Jaundice is yellow discoloration of the tissues, noticed especially in the skin and sclera ( Figs 27 and 36 ), due to accumulation of bilirubin. Jaundice may be prehepatic (due to haemolysis), hepatic (due to intrinsic liver disease) or cholestatic…
Mechanical obstruction of the bowel may be simple (one-point obstruction) or closed loop (obstruction at two points enclosing a segment of bowel). If the bowel is viable, the obstruction is termed non-strangulating. If the arterial blood supply is compromised, strangulating…
Hypertension is the persistent elevation of blood pressure. An individual is classified as hypertensive when there is a sustained rise in blood pressure to more than 140/90 mmHg. Most patients have essential hypertension with contributory factors such as aging, obesity,…
Hirsutism is the presence of male-pattern (androgen dependent) hair growth in women. This is not the same as virilism, which, in addition to hirsutism, is associated with the development of male secondary sexual characteristics in women. Whilst hypertrichosis refers to…
Hiccups (hiccoughs) are the characteristic sounds produced by the involuntary contractions of the diaphragm terminated by sudden closure of the glottis. In the majority of patients, it is a self-limiting condition. The most common cause of hiccups is thought to…
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…