Saturday, August 7, 2010

Bates’ Guide to Physical Examination and History Taking, 10th Edition

The Tenth Edition of the pre-eminent textbook on physical examination and history taking contains foundational content to guide students’ approaches to history taking, interviewing, and other core assessment concepts, as well as fully illustrated, step-by-step techniques that outline correct performance of physical examination. The comprehensive content is intended for high-level nursing education and practice markets, medical students, and related health professions such as physician assistants.



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Bullous Erythema Exsudativum Multiforme

Pathology: Conjunctiva -> Bullous Disease of Skin and Mucous Membranes -> Erythema Multiforme

Late phase with extensive scarring of the conjunctiva (symblepharon) which has led to obstruction of the accessory tear glands and tear retention cysts.

Diagnosis:late Phase of Bullous Erythema Exsudativum Multiforme, Stevens-Johnson Syndrome.

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Answered case

The patient shown below most likely has:

a. A large left pleural effusion

A large right pneumothorax

Atelectasis of the left lung

Pneumonia in the left lung

Unilateral pulmonary edema

The correct answer :
Pneumonia in the left lung

There is opacification of the left hemithorax. There is no shift of the heart and mediastinal structures (i.e. the trachea). This eliminates pleural effusion and atelectasis as possibilities. A tension pneumothorax would displace the heart and mediastinal structures away from the side of the pneumothorax and would not cause complete opacification of the opposite lung. In addition, there should be no lung markings visible in the hemithorax which contains the pneumothorax. Either pneumonia or pulmonary edema could cause the findings shown, but pneumonia is a much more common cause.

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