This is my pleasure and great honor to write a few words about Long Cases in Clinical Medicine. Professor Abdullah has written an excellent “made easy” book . Jaypee Brothers Medical Publishers, p. This book, Long Cases in Clinical Medicine, deals with clinical cases in great detail. Long Cases in. Clinical. si. Medicine. an te ss dV. terney.info G. ta hi vi r9 p 9.p -U er ni si te an dV ss terney.info G. Long Cases in. Clinical Medicine. G R (Concerned with.
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Long Cases in Clinical Medicine presents trainees with detailed clinical cases for numerous diseases and disorders. Divided into twelve. Long Cases in Clinical Medicine 1st edition Presents trainees with detailed clinical cases for numerous diseases and disorders covering various body. After long discussions with academic teachers of numerous clinical subjects in our “the case” and abilities that are useful for communicating with the patient.
Nasolabial fold less pronounced. YY Motor tests: 1. Ask the patient to look at the ceiling, keeping the head fixed and see any wrinkling of forehead, either unilateral or bilateral frontal belly of occipitofrontalis 2.
Ask the patient to close the eyes tightly and not to let you open it orbicularis oculi. If failure to close, look for Bells phenomenon 3. Ask to whistle orbicularis oris 21 Proforma of a Long Case 1.
To examine right eye, ask the patient, cover your left eye with left hand gently, look steadily at my left eye. You should cover your right eye.
No one should move the eye and should look each others tip of the nose. Hold your index finger midway and from periphery, bring toward the center until you see it. Ask the patient do you see my finger? Tell me when you see it. If patient fails to see, continue to bring the finger and ask him, tell me when you can see. In this way, see in horizontal, upper and lower quadrant temporal field.
Then, see nasal field in the same way. Change your hand and repeat in other eye in the same manner. YY Test of central scotomause a red headed pin, move it from temporal side to nasal side in the midway. Ask the patient, Do you see it? Tell me, when it disappears. YY Fundoscopy should be done at the end. Ask the patient, Look at my finger.
Follow it with your eyes with head fixed 2. See movements in horizontal and vertical directions like the pattern H 3.
See nystagmus. At extreme gaze, ask, do you see one or two fingers diplopia?
YY Pupils: size, shape, light reflex both, direct and consensualput light directly on one eye and see in other eye YY Accommodation reflex Ask the patient to look at a distant object. Then put your finger in front of his or her eyes. Now ask, Look at my finger.
See the movement of the eyeball and also pupil. Ask the patient to puff cheeks out buccinator. If paralysis, air is escaped easily on the affected side 5. Ask to show the teeth and to smile levator anguli oris and risorius.
If paralysis present, face is drawn to the healthy side. Also, test for hyperacusis nerve to the stapedius muscle. YY For cochlear division: 1. Look at the external ear and meatus wax, rash 2.
Rub hair or put the watch near the ear and ask the patient, whether he can hear or not 3.
Rinnes test and Webers test may be necessary in some cases. Normally, air conduction is more than the bone conduction. Glossopharyngeal and Vagus nerves: YY While talking with the patient, observe any nasal voice or hoarseness. Presence of hoarseness indicates bilateral paralysis of superior laryngeal branch of vagus.
If it is unilateral, usually the patient is asymptomatic YY Ask about nasal regurgitation YY Movement of the palate: ask the patient, open your mouth and say, aah. If one side remains flat and immobile, indicates paralysis of that side soft palate is pulled to the normal side YY Ask the patient to cough. Feel sternocleidomastoid test on both sides. If small and spastic unable to protrude 2. Deviation toward the weak side.
YY Ask the patient to waggle the tongue side to side. Feel the weak side. How to approach a long case 23 Practicing long case trains a physician to be a good clinician Vital parts of long cases include the following points: Detailed history taking YY Physical examination general and systemic YY Provisional diagnosis. Lecture Notes : Psychiatry 11th Ed. Lecture Notes : Urology 7th Ed.
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