Multiple sclerosis
60 Multiple sclerosis Patient 1 Instruction Examine this patient’s eyes. Salient features History • Remissions and relapses: visual loss, diplopia. Examination • Optic atrophy • Nystagmus. • Internuclearophthalmoplegia (see Fig….
Chronic lymphocytic leukaemia
126 Chronic lymphocytic leukaemia Instruction Perform a general examination of this patient. Salient features History • Asymptomatic in 70% of patients • Palpable lymph nodes or left upper quadrant abdominal…
Graves’ disease
136 Graves’ disease Instruction Look at this patient. Determine this patient’s thyroid status. Salient features • Patient is fidgety and restless. History • Easy irritability, nervousness, insomnia • Fatigue •…
Pretibial myxoedema
139 Pretibial myxoedema Instruction Look at this patient’s legs. Salient features History • As in patients with thyrotoxicosis (p. 137) Examination • Red thickened swellings above the lateral malleoli (peau…
Haemophilia A
244 Haemophilia A Instruction Examine this patient’s knee (or elbow) joint; he has a bleeding disorder. Salient features History • Family history of bleeding (X-linked recessive disorder): draw the family…
Breast lump
242 Breast lump Instruction Examine this patient’s breasts. Salient features History • History of weight loss • History of a palpable mass in breast and/or axilla • Breast pain (present…
Achondroplasia
241 Achondroplasia Instruction Look at this patient. Salient features History • Family history (autosomal dominant inheritance; however, 80% are new mutations) • Paternal age (increases in frequency with increasing age…
Yellow nail syndrome
234 Yellow nail syndrome Instruction Look at this patient’s hands. Salient features History • Ask about past history of sinusitis • History of chronic cough, bronchiectasis, pleural effusion, recurrent lung…
Collapsed lung
111 Collapsed lung Instruction Examine this patient’s chest. Salient features History • Sudden onset of breathlessness • History of cough • History of asthma, TB, lung cancer. Examination • Trachea…
