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…
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…
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…
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…
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…
53 Seventh cranial nerve palsy Lower motor neuron type Instruction Look at this patient’s face. Examine the cranial nerves. Salient features History • Onset: whether abrupt followed by worsening over…
76 Carpal tunnel syndrome Instruction Examine this patient’s hands. Salient features History • Ask the patient about nocturnal pain (commonest cause of hand pain at night). Often the pain wakes…
72 Subacute combined degeneration of the spinal cord Instruction Carry out a neurological examination of the patient’s legs. Salient features History • Family history of pernicious anaemia • History of…
130 Painful knee joint Instruction Examine this patient’s leg. Examine this patient’s joints. Examine this patient’s knee joint. Salient features History • Painful knee joint • Take a history of…
125 Abdominal masses Patient 1 Instruction Examine this patient’s abdomen. Salient features Examination There is an epigastric mass. Diagnosis Differential diagnosis: • Carcinoma of the stomach: look for supraclavicular lymph…
