2nd Edition
100 Cases in Clinical Pathology and Laboratory Medicine
A 77-year-old man phones ‘999’ after experiencing severe backache. The paramedics arrive to find him in severe pain, and cold and clammy. While at his house, they note that he smokes and also elicit a history of hypertension. He is tachycardic and hypotensive en route to hospital, and intravenous fluids are started. You have been assigned his initial assessment ...
100 Cases in Clinical Pathology and Laboratory Medicine presents 100 clinical scenarios commonly seen by medical students and junior doctors in the emergency department, outpatient clinic, operating theatre or in general practice. A succinct summary of the patient's history, examination and initial investigations is followed by questions on each case, with particular emphasis on the interpretation of the results and in which an understanding of the underlying clinical pathology is central to arriving at the correct diagnosis. The answer includes a detailed discussion on each topic, providing an essential revision aid as well as a practical guide for students and junior doctors, especially those preparing for undergraduate and postgraduate examinations.
Making speedy and appropriate clinical decisions, and choosing the best course of action to take as a result, is one of the most important and challenging parts of training to become a doctor. Fully revised and updated for this second edition, these true-to-life cases will teach students and junior doctors to recognize important clinical conditions, to request the appropriate pathological investigation and correctly interpret those results, and, as a result, to develop their diagnostic and management skills.
Section 1- LABORATORY MEDICINE
Case 1 POLYURIA AND POLYDIPSIA
Case 2 TRACES OF BLOOD FOUND ON URINE DIPSTICK
Case 3 CONFUSION, LETHARGY AND SHORTNESS OF BREATH
Case 4 A CHILD WITH FACIAL SWELLING
Case 5 JOINT PAINS AND FATIGUE
Case 6 ANXIETY, IRRITABILITY AND REDUCED MENSTRUAL FREQUENCY
Case 7 SCREENING FOR PROSTATE CANCER?
Case 8 A YOUNG WOMAN FOUND UNCONSCIOUS IN BED
Case 9 A MIDDLE-AGED WOMAN WITH JAUNDICE
Case 10 DRUG OVERDOSE
Case 11 FATIGUE, WEAKNESS AND CONSTIPATION
Case 12 EXCESSIVE HAIR GROWTH AND INFERTILITY
Case 13 FATIGUE AND IRREGULAR PERIODS
Case 14 STIFF AND PAINFUL HANDS
Case 15 ABDOMINAL PAIN, NAUSEA AND VOMITING
Case 16 FREQUENT THROAT AND CHEST INFECTIONS
Case 17 A ROUTINE ‘HEALTH CHECK’ FOR A 55-YEAR-OLD MAN
Case 18 COLLAPSE IN A PATIENT UNDERGOING CHEMOTHERAPY
Case 19 A 10-DAY-OLD BABY WITH AMBIGUOUS GENITALIA
Case 20 FATIGUE, WEAKNESS AND WEIGHT GAIN
Case 21 HYPERTENSION IN A YOUNG WOMAN
Case 22 NAUSEA, VOMITING, WEAKNESS AND PARAETHESIA
Case 23 ERECTILE DYSFUNCTION IN A YOUNG MAN
Case 24 A YOUNG MAN WITH ‘HIGH CHOLESTEROL’
Case 25 RASH AFTER A BONE MARROW TRANSPLANT
Case 26 A FALL ON AN OUTSTRETCHED HAND
Case 27 A PATIENT IN FOLLOW-UP AFTER A LIVER TRANSPLANT
Case 28 A MAN WITH POORLY CONTROLLED BLOOD PRESSURE
Case 39 DIZZINESS ON STANDING UPRIGHT
Case 30 SUDDEN-ONSET CHEST PAIN IN A TALL WOMAN
Case 31 CONCERNS ABOUT THE RISK OF BREAST CANCER
Case 32 SEIZURE IN A NEONATE
Case 33 FLU -LIKE ILLNESS AFTER FOREIGN TRAVEL
Section 2- HISTOPATHOLOGY
Case 34 A YOUNG WOMAN WITH ANKLE SWELLING AND SHORTNESS OF BREATH
Case 35 CHEST PAIN AND SUDDEN DEATH
Case 36 AN ELDERLY MAN WITH SEVERE BACK PAIN
Case 37 INCREASED BREATHLESSNESS AND SUDDEN DEATH
Case 38 A WORSENING COUGH AND HAEMOPTYSIS
Case 39 A YOUNG MAN WITH SHORTNESS OF BREATH AND HAEMOPTYSIS
Case 40 SUDDEN ONSET WEAKNESS AND DYSPHASIA
Case 41 NUMBNESS, WEAKNESS AND CLUMSINESS
Case 42 FORGETFULNESS AND DISORIENTATION
Case 43 COFFEE-GROUND VOMITING
Case 44 EPISODIC RIGHT UPPER QUADRANT ABDOMINAL PAIN
Case 45 CHRONIC DIARRHOEA AND FLATULENCE
Case 46 A YOUNG MAN WITH BLOODY DIARRHOEA
Case 47 ABDOMINAL DISCOMFORT AND GENERALISED WEAKNESS
Case 48 ABDOMINAL PAIN IN A PUBLICAN
Case 49 ABDOMINAL DISTENSION, LOSS OF APPETITE AND MALAISE
Case 50 BACK PAIN AND FEVER IN A DIABETIC
Case 51 URINARY PROBLEMS IN AN ELDERLY MAN
Case 52 A YOUNG MAN WITH A TESTICULAR LUMP
Case 53 HEAVY AND PAINFUL MENSTRUAL BLEEDING
Case 54 ABNORXMAL VAGINAL BLEEDING
Case 55 A LUMP IN THE BREAST
Case 56 LYMPH NODE ENLARGEMENT IN A YOUNG MAN
Case 57 AN ITCHY, BLEEDING MOLE ON THE BACK
Case 58 BLOOD IN THE URINE IN AN ELDERLY MAN
Case 59 THYROID DISEASE IN A YOUNG WOMAN
Section 3 – HAEMATOLOGY
Case 60 SHORTNESS OF BREATH AND HEARTBURN
Case 61 RAISED WHITE CELL COUNT IN AN ASYMPTOMATIC INDIVIDUAL
Case 62 WORSENING FATIGUE AND BLEEDING GUMS
Case 63 BURNING URINE AND AN ABNORMAL CLOTTING SCREEN
Case 64 HEADACHES, BLURRED VISION AND ITCHING
Case 65 A PAINFUL ARM AND A LARGE SPLEEN
Case 66 A RASH ON THE THIGHS
Case 67 FATIGUE AND WEIGHT LOSS
Case 68 PNEUMONIA WITH ABNORMAL LIVER FUNCTION
Case 69 RECURRENT EPISTAXIS
Case 70 BRUISING AFTER A PNEUMONIA
Case 71 HEADACHE AND A RASH
Case 72 SHORTNESS OF BREATH AND WEIGHT LOSS
Case 73 ANAEMIA RESISTANT TO A BLOOD TRANSFUSION
Case 74 ASYMPTOMATIC ANAEMIA IN THE ELDERLY
Case 75 BACK PAIN AND FATIGUE
Case 76 SHORT OF BREATH AND UNDERWEIGHT
Case 77 DETERIORATION AFTER A BLOOD TRANSFUSION
Case 78 HEADACHE AND BLURRED VISION
Case 79 LOWER BACK PAIN
Section 4 – MICROBIOLOGY
Case 80 LEG PAIN AND FEVERS
Case 81 FEVER AND COLLAPSE
Case 82 BURNING SENSATION WHEN PASSING URINE
Case 83 A BIT SHORT OF BREATH
Case 84 UNHAPPY CAMPER
Case 85 DIARRHOEA IN AN ELDERLY MAN
Case 86 A PAINFUL KNEE
Case 87 A PAIN IN THE EAR
Case 88 A RED EYE
Case 89 CHILD WITH A RASH
Case 90 PELVIC PAIN
Case 91 A PAINFUL SWOLLEN JAW
Case 92 TRAVELLER’S DIARRHOEA
Case 93 FEVER IN A RETURNING TRAVELLER
Case 94 A SPOT OF CONFUSION
Case 95 CONGENITAL INFECTION
Case 96 A CHRONIC COUGH
Case 97 A JAUNDICED VIEW
Case 98 GRAM NEGATIVE BACTERAEMIA
Case 99 A GROIN SWELLING
Case 100 URETHRAL DISCHARGE
Biography
Eamon Shamil MBBS, MRes, DOHNS, FRCS (ORL-HNS) Post-CCT Fellow in Rhinology, Anterior Skull Base, and Facial Plastic Surgery, The Royal National ENT Hospital, University College London Hospitals NHS Foundation Trust, London, UK
Praful Ravi MA MB BChir MRCP Attending Physician in Genitourinary Oncology, Dana-Farber Cancer Institute; Instructor of Medicine, Harvard Medical School, Boston, USA
Ashish Chandra FRCPath DipRCPath (Cytol) Lead Consultant for Cytopathology & Urological Histopathology, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; Chair, British Association of Urological Pathologists (BAUP); Vice President, International Academy of Cytology (IAC); Deputy Editor, Cytopathology
