CiNii Books - An aid to the MRCP short cases

The first edition of An Aid to the MRCP Short Cases rapidly estabished itself as a classic and has sold over 25,000 copies. The aims of this revised and extended second edition are the same as those of the first: to provide a comprehensive guide for those preparing for the short cases section of the Membership of the Royal College of Physicians examination. The MRCP examination is a major hurdle for all trainee hospital physicians and has a failure rate of over 70%. The largest part of the book consists of 200 short cases that are presented in order of frequency of their occurrence in the examination (based on an extensive survey of successful candidates). The clinical features of each case are fully covered and supported by illustrations and photographs. The emphasis throughout the book is on examination technique and how to present the clinical information in the style that the examiners expect. In short, it is an indispensable guide for anyone preparing for this critical examination.

Table of Contents

Preface to the second edition ix Preface to the first edition xi Introduction xiii Section 1: Preparation 1 Section 2: Examination Routines 7 1 Heart 10 2 Abdomen 14 3 Fundi 18 4 Hands 20 5 Legs 24 6 Chest 28 7 Spot diagnosis 31 8 Eyes 35 9 Face 37 10 Arms 38 11 Neck 42 12 Ask questions 43 13 Pulse 46 14 Visual fields 48 15 Skin 49 16 Gait 51 17 Rash 53 18 Legs and arms 54 19 Cranial nerves 55 20 Thyroid status 58 Section 3: 200 Short Case Records 61 1 Diabetic retinopathy 65 2 Hepatosplenomegaly 69 3 Mitral stenosis (lone) 71 4 Rheumatoid hands 73 5 Mixed mitral valve disease 76 6 Dullness at the lung base 78 7 Splenomegaly (without hepatomegaly) 80 8 Optic atrophy 82 9 Chronic liver disease 84 10 Polycystic kidneys 86 11 Paget's disease 87 12 Psoriatic arthropathy/psoriasis 90 13 Other combinations of mitral and aortic valve disease 93 14 Mixed aortic valve disease 94 15 Systemic sclerosis/CRST syndrome 96 16 Exophthalmos 98 17 Hepatomegaly (without splenomegaly) 101 18 Spastic paraparesis 102 19 Fibrosing alveolitis 103 20 Aortic incompetence (lone) 104 21 Hemiplegia 106 22 Old tuberculosis 108 23 Acromegaly 109 24 Aortic stenosis (lone) 112 25 Graves' disease 114 26 Ocular palsy 117 27 Mitral incompetence (lone) 121 28 Motor neurone disease 123 29 Goitre 126 30 Ulnar nerve palsy 129 31 Visual field defect 131 32 Peripheral neuropathy 134 33 Hypertensive retinopathy 136 34 Resuscitation Annie 138 35 Cerebellar syndrome 142 36 Retinitis pigmentosa 144 37 Carcinoma of the bronchus 145 38 Parkinson's disease 148 39 Chronic bronchitis and emphysema 150 40 Hypothyroidism 152 41 Osler-Weber-Rendu syndrome 155 42 Abdominal mass 157 43 Dystrophia myotonica 159 44 Bronchiectasis 161 45 Wasting of the small muscles of the hand 162 46 Generalized lymphadenopathy 165 47 Papilloedema 166 48 Diabetic foot 168 49 Nystagmus 171 50 Old choroiditis 174 51 Neurofibromatosis (von Recklinghausen's disease) 176 52 Erythema nodosum 178 53 Horner's syndrome 180 54 Old polio 182 55 Ankylosing spondylitis 184 56 Abnormal gait 186 57 Irregular pulse 189 58 Single palpable kidney 190 59 Ascites 191 60 Sturge-Weber syndrome 193 61 Necrobiosis lipoidica diabeticorum 195 62 Ventricular septal defect 197 63 Lower motor neurone VIIth nerve palsy 198 64 Clubbing 201 65 Retinal vein thrombosis 203 66 Eisenmenger's syndrome 205 67 Crohn's disease 207 68 Mitral valve prolapse 209 69 Cervical myelopathy 211 70 Patent ductus arteriosus 213 71 Tricuspid incompetence 214 72 Purpura 215 73 Xanthomata 218 74 Drug-induced extrapyramidal syndrome 220 75 Bilateral parotid enlargement/Mikulicz's syndrome 221 76 Primary biliary cirrhosis 222 77 Lupus pernio 224 78 Muscular dystrophy 226 79 Prosthetic valves 228 80 Addison's disease 229 81 Cushing's syndrome 231 82 Friedreich's ataxia 234 83 Peutz-Jeghers syndrome 236 84 Systemic lupus erythematosus 237 85 Superior vena cava obstruction 239 86 Vasculitis 241 87 Deep venous thrombosis/Baker's cyst/cellulitis 244 88 Cor pulmonale 247 89 Myelinated nerve fibres 248 90 Charcot-Marie-Tooth disease 249 91 Cataracts 251 92 Idiopathic haemochromatosis 253 93 Chest infection/consolidation/pneumonia 255 94 Coarctation of the aorta 256 95 Bulbar palsy 257 96 Choreoathetosis 258 97 Dysarthria 260 98 Dysphasia 261 99 Ehlers-Danlos syndrome 263 100 Erythema ab igne 265 101 Marfan's syndrome 267 102 Myasthenia gravis 269 103 Osteoarthrosis 272 104 Raised jugular venous pressure 274 105 Pretibial myxoedema 275 106 Retinal artery occlusion 277 107 Vitiligo 279 108 Tophaceous gout 282 109 Fallot's tetralogy with a Blalock shunt 284 110 Slow pulse 285 111 Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculopathy) 286 112 Pneumonectomy/lobectomy 288 113 Obesity/pickwickian syndrome 290 114 Dermatomyositis 293 115 Hypopituitarism 295 116 Swollen knee 297 117 Pseudobulbar palsy 299 118 Pemphigus/pemphigoid 300 119 Syringomyelia 303 120 Tuberculosis/apical consolidation 305 121 Rheumatoid lung 307 122 Tuberous sclerosis/adenoma sebaceum 308 123 Proximal myopathy 310 124 Pseudoxanthoma elasticum 311 125 Radiation burn on the chest 313 126 Subacute combined degeneration of the cord 314 127 Holmes-Adie-Moore syndrome 315 128 Peripheral vascular disease 316 129 Transplanted kidney 318 130 Glaucoma/peripheral field loss 320 131 Nephrotic syndrome 322 132 Jugular foramen syndrome 323 133 Herpes zoster 325 134 Henoch-Schoenlein purpura 327 135 Polymyositis 329 136 Argyll Robertson pupils 330 137 Congenital syphilis 331 138 Carpal tunnel syndrome 333 139 Cerebellopontine angle lesion 335 140 Dextrocardia 336 141 Down's syndrome 337 142 Gynaecomastia 338 143 Absent ankle jerks and extensor plantars 340 144 Lichen planus 341 145 Lateral popliteal (common peroneal) nerve palsy 343 146 Ptosis 345 147 Osteogenesis imperfecta 348 148 Pulmonary stenosis 349 149 Raynaud's phenomenon 350 150 Turner's syndrome 352 151 Mycosis fungoides 354 152 Morphoea 356 153 Laurence-Moon-Bardet-Biedl syndrome 358 154 Short stature 360 155 Pseudohypoparathyroidism 362 156 AIDS related 365 157 Porphyria 368 158 Lupus vulgaris 370 159 Cannon waves 372 160 Polycythaemia rubra vera 373 161 Asteroid hyalosis 374 162 Pernicious anaemia 375 163 Dermatitis herpetiformis 377 164 Urticaria pigmentosa (mastocytosis) 379 165 Pneumothorax 380 166 Tabes 381 167 Tylosis 383 168 Klippel-Feil syndrome 385 169 Pendred's syndrome 387 170 Secondary syphilis 389 171 Ectodermal dysplasia 391 172 Old rickets 393 173 Partial lipodystrophy 395 174 Fabry's disease 397 175 Subclavian-steal syndrome 399 176 Reiter's syndrome/keratoderma blenorrhagica 401 177 Carcinoid syndrome 403 178 Infantile hemiplegia 404 179 Pulmonary incompetence 406 180 Hereditary spherocytosis 408 181 Juvenile chronic arthritis 409 182 Cystic fibrosis 411 183 Infective endocarditis 413 184 Malignant melanoma 415 185 Leg oedema 417 186 Acanthosis nigricans 419 187 Drusen 422 188 Yellow nail syndrome 423 189 Klinefelter's syndrome/hypogonadism 424 190 Keratoacanthoma 428 191 Thalamic syndrome 429 192 Atrial septal defect 430 193 Pyoderma gangrenosum 431 194 Multiple sclerosis 433 195 Felty's syndrome 435 196 Hypertrophic obstructive cardiomyopathy 436 197 Radial nerve palsy 437 198 Lateral medullary syndrome (Wallenberg's syndrome) 438 199 Psychogenic/factitious 440 200 Normal 444 Section 4: Experiences Anecdotes Tips Facts and Figures Quotations 445 Experiences 447 The power and range of the candidate's observations 449 The candidate's examination technique 451 The clinical competence of the candidate 453 Common errors 454 Look first 455 Double pathology 456 Tell them of the expert that told you 456 Apologies accepted 457 'Even though I didn't mean to say it-I did' 457 Invigilator's diaries 458 Fly on the wall-complete accounts 460 Ungentlemanly clinical methods 466 Some experiences written in the first person 466 Miscellaneous 'pass' experiences 467 You never know you've failed until the list is published 479 Survivors of the storm 483 Some 'fail' experiences 486 Downward spirals 491 Anecdotes 493 Some anecdotes in the first person 498 Useful tips 501 Facts and figures 502 Quotations 503 Adopt good bedside manners 503 Practise clinical examination and presentation 504 Get it right 505 Listen obey and do not stray 505 One wrong does not make one fail 506 If you say less they want more 506 If you know it-say it 506 Humility is more persuasive than self-righteousness 507 Keep cool: agitation generates aggression 507 Simple explanations raise simple questions 507 Think straight look smart and speak convincingly 508 You have seen it all before 508 Use your eyes first and most 508 Doing and forgetting 509 Examiners are different 509 Appendices 511 1 Checklists 513 2 Examination frequency of MRCP short cases 517 3 Examination frequency of examiners' instructions 522 4 Pocket Snellen's chart 524 5 Texidor's twinge and related matters 525 6 Colour photographs of some MRCP short cases 527 7 Detailed contents of Section 4 544 Index 547

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An aid to the MRCP short cases

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