Medicine in a Day 2: Case Presentations

Marcus Drake is Professor of Neurological Urology at Imperial College London, and Honorary Consultant Urologist at Charing Cross Hospital. Dr. Drake has clinical and research interests in urodynamics, neuro-urology, lower urinary tract symptoms (LUTS) and lower urinary tract physiology. He was Chief Investigator of several major National Institute of Health Research studies, including UPSTREAM, which clarified the role of urodynamics for assessing men with voiding LUTS; TRIUMPH, which showed the value of conservative management of male LUTS; and PLANET which reviewed the wide range of medical causes of nocturia. Dr. Drake is currently helping lead the PREMISE study on minimally invasive surgery of the prostate. He was a Trustee of the International Continence Society for nine years, and chair of their Standardisation Steering Committee for six years. He was a member of two European Association of Urology Guidelines committees- Male LUTS and Female Incontinence.

• 1 Nipple Discharge2 Breast Tenderness3 Breast Lump4 Limb Claudication5 Cold, Painful, Pale, Pulseless Leg/Foot6 Skin Ulcer7 Hypertension8 Peripheral Oedema and Ankle Swelling9 Heart Murmur10 Palpitations11 Chest Pain and Pain on Inspiration,12 Dizziness13 Obesity - Outline14 Scarring15 Acute Rash16 Chronic Rash17 Skin Lesion18 Skin or Subcutaneous Lump19 Nail Abnormalities - Outline20 Ear and Nasal Discharge21 Painful Ear22 Hearing Loss23 Tinnitus24 Vertigo25 Nasal Obstruction26 Anosmia27 Epistaxis28 Sore Throat29 Hoarseness and Voice Change30 Diplopia and Ptosis31 Squint32 Loss of Red Reflex33 Flashes and Floaters in Visual Fields34 Eye Trauma and Foreign Object in Eye35 Red Eye36 Eye Pain and Discomfort37 Acute Change in or Loss of Vision38 Gradual Loss of Vision39 Facial/Periorbital Swelling40 Breathlessness41 Deteriorating Patient - Outline42 Shock and Low Blood Pressure43 Cardiorespiratory Arrest44 Trauma and Massive Haemorrhage45 Painful Swollen Leg46 Blackouts, Faints and Loss of Consciousness47 Confusion48 Falls49 Head Injury50 Bleeding From Upper GI Tract/Melaena51 Poisoning52 Overdose53 Anaphylaxis54 Bites and Stings55 Burns56 Laceration57 Snoring58 Weight Loss59 Weight Gain60 Neck Lump61 Hypercalcaemia62 Driving Advice63 Pubertal Development64 Loss of Libido65 Gynaecomastia66 Post-Surgical Care and Complications67 Acute Abdominal Pain68 Abdominal Distension69 Change in Stool Colour70 Abdominal Mass71 Bleeding from the Lower Gastrointestinal Tract72 Lump In Groin73 Perianal Symptoms74 Rectal Prolapse and Anal Cancer75 Faecal Incontinence76 Misplaced Nasogastric Tube and NGT Placement - Outline77 Swallowing Problems78 Decreased Appetite79 Food Intolerance80 Nausea and Vomiting81 Chronic Abdominal Pain82 Pruritis83 Ascites84 Change in Bowel Habit85 Constipation86 Diarrhoea87 Pallor88 Petechial Rash and Purpura89 Bruising90 Fever91 Lymphadenopathy92 Organomegaly93 Neck Pain/Stiffness94 Jaundice95 Haemoptysis96 Viral Exanthems97 Vaccination - Outline98 Travelling Advice99 Headache100 Fits/Seizures101 Speech and Language Problems102 Facial Weakness103 Memory Loss104 Visual Hallucinations105 Tremor106 Abnormal Involuntary Movements107 Facial Pain108 Altered Sensation, Numbness and Tingling109 Fasciculations110 Neuromuscular Weakness111 Unsteadiness112 Sleep Problems113 Raised Intracranial Pressure114 Amenorrhoea115 Menopausal Problems116 Contraception Advice - Outline117 Hyperemesis/Vomiting in Early Pregnancy118 Unwanted Pregnancy and Termination - Outline119 Subfertility120 Normal Pregnancy and Risk Assessment - Outline121 Substance Misuse122 Intrauterine Death and Miscarriage - Outline123 Large for Gestational Age124 Small for Gestational Age125 Reduced Foetal Movements - Outline126 Bleeding Antepartum127 Labour - Outline128 Complications of Labour129 Bleeding Post-Partum130 Difficulty With Breastfeeding131 Pain on Sexual Intercourse (Dyspareunia)132 Vaginal Prolapse133 Pelvic Pain134 Pelvic Mass135 Vulval Lump136 Vulval Lesion/Itch137 Abnormal Cervical Smear138 Vaginal and Urethral Discharge139 Genital Ulcers/Warts140 Prematurity - Outline141 Neonatal Death142 Well-Being Checks - Outline143 Infant Feeding Problems144 Crying Baby145 The Sick Child146 Allergies147 Abnormal Development/Developmental Delay148 Dysmorphic Child149 Family History of Genetic Disorder150 Cyanosis151 Limping Child152 Congenital Abnormality153 Congenital Abnormality, Biliary Atresia - Outline154 Learning Disability155 Behavioural Difficulties in Childhood156 Child Abuse157 Frailty, Immobility and Struggling to Cope at Home158 Bone Pain159 Acute and Chronic Pain Management - Outline160 Chronic Pain161 Death, Dying and End-of-Life Care162 Elder Abuse163 Mental Health Problems in Pregnancy or Postpartum164 Low Mood/Affective Problems165 Elation, Elated Mood and Pressure of Speech166 Auditory Hallucinations167 Anxiety, Phobias, OCD168 Somatisation/Medically Unexplained Physical Symptoms169 Addiction170 Fixed Abnormal Beliefs - Outline171 Suicidal Thoughts and Self-Harm172 Threats to Harm Others173 Abnormal Eating or Exercising Behaviour174 Mental Capacity Concerns - Outline175 Polydipsia and Dehydration176 Acute Kidney Injury and Oliguria177 Chronic Kidney Disease178 Electrolyte Abnormalities - Overview Table179 Hyponatraemia180 Hyperkalaemia181 Investigation Results - Overview Table182 Stridor183 Wheeze184 Pleural Effusion185 Cough186 Acute Joint Pain187 Chronic Joint Pain188 Fatigue189 Muscle Pain/Myalgia190 Fit Notes191 Soft Tissue Injury/Minor Trauma192 Back Pain193 Musculoskeletal Deformity194 Trauma in Children195 Anuria and Acute or Chronic Urinary Retention196 Loin Pain197 Scrotal/Testicular Pain and/or Lump/Swelling198 Abnormal Urinalysis199 Haematuria200 Urinary Symptoms and Incontinence201 Erectile DysfunctionIndex