By Steve Bain M.D., Janesh K. Gupta M.D.
You've gotten learn your textbook and your path notes. Now you want to observe your wisdom to genuine lifestyles scientific occasions. middle scientific instances courses you to consider the sufferer as an entire, instead of as a series of unconnected indicators. With its sensible method strongly associated with underlying conception, the sequence integrates your wisdom with the realities of dealing with scientific difficulties, and gives a foundation for constructing problem-solving talents. The center components of undergraduate research are coated in a logical series of studying actions: each one case is by way of a close resolution, in addition to a couple of OSCE-style inquiries to assist you training for the examination. comparable OSCE counselling type questions and solutions additionally characteristic on the finish of every part. Key strategies and significant info are highlighted, and the reader-friendly structure displays precisely the kind of query you'll stumble upon, making the suitable revision reduction for all sorts of case-based exam. the excellent quantity, clinical and Surgical Specialties, specializes in the subsequent subject matters: ENT Ophthalmology Haematology Orthopaedics and Trauma Oncology Neurology Urology Infectious ailments Dermatology The middle medical instances sequence is admittedly useful within the run as much as scientific, written or OSCE examinations, and a vital revision relief for all undergraduate clinical scholars at a number of levels of their medical education. Steve Bain MA MD FRCP Professor of drugs (Diabetes), collage of Wales, Swansea & Honorary advisor health care provider, Swansea NHS belief, Singleton health center, Swansea, united kingdom Janesh okay. Gupta MSc MD FRCOG medical Senior Lecturer & Honorary advisor in Obstetrics and Gynaecology, college of Birmingham, Birmingham Women's clinic, united kingdom
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Extra info for Core Clinical Cases in Medical and Surgical Specialties: A Problem-Solving Approach
Questions for each of the clinical case scenarios given Q1: Q2: Q3: Q4: What is the likely differential diagnosis? What is the important ﬁnding on examination? What additional features in the history would you like to elicit? What are the treatment options? 9 – Ear discharge. A 25-year-old man presents with progressive hearing loss of 3 years and recently an intermittent, but scanty, smelly discharge. 10 – Progressive hearing loss. A woman aged 53 years presents with a 12-month history of a progressive, left-sided, sensorineural hearing loss with occasional tinnitus.
Q2: What should one look for in the examination? A2 Examine both ears and see whether one sticks out more than the other. A child might have a more severe problem such as acute mastoiditis. There is swelling behind the ear and it is pushed forwards and slightly downwards. Examine the better ear ﬁrst. Children often have a pink eardrum when they have a cold. If both ears look the same, acute otitis media is unlikely. If there is pus behind the drum, it is pushed forwards. This is most obvious in the posterosuperior region and this is the most common site of rupture.
A 66-year-old man comes to the department with decreased hearing over the previous 7 years and both ears are the same. 11 – A patient wants to use a hearing aid but feels that it will exacerbate the condition. What is your advice? Key concepts Presbyacusis may require a hearing aid. Hearing aids work if the patient requests them. Digital hearing aids may be better than analogue ones. 11 – Adult with bilateral deafness. A Q1: What additional features in the history would you like to elicit? 9, to determine whether there are any others.
Core Clinical Cases in Medical and Surgical Specialties: A Problem-Solving Approach by Steve Bain M.D., Janesh K. Gupta M.D.