Nephrotic syndrome
227 Nephrotic syndrome Instruction Look at this patient. Salient features History • History of diabetes (N Engl J Med 1998;338:1202–11) • Hypertension • History of acute glomerulonephritis, streptococcal sore throat…
Ebstein’s anomaly
35 Ebstein’s anomaly Instruction Listen to this patient’s heart. He was told he had an innocent murmur during a school medical examination many years ago but now has a large…
Tabes dorsalis
73 Tabes dorsalis Instruction Examine this patient with lightning pains (lightning denotes that the pains are fleeting and does not necessarily mean they are excruciating). Salient features History • ‘Lightening…
Internuclear ophthalmoplegia
81 Internuclear ophthalmoplegia Instruction Examine this patient’s eyes. Salient features History • Diplopia • History of multiple sclerosis • Neurofibroma (causing pontine gliomas) • Drugs (phenytoin, carbamezapine). Examination • Nystagmus…
Abnormal gait
61 Abnormal gait Instruction Look at this patient walking. Test this patient’s gait. Salient features Examination There are several types of abnormal gait. Keep in mind the phases and pathogenesis…
Dermatomyositis
63 Dermatomyositis Instruction Examine this patient. Salient features History • The adult form usually occurs after the age of 40 years • Weakness of proximal muscles evolving over weeks or…
Gynaecomastia
146 Gynaecomastia Instruction Look at this patient’s chest. Salient features History • Take a drug history: oestrogens, digoxin, spironolactone, cimetidine, diazepam, alkylating agents, methyldopa, clomiphene • Ask the patient whether…
Peripheral neuropathy
55 Peripheral neuropathy Instruction Examine this patient’s legs. Carry out a neurological examination of this patient’s legs. Salient features History • Progressive and symmetrical numbness in the hands and feet…
