Short Cases in
Postgraduate
Clinical Exams of
INTERNAL
MEDICINE
~ Foreword
F, RA Malik
, Contents
1. Cardiovascular Cases 1
How to Examine a Patient with Heart Disease in the
Clinical Examination? 7
Important Clues Regarding Cardiovascular Cases in the
Clinical Examination 5
Mitral Stenosis 6
Mitral Regurgitation 8
Aortic Regurgitation 70
Aortic Stenosis 72
Patient with a Prosthetic Heart Valve 74
Ventricular Septal Defect 76
Eisenmenger Complex 77
Atrial Septal Defect 78
Dextrocardia 79
Atrial Fibrillation 20
Infective Endocarditis 27
2. Respiratory Cases 26
How to Examine the Respiratory System? 26
Bilateral Basal Crackles 28
Idiopathic Pulmonary Fibrosis and Interstitial Lung Disease 29
Bronchiectasis 3 7
Cystic Fibrosis 32
Dullness at the Lung Base 33
Pleural Effusion 34
Pneumonectomy/Lobectomy 36
Unilateral Lung Fibrosis {Post-tuberculous) 37
Ch ronic Obstructive Pulmonary Disease 37
3. Abdominal Cases 41
How to Examine the Abdomen? 47
Chronic Liver Disease 45
Hemochromatosis 50
Primary Biliary Cirrhosis 57
Jaundice 52
Thalassemia Major 56
Adult Polycystic Kidney Disease (APKD) 57
Renal Transplant 59
Hepatosplenomegaly 62
,xiv Short Cases in Clinical Exams of Internal Medicine
Massive Splenomegaly 62
Hepatomegaly without Splenomegaly 63
Primary Myelofibrosis 63
Polycythemia Vera 66
Ascites 67
Liver Transplant 72
4. Neurology Cases 76
How to Perform a Neurologic Examination of the Lower
(or Upper) Limbs? 76
Common Lower Limb Neurologic Cases 78
Flaccid (Lower Motor Neuron) Paraparesis 78
Spastic Paraparesis 79
Multiple Sclerosis 82
Subacute Combined Degeneration of the Cord
(B 12 Deficiency) 84
Tabes Dorsalis 85
Friedreich's Ataxia 86
Motor Neuron Disease 86
Peripheral Neuropathy 88
Hereditary Sensorimotor Neuropathy
(Charcot-Marie-Tooth) 97
Guillain-Barre Syndrome 92
Cranial Nerve Palsies 93
Third Cranial Nerve Palsy 94
Sixth Cranial Nerve Palsy 96
Lower Motor Neuron Facial Palsy 97
Hypoglossal Nerve Palsy 98
Internuclear Ophthalmoplegia 700
Cerebellar Syndrome 707
Myasthenia Gravis 703
Myotonic Dystrophy 706
Parkinson's Disease 708
Ptosis 770
Horner's Syndrome 777
S. Endocrine, Rheumatology, Connective Tissue
and Skin Cases 113
Graves' Disease 773
Acromegaly 778
Cushing's Syndrome 722
Pseudohypoparathyroidism 724
Turner Syndrome 727
Deforming Arthritis of the Hands 728
, Contents XV
An.kylosing Spondylitis 133
Systemic Sclerosis 136
Takayasu's Arteritis Pulseless Disease 140
Marfan's Syndrome 141
Paget's Disease of the Bone 144
Henoch-Schonlein Purpura 746
Dermatomyositis 149
Hereditary Hemorrhagic Telangiectasia
(Osler-Weber-Rendu Disease) 752
Neurofibromatosis "Type 1" "von Recklinghausen's
Disease" 154
Diabetic Foot, Neuropathy and Arthropathy 756
Charcot Joint 758
6. Fundus Cases 161
Fundus Cases in the Clinical Examination 767
Diabetic Retinopathy 762
Hypertensive Retinopathy 765
Optic Atrophy 765
Papilledema 766
Retinitis Pigmentosa 767
Central Retinal Vein Occlusion 769
Index 773
Postgraduate
Clinical Exams of
INTERNAL
MEDICINE
~ Foreword
F, RA Malik
, Contents
1. Cardiovascular Cases 1
How to Examine a Patient with Heart Disease in the
Clinical Examination? 7
Important Clues Regarding Cardiovascular Cases in the
Clinical Examination 5
Mitral Stenosis 6
Mitral Regurgitation 8
Aortic Regurgitation 70
Aortic Stenosis 72
Patient with a Prosthetic Heart Valve 74
Ventricular Septal Defect 76
Eisenmenger Complex 77
Atrial Septal Defect 78
Dextrocardia 79
Atrial Fibrillation 20
Infective Endocarditis 27
2. Respiratory Cases 26
How to Examine the Respiratory System? 26
Bilateral Basal Crackles 28
Idiopathic Pulmonary Fibrosis and Interstitial Lung Disease 29
Bronchiectasis 3 7
Cystic Fibrosis 32
Dullness at the Lung Base 33
Pleural Effusion 34
Pneumonectomy/Lobectomy 36
Unilateral Lung Fibrosis {Post-tuberculous) 37
Ch ronic Obstructive Pulmonary Disease 37
3. Abdominal Cases 41
How to Examine the Abdomen? 47
Chronic Liver Disease 45
Hemochromatosis 50
Primary Biliary Cirrhosis 57
Jaundice 52
Thalassemia Major 56
Adult Polycystic Kidney Disease (APKD) 57
Renal Transplant 59
Hepatosplenomegaly 62
,xiv Short Cases in Clinical Exams of Internal Medicine
Massive Splenomegaly 62
Hepatomegaly without Splenomegaly 63
Primary Myelofibrosis 63
Polycythemia Vera 66
Ascites 67
Liver Transplant 72
4. Neurology Cases 76
How to Perform a Neurologic Examination of the Lower
(or Upper) Limbs? 76
Common Lower Limb Neurologic Cases 78
Flaccid (Lower Motor Neuron) Paraparesis 78
Spastic Paraparesis 79
Multiple Sclerosis 82
Subacute Combined Degeneration of the Cord
(B 12 Deficiency) 84
Tabes Dorsalis 85
Friedreich's Ataxia 86
Motor Neuron Disease 86
Peripheral Neuropathy 88
Hereditary Sensorimotor Neuropathy
(Charcot-Marie-Tooth) 97
Guillain-Barre Syndrome 92
Cranial Nerve Palsies 93
Third Cranial Nerve Palsy 94
Sixth Cranial Nerve Palsy 96
Lower Motor Neuron Facial Palsy 97
Hypoglossal Nerve Palsy 98
Internuclear Ophthalmoplegia 700
Cerebellar Syndrome 707
Myasthenia Gravis 703
Myotonic Dystrophy 706
Parkinson's Disease 708
Ptosis 770
Horner's Syndrome 777
S. Endocrine, Rheumatology, Connective Tissue
and Skin Cases 113
Graves' Disease 773
Acromegaly 778
Cushing's Syndrome 722
Pseudohypoparathyroidism 724
Turner Syndrome 727
Deforming Arthritis of the Hands 728
, Contents XV
An.kylosing Spondylitis 133
Systemic Sclerosis 136
Takayasu's Arteritis Pulseless Disease 140
Marfan's Syndrome 141
Paget's Disease of the Bone 144
Henoch-Schonlein Purpura 746
Dermatomyositis 149
Hereditary Hemorrhagic Telangiectasia
(Osler-Weber-Rendu Disease) 752
Neurofibromatosis "Type 1" "von Recklinghausen's
Disease" 154
Diabetic Foot, Neuropathy and Arthropathy 756
Charcot Joint 758
6. Fundus Cases 161
Fundus Cases in the Clinical Examination 767
Diabetic Retinopathy 762
Hypertensive Retinopathy 765
Optic Atrophy 765
Papilledema 766
Retinitis Pigmentosa 767
Central Retinal Vein Occlusion 769
Index 773
