An hallucination is an apparent sensory perception of an external object when no such object is present. They may be auditory, visual, tactile, olfactory or gustatory in nature. It is to be differentiated from an illusion, which is a real…
Haemoptysis is the expectoration of blood or bloodstained sputum. With massive haemoptysis, the main priorities are to secure the airway and initiate emergency resuscitative measures before establishing a diagnosis. Causes Respiratory ● Bronchial carcinoma ● Pneumonia ● TB (worldwide) (…
Haematuria is the passage of red blood cells in the urine. Care must be taken to distinguish it from other causes of discoloration of urine. All patients with haematuria must be fully investigated. If haematuria has initially been diagnosed on…
Haematemesis is the vomiting of blood. This may be frank blood or blood altered by the action of gastric acid and digestive enzymes, i.e. ‘coffee grounds’. Haematemesis is usually caused by lesions proximal to the duodenojejunal junction. Causes (all patients…
Gynaecomastia is enlargement of the male breast. There is an increase in the ductal and connective tissue elements of the breast. The condition should not be confused with fat in the mammary region, which may occur in obese patients and…
These are common clinical problems, especially hernias. They are therefore common in clinical examinations. Causes Above the inguinal ligament ● Sebaceous cyst/abscess ● Lipoma ● Direct inguinal hernia ● Indirect inguinal hernia ( Fig. 26 ) ● Imperfectly descended testis…
A goitre is an enlargement of the thyroid gland ( Fig. 25 ). It can result from physiological causes such as puberty (due to increased demand for thyroid hormone) which require no treatment, to frank malignant disease requiring urgent diagnosis…
Disorders of gait may be structural or neurological. When assessing gait, it is important to observe the whole patient and not merely the feet. Causes Structural ● Pain – antalgic gait ● Length discrepancies – short leg gait ● Weak…
Ulcers on the feet are common. The majority of them are of vascular or neuropathic origin. Causes Vascular Large vessel disease ● Arteriosclerosis ● Embolism Small vessel disease ● Diabetes ● Raynaud’s disease ● Embolism ● Vasculitis, e.g. SLE, rheumatoid…
Pain in the foot is a common presenting complaint. The majority of causes are related to injury, overuse or conditions causing inflammation. Causes Traumatic ● Fractures ● March fracture Infective ● Cellulitis – esp if suspected necrotising fascitis ● Osteomyelitis…