Basicmedical Key

31 Constrictive pericarditis Instruction Examine this patient’s cardiovascular system. Salient features History • Dyspnoea • Fatigue • Ankle or abdominal swelling • Nausea, vomiting, dizziness and cough. Examination • The…

147 Carcinoid syndrome Instruction Look at this patient who was told by her GP that she has a ‘nervous bowel’. Salient features History • Confirm a history of chronic intermittent…

133 Ehlers–Danlos syndrome Instruction Do a general examination. Examine this patient’s joints. Salient features History • Family history (JAMA 1997;278:1284–5) • Hypermobile joints (Fig. 133.1) • Fragile skin with impaired…

160 Vitiligo Instruction Look at this patient. Salient features History • Age of onset (about half the patients present before the age of 20) • Whether or not it runs…

166 Hirsutism Instruction Examine this patient. Salient features History • Age of onset • Rate of progression of hirsutism • History of thinning of scalp hair, or deepening of voice…

140 Multinodular goitre Instruction Examine this patient’s neck. Salient features History • Stridor: trachea must be narrowed to 20–30% for this symptom • Hoarseness of voice (caused by pressure on…

120 Felty’s syndrome Instruction Examine this patient’s abdomen. Salient features History • Fever, weigh loss • Rheumatoid arthritis • Leg ulcers, hyperpigmentation. Examination • Mild to moderate splenomegaly • Rheumatoid…

154 Henoch–Schönlein purpura Instruction Look at this patient’s legs. Salient features History • Ask the patient about the following: • Upper respiratory tract infection • Joint pains (knees and ankles…

152 Psoriasis Instruction Look at this patient. Do a general examination. Salient features History • Symptoms (itching, pain, flexural intertrigo, limitation of manual dexterity), cosmetic problems or both • Joint…

129 Psoriatic arthritis Instruction Examine this patient’s hands. Salient features History • Cutaneous psoriasis with itching in a fifth of the patients • Joint pain, joint stiffness worse in the…