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Robert E.J. Ryder is Consultant Physician and Clinical IT Lead at City Hospital NHS Trust, Birmingham, and Honorary Senior Lecturer in Medicine at the University of Birmingham.
Dr M. Afzal Mir is Senior Lecturer and Consultant Physician at University Hospital of Wales, Cardiff
Dr Anne Freeman is Consultant Physician at Royal Gwent Hospital, Newport, and Clinical Adviser and Chairwoman of the Welsh Stroke Alliance
Dr Edward Fogden is Consultant Physician and Gastroenterologist at Sandwell and West Birmingham Hospitals NHS Trust
Preface
Introduction
Section G: Examination Routines 0
1 Pulse
2 Heart
3 Chest
4 Abdomen
5 Visual fields
6 Cranial nerves
7 Arms
8 Legs
9 Legs and arms
10 Gait
11 Ask some questions
12 Fundi
13 Eyes
14 Face
15 Hands
16 Skin
17 Rash
18 Neck
19 Thyroid status
20 Knee
21 Hip
22 What is the diagnosis?
Section H: Integrated Clinical Assessement 000
Station 5 Scenarios by speciality
Dermatology
1 Pyoderma gangrenosum
2 Psoriasis
3 Dermatomyositis
Rheumatology
4 systemic sclerosis and raynauds with digital ulceration
5 RA (NB fx on ADL)
6 Psoriatic arthropathy (rash and joints) – pitting / rash
7 Ankylosing spondylitis – short notes
8 Gout – short notes
9 Steroid toxicity – short notes
Endocrine
10 Thyroid eye disease
11 Acromegaly
12 Charcot joint
13 DM foot and DM control
14 Goitre / other neck swelling
Eyes
15 Retinitis pigmentosa
16 Diabetic retinopathy
17 Optic atrophy
Gastroenterology
18 Male with IDA
19 GI bleed - MW tear; hx; Rockall & Blatchford; early OP OGD.
20 Elevated LFT - Raised LFT and alcohol history
21 Elevated LFT and hep B serology
22 Crohn’s Disease / IBD - diarrhoea weight loss urgency rectal bleeding
23 Dysphagia weight loss - cancer risk
24 Diarrhoea – recent foreign travel or antibiotics
25 Weight loss
26 GI bleed – significant bleed (DU/NSAID)
Haematology
27 Anaemia – hb 7 mcv 68 menorrhagia
28 Easy bruising / ITP
29 High INR epistaxis
30 Neutropenic patient on chemo – results just phoned back
Cardiology
31 Young syncope
32 Angina / chest pain
33 Palpitations ? AF
34 Breathlessness / CCF
35 Syncope / AS
36 Syncope / orthostatic
Respiratory
37 COPD / “breathlessness”
38 Asthma
39 Pleural effusion
40 SOB in normal ?PE
41 RA / fibrosis ?? SOB
42 Haemoptysis
Neurology
43 Headache – progressive / memory issues
44 Headache – migraine
45 Headache - ?SAH
46 TIA – loss of vision
47 left sided weakness in young female whilst at hairdresser with FHx stroke
48 PD – falls elderly
49 CN palsy – VI sudden
50 Blackout - First Fit
51 Essential Tremor:
52 GCA / temporal arteritis – painful to brush hair
53 Carpal tunnel
54 MS diplopia
55 Peripheral neuropathy
Miscellaneous
56 UTI – male / sexual history
57 Swollen calf – young
58 DVT – older secondary to neoplasia
59 Deterioration in UE
60 Fever in the returning traveller
Section I: Short Case Records
[Ed – names in red have been changed from last edition – please check all contents short case names match the actual short cases! Alert me to any discrepancies – thanks]
Station 5 Skin
1 Systemic sclerosis/CRST syndrome
2 Neurofibromatosis (von Recklinghausen’s disease)
3 Osler–Weber–Rendu syndrome
4 Psoriasis
5 Rash of uncertain cause
6 Dermatomyositis
7 Xanthomata
8 Vitiligo
9 Adenoma sebaceum in tuberous sclerosis complex
10 Pseudoxanthoma elasticum
11 Lichen planus
12 Yellow nail syndrome
13 Gouty tophi
14 Alopecia areata
15 Eczema
16 Pretibial myxoedema
17 Clubbing
18 Necrobiosis lipoidica diabeticorum
19 Lupus pernio
20 Tinea
21 Koilonychia
22 Raynaud’s phenomenon
23 Erythema nodosum
24 Sturge–Weber syndrome
25 Purpura
26 Peutz–Jeghers syndrome
27 Vasculitis
28 Ehlers–Danlos syndrome
29 Livedo reticularis
30 Pemphigus/pemphigoid
31 Radiation burn on the chest
32 Herpes zoster
33 Henoch–Schönlein purpura
34 Mycosis fungoides
35 Morphoea
36 Kaposi’s sarcoma (AIDS)
37 Porphyria
38 Lupus vulgaris
39 Dermatitis herpetiformis
40 Urticaria pigmentosa (mastocytosis)
41 Palmoplantar keratoderma (tylosis)
42 Secondary syphilis
43 Ectodermal dysplasia
44 Partial lipodystrophy
45 Fabry’s disease
46 Reiter’s syndrome/reactive arthritis/keratoderma blenorrhagica
47 Malignant melanoma
48 Acanthosis nigricans
49 Keratoacanthoma
50 Pyoderma gangrenosum
51 Psychogenic/factitious
Station 5 Locomotor
1 Rheumatoid arthritis
2 Psoriatic arthropathy
3 Systemic sclerosis/CRST syndrome
4 Diabetic foot/Charcot’s joint
5 Tophaceous gout
6 Ankylosing spondylitis
7 Paget’s disease
8 Osteoarthritis
9 Marfan’s syndrome
10 Vasculitis
11 Proximal myopathy
12 One leg shorter and smaller than the other
13 Radial nerve palsy
14 Arthropathy associated with inflammatory bowel disease
15 Polymyositis
16 Systemic lupus erythematosus
17 Old rickets
18 Juvenile idiopathic arthritis
19 Swollen knee
Station 5 Endocrine
1 Exophthalmos
2 Acromegaly
3 Graves’ disease
4 Goitre
5 Hypothyroidism
6 Cushing’s syndrome
7 Addison’s disease
8 Hypopituitarism
9 Pretibial myxoedema
10 Gynaecomastia
11 Turner’s syndrome
12 Klinefelter’s syndrome / hypogonadism
13 Bitemporal hemianopia
14 Charcot’s joint
15 Necrobiosis lipoidica diabeticorum
16 Short stature
17 Pseudohypoparathyroidism
18 Pendred’s syndrome
Station 5 Eyes
1 Diabetic retinopathy
2 Retinitis pigmentosa
3 Optic atrophy
4 Ocular palsy
5 Visual field defect
6 Retinal vein occlusion
7 Old choroiditis
8 Papilloedema
9 Cataracts
10 Myasthenia gravis
11 Albinism
12 Exophthalmos
13 Myelinated nerve fibres
14 Hypertensive retinopathy
15 Glaucoma/peripheral field loss
16 Retinal artery occlusion
17 Asteroid hyalosis
18 Drusen
19 Laurence–Moon–Bardet–Biedl syndrome
20 Cytomegalovirus choroidoretinitis (AIDS)
21 Normal fundus
Station 5 Other
1 Bilateral parotid enlargement/Mikulicz’s syndrome
2 Deep venous thrombosis/Baker’s cyst/cellulitis
3 Peripheral vascular disease
4 Osteogenesis imperfecta
5 Down’s syndrome
6 Pernicious anaemia
7 Klippel–Feil syndrome
8 Leg oedema
Appendices
1 Checklists
2 Texidor’s twinge and related matters
3 Abbreviations
Index
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