The book has two parts. Part One contains seventy-nine disease cases arranged by system, drawn from both internal medicine courses, and every one of them follows the same seven-part sequence set out below. The order is deliberate: it mirrors the order in which you will actually meet the patient on the ward, and it is the order in which an examiner will expect you to present.
Part Two contains sixteen seminars built around a presenting symptom rather than a diagnosis, and these follow a different sequence — the differential is generated before the history is taken, because the differential is what the history is for. That template is explained at the start of Part Two.
Part Three is different again: eleven chapters on reading an electrocardiogram, a blood count and film, renal and liver tests, a chest radiograph and lung function, and rheumatological serology. They are numbered as chapters rather than cases, and are meant to be returned to rather than read once.
| Section | What it trains |
|---|---|
| 1. Clinical vignette | Pattern recognition. Read the stem and commit to a working diagnosis before reading on. |
| 2. Focused history | Not a checklist — every question is paired with the reason you are asking it. |
| 3. Physical examination | What to look for, the sign you expect to find, and the mechanism that produces it. |
| 4. Differential diagnosis | The competing diagnoses and the single discriminating feature for each. |
| 5. Investigations | Bedside, laboratory, imaging — with the expected result and what it changes. Tests that do not change management are named as such. |
| 6. Management | Immediate stabilisation, severity scoring and disposition, definitive treatment, complications, discharge. |
| 7. Teaching points and viva questions | The pearls that separate a pass from a distinction, and the questions examiners actually ask. |
A note on units. Glucose and urea are given in millimoles per litre (mmol/L) with the milligrams per decilitre (mg/dL) equivalent in brackets. Drug doses are for an adult with normal renal and hepatic function; always check against your local formulary and antibiogram, since resistance patterns are regional.
A note on protocols. Where national guidelines differ, the text follows the approach most widely taught and flags the alternative. Your hospital protocol overrides this book.
Navigating this volume. The three parts carry three separate sequences: Cases 1 to 79 in Part One, Seminars 1 to 16 in Part Two, and Chapters 1 to 11 in Part Three. Every cross-reference names the part explicitly — "Case 37", "Seminar 14", "Chapter 9" — so no reference is ambiguous. All headings use built-in heading styles, so the document can also be navigated using the navigation pane in Word.
Contents
Part One · Disease Cases by System
Seventy-nine cases in ten blocks, each opening with a one-page system opener covering the history and examination for that system.
Respiratory
| Case | Title |
|---|---|
| 1 | Community-acquired pneumonia |
| 2 | Acute severe asthma |
| 3 | Exacerbation of chronic obstructive pulmonary disease |
| 4 | Suppurative lung disease: bronchiectasis and lung abscess |
| 5 | Acute-on-chronic hypercapnic respiratory failure |
| 6 | Pleural effusion |
| 7 | Lung cancer |
| 8 | Pulmonary hypertension |
Cardiology
| Case | Title |
|---|---|
| 9 | Acute rheumatic fever |
| 10 | Rheumatic mitral stenosis |
| 11 | ST-elevation myocardial infarction |
| 12 | Acute decompensated heart failure |
| 13 | Infective endocarditis |
| 14 | Newly diagnosed hypertension |
| 15 | Aortic stenosis |
| 16 | Chronic regurgitant valve disease |
| 17 | Pericardial disease |
| 18 | The cardiomyopathies |
Endocrinology
| Case | Title |
|---|---|
| 19 | Diabetic ketoacidosis |
| 20 | Newly diagnosed type 2 diabetes mellitus |
| 21 | Hyperosmolar hyperglycaemic state, with hypoglycaemia |
| 22 | Thyrotoxicosis, with hypothyroidism |
| 23 | Hypercalcaemia and primary hyperparathyroidism |
| 24 | Pituitary disorders |
| 25 | The chronic complications of diabetes |
| 26 | Cushing syndrome and adrenal insufficiency |
| 27 | Lipid and lipoprotein disorders |
Nephrology
| Case | Title |
|---|---|
| 28 | Acute kidney injury |
| 29 | Chronic kidney disease |
| 30 | Acid–base disorders |
| 31 | Hyponatraemia |
| 32 | Urinary tract infection |
| 33 | Glomerulonephritis |
Gastroenterology
| Case | Title |
|---|---|
| 34 | Dyspepsia, reflux and peptic ulcer disease |
| 35 | Acute viral hepatitis |
| 36 | Chronic viral hepatitis |
| 37 | Decompensated cirrhosis and portal hypertension |
| 38 | Upper gastrointestinal bleeding |
| 39 | Inflammatory bowel disease |
| 40 | Hepatocellular carcinoma |
Infectious diseases
| Case | Title |
|---|---|
| 41 | Brucellosis |
| 42 | Malaria |
| 43 | Pulmonary tuberculosis |
| 44 | Bacterial meningitis |
| 45 | Human immunodeficiency virus infection |
| 46 | Pneumonia in the immunocompromised host |
| 47 | Encephalitis |
| 48 | The principles of antimicrobial use |
Haematology
| Case | Title |
|---|---|
| 49 | Microcytic anaemia and the iron deficiency workup |
| 50 | Macrocytic and haemolytic anaemia |
| 51 | Sickle cell disease and thalassaemia |
| 52 | The bleeding patient |
| 53 | Acute leukaemia |
| 54 | The chronic leukaemias |
| 55 | Lymphoma |
| 56 | Multiple myeloma |
| 57 | The myeloproliferative neoplasms |
Rheumatology
| Case | Title |
|---|---|
| 58 | Rheumatoid arthritis |
| 59 | Systemic lupus erythematosus |
| 60 | Axial spondyloarthritis |
| 61 | Vasculitis |
| 62 | Gout and calcium pyrophosphate deposition disease |
| 63 | Antiphospholipid syndrome |
Neurology
| Case | Title |
|---|---|
| 64 | Acute ischaemic stroke |
| 65 | Seizures and status epilepticus |
| 66 | Acute neuromuscular weakness |
| 67 | Peripheral neuropathy |
| 68 | Myelopathy and demyelinating disease |
| 69 | Parkinson disease and the extrapyramidal disorders |
Dermatology and envenomation
| Case | Title |
|---|---|
| 70 | Cutaneous manifestations of systemic disease |
| 71 | Eczema |
| 72 | Snake, scorpion and spider envenomation |
| 73 | Bacterial and viral infections of the skin |
| 74 | Fungal infections and infestations |
| 75 | Psoriasis and the papulosquamous diseases |
| 76 | Blistering disease and the cutaneous drug emergencies |
| 77 | Skin tumours and the pigmented lesion |
| 78 | Acne, rosacea, and disorders of pigmentation, hair and nails |
| 79 | Sexually transmitted infections |
Part Two · Approach to the Patient
Sixteen undifferentiated presentations, numbered as seminars in their own sequence. They use a different template: the differential is generated before the history.
Seminars
| Seminar | Title |
|---|---|
| 1 | Jaundice |
| 2 | Generalised anasarca |
| 3 | Acute chest pain |
| 4 | Acute dyspnoea |
| 5 | Headache |
| 6 | Arthritis |
| 7 | Chronic cough |
| 8 | Hypertensive urgencies and emergencies |
| 9 | Pyrexia of unknown origin |
| 10 | Coma |
| 11 | Venous thromboembolism |
| 12 | Shock |
| 13 | Chronic diarrhoea |
| 14 | Ascites |
| 15 | Dementia |
| 16 | Acute poisoning |
Part Three · Interpretation
Eleven chapters on reading the investigations, numbered as chapters in their own sequence.
Chapters
| Chapter | Title |
|---|---|
| 1 | Reading the electrocardiogram systematically |
| 2 | Ischaemia, pericarditis and the electrolytes |
| 3 | The narrow-complex tachycardias |
| 4 | The broad-complex tachycardias |
| 5 | Bradycardia and conduction block |
| 6 | A reading drill |
| 7 | The blood count, film, coagulation screen and marrow |
| 8 | Renal function and urinalysis |
| 9 | Liver function tests |
| 10 | The chest radiograph and pulmonary function tests |
| 11 | Rheumatological and immunological serology |
PART ONE
Disease Cases by System
Seventy-nine cases in ten blocks