100 Diagnostic Dilemmas in Clinical Medicine

Kerry Layne, Consultant in Acute Medicine Department, Guy's and St Thomas' Hospital NHS Foundation Trust, London, UK.

• Preface. Acknowledgements. List of Abbreviations. Reference Ranges for Common Investigations. Confusion and Persistent Fever. Painful Upper Limb Swelling. An Unusual Infection. A Teenager with Falls. A Case of Intrapartum Fever. Jaundice and Diarrhoea. Erratic Behaviour. A Young Woman with Fever and Chest Pain. An Enlarged Tongue. A Young Man with an Abnormal Chest X-ray. Visual Loss and Confusion. Left-Eye Pain. Spontaneous Bleeding. A Young Man with a Rash and Hearing Impairment. Recurrent Loss of Consciousness. Visual Loss and Anuria. Abdominal Pain and Weight Loss. Worsening Shortness of Breath and Cough. Fatigue and Constipation. An Upper Limb Mass. A Teenager with a Rash and Fever. Hepatitis in a Nightshift Worker. Yellow Blood. An Unusual Method of Deliberate Self-Harm. Coffee Ground Vomiting. A Case of Parotitis Followed by Acute Hearing Loss. A Purpuric Rash. An Elderly Patient Admitted with a Fall. A Young Mother with Constipation. Hyperpigmented Skin Lesions. It’s All in Your Head. A Right Upper Quadrant Pain Puzzle. Arthritis, Miscarriage and Drowsiness. A Confused Traveller. A Pleural Effusion on a Background of Knee Pain. A Hypertensive Patient with Carpal Spasms. A Patient with HIV and Personality Change. Unilateral Facial Weakness. Chest Pain with a Gynaecological Cause. A First Fit. Collapse in the Corridor. ITP or Not ITP?. Recurrent Haemothorax. Hepatosplenomegaly. Cutaneous Ulceration in a Patient with Rheumatoid Arthritis. An Elderly Man with Confusion. Severe Sepsis Following Tonsillitis. A Farmer with Abdominal Pain. Recurrent Episodes of Acute Kidney Injury. A Sauna Cleaner with Shortness of Breath. A Hypernatraemic Patient. Recurrent Abdominal Pain and Diarrhoea. A Teenager with a Rash. Bilateral Foot Weakness. Hepatomegaly in a Patient with Newly Diagnosed Diabetes Mellitus. A Teenager with Palpitations. A Patient with Sickle Cell Disease and Flu-Like Symptoms. Vomiting without Gastrointestinal Pathology. Seizures and Hand Lesions. New Confusion in a Patient with Bipolar Affective Disorder. A Blistering Rash. Heart and Lungs. Sudden Onset Headache. A Febrile Canoeist. Chest Pain and an Abnormal Blood Film. Numb Fingers and Eosinophilia. Fevers and Cough (Part 1). Fever and Cough (Part 2). Fevers, Night Sweats and Lymphadenopathy. Unconscious outside a Club. A Relentless Rash. Bleeding Gums. Chest Pain after Bad News. HIV and Seizures. A Patient with Crohn’s Disease and Worsening Diarrhoea. Bilateral Hip Pain. A Young Woman with Chest Pain. A Heavy Smoker with Proximal Weakness. Collapse Following Influenza. Diarrhoea and Proximal Weakness. Haemoptysis and Renal Failure. A Young Patient with a Chronic Cough. Abdominal Pain and Bloody Diarrhoea. Nocturnal Enuresis and Back Pain. Shivering at the Station. Loss of Vision and Ophthalmitis. A Pregnant Woman with Loss of Vision. Rash, Fevers and Headache. Haemoptysis and Diplopia. Post-Partum Auditory Hallucinations. Rapidly Progressive Dementia. A Hillwalker with Fever and Chest Pain. Fever, Weight Loss and Night Sweats. Painless Jaundice. A Young Man with Chest Pain. An Unusual Cause of Haematemesis. TB or Not TB?. Headache at the Cattle Farm. Recurrent Lower Respiratory Infections Following a Renal Transplant. An Unsolved Mystery. Index.