Mesothelioma is a cancer that arise from the pleura surroudning the lungs.  Increased incidence among people with heavy exposure to asbestos.  Long latent period of 25-45 years for the development of asbestos related mesothelioma.  Estimated 7-10% lifetime risk for people with heavy exposure of asbestos.  If they smoke, there is greater chance of dying from [...]

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The Mayo Foundation and Mayo Clinic is the world’s largest group practice, and the medical school is an important part of it.  The clinics, run as outpatients, are in 3 locations: Rochester (Minnesota), Jacksonville (Florida), and Scottsdale (Arizona).  4 hospitals (St. Mary’s Rochester, Rochester Methodist, St. Luke’s, Jacksonville and May Clinic Hospital, Scottsdale) are linked [...]

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The medical school (part of the oldest Catholic- and Jesuit-sponsored university in the USA) works with the University Hospital, 389 beds, and 9 federal and community hospitals.  The Medical Center, the largest in the capital, has a concentrated care center providing emergency, outpatient, surgery, X-ray, and transplant facilitites.  The Lombardi Cancer Research Center is near [...]

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Diarrhoea questions

Diarrhoea is subjective, and can be defined as an increase in the volume, frequency or fluidity of stool relative to normal for the patient. Dysentery is diarrhoea with the presence of blood, mucous and protein in the stool, and often associated with signs and symptoms of systemic illness, e.g. fever, weight loss, anorexia, [...]

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Chest pain questions:

Where –> system involved
What –> pathology
How –> functional limitation
Why –> aetiology

Patient’s age
SOCRATES – site, onset, character, radiation, associated symptoms, time course, exacerbating/relieving factors, and severity.

Character:

crushing or pressure –> cardiac
tearing pain through to back –> dissection
sharp, stabbing –> pulmonary
burning, ‘indigestion’ –> GI

…but be careful with [...]

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Abdominal pain questions:

Where –> system involved
What –> pathology
How –> functional limitation
Why –> aetiology

Patient’s age
SOCRATES – site, onset, character, radiation, associated symptoms, time course, exacerbating/relieving factors, and severity.

Character:
Onset:

constant pain rather than intermittent = worse

Location: correlate with organs potentially affected
Radiation: started centrally and migrated to RIF = appendicitis
Duration: [...]

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Confusion and syncope

Confusion is a symptom, not a diagnosis. Confusion is a recent alteration in higher cerebral functions such as memory, attention and awareness (not alertness or consciousness). There is a broad range of severity of confusion; it can be as minor as a disturbance to short-term memory, to an inability to relate at [...]

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