Hepatomegaly is enlargement of the liver. The most common causes in the UK are cirrhosis, cardiac failure and secondary malignancy. Causes Hepatitis/infection Acute ● Alcohol ● Viruses (Hep A/B/C, EBV) ● Bacteria (Leptospirosis, actinomycosis, pyogenic abscess) ● Protozoans (malaria, amoeba)…
Hemiparesis is weakness or paralysis of one side of the body; it usually arises from unilateral lesions above the midcervical spinal cord. Causes (all causes of acute hemiparesis require urgent assessment) Vascular ● Cerebrovascular ischaemia ● Cerebral or spinal infarction…
When assessing a patient with headache, it is important to exclude life-threatening causes first. Causes Acute headache ● Trauma ● Cerebrovascular ● Subarachnoid haemorrhage ( Fig. 33 ) ● Intracranial haemorrhage/infarction ● Systemic infection ● Meningitis ● Acute angle-closure glaucoma…
Impairment of hand function can lead to severe disability and is a common presentation. Causes Congenital Failure of formation ● Absent digit ● Finger and thumb hypoplasia ● Radial club hand ● Macrodactyly Failure of separation ● Syndactyly (fusion of…
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…