By John Rees, James Pattison, Gwyn Williams
This article covers middle fabric in medical drugs. overlaying the foremost platforms in 15 sections, every one part contains 8 situations. those instances reflect these which scholars and apartment officials will meet in outpatients and common perform. disguise; ebook identify; Contents; Preface; Acknowledgements; Abbreviations; part 1: Systems-related situations; part 2: basic self-assessment situations; Index
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Additional resources for 100 Cases in Clinical Medicine
KEY POINTS • Motor neurone disease most commonly presents with weakness and wasting of the muscles of one hand. • Fasciculation of the muscles is characteristic of this condition. • There is no sensory loss in this condition. 34 CASE 14: DOUBLE VISION History A 43-year-old woman presents to her general practitioner (GP) complaining of diplopia, more marked in the evenings, for the last 3 months. She has noticed difficulty holding her head up, again especially in the evenings. She has problems finishing a meal because of difficulty chewing.
Dystrophia myotonica: this causes ptosis, wasting of the masseter, temporal and • • • sternomastoid muscles and distal muscular atrophy. There is a characteristic facial appearance with frontal baldness, expressionless facies and sunken cheeks. There may be gonadal atrophy and mental retardation. There is usually a family history. The electromyogram (EMG) is diagnostic. Polymyositis: this may have an acute or chronic onset. A skin rash and joint pains are common. The creatine kinase level is raised and a muscle biopsy is diagnostic.
During the last 3 months he has had intermittent nausea, especially in the mornings, and in the last 3 months the morning nausea has been accompanied by vomiting on several occasions. For 1 month he has noted swelling of his ankles. Despite his weight loss he has recently noticed his trousers getting tighter. He has had no abdominal pain. He has no relevant past history and knows no family history as he was adopted. He takes no medication. From the age of 18 he has smoked 5–6 cigarettes daily and drunk 15–20 units of alcohol per week.
100 Cases in Clinical Medicine by John Rees, James Pattison, Gwyn Williams