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TitleContemporary Internal Medicine [electronic resource] : Clinical Case Studies / edited by Juan Bowen, Ernest L. Mazzaferri
ImprintBoston, MA : Springer US, 1988
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Descript 336 p. online resource


Read with two objectives: first, to acquaint yourself with the current knowledge of a subject and the steps by which it has been reached; and secondly, and more important, read to understand and analyze your cases. William Osler, The Student Life What follows is a collection of cases-or more aptly, the stories of our patients and friends who have been seen at The Ohio State University Hospitals where our faculty have provided their care and about whom this volume is written. Today many fear that our patients are being moved from center stage while we are being distracted by the technology of medicine. This volume was written with patients in mind. The idea is that the most intriguing questions and the most rewarding answers begin and end at the bedside. This is a story of our patients, told by expert clinicians and spiced with commentary along the way. This volume in no way atยญ tempts to be comprehensive. Instead, it is like the practice of medicine, scattered, somewhat disjointed, while at the same time intensely personal and focused upon whatever problem the patient brings to us. The discussions are not so much about disease entities as they are about patients with problem". The two are uniquely difยญ ferent. For instance, when the physician suspects hepatitis, not every imaginable cause can be actively investigated. Instead, tests and procedures are discriminateยญ ly chosen, a part of medicine that is still more art than science


Case 1 Chronic Liver Disease and Neurologic Abnormalities -- In this case study of Wilsonโ{128}{153}s disease, the author discusses contemporary views of its pathophysiology and clinical features, along with the differential diagnosis of chronic liver disease. -- Case 2 Dyspnea and Rapidly Enlarging Goiter -- A patient with Hashimotoโ{128}{153}s thyroiditis and thyroid lymphoma provides the framework for a discussion of these increasingly more common disorders. The author includes a summary of the clinical approach to nodular goiter. -- Case 3 Atheroembolic Disease Mimicking Systemic Vasculitis -- This case highlights the clinical and laboratory features of atheromatous embolic disease of the kidneys, emphasizing laboratory features of the disease which may lead to diagnostic confusion. -- Case 4 Erythrocytosis -- A patient with polycythemia furnishes the setting for a discussion of the pathophysiology, differential diagnosis, and treatment of a classic problem in internal medicine. -- Case 5 Obstructive Sleep Apnea -- A patient with snoring, nightmares, and palpitations during sleep provides the basis for a discussion of the current concepts in the diagnosis and treatment of obstructive sleep apnea, an important but frequently misdiagnosed condition. -- Case 6 Dyspnea and Cirrhosis -- A case of alpha-1-antitrypsin deficiency is reviewed by an author who has done pioneering work in this area. The inheritance, pathophysiology, and clinical features of the disorder are discussed in detail. -- Case 7 Chest Pain in a Young Man -- This case study of a young patient with coronary artery disease emphasizes the logical evaluation of this common problem. The author analyzes testing strategies based on current concepts of medical decision-making. -- Case 8 A Reactive Arthropathy -- A patient with low back pain and joint complaints sets the stage for a discussion of the distinctive features, diagnosis, and treatment of the sero-negative spondyloarthropathies. -- Case 9 Community Acquired Pneumonia -- In this case study of a patient with pneumonia, the author reviews the current diagnostic and treatment decisions involved in this common and difficult clinical problem. -- Case 10 Lens Subluxation and Tall Stature -- A patient with Marfan syndrome is the motivation for a discussion of the clinical features, diagnosis, and pathophysiology of this important disorder. -- Case 11 Breast Cancer in a Premenopausal Woman -- This case study highlights the major contemporary clinical issues surrounding this tragic problem which is among the most difficult dilemmas facing the practicing physician. -- Case 12 Recurrent Fever, Chills, Pyuria, and Bacteriuria in an Adult Male Following Urinary Catheterization -- A case study of chronic prostatitis leads to a discussion of the causes, contemporary diagnostic approaches, and treatment of recurrent urinary tract infections. -- Case 13 Fever and Bloody Diarrhea -- A patient with infectious bloody diarrhea is presented with emphasis on the essential epidemiologic and clinical features. Recently recognized pathogens such as Campylobacter jejuni are discussed. -- Case 14 Chest Pain and Heart Murmur in a Young Woman -- This is a case of mitral valve prolapse, the most common heritable disorder of connective tissue with cardiovascular manifestations. The author discusses the causes, cardiac dynamics, diagnosis, and complications of mitral valve prolapse. -- Case 15 Peptic Ulcer Disease -- A patient with peptic ulcer disease provides the backdrop for a discussion of recent developments in the etiology, pathophysiology, diagnosis, and treatment of this common problem. -- Case 16 Microcytic Anemia -- A case of thalassemia provides the framework for a discussion of the distinctions between iron deficiency anemia, hemoglobinopathies, and other reasons for microcytosis. -- Case 17 Recurrent Abdominal Pain and Edema -- In this case of hereditary angioedema, the crucial clinical distinction between this life-threatening disease and other urticarial disorders is discussed. -- Case 18 Hepatitis in a Chinese Student -- This discussion focuses on the clinical evaluation of chronic hepatitis, with emphasis on the appropriate interpretation of serological tests for hepatitis. -- Case 19 A Woman with Rheumatoid Arthritis -- The author reviews pertinent clinical issues in the diagnosis and treatment of rheumatoid arthritis. -- Case 20 Aortic Stenosis -- The clinical features, natural history, and current therapy of obstructive aortic valvular disorders are discussed in the context of a patient with aortic stenosis. -- Case 21 A Case of Weakness and Fatigue in a Teenager -- A patient with Addisonโ{128}{153}s disease provides the circumstances for a clinical discussion of acute and chronic adrenal insufficiency. -- Case 22 Practical Approach to Syncope -- A common and potentially serious clinical problem is discussed from the vantage point of the electrophysiologic derangements that may cause syncope. -- Case 23 Thrombocytopenia -- A patient with idiopathic thrombocytopenia gives insight into our contemporary understanding of the pathophysiology, diagnosis, and treatment of the immune thrombocytopenias. -- Case 24 New Onset of Dyspnea in a Middle-Aged Man -- A patient with dilated cardiomyopathy provides the basis for a discussion of this disorder. The author summarizes innovative diagnostic and therapeutic approaches which have been developed in the past decade. -- Case 25 Test Case -- A patient with acute myocardial infarction forms the framework for an approach to the contemporary management of this disorder. The author provides a step-by-step guide to management in a question-and-answer format

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