Ventricular septal defect
21 Ventricular septal defect Instruction Listen to this patient’s heart. Salient features History • Small defects are usually asymptomatic • Large defects with shunts: repeated respiratory tract infections, debilitating dyspnoea…
Thomsen’s disease (myotonia congenita)
67 Thomsen’s disease (myotonia congenita) Instruction Look at this patient. Salient features History • Ask the patient whether or not there is any seasonal variation in symptoms: myotonia is worse…
Proximal myopathy
58 Proximal myopathy Instruction Perform a neurological examination of this patient’s arms or legs. Salient features History • Weakness of proximal muscles • Patient has difficulty in standing from the…
Sixth cranial nerve palsy
52 Sixth cranial nerve palsy Instruction Examine this patient’s eyes. Salient features History • Diplopia in all directions of gaze except away from the affected side • Patient may rotate…
Third cranial nerve palsy
51 Third cranial nerve palsy Instruction Examine this patient’s eyes. Salient features History • Diplopia in all directions except on lateral gaze to the side of the third nerve lesion…
Cerebellar dysarthria
50 Cerebellar dysarthria Instruction Ask this patient a few questions. Salient features Examination • The speech may be scanning (enunciation is difficult, words are produced slowly and in a measured…
Infective endocarditis
17 Infective endocarditis Instruction This patient is suspected to have endocarditis; would you like to examine him? Salient features History • Fever, malaise, anorexia, weight loss, rigors: non-specific symptoms of…
Jerky nystagmus
47 Jerky nystagmus Instruction Examine this patient’s eyes. Test the patient’s eye movements. Salient features History • Obtain a history regarding cerebellar syndrome: multiple sclerosis, alcohol, etc. (case 46) •…
