Clinical cases e.g. Flashcards
Henry Marner is a 58 Year old teacher who presents Saturday morning to the emergency clinic in his local General Practice. He has been reluctant to come to see anyone at all about his problems which have been present for the last 3 months.
Presenting Complaint: Weight loss and anxiety.
On examination it is noticed he has an enlarged thyroid.
Diagnosis: Thyroid cancer
Red flags?
HIC: Gender patterns of access to health, triggers to seeking medical help
Molecules: Thyroid hormone pathway, steroid receptor signalling
Essentials: Imaging tests, clinical tests
GI: anatomy
Sophie Brooke is a 24 year old teacher who presents with a three day history of excessive thirst (polydipsia) and passing large quantities of urine (polyuria). She has lost a few kilograms in weight.
She has had no significant illnesses in the past. She is a little drowsy and clearly unwell.
Examination: Unwell, Drowsy, Dehydrated, Breathing deeply, Funny smell on breath, Test glucose in urine
HIC: Risk factors associated with diabetes, health behaviour
Molecules: Metabolism of glucose, cause of ketoacidosis, cause of polyuria/polydipsia,
GI: Secretion of endocrine pancreas, anatomy, fat metabolism
Essentials: Clinical tests
Michael Foley is a 32 year old computer programmer. He presents to his GP with a four week history of episodes of pain in the upper abdomen. These attacks tend to occur before meals and are relieved by food. He has been woken from sleep by the pain. He has a stressful job, is divorced and lives alone. He has smoked 10 cigarettes/day for 25 years but drinks alcohol only occasionally.
GI: Mechanism of PUD, phases of acid secretion, gastric hormones
Molecules: Mechanism of acid secretion, parietal cells - signalling,
HIC: How do theoretical explanations of health inequality relate?
HADPOP: prevalence survey of gastric ulcers
Essentials: imaging, innervation of stomach
Julie Desmond is a 25 year old single parent. She is referred to the Gastroenterology Clinic with a six week history of diarrhoea, dysphagia, abdominal pain and rectal bleeding.
There is a prior diagnosis of Irritable Bowel Syndrome. She does not smoke or drink alcohol. Her mother died at the age of 64 from bowel cancer.
Endscopy reveals chrons
Clin skills: differential diagnosis
GI: Causes of blood in stool, phases of swallowing, pathology of Chron’s disease, Innervation of abdomen
Maureen Fox is a 68 year old retired postmistress. She has a history of angina, heart failure and stroke and is under follow-up in the Cardiology Clinic. She is an ex-smoker.
Her symptoms are well-controlled but her blood pressure is 210/120. Blood tests show that her kidney function is gradually deteriorating.
HIC: Describe the relationship between health behaviours and patients’ social and material circumstances. Why is understanding healh behaviour important?
Essentials: Normal BP? Blood tests for kidney function?
Clin skills: what is angina? 3 signs of heart failure, cause of stroke
Molecules: endocrine control of blood pressure
Lawrence Morgan is 23 years old and unemployed. He is taken to the Accident & Emergency Department following a fit in his local. On arrival he is drowsy, feverish and complains of a headache.
There is a history of intravenous drug use, he is HIV positive and he has in the past been treated for tuberculosis.
HIC: Socioeceonomic impact on health and health behaviour
Clin skills: Differential diagnoses
Essentials: Organisation of motor control. Histological signs of inflammation, Cells involved.
James Kendall is a 76 year old retired farmer who presented with a chest infection to his GP. This did not clear despite 4 courses of antibiotics. A FBC revealed abnormal cells and a haematology review was requested.
Diagnosis: chronic myeloid leukemia
Molecules: Karyotyping, genetics of CML
HADPOP: Design prevalence survey
Essentials: Pathway of haematopoeisis
Kirk Grendfell is presented to his GP by his mother. Kirk is 34 years old and has been very forgetful recently and very difficult to look after. Kirk is known to have Down’s syndrome.
Presenting Complaint: Forgetfulness
Molecules: Meiosis/Non-disjunction,
Clin skills: signs of dementia, pre-natal diagnosis
HIC: ICE? Why is it important to consider patient perspectives?
