Confusion is a behavioural state of reduced mental clarity, coherence, comprehension and reasoning. The causes may be organic or psychiatric. The organic causes are listed below. Causes (all causes of acute confusion require urgent assessment) Toxins/drugs ● Alcohol intoxication/withdrawal ●…
Coma can be defined as a state of prolonged unconsciousness from which a person cannot be roused, or numerically categorised as a GCS score of <8. Causes (all causes of coma require emergency assessment) Trauma ● Head injury (diffuse axonal…
Clubbing is the selective bulbous enlargement of the distal segments of fingers or toes due to proliferation of connective tissues ( Fig. 10 ). Open full size image Figure 10 Clubbing . Note the exaggerated longitudinal curvature and the loss…
Chest pain is a common presenting symptom of disorders that can range from trivial to life-threatening. Causes Cardiovascular ● Angina ● Myocardial infarction ● Pericarditis/myocarditis ● Acute aortic dissection Gastrointestinal ● Gastro-oesophageal reflux disease ● Peptic ulcer disease ● Oesophageal…
Pain in the breast is a common symptom in general surgical practice. Most cases are benign and due to cyclical mastalgia, but occasionally pain may be the presenting symptom of carcinoma. Causes ● Cyclical mastalgia (fibroadenosis, cystic mastitis) ● Noncyclical…
A lump in the breast is a common clinical presentation. In every case of a breast lump, in both males and females, carcinoma must be excluded. Causes Discrete lumps Malignant ● Carcinoma ( Fig. 7 ) ● Phyllodes tumour (some…
Backache is one of the most common complaints seen in general practice and orthopaedic clinics. Most causes are either traumatic or degenerative, but other causes are numerous and may occur as a result of pathology in almost any system of…
The great majority of axillary swellings are enlarged lymph nodes. Axillary nodes can be enlarged due to secondary deposits from carcinoma of the breast. Most axillary swellings are easily diagnosed from clinical examination alone. Causes Superficial ● Acute abscess ●…
Ascites is the accumulation of excess free fluid in the peritoneal cavity ( Fig. 5 ). Open full size image Figure 5 CT scan of ascites . There is free fluid throughout the peritoneal cavity (arrows) . Causes Hepatic ●…
Swelling may be localised or generalised. Localised swellings may be related to joints or fractures. Localised swellings around joints are covered in the section on Joint Disorders (p. 247). This section includes only those conditions that may cause generalised swelling…