Scleritis is painful, episcleritis is not painful A key way to discriminate between scleritis and episcleritis is the presence of pain. Keratoconjunctivitis sicca is usually bilateral and associated more with dryness, burning and itch Rheumatoid arthritis: ocular manifestations Ocular manifestations …
Hypertension and haematuria are rare in minimal change glomerulonephritis Minimal change glomerulonephritis Minimal change glomerulonephritis nearly always presents as nephrotic syndrome, accounting for 75% of cases in children and 25% in adults The majority of cases are idiopathic, but in …
Painless vaginal bleeding without abdominal pain should raise suspicion of placenta praevia. In the UK, it is common to have an ultrasound scan during the first trimester and again around 20 weeks for an anomaly scan which the sonongrapher would …
An implantable cardioverter defibrillator is only required in high risk cases, for example if the patient has a QTc > 500ms or previous episodes of cardiac arrest. Long QT syndrome Long QT syndrome (LQTS) is an inherited condition associated with …
 Common Heart Murmurs Defect Type of Murmur Where Is It Heard? Symptoms Aortic Stenosis Ejection Systolic 2nd intercostal space to the right of the sternum Dyspnoea with activity, anginal chest pain, and syncope Aortic Regurgitation Early Diastolic 2nd intercostal …
Prolonged plane journey is a recognized risk factor for thromboembolism and hencepulmonary embolism as well. Sharp chest pain and breathlessness after 3 days of planejourney is highly suggestive of pulmonary embolism. CTPA is the answer here as it is thebest …
The diagnosis here is primary biliary cirrhosis The classic presentation is itching in a middle-aged woman as we see here. Often asymptomatic and diagnosed after finding alkaline phosphatase on routine LFT.Lethargy, sleepiness, and pruritus may precede jaundice. There is an …
Acute fatty liver of pregnancy (AFLP) and HELLP (Haemolysis, Elevated Liver enzymes,Low Platelets) syndrome both have low platelets and deranged liver function as part ofthe clinical picture. However, low serum glucose and/or raised serum ammonia aremore suggestive of AFLP. Vomiting …
The diagnosis can be seen with the examination of the ear. A red tympanic membrane that is bulging is classical for otitis media. We know that the membrane is bulging because there is a loss of light reflex. The light …
Muscle weakness and cramping are features of low potassium. The potassium levels shown here are severely low. Low enough that management is likely going to be IV replacement in an area where there is cardiac monitoring. Thiazides such as bendroflumethiazide …