Short Cases in Clinical Medicine PDF
Preview Short Cases in Clinical Medicine
Short Cases in Clinical Medicine This page intentionally left blank Short Cases in Clinical Medicine Sixth Edition ABM Abdullah MRCP (UK), FRCP (Edin) Dean, Faculty of Medicine Professor of Medicine Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh RELX India Pvt. Ltd. Registered Office: 818, Indraprakash Building, 8thFloor, 21, Barakhamba Road, New Delhi-110001 Corporate Office: 14th Floor, Building No. 10B, DLF Cyber City, Phase II, Gurgaon-122 002, Haryana, India Short Cases in Clinical Medicine, 6e Copyright © 2018 by RELX India Pvt. Ltd. (formerly known as Reed Elsevier India Pvt. Ltd) All rights reserved. Previous edition copyrighted 2013 ISBN: 978-81-312-5000-6 e-Book ISBN: 978-81-312-5001-3 No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions. This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein). Notice Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors in relation to the adaptation or for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein. Content Strategist: Arun Khemariya Content Project Manager: Ayan Dhar Cover Designer: Milind Majgaonkar Senior Production Executive: Ravinder Sharma Printed in ... by ... “To study the phenomena of disease without books is to sail an uncharted sea, while to study books without patients is not to go to sea at all” –Sir William Osler Dedicated to My parents for their never-ending blessings, love and encouragement This page intentionally left blank Preface to the 6th Edition All praise to Almighty Allah for enabling me to bring out the 6th edition of this book. The last edition was well accepted and appreciated by a wide variety of undergraduate and postgraduate medi- cal students from different countries. It is a difficult task to improve on the already popular version, but my sincere efforts are to incorporate the advances in medical knowledge as new texts, diagrams, tables, latest investigations and treatments, which I hope, have enriched the book. All the chapters have been extensively revised and updated with well established format that will be easier to imbibe and memorize for the students, examinees and also the doctors. Many topics have been rewritten and some new topics have been incorporated in the light of the latest development and internationally accepted standard of care on that field. Important cardinal points are highlighted in boxes and tables, so that the readers can have a quick review. Valuable suggestions and recommendations from renowned professors, doctors and students have helped me to raise the overall quality and acceptability of this book. I would like to mention, as always, that this book is merely a guide to the practical approaches to a patient in examination set-up and in no way is a substitute to dealing with patients directly. To achieve the most out of this book, I would advise to take it in clinical wards and study it while working with real life patients. There is no substitute for knowledge, and I hope, this edition will get increasing popularity and will help to serve my purpose to make good and efficient clinicians. Remember, “Machine, how much sophisticated it may be, cannot replace the tender touch of physician’s hand”. Despite tremendous efforts to ensure adequate, correct and current information, errors and mistakes are natural. So, I would gratefully welcome and appreciate any constructive criticism, comment and corrections. Dr. A B M Abdullah Dean, Faculty of Medicine Professor, Department of Medicine Bangabandhu Sheikh Mujib Medical University Dhaka, Bangladesh. vii This page intentionally left blank Preface to the 1st Edition Short cases are the most difficult part of the examination and no amount of brilliance will enable one to pass if one does not perform well in this section. It is this part where the candidates’ ability to elicit and interpret the physical signs is closely scrutinized by the examiner, so chances of failure rate are very high, if this part is not performed properly. From my experience, I feel that many candidates fail because of lack of necessary clinical compe- tence, even they have good theoretical knowledge. Others fail because of inadequate preparation, lack of technique and poor presentation. So the only way to pass is “Continued practice in a systematic way, repeated exposure to different cases and rehearsal of presentation in front of others.” Only reading a book will not replace this. With this idea, I have written this book to help the students to prepare them- selves exactly in the way in any clinical examination. In such examination, the candidate needs to convey the impression that he is competent. I hope that this book will help to promote such an approach. It has been divided in different chapters. Each of the short cases is also divided and described in the following way- instruction by the examiner, presentation of the case in front of the examiner and a brief discussion with relevant questions. I think that learning and acquiring skill in short cases will be enhanced if this book is used soon after examining a patient. This will also encourage the candidate to practice with classical clinical features of the patients. I would encourage the candidates to take this book to the ward and practice during examination of the patient in a systematic way. I would also advise the candidates to have a group discussion with the help of this book, one should present the case in front of the others and others should ask questions etc. This will make a good practice and fluency and dexterity will be achieved. Postgraduate students studying in FCPS, MD, MRCP, FRACP or other equivalent examinations in internal medicine should find this book very useful. It contains more than enough informations for the undergraduate students also. It should also be remembered that short cases are also an important milestone for a good and practicing physician. I do not claim that this book is adequate enough for whole clinical medicine and one should consult other standard textbooks. I would invite constructive criticism from the valued readers of this book, so that any errors or omission may be corrected. I pay my humble respect to my teacher Professor M A Quaderi, FRCP (London), FRCP (Glasgow), FCPS (BD), Vice-Chancellor, Bangabandhu Sheikh Mujib Medical University and Ex-Professor of Medicine, Dhaka Medical College & Hospital and Institute of Postgraduate Medicine & Research, whose continuous encouragement and support helped me to prepare this book. I sincerely acknowledge my debt to my teacher Professor Muniruddin Ahmed, FRCP (Glasgow), FRCP (London), Ex-Professor of Medicine, Dhaka Medical College & Hospital for his inspiration, guidance and constructive criticism and corrections in preparing the manuscript of this text. I am grateful to Professor M N Alam, FRCP (Glasgow), FCPS (BD), Professor of Medicine, Bangabandhu Sheikh Mujib Medical University, for his valuable suggestions and encouragement in writing this book. My heartfelt thanks to Dr. Syed Atiqul Haque, FCPS, MD, Associate Professor of Medicine, for his valuable encouragement and constructive suggestions. ix
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