100 Cases in Acute Medicine

A 19-year-old student is admitted to hospital after being found unconscious in her room in the university halls of residence. Her roommate told the paramedics that the patient had recently failed her end of year exams. She was reportedly found with several packets of paracetamol and codeine phosphate nearby and an empty bottle of wine on her bedside table. You are the medic on duty... 100 Cases in Acute Medicine presents 100 acute conditions commonly seen by medical students and junior doctors in the emergency department, or on the ward or in the community setting. A succinct summary of the patient's history, examination and initial investigations, including photographs where relevant, is followed by questions on the diagnosis and management of each case. The answer includes a detailed discussion on each topic, with further illustration where appropriate, providing an essential revision aid as well as a practical guide for students and junior doctors. Making clinical decisions and choosing the best course of action is one of the most challenging and difficult parts of training to become a doctor. Fully revised and updated for this second edition, these cases will teach students and junior doctors to recognize important clinical symptoms and signs, and to develop their diagnostic and management skills.

Abbreviations Case 1: Acute Confusion Case 2: Apparent Adverse Drug Reaction Case 3: Shortness of Breath and a Cough Case 4: Collapse and Confusion in a Young Woman Case 5: Drowsy After a Fall Case 6: Constipation with Confusion Case 7: Diarrhoea Following Antibiotics Case 8: Worsening Delirium Case 9: Swollen Glands and Hearing Impairment Case 10: Nose Bleed (Epistaxis) Following an Operation Case 11: Deliberate Self-Harm with Antifreeze Case 12: Right-Sided Chest Pain Case 13: A Case of Deliberate Self-Harm Case 14: Lymphadenopathy and Malaise Case 15: Loss of Consciousness in Diabetes Case 16: Fevers, Weight Loss, and Night Sweats Case 17: The Ill Returning Traveller Case 18: An Atypical Seizure Case 19: Delirium and Urinary Symptoms Case 20: Headache in Pregnancy Case 21: Epigastric Pain and Vomiting Case 22: Fever in a Returning Traveller Case 23: Shortness of Breath during a Sickle Cell Crisis Case 24: Chest Pain Radiating to the Back Case 25: Shortness of Breath Case 26: Recurrent Abdominal Pain Case 27: A Persistent Cough Case 28: Bloody Diarrhoea Case 29: Progressive Dysphagia in a Patient with Known Malignancy Case 30: Progressive Lower Limb Weakness Case 31: Seizure and Agitation Case 32: Substance Misuse Case 33: Unilateral Leg Swelling Case 34: Vomiting Caused by Norovirus Case 35: Fever and Sore Throat Case 36: A Couple with Headaches and Vomiting Case 37: Recurring Dizziness with Exercise Case 38: Palpitations and Collapse Case 39: Shortness of Breath in a Young Non-Smoker Case 40: ‘Indigestion’ with Radiating Pain Case 41: Memory Loss and Unsteadiness Case 42: Ecchymosis Case 43: Petechiae and Limb Weakness Case 44: Acute Breathlessness Case 45: Dysphagia and Shallow Breathing Case 46: Painful Ankles and Rash Case 47: Collapse Associated with a Headache Case 48: Blisters and Itchy Skin Case 49: Postoperative Hypotension Case 50: Drowsiness Bordering on Coma Case 51: Anxiety with Graves’ Disease Case 52: Episodic Anxiety and Headache Case 53: Cough, Fever, and Shortness of Breath Case 54: Shortness of Breath Following a Fall Case 55: A Lady with Fatigue Case 56: Haematuria and Flank Pain Case 57: Bradycardia and Malaise Case 58: Swelling of Lower Limbs Case 59: Haemoptysis and Shortness of Breath Case 60: Headache and Eyelid Drooping Case 61: Knee Swelling and Pain Case 62: Lower Abdominal Pain Case 63: Abdominal Pain, Bruising, and Confusion Case 64: Jaundice and Pruritis Case 65: Bleeding Gums and Nose Case 66: Palpitations and Shortness of Breath Case 67: Shortness of Breath and Pedal Oedema Case 68: Sharp Central Chest Pain Case 69: Chest Pain with Fever, Malaise, and Myalgia Case 70: Deteriorating Renal Function Case 71: Petechial Rash and Loss of Consciousness Case 72: Wheeze and Productive Cough Case 73: Flu-Like Illness and Generalised Weakness Case 74: Fever and a Murmur Case 75: Wheeze and Shortness of Breath Case 76: Red Eyes and Sight Impairment Case 77: Severe Abdominal Pain and Fever Case 78: Rash and Flu-Like Symptoms Case 79: Substance Abuse and Agitation Case 80: Generalised Rash and Malaise Case 81: Coffee-Ground Vomiting Case 82: Blurred Vision with Headache Case 83: Pruritic Rash and Alopecia Case 84: Abdominal Pain, Diarrhoea, and Fever Case 85: Progressive Dysphagia and Muscle Stiffness Case 86: Headache and Double Vision Case 87: Defective Vision and Eye Pain Case 88: Back Pain and Weight Loss Case 89: Abdominal Pain Following Alcohol Binge Case 90: Abdominal Pain, Malaise, and Fever Case 91: Respiratory Distress and Oedema Case 92: Night Sweats, Polyuria, and Polydipsia Case 93: Painful Shoulder and Malaise Case 94: Facial Rash Case 95: Self-Limiting Generalised Seizures Case 96: Target-Like Rash and Fever Case 97: Seizure Case 98: Loss of Pain Sensation Case 99: Shortness of Breath in a Returning Traveller Case 100: A Woman "Off Her Legs" Index

Henry Fok, Clinical Senior Lecturer in Clinical Pharmacology, Institute of Medical and Biomedical Education, St George’s University of London, UK Kerry Layne, Consultant in Acute Medicine Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK Adam Nabeebaccus, Clinical Lecturer, Cardiovascular Division, King’s College London, UK