Essentials 1 Over one-third of patients who have fever for more than 2 to 3 days with no localizing symptoms and signs are likely to have a bacterial infection; half of these will be in the respiratory or urinary tracts.…
Essentials 1 The differential diagnosis of weakness in the emergency department (ED) is very broad. Careful history taking and examination with targeted investigations will help to identify most of the important causes. 2 Causes of weakness must be distinguished as…
Essentials 1 It is important to distinguish between syncope and true vertigo. 2 The most common cause of syncope is neurally mediated syncope. 3 A detailed history and physical examination are more useful than extensive investigations. 4 It is essential…
Essentials 1 Approximately 9% of the population will have at least one seizure in their lifetimes but only 1% to 3% will develop epilepsy. 2 The management of an acute episode is directed at rapid control of seizures, identification of…
Essentials 1 For clinical purposes, the ability of the individual to respond appropriately to environmental stimuli provides a quantifiable definition of consciousness. 2 The causes of altered conscious state can be divided pathophysiologically into structural and metabolic insults. 3 A…
Essentials 1 The diagnosis of subarachnoid haemorrhage (SAH) requires a high index of suspicion. 2 Up to a third of patients with SAH experience a warning leak—the sentinel haemorrhage—in the hours to days prior to the major bleed. 3 Risk…
Essentials 1 Ischaemic strokes and transient ischaemic attacks (TIAs) are most commonly due to atherosclerotic thromboembolism of the cerebral vasculature or emboli from the heart. Other causes should be considered in younger patients, those presenting with atypical features or when…
Essentials 1 The pathophysiological basis of headache is understood to be traction or inflammation of extracranial structures, the basal dura or the large intracranial arteries and veins, dilatation/distension of cranial vascular structures or activation/sensitization of perivascular nerves. 2 Severity of…
Essentials 1 Anal pain, bleeding and masses are common symptoms in many different types of anorectal pathology. A careful history and anorectal examination are important in making the correct diagnosis. 2 Increasing fibre intake and reducing constipation are effective initial…
Essentials 1 Haematochezia is a common presentation in patients aged over 50 years and can result in shock due to large-volume blood loss. 2 The most common cause of lower gastrointestinal bleeding (LGIB) in younger patients (<50 years of age)…