Read e-book online A Clinical Approach to Medicine PDF

By Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng

ISBN-10: 9812389261

ISBN-13: 9789812389268

ISBN-10: 9812560734

ISBN-13: 9789812560735

During this new version of A scientific method of drugs, the editor has assembled a panel of best clinicians and researchers, and reorganized the cloth within the key components of medication, cardiology, endocrinology, gastroenterology, hematology, neurology, oncology, rheumatology, renal drugs and respiration medication. This ebook is exclusive -- it displays the adventure of best specialists on styles of illness within the Asia-Pacific quarter. There are numerous different comparable books, yet these are by means of authors from the West and hence provide a special viewpoint. The publication additionally contains discussions on genetic ailments, an infection and antimicrobial resistance to antibiotics, highlighting neighborhood incidences and information. each one bankruptcy begins with the elemental suggestions of a selected subject and steadily develops the topic to give the cutting-edge within the subject. With its concentrate on practices detailed to Asia-Pacific, this publication is a needs to for the coed, working towards clinician and study scientist attracted to the most recent advancements during this a part of the realm.

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5) Cushing’s syndrome Cushingnoid features can be subtle and may lack specificity. A 24-hour urinary-free cortisol excretion Ͻ 100 ␮g/day screens out the diagnosis in most patients, although some alcoholics and depressives have modest 20 A Clinical Approach to Medicine elevations. In the dexamethasone suppression test, 1 mg of dexamethasone is taken orally at 11 pm and plasma cortisol level taken at 8 am the next day. A level of Ͻ 5 ␮g/dL excludes Cushing’s syndrome in most patients. If these screening tests are abnormal, further specialized investigations are required to define the anatomic lesion — pituitary microadenoma (80%), adrenal adenoma or hyperplasia.

40 A Clinical Approach to Medicine Admission to CCU for Ischemic Chest Pain Oxygen therapy Analgesics Aspirin Nitrates ±Beta-blockers ±Calcium channel blockers Consider heparin or GP IIb/IIIa blockade therapy Intravenous nitroglycerin Continuing ischemic chest pain Patient pain-free and stabilized High risk Low risk IABP Coronary angiography Emergency revascularization Functional testing Positive Equivocal Poor effort Coronary angiography for revascularization Negative Medical therapy Fig. 5 A strategy for management of patients admitted to the coronary care unit.

Chronic glomerulonephritis, diabetic nephropathy) is more commonly associated with hypertension. An exception is polycystic kidney disease, where hypertension is an early manifestation. Abnormal urinalysis and elevated serum creatinine level (late feature) are clues that suggest the diagnosis. Renal ultrasonography is indicated to determine renal size and symmetry. 5 mg/dL Cardiomegaly (chest radiograph) Left ventricular hypertrophy (electrocardiograph, echocardiography) Features suggestive of secondary causes Headaches, palpitations and sweating (pheochromocytoma) Abdominal bruit (renal artery stenosis) Radiofemoral delay (coarctation of aorta) Unprovoked hypokalemia (hyperaldosteronism) Truncal obesity, abdominal stria (Cushingnoid features) Obesity, snoring, daytime somnolence (sleep apnea) Hypertension 19 2) Renal artery stenosis Atherosclerotic renal artery stenosis (two-thirds of cases) usually presents after 50 years of age, frequently in association with concomitant coronary, cerebral or peripheral vessel disease and diabetes; and is bilateral in 35–50% of cases.

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A Clinical Approach to Medicine by Ong Yong Yau, Woo Keng Thye, Ng Han Seong, Patrick Tan, Tang Ong Teng

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