Acromegaly
142 Acromegaly Instruction Examine this patient’s face. This patient complains of excessive sweating; examine him. Examine this patient’s hands. Salient features History • Ask the patient about old photographs of…
Facioscapulohumeral dystrophy (Landouzy–Déjérine syndrome)
64 Facioscapulohumeral dystrophy (Landouzy–Déjérine syndrome) Instruction Perform a neurological examination of this patient’s cranial nerves and upper limbs. Salient features History • Age of onset (usually between 10 and 40…
Friedreich’s ataxia
68 Friedreich’s ataxia Instruction Perform a neurological examination of this patient’s legs. Salient features History • Age of onset (usually the same in each family and ranges from 8 to…
Myasthenia gravis
66 Myasthenia gravis Instruction This patient complains of drooping of the eyelids in the evenings; examine this patient. Salient features History • Weakness in muscles is more marked in the…
Wasting of the small muscles of the hand
62 Wasting of the small muscles of the hand Instruction Examine this patient’s hands. Ask the patient whether her hands are painful. Salient features History • Rheumatoid arthritis • Painful…
Ankylosing spondylitis
128 Ankylosing spondylitis Instruction Examine this patient’s back. Examine this patient. Salient features History • Back stiffness and back pain: worse in the morning, improves on exercise and worsens on…
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…
