Clinical Problems in Medicine and Surgery

Clinical Problems in Medicine and Surgery is a departure from traditional medical textbooks in that it deals with the real problems of clinical medicine through scenarios encountered in the emergency department, on the wards and in outpatient clinics. First published in 1992, the book has found great popularity with medical students, residents and interns about to experience, or already experiencing, the real world of medical practice. The book comprises 55 real-life medical scenarios to illustrate important everyday principles in clinical medicine. For this new Third Edition the successful format of case presentation, interspersed with questions and answers, and a final synopsis of key material, has been retained, while new cases have been added and the many useful web-links updated. With the assistance of expert colleagues across three continents, each problem has been revised and updated. New images have been added which reflect the extensive changes in the field of minimally invasive diagnostics. Searching questions will guide the reader towards further self-directed learning. This book does not purport to be an exhaustive text on clinical medicine. Nor is it a replacement for real-life clinical experience and the hands-on teaching of expert clinicians. It is designed rather as a wide-ranging source of information and a practical aid to the management of clinical problems. The authors hope it will instil in the reader a real sense of excitement and curiosity towards further learning. New to this edition * Several new cases cover topics such as secondary hypertension, urosepsis and stroke. * Searching questions have been added to guide the reader towards further self-directed learning. * New imaging reflects the extensive changes in the field of minimally invasive diagnostics. By Peter G Devitt, MBBS, MS, FRACS, Professorial Surgical Unit, University of Adelaide and Royal Adelaide Hospital, Adelaide, Australia; Jonathan D. Mitchell, FRCP, Consultant Hepatologist, South West Liver Unit, Plymouth, UK and Christian Hamilton-Craig, MBBS PhD BMedSci(Hons) FRACP FSCCT, Consultant Cardiologist, Cardiac Imaging, The Prince Charles Hospital; Consultant Cardiologist, Heart Care Partners, Mater Private Hospital; Senior Lecturer, University of Queensland, Brisbane, Australia; Assistant Professor of Radiology, University of Washington, Seattle, USA Table of Contents: THE PROBLEMS 1 Difficulties with post-operative fluid balance in a 58 year old man 2 Postoperative fever 3 Postoperative hypotension 4 Confusion in the post-op ward 5 Swelling in the neck in a 58 year old man 6 A 55 year old woman with hypertension 7 A young woman with abnormal vaginal bleeding 8 A scrotal swelling in a 27-year-old man 9 A 63-year-old woman with a screen-detected abnormality 10 A 54-year old man with a high-voltage electrical conduction injury 11 Reflux in a 35-year-old man 12 Dysphagia and weight loss in a middle-aged man 13 Abdominal pain in a young woman 14 A woman with acute upper abdominal pain 15 Flank pain in a 60-year-old man 16 Lower abdominal pain in a 77-year-old woman 17 Nausea and constipation in an older woman 18 A lady with diarrhoea and abdominal pain 19 Rectal bleeding in a 45-year-old woman 20 Haematuria a 60-year-old man   22 Acute back pain in a 75-year-old man 23 A 59-year-old man with calf pain 24 Acute leg pain in a 73-year-old man 25 A 68-year-old woman with a leg ulcer 26 A 41-year-old man involved in a car crash 27 Management of Acute Coronary Syndrome (ACS) 28 Breathlessness in a young female 29 A 25-year-old woman with chest pain and breathlessness 30 Recurrent collapse in a 56-year-old truck driver 31 A 68-year-old woman with breathlessness and yellow sputum 32 Persistent cough in a young woman 33 Cough, dyspnoea and fever in a 55 year old man 34 Breathlessness and weight loss in a 58-year-old man 35 A 35-year-old woman vomiting blood 36 A young woman with jaundice 37 A 47 year-old man with lethargy and hypertension 38 A 35-year-old woman with hypertension 39 A young man with depressed conscious state and seizures 40 A middle-aged man with sudden visual loss 41 "Jack has leg weakness" 42 Fall during a fishing weekend 43 An unwell young man in the emergency room 44 A 68 year-old female with a left hemiplegia following a conscious collapse 45 A 31-year-old woman with vertigo 46 A 31-year-old man with sudden onset headache and vomiting 47 Fatigue and bruising in a teenager 48 Severe dehydration in a young woman 49 A woman with palpitations 50 A collapsed, breathless woman 51 Management of a young man who is HIV positive 52 Back and leg pain in a middle-aged man 53 Back and leg pain in a middle-aged man 54 A listless 45-year-old man 55 A 74 year old man with confusion and oliguria