Foreword ix
Preface x
Acknowledgements xi
Abbreviations xii
Advice xv
Station 1: Abdominal and Respiratory 1
Clinical mark sheet 1
Chronic liver disease and hepatomegaly 2
Haemochromatosis 5
Splenomegaly 7
Renal enlargement 9
The liver transplant patient 11
The renal patient 12
Pulmonary fibrosis 14
Bronchiectasis 16
Old tuberculosis 17
Surgical respiratory cases 18
Chronic obstructive airways disease 19
Pleural effusion 21
Lung cancer 22
Cystic fibrosis 24
Pneumonia 25
Station 2: History Taking 27
Clinical mark sheet 27
Introduction and advice 28
Case 1 32
Case 2 33
Case 3 34
Case 4 35
Case 5 36
Case 6 37
Case 7 38
Case 8 39
Case 9 40
Case 10 41
Case 11 42
Case 12 43
Station 3: Cardiology and Neurology 44
Clinical mark sheet 44
Aortic stenosis 45
Aortic incompetence 47
Mitral stenosis 49
Mitral incompetence 51
Tricuspid incompetence 53
Pulmonary stenosis 54
Prosthetic valves: aortic and mitral 55
Implantable devices 57
Pericardial disease 58
Other Common Congenital Defects 60
Atrial septal defect 60
Ventricular septal defect 61
Hypertrophic (obstructive) cardiomyopathy 63
Dystrophia myotonica 65
Cerebellar syndrome 67
Multiple sclerosis 69
Stroke 71
Lateral medullary (Wallenberg) syndrome 74
Spastic legs 75
Syringomyelia 77
Motor neurone disease 79
Parkinson's disease 81
Hereditary sensory motor neuropathy 83
Friedreich's ataxia 84
Facial nerve palsy 85
Myasthenia gravis 86
Tuberous sclerosis 88
Neurofibromatosis 89
Abnormal pupils 90
Optic atrophy 92
Retinal Patholo gy 93
Age?]related macular degeneration (AMD) 93
Retinitis pigmentosa 94
Retinal artery occlusion 95
Retinal vein occlusion 96
Station 4: Ethics Law and Communication Skills 97
Clinical mark sheet 97
Ethics And Law In Medicine 98
Principles of medical ethics 98
Medico?]legal system 99
Negligence 100
Competency and consent 101
Confidentiality 104
End of life decisions 105
Communication skills 107
Dealing with a difficult patient 108
Driving restrictions 109
Information delivery 110
Worked examples 111
Sample questions 116
Station 5: Brief Clinical Consultations 117
Clinical mark sheet 117
Chest pain 119
Headache 121
Swollen calf 123
Altered conscious state 124
Anaemia 125
Osler-Weber-Rendu syndrome (hereditary haemorrhagic telangiectasia) 127
Haemoptysis 128
Worsening mobility 129
Persistent fever 131
Dyspnoea 133
Syncope 135
Atrial fibrillation 137
Inflammatory bowel disease 139
Hypertension 141
Red rashes 143
Leg ulcers 146
Diabetes and the skin 148
Erythema nodosum 150
Henoch-Schonlein purpura 151
Skin malignancy 152
Skin and hyperextensible joints 154
Rheumatoid arthritis 156
Systemic lupus erythematosus 159
Systemic sclerosis 161
Ankylosing spondylitis 163
Marfan's syndrome 164
Paget's disease 165
Other joint problems 166
Diabetic retinopathy 168
Hyperthyroidism and Graves' disease 171
Hypothyroidism 173
Acromegaly 174
Cushing's disease 176
Addison's disease 178
Sickle cell disease 180
Index 182
