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By P John Rees, James Pattison, Visit Amazon's Christopher Kosky Page, search results, Learn about Author Central, Christopher Kosky,

"Preface so much medical professionals imagine that the main memorable approach to research medication is to work out sufferers. it really is more uncomplicated to keep in mind info in line with a true individual than a web page in a textbook. one other very important point within the retention of knowledge is the intensity of studying. studying that seeks to appreciate difficulties is prone to be available later than superficial authentic accumulation. this can be the root of problem-based  Read more...

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The case raises the dilemma of whether dialysis is appropriate in this patient. Hospital-based haemodialysis and home-based peritoneal dialysis are the options available. Her age and comorbid illnesses preclude renal transplantation. Conservative management without dialysis may be appropriate in this case. KEY POINTS • Patients often become symptomatic due to renal failure only when their glomerular filtration rate (GFR) is less than 15 mL/min and thus may present with end-stage renal failure. • Previous measurements of serum creatinine enable the rate of deterioration of renal function to be known.

6°C and looks unwell. He looks as if he may be a little jaundiced. He is a little tender in the right upper quadrant of the abdomen. There are no abnormalities to find on examination of the joints or in any other system. 0 mmol/L Questions • What is your interpretation of the findings? • What is the likely diagnosis? • What treatment is required? 21 100 Cases in Clinical Medicine ANSWER 8 The diagnosis is likely to be acute viral hepatitis. The biochemical results show abnormal liver function tests with a predominant change in the transaminases, indicating a hepatocellular rather than an obstructive problem in the liver.

The blood pressure is 148/90 mmHg. 7 mmol/L 70–120 μmol/L Urinalysis: no protein, no blood Blood film shows a microcytic hypochromic picture. Questions • What is the likeliest diagnosis? • How would you investigate the patient? 17 100 Cases in Clinical Medicine ANSWER 6 The investigations show a microcytic, hypochromic anaemia. In a premenopausal woman the most likely cause would be excessive menstrual blood loss. In men or postmenopausal women the most likely cause would be loss from the gastrointestinal tract.

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