Acute Medicine: Clinical Cases Uncovered

Preface vii

Acknowledgements ix

How to use this book x

List of abbreviations xi

Part 1 Basics 1

Introduction and specialty overview 1

Approach to the patient 5

Part 2 Cases 28

Case 1 A 45-year-old man with ‘cardiac-type’ chest pain 28

Case 2 A 35-year-old woman with ‘pleuritic’ chest pain 37

Case 3 A 50-year-old man presenting with palpitations 47

Case 4 A 60-year-old man with a broad complex tachycardia 56

Case 5 A 25-year-old woman with acute asthma 62

Case 6 A 60-year-old woman with an ‘exacerbation’ of chronic obstructive pulmonary disease 70

Case 7 An 86-year-old woman with acute shortness of breath 79

Case 8 A 68-year-old man presenting with shock 88

Case 9 A 55-year-old man with suspected upper gastrointestinal bleeding 94

Case 10 A 60-year-old man with diarrhoea 103

Case 11 A 37-year-old woman with sudden severe headache 111

Case 12 A 21-year-old man presenting following a seizure 118

Case 13 A 22-year-old unconscious man 125

Case 14 A 64-year-old man presenting with unilateral weakness 136

Case 15 A 60-year-old man presenting following a blackout 145

Case 16 A 45-year-old man with acute confusion 152

Case 17 An 81-year-old woman with acute confusion 158

Case 18 A 25-year-old woman with acute hyperglycaemia 166

Case 19 A 73-year-old man with abnormal renal function 173

Case 20 A 55-year-old man with pyrexia of unknown origin 182

Case 21 A 25-year-old woman admitted following an overdose 191

Case 22 A 35-year-old woman with an acutely swollen leg 200

Part 3 Self-assessment 205

MCQs 205

EMQs 211

SAQs 216

Answers 219

Appendix: Normal ranges units and common abbreviations for blood tests 229

Index of cases by diagnosis 231

Index 233

Colour plate section can be found facing p.148