS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 20: SUPERIOR VENA CAVA OBSTRUCTION SYNDROME: SUPERIOR MEDIASTINAL SYNDROME
CAUSES OF SVC OBSTRUCTION
SYMPTOMS
SIGNS
INVESTIGATIONS
MANAGEMENT
CASE 21: EMPYEMA
INTRODUCTION
ETIOPATHOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PRINCIPLES OF MANAGEMENT
SECTION 3:
Cardiovascular System
CASE 1: ACUTE RHEUMATIC FEVER
INTRODUCTION
SALIENT CLINICAL FEATURES
Major Criteria
Minor Criteria
Laboratory Investigations
MANAGEMENT
Treatment of Group A Streptococcus Infection
Symptomatic Treatment
Prevention
CASE 2: MITRAL STENOSIS
INTRODUCTION
ETIOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
Electrocardiogram
Chest X-ray
2D Echocardiogram
Cardiac Catheterization
DIFFERENTIAL DIAGNOSIS
COMPLICATIONS
PROGNOSIS
TREATMENT
Medical
Indications for Surgery in MS
Surgical
CASE 3: MITRAL REGURGITATION
INTRODUCTION
ETIOLOGICAL CAUSES
CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS OF RHEUMATIC MITRAL REGURGITATION
MANAGEMENT
Medical
Surgical
CASE 4: AORTIC STENOSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Signs
ETIOLOGICAL CAUSES OF VALVULAR AORTIC STENOSIS
INVESTIGATIONS
COMPLICATIONS
TREATMENT
Medical
Surgical
CASE 5: AORTIC REGURGITATION
INTRODUCTION
SALIENT CLINICAL FEATURES OF AORTIC REGURGITATION
Symptoms
Signs
INVESTIGATIONS
Chest X-ray
ECG
2D Echo
Cardiac Catheterization and Coronary Angiography
COMPLICATIONS
TREATMENT
Medical
Surgical
CASE 6: MITRAL STENOSIS AND MITRAL REGURGITATION
INTRODUCTION
SALIENT CLINICAL FEATURES
MANAGEMENT
Medical
Surgical
CASE 7: AORTIC STENOSIS AND AORTIC REGURGITATION
INTRODUCTION
SALIENT CLINICAL FEATURES
MANAGEMENT
Medical
Surgical
CASE 8: MITRAL STENOSIS AND AORTIC REGURGITATION
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
Medical
Surgical
CASE 9: TRICUSPID STENOSIS
INTRODUCTION
Etiological Causes
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
DIFFERENTIAL POINTS
MANAGEMENT
CASE 10: TRICUSPID REGURGITATION
ETIOPATHOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 11: INFECTIVE ENDOCARDITIS
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
TREATMENT
CASE 12: SYSTEMIC HYPERTENSION
SALIENT CLINICAL FEATURES
History
Symptoms
CLASSIFICATION
CLINICAL EXAMINATION
INVESTIGATIONS
BROAD PRINCIPLES OF MANAGEMENT OF HYPERTENSION
CASE 13: SECONDARY HYPERTENSION
INTRODUCTION
Causes of Secondary Hypertension
Endocrine Causes (2%)
Miscellaneous
CASE 14: CONGESTIVE CARDIAC FAILURE (CCF)
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT OF VENTRICULAR SYSTOLIC DYSFUNCTION AND HEART FAILURE
CASE 15: ANGINA PECTORIS
CHRONIC STABLE ANGINA
Salient Clinical Features
Investigations
Management
PRINZMETAL'S VARIANT ANGINA (CORONARY VASOSPASM)
UNSTABLE ANGINA
CASE 16: ACUTE MYOCARDIAL INFARCTION (ST SEGMENT ELEVATION MYOCARDIAL INFARCTION) (STEMI)
SALIENT CLINICAL FEATURES
LOCALIZATION OF STEMI BY ECG
CARDIAC ENZYMES AND BIOMARKERS
COMPLICATIONS
MEDICAL MANAGEMENT
Analgesics
Antithrombotic Therapy
Antianginal Therapy
Reperfusion Therapy
Primary Percutaneous Coronary Intervention (PCI)
Thrombolysis
PERICARDITIS
TYPES OF PERICARDITIS
ETIOLOGICAL FEATURES
CASE 17: ACUTE FIBRINOUS PERICARDITIS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT OF ACUTE FIBRINOUS PERICARDITIS
CASE 18: PERICARDITIS WITH EFFUSION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
TREATMENT
CASE 19: CHRONIC CONSTRUCTIVE PERICARDITIS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
CARDIOMYOPATHIES
WHO CLASSIFICATION OF CARDIOMYOPATHY (FIG. 3.29)
CASE 20: DILATED CARDIOMYOPATHY
INTRODUCTION
ETIOLOGICAL CAUSES
CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
CASE 21: RESTRICTIVE CARDIOMYOPATHY
SALIENT CLINICAL FEATURES
CASE 22: HYPERTROPHIC CARDIOMYOPATHY
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS OF HOCM
MANAGEMENT
CASE 23: ATRIAL FIBRILLATION
SALIENT CLINICAL FEATURES
CAUSES OF ATRIAL FIBRILLATION
INVESTIGATIONS
COMPLICATIONS
MANAGEMENT
CASE 24: TACHYARRHYTHMIAS
SALIENT CLINICAL FEATURES
IMPORTANT PHYSICAL EXAMINATION
INVESTIGATIONS
CASE 25: BRADYCARDIA
IMPORTANT CLINICAL FEATURES
CAUSES OF BRADYCARDIA
CASE 26: PROSTHETIC HEART VALVES
CASE 27: RAISED JUGULAR VENOUS PRESSURE
CASE 28: DEXTROCARDIA
SALIENT CLINICAL FEATURES
CASE 29: ATRIAL SEPTAL DEFECT
INTRODUCTION
SALIENT CLINICAL FEATURES
Ostium Secundum
Ostium Primum
Sinus Venosus
INVESTIGATIONS IN ASD
ECG
X-ray Chest
Echocardiography
Cardiac Catheterization
Management
CASE 30: VENTRICULAR SEPTAL DEFECT
INTRODUCTION
Types of VSDs
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
PROGNOSIS
TREATMENT
CASE 31: PATENT DUCTUS ARTERIOSUS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 32: COARCTATION OF AORTA
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
Medical
Surgical
CASE 33: PULMONARY STENOSIS
SALIENT CLINICAL FEATURES
TYPES OF PULMONARY STENOSIS
INVESTIGATIONS
COMPLICATIONS
MANAGEMENT OF PULMONARY STENOSIS
CASE 34: FALLOT'S TETRALOGY
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS OF THE FALLOT'S TETRALOGY
MANAGEMENT
CASE 35: EISENMENGER'S SYNDROME AND EISENMENGER'S COMPLEX
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Physical Examination
INVESTIGATIONS
COMPLICATIONS OF EISENMENGER'S SYNDROME
MANAGEMENT
CASE 36: EBSTEIN'S ANOMALY
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
Medical
Surgical
INDICATION FOR SURGERY
CASE 37: AORTOARTERITIS (TAKAYASU'S ARTERITIS)
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TYPES OF TAKAYASU'S ARTERIES
MANAGEMENT
Medical
Surgical
CASE 38: DISSECTING ANEURYSMS OF AORTA
INTRODUCTIONS
TYPES OF DISSECTING ANEURYSMS OF AORTA (FIG. 3.59)
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 39: MITRAL VALVE PROLAPSE (MVP)
SALIENT CLINICAL FEATURE
INVESTIGATIONS
COMPLICATIONS OF MITRAL VALVE PROLAPSE
ASSOCIATED CONDITIONS WITH MITRAL VALVE PROLAPSE
MANAGEMENT OF MITRAL VALVE PROLAPSE
CASE 40: PRIMARY PULMONARY HYPERTENSION
IMPORTANT CLINICAL FEATURES
INVESTIGATIONS
PROGNOSIS
PRINCIPLES OF TREATMENT
CASE 41: AORTIC ANEURYSM
INTRODUCTION
ETIOPATHOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PRINCIPLES OF MANAGEMENT
CASE 42: ABDOMINAL AORTIC ANEURYSM
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Physical Signs
INVESTIGATIONS
MANAGEMENT
SECTION 4:
Nephrology
CASE 1: NEPHROTIC SYNDROME
INTRODUCTION
ETIOPATHOLOGICAL FACTORS
SALIENT CLINICAL FEATURES
INVESTIGATIONS TO ASCERTAIN ETIOLOGY OF THE DISEASE
ASSESSMENT OF NEPHROTIC SYNDROME FOR SEVERITY OF DISEASE
PROGNOSIS
COMPLICATIONS
MANAGEMENT
VIVA VOCE
CASE 2: UREMIA (CHRONIC RENAL FAILURE)
INTRODUCTION
CAUSES
SALIENT CLINICAL MANIFESTATIONS
Stages of Chronic Renal Failure
INVESTIGATIONS
ETIOLOGICAL DIAGNOSIS
MANAGEMENT
CASE 3: POLYCYSTIC KIDNEY DISEASE
INTRODUCTION
SALIENT CLINICAL FEATURES OF ADULT POLYCYSTIC KIDNEYS
INVESTIGATIONS
MANAGEMENT
CASE 4: UNILATERAL PALPABLE KIDNEY
CAUSES OF PALPABLE KIDNEY ON ONE SIDE
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 5: ACUTE RENAL FAILURE
INTRODUCTION
CAUSES OF ACUTE RENAL FAILURE
Prerenal
Intrarenal Failure
Postrenal Failure
CASE 6: ACUTE TUBULAR NECROSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
Course
COMPLICATIONS
MANAGEMENT
CASE 7: HYPERNEPHROMA (RENAL ADENOCARCINOMA)
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
PROGNOSIS
SECTION 5:
Neurology
CASE 1: THIRD CRANIAL NERVE
ANATOMY
ETIOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
CASE 2: FOURTH CRANIAL NERVE
ANATOMY
SALIENT CLINICAL FEATURES
CASE 3: SIXTH CRANIAL NERVE (ABDUCENS NERVE)
ANATOMY
ETIOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
Symptoms
Signs
CASE 4: FIFTH CRANIAL NERVE
ANATOMY
DIVISIONS OF THE 5TH CRANIAL NERVE
SALIENT CLINICAL FEATURES
EXAMINATION OF 5TH CRANIAL NERVE
Motor Functions
Reflexes
Jaw Jerk
Glabella Reflex
CASE 5: SEVENTH CRANIAL NERVE
ANATOMY
SALIENT FEATURES OF PALSY [LOWER MOTOR NEURON (LMN)]
PHYSICAL EXAMINATION
PROGNOSIS OF BELL'S PALSY
MANAGEMENT OF BELL'S PALSY
CASE 6: TWELFTH CRANIAL NERVE
ANATOMY
EXAMINATION OF 12TH NERVE
CASE 7: EPILEPSY
HISTORY
TYPES OF EPILEPSY
PHYSICAL EXAMINATION
INVESTIGATIONS
PROGNOSIS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
CASE 8: STATUS EPILEPTICUS
SALIENT CLINICAL FEATURES
MANAGEMENT OF STATUS EPILEPTICUS
Antiseizure Drugs
CASE 9: SPEECH DISORDERS
ANATOMY
Motor Speech Area
Sensory Speech Area (Wernicke's Area)
DISTURBANCES OF ARTICULATION (DYSARTHRIA)
DISTURBANCES OF SPEECH—APHASIAS
CASE 10: PARIETAL LOBE SYNDROME
FUNCTIONS OF PARIETAL LOBE
DOMINANT PARIETAL LOBE
SALIENT FEATURES OF NONDOMINANT PARIETAL LOBE
CASE 11: ABNORMAL GAIT
ABNORMAL GAITS
Spastic Paraplegic Gait
Spastic Hemiplegic Gait
Festinant Gait
Sensory Ataxic Gait
Cerebellar Ataxic Gait
Waddling Gait
Hysterical Gait
Limping Gait
Spastic-ataxic Gait
High Stepping Gait
CASE 12: HEMIPLEGIA
INTRODUCTION
ETIOLOGICAL CAUSES OF CEREBROVASCULAR EPISODES
RISK FACTORS FOR THROMBOTIC STROKE
CLINICAL EXAMINATION
PRINCIPLES OF MANAGEMENT OF STROKE
CASE 13: PARAPLEGIA
INTRODUCTION
CAUSES
(A) Cerebral Pathology
(B) Spinal Cord Pathology
(C) Roots and Peripheral Nerves
(D) Diseases of Muscles, e.g. Poliomyelitis
CASE 14: SPASTIC PARAPLEGIA (PARAPLEGIA IN EXTENSION)
CENTRAL NERVOUS SYSTEM EXAMINATION
Motor System
CASE 15: SPINAL CORD COMPRESSION
CAUSES OF EXTRADURAL COMPRESSION
Salient Clinical Features of Extradural Compression
CAUSES OF INTRADURAL–EXTRAMEDULLARY COMPRESSION
Salient Clinical Features of Intradural–Extramedullary Compression
CAUSES OF INTRADURAL– INTRAMEDULLARY COMPRESSION
Salient Clinical Features of Intradural– Intramedullary Compression
Investigations of Spinal Cord Compression
TREATMENT OF SPINAL CORD COMPRESSION
CASE 16: CONUS MEDULLARIS AND CAUDA EQUINA SYNDROME
INTRODUCTION
CAUSES AND SALIENT CLINICAL FEATURES OF CONUS MEDULLARIS
CAUSES AND FEATURES OF CAUDA EQUINA SYNDROME
COMBINED CONUS MEDULLARIS AND CAUDA EQUINA LESIONS
CASE 17: BROWN SEQUARD SYNDROME (HEMISECTION OF THE SPINAL CORD)
SALIENT CLINICAL FEATURES
CAUSES OF HEMISECTION OF CORD
CASE 18: SUBACUTE COMBINED DEGENERATION
INTRODUCTION
SALIENT CLINICAL FEATURES
HEMATOLOGICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 19: TREMORS
INTRODUCTION
TYPES OF TREMORS
ETIOLOGICAL CAUSES OF TREMORS
Benign Essential Tremor
Anxiety Tremor
Senile Tremor
Intention Tremor (Action Tremor)
Tremor of Hyperthyroidism or Thyrotoxicosis
Parkinsonian Tremor
Flapping Tremor
Orthostatic Tremor
Hysterical Tremor
Clonus
PRINCIPLES OF MANAGEMENT
Parkinson's Tremor
Essential Tremor
Cerebellar Tremor
Drug Resistant Tremor
CASE 20: PARKINSON'S DISEASE
INTRODUCTION
HISTORY
IMPORTANT CAUSES OF PARKINSONISM
History Regarding Less Important Causes of Parkinsonism
SALIENT CLINICAL FEATURES
TYPICAL PATHOLOGICAL CHANGES IN PARKINSON'S DISEASE
TREATMENT OF PARKINSON'S DISEASE
First Line Dopaminergic Agents
CASE 21: RHEUMATIC CHOREA (SYDENHAM'S CHOREA)
INTRODUCTION
NEUROLOGICAL MANIFESTATIONS
Motor System
TREATMENT
CASE 22: HUNTINGTON'S CHOREA
INTRODUCTION
MANAGEMENT
CASE 23: PERIPHERAL NEUROPATHY
INTRODUCTION
ETIOLOGICAL CAUSES OF PERIPHERAL NEUROPATHY
CLASSIFICATION OF POLYNEUROPATHIES
SALIENT CLINICAL FEATURES
i. Sensory Peripheral Neuropathy
ii. Motor Neuropathy
INVESTIGATIONS
MANAGEMENT
CASE 24: NEUROGENIC URINARY BLADDER
INTRODUCTION
CAUSES OF NEUROGENIC BLADDER
TYPES OF NEUROGENIC BLADDER WITH SALIENT CLINICAL FEATURES
Spastic
Flaccid Bladder
Autonomous Bladder
Uninhibited Bladder
INVESTIGATIONS
MANAGEMENT
CASE 25: PTOSIS
CAUSES OF PTOSIS
SALIENT CLINICAL FEATURES
History
Physical Examination
CASE 26: ARGYLL ROBERTSON PUPIL (ARP)
SALIENT CLINICAL FEATURES
ETIOLOGICAL CAUSES OF ARP
REFLEX PATHWAY OF LIGHT REFLEX
REFLEX PATHWAY OF ACCOMMODATION REFLEX
CASE 27: RADIAL NERVE PALSY
ANATOMY
ETIOPATHOLOGICAL CAUSES
Saturday Night Palsy
PHYSICAL FINDINGS
CASE 28: ULNAR NERVE PALSY
ANATOMY
SALIENT PHYSICAL FINDINGS
CASE 29: COMMON PERONEAL NERVE PALSY (LATERAL POPLITEAL NERVE PALSY)
INTRODUCTION
CAUSES OF PALSY
PHYSICAL FINDINGS
INVESTIGATIONS
MANAGEMENT
CASE 30: MOTOR NEURON DISEASE
MOTOR NEURON DISEASE
Introduction
Clinical Types
1. PROGRESSIVE MUSCULAR ATROPHY
Salient Clinical Features
2. PROGRESSIVE BULBAR PALSY
Salient Clinical Features
3. AMYOTROPHIC LATERAL SCLEROSIS
Salient Clinical Features
Differential Diagnosis of Amyotrophic Lateral Sclerosis
4. PRIMARY LATERAL SCLEROSIS (RARE)
5. MADRAS MOTOR NEURON DISEASE
CHARACTERISTIC FEATURES OF MOTOR NEURON DISEASE IN GENERAL
TREATMENT FOR MOTOR NEURON DISEASE
Symptomatic Treatment in Motor Neuron Disease
CASE 31: CEREBELLAR ATAXIA
INTRODUCTION
ETIOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
DIAGNOSIS
MANAGEMENT
CASE 32: CEREBELLAR SYNDROME
INTRODUCTION
CAUSES
SALIENT CLINICAL FEATURES
Localization of Important Cerebellar Signs
INVESTIGATIONS
MANAGEMENT
CASE 33: FRIEDREICH'S ATAXIA
INTRODUCTION
SALIENT CLINICAL FEATURES
PROGNOSIS
TREATMENT
CASE 34: INTERNUCLEAR OPHTHALMOPLEGIA
ANATOMY
SALIENT CLINICAL FEATURES
Causes of Internuclear Ophthalmoplegia
INVESTIGATIONS
CASE 35: BULBAR PALSY
ETIOLOGICAL CAUSES
SALIENT CLINICAL FEATURES
CASE 36: PSEUDOBULBAR PALSY
SALIENT CLINICAL FEATURES
History
Physical Findings
MANAGEMENT
CASE 37: CERVICAL SPONDYLOSIS
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 38: CRANIOVERTEBRAL JUNCTION ANOMALIES
INTRODUCTION
CAUSES
Congenital or Developmental
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 39: SYRINGOMYELIA
DEFINITION
INTRODUCTION
CAUSES OF SYRINGOMYELIA
CLINICAL FEATURES OF SYRINGOMYELIA
CLINICAL FEATURES OF SYRINGOBULBIA
DIFFERENTIAL DIAGNOSIS
INVESTIGATIONS
MANAGEMENT
CASE 40: JUGULAR FORAMEN SYNDROME
INTRODUCTION
SALIENT CLINICAL FEATURES
Investigations
Management
CASE 41: TABES DORSALIS
1. INTRODUCTION
2. CLINICAL PATTERNS OF NEUROSYPHILIS
3. INVESTIGATIONS
4. TREATMENT
CASE 42: OROFACIAL DYSKINESIA
SALIENT CLINICAL FEATURES
MANAGEMENT OF SUCH PATIENT
CASE 43: CEREBELLOPONTINE ANGLE TUMOR
ANATOMY
SALIENT CLINICAL FEATURES
Types of Tumors
INVESTIGATIONS
MANAGEMENT
CASE 44: BECKER'S MUSCULAR DYSTROPHY
SALIENT CLINICAL FEATURES
CASE 45: DUCHENNE'S MUSCULAR DYSTROPHY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
CASE 46: CHARCOT–MARIE–TOOTH DISEASE (PERONEAL MUSCULAR ATROPHY)
INTRODUCTION
SALIENT CLINICAL FEATURES
CASE 47: MULTIPLE SCLEROSIS
INTRODUCTION
CLINICAL SYMPTOMS
SALIENT CLINICAL SIGNS
INVESTIGATIONS
TREATMENT OF MS PATIENT
CASE 48: DEVIC'S DISEASE (NEUROMYELITIS OPTICA)
INTRODUCTION
CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
CASE 49: INTRACRANIAL TUMOR
TYPES OF TUMORS
Other Causes of Space Occupying Lesions
CLINICAL PRESENTATION
INVESTIGATIONS
PRINCIPLES OF MANAGEMENT
MANAGEMENT
CASE 50: GUILLAIN-BARRÉ SYNDROME (LANDRY'S ASCENDING PARALYSIS)
ETIOPATHOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
PROGNOSIS
PRINCIPLES OF MANAGEMENT
CASE 51: THOMSEN'S DISEASE (MYOTONIA CONGENITA)
SALIENT CLINICAL FEATURES
GENETICS OF DISEASE
MANAGEMENT
CASE 52: TORSION DYSTONIA (DYSTONIA MUSCULORUM DEFORMANS)
SALIENT CLINICAL FEATURES
PRINCIPLES OF MANAGEMENT
CASE 53: NEUROFIBROMATOSIS (VON RECKLINGHAUSEN'S DISEASE)
SALIENT CLINICAL FEATURES
DIAGNOSIS
MANAGEMENT
CASE 54: FACIOSCAPULOHUMERAL DYSTROPHY (LANDOUZY-DEJERINE SYNDROME)
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 55: LIMB GIRDLE DYSTROPHY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
CASE 56: MYASTHENIA GRAVIS
SALIENT CLINICAL FEATURES
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
SECTION 6:
Hematology
CASE 1: IRON DEFICIENCY ANEMIA
INTRODUCTION
DAILY IRON REQUIREMENT
PREVALENCE
CAUSES OF IRON DEFICIENCY ANEMIA
SALIENT CLINICAL FEATURES
INVESTIGATIONS
CAUSES OF HYPOCHROMIC ANEMIA
DIFFERENTIAL DIAGNOSIS OF COMMON MICROCYTIC HYPOCHROMIC ANEMIAS
MANAGEMENT
PREVENTIVE MEASURES
CASE 2: MEGALOBLASTIC ANEMIA
INTRODUCTION
VITAMIN B12
Causes of Vitamin B12 Deficiency
FOLIC ACID
Causes of Folic Acid Deficiency
MEGALOBLASTIC ANEMIA UNRELATED TO B12 AND FOLIC ACID DEFICIENCY
SALIENT CLINICAL FEATURES OF MEGALOBLASTIC ANEMIA
Vitamin B12 Deficiency
Folic Acid Deficiency
INVESTIGATIONS
B12 Deficiency Megaloblastic Anemia
Folic Acid Deficiency Megaloblastic Anemia
PRINCIPLES OF MANAGEMENT
B12 Deficiency
Folic Acid Deficiency
CASE 3: PERNICIOUS ANEMIA
INTRODUCTION
History
SALIENT CLINICAL FEATURES
LABORATORY INVESTIGATIONS
CASE 4: HEMOLYTIC ANEMIA
INTRODUCTION
ETIOPATHOLOGICAL CAUSES OF HEMOLYTIC ANEMIA
I. Congenital
II. Acquired
SALIENT CLINICAL FEATURES
INVESTIGATIONS
HEREDITARY SPHEROCYTOSIS
Treatment
HEREDITARY ELLIPTOCYTOSIS
GLUCOSE-6-PHOSPHATE DEHYDROGENASE DEFICIENCY (G6PD DEFICIENCY)
List of Drugs to be Avoided in G6pd Deficiency
THALASSEMIA
INTRODUCTION
TYPES OF THALASSEMIA
CASE 5: β-THALASSEMIA MAJOR (COOLEY'S ANEMIA)
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
Major Type
Minor Type
CASE 6: SICKLE CELL DISEASE
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT PRINCIPLES
CASE 7: APLASTIC ANEMIA
INTRODUCTION
CAUSES
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PRINCIPLES OF TREATMENT
CASE 8: SIDEROBLASTIC ANEMIA
SALIENT CLINICAL FEATURES
CASE 9: ANEMIA IN GENERAL
PRESENTING COMPLAINTS
SALIENT PHYSICAL SIGNS
SECTION 7:
Oncology
CASE 1: ACUTE LEUKEMIA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT PRINCIPLES
Chemotherapy
CASE 2: CHRONIC MYELOID LEUKEMIA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS AND DIAGNOSIS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
Palliative/Symptomatic
Curative Treatment
CASE 3: CHRONIC LYMPHATIC LEUKEMIA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
STAGING OF CHRONIC LYMPHOCYTIC LEUKEMIA
RAI Staging
Modified RAI Staging as per Risk
DIAGNOSIS
Differential Diagnosis
PROGNOSIS
MANAGEMENT
Specific Chemotherapeutic Treatment
CASE 4: MULTIPLE MYELOMA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
DIAGNOSIS
PROGNOSIS
MANAGEMENT
General Supportive Treatment
CASE 5: MYELOFIBROSIS (PRIMARY MYELOSCLEROSIS)
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
Principles of Management
MYELOPROLIFERATIVE DISORDERS
CASE 6: POLYCYTHEMIA VERA
SALIENT CLINICAL FEATURES
INVESTIGATIONS
SECONDARY POLYCYTHEMIA
MANAGEMENT
CASE 7: ESSENTIAL THROMBOCYTHEMIA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
LYMPHOMAS
CASE 8: NON-HODGKIN'S LYMPHOMA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 9: HODGKIN'S LYMPHOMA (HODGKIN'S DISEASE)
INTRODUCTION
SALIENT CLINICAL FEATURES
Clinical Staging (Ann Arbor Classification)
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
PROGNOSIS
MANAGEMENT
SECTION 8:
Endocrinology
CASE 1: ACROMEGALY
KEY CLINICAL FEATURES
LABORATORY TESTS
IMAGING
TREATMENT
a. Surgery
b. Medical
c. Other Modes of Treatment
CASE 2: SIMMONDS’ DISEASE (HYPOPITUITARISM)
1. SYMPTOMS
2. ETIOPATHOLOGICAL CAUSES OF HYPOPITUITARISM
3. SALIENT CLINICAL SIGNS
4. INVESTIGATIONS
5. MANAGEMENT
CASE 3: GRAVES’ DISEASE (PRIMARY HYPERTHYROIDISM)
1. ETIOPATHOLOGY
2. CAUSES OF HYPERTHYROIDISM
a. Disorders of Thyroid
b. Extrathyroidal Disorders
c. Excessive TSH Secretion
Graves’ Disease (Primary Hyperthyroidism)
CASE 4: SECONDARY HYPERTHYROIDISM
CAUSES OF SECONDARY HYPERTHYROIDISM
TSH-SECRETING PITUITARY ADENOMA
THYROTOXICOSIS WITH SOLITARY THYROID NODULES
1. Salient Clinical Features
2. Investigations
3. Management
CASE 5: THYROTOXICOSIS
1. SYMPTOMS
2. SALIENT CLINICAL FEATURES OF THYROTOXICOSIS
3. INVESTIGATIONS
4. MANAGEMENT
a. Medical
b. Radioactive Iodine Therapy
c. Surgical
Complications of Surgery
CASE 6: MULTINODULAR GOITER
1. SALIENT CLINICAL FEATURES
a. Symptoms
b. Physical Findings
2. INVESTIGATIONS
3. TREATMENT
CASE 7: MYXEDEMA (HYPOTHYROIDISM)
1. INTRODUCTION
2. ETIOLOGY
3. PREVALENCE
4. SALIENT CLINICAL FEATURES
a. Symptoms
b. Salient Clinical Signs
5. INVESTIGATIONS
6. COMPLICATIONS
Myxedema Coma
7. TREATMENT OF MYXEDEMA
8. TREATMENT OF MYXEDEMA COMA
CASE 8: HYPERPARATHYROIDISM
1. ANATOMY AND PHYSIOLOGY OF PARATHYROID GLANDS
2. TYPES OF HYPERPARATHYROIDISM
3. SALIENT CLINICAL FEATURES
4. INVESTIGATIONS
5. MANAGEMENT
CASE 9: HYPOPARATHYROIDISM
ETIOLOGICAL CAUSES
CLINICAL FEATURES
Causes of Trousseau's Sign
INVESTIGATIONS
CASE 10: PSEUDOHYPOPARATHYROIDISM
SALIENT CLINICAL FEATURES
MANAGEMENT OF PSEUDO-HYPOPARATHYROIDISM
CASE 11: CUSHING'S SYNDROME
1. ETIOPATHOLOGY
A. Endogenous
B. Exogenous
2. SYMPTOMS
3. SALIENT CLINICAL SIGNS
4. INVESTIGATIONS
5. MANAGEMENT
A. Medical
B. Surgical
CASE 12: ADDISON'S DISEASE
1. SALIENT CLINICAL FEATURES
2. LABORATORY TESTS
3. IMAGING STUDIES
4. MANAGEMENT
CASE 13: PHEOCHROMOCYTOMA
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
Medical
Surgical
CASE 14: CARCINOID SYNDROME
1. ETIOPATHOLOGY
2. SALIENT CLINICAL MANIFESTATIONS
3. TYPES OF GASTRIC CARCINOID TUMORS
4. INVESTIGATIONS AND CONFIRMATION OF DIAGNOSIS
5. TREATMENT
SECTION 9:
Metabolic Diseases
CASE 1: OBESITY
INTRODUCTION
Waist-Hip Ratio
TYPES OF OBESITY
Android Obesity
Gynoid
Truncal or Superior Obesity
Abdominal or Visceral Obesity
SALIENT CLINICAL FEATURES
History
Physical Examination
INVESTIGATIONS
MANAGEMENT
Medical
Surgical
CASE 2: DIABETES MELLITUS
INTRODUCTION
PREVALENCE
CLINICAL TYPES
SALIENT CLINICAL FEATURES
Insulin Dependent Diabetes Mellitus
Noninsulin Dependent Diabetes Mellitus
Physical Examination
INVESTIGATIONS
COMPLICATIONS OF DIABETES MELLITUS
Acute complications
DIABETIC KETOACIDOSIS
Clinical Features
Pathogenesis of Diabetic Ketoacidosis
Investigations
Management
HYPEROSMOLAR NONKETOTIC DIABETIC COMA
Introduction
Etiopathology
Salient Clinical Features
Principles of Management
LACTIC ACIDOSIS
Salient Clinical Features
Investigations
Management
HYPOGLYCEMIC COMA
Introduction
Salient Clinical Features
Investigations
Management
Infections
CHRONIC COMPLICATIONS OF DIABETES MELLITUS
Macroangiopathy
Microangiopathy
PATHOGENESIS OF CHRONIC COMPLICATIONS
Macroangiopathy
Microangiopathy Complications
SECTION 10:
Musculoskeletal System
CASE 1: RHEUMATOID ARTHRITIS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
a. Joint Manifestations (Articular Manifestations)
b. Juxta-articular Manifestations
c. Extra-articular Manifestations
3. INVESTIGATIONS
a. Blood
b. X-ray Hands (Fig. 10.2)
4. COMPLICATIONS
5. DIFFERENTIAL DIAGNOSIS OF RA
6. PRINCIPLES OF MANAGEMENT
CASE 2: ANKYLOSING SPONDYLITIS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
3. INVESTIGATIONS
Radiological Findings
4. OTHER INVESTIGATIONS
5. DIFFERENTIAL DIAGNOSIS
6. PRINCIPLES OF MANAGEMENT
CASE 3: SYSTEMIC LUPUS ERYTHEMATOSUS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
3. DIAGNOSIS
4. MANAGEMENT
i. General Instructions and Symptomatic Treatment
ii. Specific Treatment
CASE 4: CHRONIC TOPHACEOUS GOUT
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
3. DIAGNOSIS
4. MANAGEMENT
CASE 5: JUVENILE IDIOPATHIC ARTHRITIS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
a. Fever
b. Joint Manifestations
c. Rash
d. Other Clinical Features
3. INVESTIGATIONS
4. DIAGNOSIS
5. DIFFERENTIAL DIAGNOSIS
6. COMPLICATIONS
7. TREATMENT
CASE 6: DERMATOMYOSITIS (POLYMYOSITIS)
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
3. INVESTIGATIONS
4. TREATMENT
CASE 7: PSORIATIC ARTHRITIS
1. SALIENT CLINICAL FEATURES
2. PATTERN OF JOINT INVOLVEMENT IS VARIABLE
3. RADIOLOGICAL CHANGES
4. PROGNOSIS
5. MANAGEMENT
CASE 8: PROGRESSIVE SYSTEMIC SCLEROSIS (SCLERODERMA)
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
a. Symptoms
b. Signs
3. PROGNOSIS
4. DIAGNOSIS
5. MANAGEMENT
CASE 9: REACTIVE ARTHRITIS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
3. PROGNOSIS
4. MANAGEMENT
CASE 10: OSTEOARTHRITIS
1. INTRODUCTION
2. SALIENT CLINICAL FEATURES
a. Symptoms
b. Physical Signs
3. RADIOLOGICAL FEATURES
4. MANAGEMENT
a. General
b. Drugs
c. Surgery
CASE 11: CHARCOT'S JOINT
1. INTRODUCTION
2. CAUSES
3. SALIENT CLINICAL FEATURES
a. Symptoms
b. Signs
4. PREVENTIVE MEASURES FOR NEUROPATHIC JOINTS
5. MANAGEMENT
CASE 12: CARPAL TUNNEL SYNDROME
1. SALIENT CLINICAL FEATURES
2. CAUSES OF CARPAL TUNNEL SYNDROME
3. MANAGEMENT OF CARPAL SYNDROME
SECTION 11:
Miscellaneous
CASE 1: Marfan's Syndrome
SALIENT CLINICAL FEATURES
INVESTIGATION
TREATMENT
CASE 2: KLINEFELTER SYNDROME
SALIENT CLINICAL FEATURES
INVESTIGATIONS
CASE 3: Turner's Syndrome
SALIENT CLINICAL FEATURES
INVESTIGATIONS
TREATMENT
CASE 4: DOWN'S SYNDROME
SALIENT CLINICAL FEATURES
INVESTIGATIONS
COMPLICATIONS
TREATMENT
CASE 5: ACHONDROPLASIA
SALIENT CLINICAL FEATURES
INVESTIGATION
COMPLICATIONS
CASE 6: Diabetic Retinopathy
COMPLAINTS
PATHOGENESIS OF DIABETIC RETINOPATHY
Microaneurysm
HEMORRHAGES
Deep Hemorrhages
Superficial Hemorrhages
EXUDATES
Cotton Wool Spots
Hard Exudates
MACULAR EDEMA
VENOUS CHANGES
INTRARETINAL MICROVASCULAR ABNORMALITIES
NEOVASCULARIZATION
RUBEOSIS IRIDIS
CASE 7: Hypertensive Retinopathy
KEITH–WAGENER–BARKER CLASSIFICATION
CASE 8: Paget's Disease
INTRODUCTION
PATHOPHYSIOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 9: Henoch-Schönlein Purpura
INTRODUCTION
SALIENT CLINICAL FEATURES
INVESTIGATIONS
DIFFERENTIAL DIAGNOSIS
MANAGEMENT
CASE 10: Purpura in General
INTRODUCTION
COMMON CAUSES
SALIENT CLINICAL FEATURES
Symptoms
Signs
CASE 11: Acute Idiopathic Thrombocytopenic Purpura (ITP)
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
Acute ITP
Chronic ITP
CASE 12: HEMOPHILIA
INTRODUCTION
SALIENT CLINICAL FEATURES
Symptoms
Signs
INVESTIGATIONS
Blood
MANAGEMENT
CASE 13: DIABETIC FOOT
INTRODUCTION
PATHOPHYSIOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
MANAGEMENT
CASE 14: Deep Vein Thrombosis
INTRODUCTION
ETIOPATHOLOGY
SALIENT CLINICAL FEATURES
INVESTIGATIONS
PREDISPOSING FACTORS
COMPLICATIONS
TREATMENT
Treatment of Patients withBelow Knee DVT
Management of Patients withDVT above Knees
PREVENTION OF DEEP VENOUS THROMBOSIS
PART 2: PEARLS IN MEDICINE
PEARLS IN MEDICINE
INDEX
TOC
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