Tài liệu Alarm Bells in Medicine Danger Symptoms in Medicine, Surgery and Clinical Specialties pptx

[...]... springing you into action Symptoms such as this are what make up this book – they are alarm bells Of course, every area of medicine, surgery and the clinical specialities has its own alarm bells, those crucial symptoms that, if missed, may lead to death or demise (of the patient and, increasingly, the doctor) These are the clinical pearls that slip out on the ward rounds and in the clinics of experienced... of daily living (ADLs) and instrumental ADLs (IADLs), is a sign of deterioration in many health conditions in older patients ADLs include the basic functions of bathing, dressing, getting to the bathroom, transferring out of bed or chair, remaining continent and feeding oneself IADLs include more advanced functions that enable a person to live independently: preparing meals, shopping, taking medications,... normal breast examination 10 Men also get breast cancer 1 2 ALARM BELLS IN MEDICINE NOTES 1 Breast lump Approximately one in ten patients with a discrete breast lump has cancer Benign lumps are common but so are cancers, particularly in postmenopausal women All lumps undergo triple assessment in the breast clinic: clinical examination, imaging and cytology or pathology Clinical examination alone is... the breast unit 4 Skin dimpling and retraction Skin dimpling and retraction rarely occur in the setting of benign breast disease A malignancy or the surrounding reaction can cause retraction of Cooper’s ligaments, which attach to BREAST SURGERY 3 the skin In addition, cancer can involve skin directly Often the patient has not noticed the underlying lump, and complains of the skin changes only Action:... Leeds Rosalind Franklin University of Medicine and Science, Chicago, USA Graham Niepel Lori Siegel Research Fellow, University Hospital, Nottingham Professor and Chief of Division of Rheumatology, Rosalind Franklin University of Medicine and Science, Chicago, USA Robert Ord Professor and Chairman, Department of Oral and Maxillofacial Surgery, University of Maryland, Baltimore, USA Navin Singh Assistant... Clumsy hands may herald spinal cord compression 8 Worsening breathlessness may be chronic pulmonary emboli 9 Think of shingles before the skin lesions appear 10 Acute confusion in a patient on neuroleptics or in a patient with Parkinson’s disease could signal underlying Lewy body dementia 15 16 ALARM BELLS IN MEDICINE NOTES 1 Functional impairment Impaired function, as determined by inability to perform... frequent and underdiagnosed killer among older adults It occurs in 15–30% of older adults when looked for, but is identified much less frequently than this in usual clinical settings As well as being the major risk factor for suicide, depression is often associated with worsening of 18 ALARM BELLS IN MEDICINE medical illness and functional status through self-neglect It should be routinely screened for in. .. also an important risk factor Action: Take a detailed history and perform a cardiovascular examination, looking out for signs of valvular heart disease and heart failure Do an ECG Address risk factors, and commence aspirin and a beta blocker if there are no contraindications Refer to the rapid access chest pain clinic 8 ALARM BELLS IN MEDICINE 6 Phaeochromocytoma Phaeochromocytoma is a rare cause of... ischaemic attack urea and electrolytes (including creatinine) upper respiratory tract infection urinary tract infection ventilation perfusion beta human chorionic gonadotropin gamma-glutamyltransferase NOTES ON REFERRAL There is an explanatory paragraph for each Alarm Bell which includes instructions on what action should be taken This usually involves referring to a specialist team When the instruction is... flattening of the breast with arm movement and no evidence of a mass Lobular cancers can be very infiltrative and yet might not produce a mass Cancer or its fibrous reaction can cause retraction of Cooper’s ligaments causing a shape change in the breast Every breast exam should include visual inspection with the arms in various positions Action: Refer urgently to the breast clinic 4 ALARM BELLS IN MEDICINE . alt="" Alarm Bells in Medicine Danger Symptoms in Medicine, Surgery and Clinical Specialties Alarm Bells in Medicine Danger Symptoms in Medicine, Surgery and. Cataloging -in- Publication Data Alarm bells in medicine : danger symptoms in medicine, surgery, and clinical specialties/ [edited by] Nadeem Ali. p. ; cm. Includes