2nd Edition

100 Diagnostic Dilemmas in Clinical Medicine

By Kerry Layne Copyright 2024
    423 Pages 40 Color & 50 B/W Illustrations
    by CRC Press

    423 Pages 40 Color & 50 B/W Illustrations
    by CRC Press

    423 Pages 40 Color & 50 B/W Illustrations
    by CRC Press

    A 57-year-old man presented to the emergency department complaining of a worsening cough. The cough had been present for approximately two weeks and was productive of green sputum. The patient had seen his general practitioner one week earlier and taken a course of amoxicillin for a presumed lower respiratory tract infection with no improvement of symptoms. He was febrile, experiencing frequent headaches and a feeling of general malaise, and had been unable to eat solid food for the last 48 hours due to facial pain on chewing. You have been asked to assess him and devise a management plan…

    100 Diagnostic Dilemmas in Clinical Medicine presents 100 real-life scenarios seen in the hospital and community setting. A succinct summary of the patient's history, examination and any initial investigations is followed by a detailed consideration of the diagnosis and management of each case, in the short, medium and, where appropriate, long term.

    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. These extended true-to-life cases will teach students and junior doctors to recognize important medical conditions and to develop their diagnostic and management skills.

    Key features:

    • Extended case studies presented in an easy-to-read format, presenting patient history, examination, investigations and differential diagnosis
    • Readers are guided through the clinician's sequence of thoughts and actions as they consider how to manage the case appropriately in the short, medium and, if necessary, long term
    • Plentiful illustrations supplement the text
    • A broad range of conditions is covered, from acquired haemophilia to intestinal tuberculosis



    List of Abbreviations

    Reference Ranges for Common Investigations

    Case 1. Confusion and Persistent Fever

    Case 2. Painful Upper Limb Swelling

    Case 3. An Unusual Infection

    Case 4. A Teenager with Falls

    Case 5. A Case of Intrapartum Fever

    Case 6. Jaundice and Diarrhoea

    Case 7. Erratic Behaviour

    Case 8. A Young Woman with Fever and Chest Pain

    Case 9. An Enlarged Tongue

    Case 10. A Young Man with an Abnormal Chest X-ray

    Case 11. Visual Loss and Confusion

    Case 12. Left-Eye Pain

    Case 13. Spontaneous Bleeding

    Case 14. A Young Man with a Rash and Hearing Impairment

    Case 15. Recurrent Loss of Consciousness

    Case 16. Visual Loss and Anuria

    Case 17. Abdominal Pain and Weight Loss

    Case 18. Worsening Shortness of Breath and Cough

    Case 19. Fatigue and Constipation

    Case 20. An Upper Limb Mass

    Case 21. A Teenager with a Rash and Fever

    Case 22. Hepatitis in a Nightshift Worker

    Case 23. Yellow Blood

    Case 24. An Unusual Method of Deliberate Self-Harm

    Case 25. Coffee Ground Vomiting

    Case 26. A Case of Parotitis Followed by Acute Hearing Loss

    Case 27. A Purpuric Rash

    Case 28. An Elderly Patient Admitted with a Fall

    Case 29. A Young Mother with Constipation

    Case 30. Hyperpigmented Skin Lesions

    Case 31. It’s All in Your Head

    Case 32. A Right Upper Quadrant Pain Puzzle

    Case 33. Arthritis, Miscarriage and Drowsiness

    Case 34. A Confused Traveller

    Case 35. A Pleural Effusion on a Background of Knee Pain

    Case 36. A Hypertensive Patient with Carpal Spasms

    Case 37. A Patient with HIV and Personality Change

    Case 38. Unilateral Facial Weakness

    Case 39. Chest Pain with a Gynaecological Cause

    Case 40. A First Fit

    Case 41. Collapse in the Corridor

    Case 42. ITP or Not ITP?

    Case 43. Recurrent Haemothorax

    Case 44. Hepatosplenomegaly

    Case 45. Cutaneous Ulceration in a Patient with Rheumatoid Arthritis

    Case 46. An Elderly Man with Confusion

    Case 47. Severe Sepsis Following Tonsillitis

    Case 48. A Farmer with Abdominal Pain

    Case 49. Recurrent Episodes of Acute Kidney Injury

    Case 50. A Sauna Cleaner with Shortness of Breath

    Case 51. A Hypernatraemic Patient

    Case 52. Recurrent Abdominal Pain and Diarrhoea

    Case 53. A Teenager with a Rash

    Case 54. Bilateral Foot Weakness

    Case 55. Hepatomegaly in a Patient with Newly Diagnosed Diabetes Mellitus

    Case 56. A Teenager with Palpitations

    Case 57. A Patient with Sickle Cell Disease and Flu-Like Symptoms

    Case 58. Vomiting without Gastrointestinal Pathology

    Case 59. Seizures and Hand Lesions

    Case 60. New Confusion in a Patient with Bipolar Affective Disorder

    Case 61. A Blistering Rash

    Case 62. Heart and Lungs

    Case 63. Sudden Onset Headache

    Case 64. A Febrile Canoeist

    Case 65. Chest Pain and an Abnormal Blood Film

    Case 66. Numb Fingers and Eosinophilia

    Case 67. Fevers and Cough (Part 1)

    Case 68. Fever and Cough (Part 2)

    Case 69. Fevers, Night Sweats and Lymphadenopathy

    Case 70. Unconscious outside a Club

    Case 71. A Relentless Rash

    Case 72. Bleeding Gums

    Case 73. Chest Pain after Bad News

    Case 74. HIV and Seizures

    Case 75. A Patient with Crohn’s Disease and Worsening Diarrhoea

    Case 76. Bilateral Hip Pain

    Case 77. A Young Woman with Chest Pain

    Case 78. A Heavy Smoker with Proximal Weakness

    Case 79. Collapse Following Influenza

    Case 80. Diarrhoea and Proximal Weakness

    Case 81. Haemoptysis and Renal Failure

    Case 82. A Young Patient with a Chronic Cough

    Case 83. Abdominal Pain and Bloody Diarrhoea

    Case 84. Nocturnal Enuresis and Back Pain

    Case 85. Shivering at the Station

    Case 86. Loss of Vision and Ophthalmitis

    Case 87. A Pregnant Woman with Loss of Vision

    Case 88. Rash, Fevers and Headache

    Case 89. Haemoptysis and Diplopia

    Case 90. Post-Partum Auditory Hallucinations

    Case 91. Rapidly Progressive Dementia

    Case 92. A Hillwalker with Fever and Chest Pain

    Case 93. Fever, Weight Loss and Night Sweats

    Case 94. Painless Jaundice

    Case 95. A Young Man with Chest Pain

    Case 96. An Unusual Cause of Haematemesis

    Case 97. TB or Not TB?

    Case 98. Headache at the Cattle Farm

    Case 99. Recurrent Lower Respiratory Infections Following a Renal Transplant

    Case 100. An Unsolved Mystery



    Kerry Layne, Consultant in Acute Medicine Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.