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172

Rheumatoid Arthritis

RA is a type of inflammatory arthritis. Other examples include seronegative spondyarthritides, reactive arthritis, lyme arthritis, crystal arthritis and postviral arthritis.   Features of inflammatory arthritis Pain and stiffness worse in the morning and after rest Early morning pain and stiffness may last several hours (in OA, duration is much shorter)  
almostadoctor.com - free medical student revision notes
over 5 years ago
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37

Mechanical Back Pain

 
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over 5 years ago
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23

Myelofibrosis

Marrow fibrosis and splenomegaly, de novo or following transformation of PV or ET Usually >50 years old Abnormal megkaryocytes produced in increased numbers. PDGF and TGFβ are released by megakaryocytes, stimulating fibrosis. Haematopoietic stem cells move to the spleen and liver Presentation: fatigue, weight loss, splenomegaly, splenic pain, portal hypertension, bleeding varices, ascites and hepatomegaly  
almostadoctor.com - free medical student revision notes
over 5 years ago
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28

Large Bowel Obstruction

Large bowel obstruction Typically causes a less severe disease than small bowel obstruction Symptoms are more gradual in onset There are often loud borborygmi (normal bowel sounds) Rectum is usually empty, and the abdomen is non-tender Pain is lower down in the abdomen There may be greater distension than with small bowel obstruction    
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over 5 years ago
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14

Post Coital Bleeding

Causes InfectionChlamydia, gonorrhoea, trichomoniasis (rarer cause) Risk factors – ask about partners (number of partners, protection, Hx of sexually transmitted infection etc) Ask about other symptoms –discharge, pain Cervical / endometrial polyps  
almostadoctor.com - free medical student revision notes
over 5 years ago
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15

Facial Pain

Sinusitis Clinical features Dull constant aching pain over the maxillary sinus Tenderness over underlying skin Postnasal drip Ethmoid/sphenoid a pain felt deep in the midline at the root of the nose Pain is worse on bending Pain usually lasts 1-2 weeks and is often associated with symptoms of a cold (coryza)    
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over 5 years ago
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15

Medication Overuse Headache

 
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over 5 years ago
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60

Summary of Headaches

  Headache  
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over 5 years ago
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49

Peripheral Neuropathy

All peripheral nerves are myelinated, except C fibres – which carry information about pain. These C fibres are sometimes called ‘slow fibres’ because the signal travels slowly due to the lack of myelination.   Specific causes of peripheral neuropathy The mnemonic DAVID can be used as a method to remember specific causes of peripheral neuropathies  
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over 5 years ago
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57

Osteosarcoma

Osteosarcoma is the most common malignant primary bone tumour. It frequently occurs in late childhood and tends to arise in the metaphyses of the long bones. It may present with pain, swelling or a pathological fracture. Treatment involves resection and chemotherapy. The cure rate is approximately 50% as metastatic disease is not uncommon.  
almostadoctor.com - free medical student revision notes
over 5 years ago
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667

An Introduction to Pain [Nociceptors]

Hand drawn tutorial on Nociceptors.  
YouTube
over 5 years ago
Www.bmj
1
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FDA chief defends Zohydro approval as US states rebel

Margaret Hamburg, commissioner of the US Food and Drug Administration, has defended her agency’s decision to approve the potent long acting opioid Zohydro ER, arguing that the FDA had to balance the risks of opioid prescription abuse with “the very real medical needs of the estimated 100 million Americans living with severe chronic pain or coping with pain at the end of life, which is also a major public health problem in this country.”  
bmj.com
over 5 years ago
Www.bmj
1
46

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
13

What is an “n-of-1” trial?

Researchers assessed the effectiveness of “n-of-1” trials for the short term choice of drugs for osteoarthritis. The efficacy of sustained release paracetamol was compared with celecoxib in the management of symptoms associated with osteoarthritis. A series of double blind randomised n-of-1 controlled trials using a double dummy design was performed. The intervention was sustained release paracetamol (two 665 mg tablets, three times a day), or celecoxib (200 mg daily, or 200 mg twice a day for those who were already using this dose). Each treatment regimen was taken for two weeks, administered for three treatment cycles. The primary outcome measures included pain, stiffness, and functional limitation scores; preferred treatment; and adverse effects.1  
bmj.com
over 5 years ago
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The end of life

Increasingly, US physicians face legal risks for doing too much or too little to help patients with end of life issues. On one hand, doctors are under more pressure to hold discussions with people who are diagnosed with terminal illnesses—exploring whether they would want to stop treatment if it became ineffective. In that case, the patient would shift to palliative care, which involves pain medications and other therapies to enhance quality of life.  
bmj.com
over 5 years ago
Www.bmj
1
53

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
25

A man with fever, a productive cough, and a striking chest radiograph | The BMJ

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day. - currently located behind a paywall. Your institution may have access through Athens/Elservier or similar.  
bmj.com
over 5 years ago
Www.bmj
1
22

A man with fever, a productive cough, and a striking chest radiograph

A 41 year old man presented to the emergency department with a two week history of worsening shortness of breath. Associated symptoms included a cough productive of green sputum, intermittent fevers, night sweats, and non-pleuritic pain in the right side of the chest wall. He had a history of chronic pancreatitis secondary to alcohol excess, which was complicated by diet controlled type 2 diabetes. He also smoked 40 cigarettes a day.  
bmj.com
over 5 years ago
Www.bmj
1
45

A man with a mass in the thigh

A 54 year old man presented to his general practitioner because of a fullness in his left lateral thigh that he first noticed while playing golf, although it was not related to an identifiable injury. He had a history of hypertension and fibromyalgia and was taking atenolol, ramipril, pregabalin, and tramadol but was otherwise well. The GP thought that the swelling was caused by a muscular injury, but the patient re-presented four months later because the mass had grown from a small bump to a swelling of 8 cm in diameter. It was also beginning to cause some knee stiffness but no pain. On examination he had a large firm swelling in his lateral thigh. On this occasion his GP referred him on a two week wait to the regional plastic surgery department. An ultrasound scan showed a 6 × 8 cm intramuscular mass with cystic changes and patchy neovascularity, but no inguinal or pelvic lymphadenopathy. Ultrasonography was followed by magnetic resonance imaging, with and without gadolinium contrast (fig 1⇓).  
bmj.com
over 5 years ago
Www.bmj
1
28

Trigeminal neuralgia

Trigeminal neuralgia is a severe, unilateral, episodic pain of the face that is provoked by light touch; it should be differentiated from dental causes of pain  
www.bmj.com
over 5 years ago