By Andrew T. Raftery, Eric K. S. Lim, Andrew J. K. Ostor
Having the ability to make an accurate analysis is among the key points of each clinical student's and junior doctor's medical education. Problem-based studying is more and more getting used to target the reasons in the back of the presentation of a scientific function. The 3rd version of this best-selling e-book is packed jam-packed with info to assist the reader movement from a featuring challenge to a correct prognosis.
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Extra info for Churchill’s Pocketbook of Differential Diagnosis
Pregnancy. Ectopic pregnancy. Iliac artery aneurysms. Lymphadenopathy. Appendix mass. Crohn’s mass. ■■ AXR Obstruction. Dilated loops of bowel. ). Erosion of iliac bone – bone tumours. SPECIFIC INVESTIGATIONS ■■ bHCG Raised in pregnancy. ■■ Mantoux test Ileo-caecal TB. ■■ CT Ovarian lesions. Uterine lesions. Abscess. Ectopic pregnancy. Iliac artery aneurysm. Lymphadenopathy. Appendix mass. Bone tumours. ■■ Barium enema Carcinoma. Diverticular disease. ■■ Small bowel enema Crohn’s disease. Carcinoma.
Check the chest, thyroid, breast, kidney and prostate for malignancy. Check for any neurological signs. Degenerative There will be limitation of movement of the spine with osteoarthritis. With acute disc lesion there will be limitation of spine movement, lordosis and neurological symptoms of the lower limbs. Carry out a full neurological examination. Backache 47 Metabolic With osteoporosis, usually there will be only localised bone tenderness. There may be evidence of recent vertebral collapse.
TB. Ankylosing spondylitis. Section A GENERAL INVESTIGATIONS 48 Backache ■■ CRP infection, inflammation. ■■ U&Es May be abnormal in renal disease. ■■ LFTs Bilirubin and alkaline phosphatase will be raised in biliary tract obstruction related to carcinoma of the head of the pancreas. Alkaline phosphatase may also be raised in Paget’s disease, osteomalacia and secondary deposits in bone. This is bony alkaline phosphatase that is raised and isoenzymes will need checking. g. bronchial carcinoma. Secondary tumours.
Churchill’s Pocketbook of Differential Diagnosis by Andrew T. Raftery, Eric K. S. Lim, Andrew J. K. Ostor