Key Features               

• An easy book to learn the approach in common short cases with the basic knowledge and skill, essential for presentation and interpretation in any examination.
• A complete outline of comprehensive medical encounter including physical examination and interpretation of gathered information to formulate a diagnosis.
• Provides short notes and brief discussions on various common diseases, helpful for a quick review without going through voluminous textbooks.
• 800 coloured photographs are there to help the students to develop a good clinical eye.
• Easy to understand, concise, yet full of necessary information.

New in this edition:

• Some new short cases like "Inferior vena caval obstruction", "Tricuspid stenosis", "Pulmonary regurgitation", "Lobectomy and pneumonectomy", "Rheumatoid lung", "Polycythemia Rubra Vera" including many others are added. Also, new investigations and latest treatment protocols of many diseases are added, such as Filariasis, DVT, Atrial fibrillation, pneumothorax, consolidation, Kala-azar etc.   

Table of Contents

Preface to the 6th Edition ................................ vii

Acknowledgements ......................................... ix

Section A: Short Cases

CHAPTER 1 General Examination ...... 3  

Introduction ...................................................... 3

Jaundice .......................................................... 12

Cyanosis ......................................................... 16

Clubbing ......................................................... 18

Koilonychia .................................................... 23

Examination of Hands .................................... 30

Generalized Oedema ...................................... 34

Cervical Lymphadenopathy ........................... 36

Generalized Lymphadenopathy ..................... 40

Pigmentation .................................................. 43

Erythema Ab Igne .......................................... 47

Gynaecomastia ............................................... 49

Erythema Nodosum ....................................... 53

Leprosy (Hansen’s Disease) ........................... 57

Superior Vena Caval Obstruction

(Superior Vena Caval Syndrome) ............... 61

Inferior Vena Caval Obstruction .................... 64

Hirsutism ........................................................ 66

Polycystic Ovarian Syndrome ........................ 71

Leg Ulcer ....................................................... 74

Pyoderma Gangrenosum ................................ 77

Diabetic Foot .................................................. 80

Diabetic Ulcer ................................................ 82

Diabetic Amyotrophy ..................................... 85

Lipodystrophy of Thigh ................................. 87

Necrobiosis Lipoidica Diabeticorum ............. 88

Unilateral or Bilateral Leg Swelling .............. 90

Angioedema ................................................... 95

Deep Venous Thrombosis (DVT) ................... 97

Cellulitis ...................................................... 102

Erysipelas .................................................... 104

Peripheral Vascular Disease ........................ 106

Buerger’s Disease (Thromboangiitis

Obliterans) ............................................... 108

Bardet–Biedl Syndrome .............................. 109

Tongue ......................................................... 110

Hairy Leukoplakia ...................................... 114

Dupuytren’s Contracture ............................. 116

Paget’s Disease ............................................ 118

Lupus Pernio ............................................... 121

CHAPTE 2 Cardiovascular System ........................................ 127  

Introduction ................................................. 127

Mitral Stenosis ............................................ 140

Mitral Regurgitation .................................... 147

Mitral Valve Prolapse (Barlow’s

Syndrome or Floppy Mitral Valve) ......... 150

Mitral Stenosis with Mitral Regurgitation

(Mixed Mitral Valve Disease) ................. 152

Aortic Stenosis ............................................ 154

Aortic Regurgitation ................................... 159

Aortic Stenosis with Aortic Regurgitation

(Mixed Aortic Valve Disease) ................. 165

Tricuspid Regurgitation (TR) ...................... 167

Tricuspid Stenosis (TS) ............................... 169

Pulmonary Stenosis (PS) ............................ 170

Pulmonary regurgitation (PR) ..................... 173

Prosthetic Heart Valves ............................... 175

Congenital Heart Disease ............................ 179

Tetralogy of Fallot (TOF) ........................... 181

Ventricular Septal Defect (VSD) ................ 185

Eisenmenger’s Syndrome ............................ 188

Atrial Septal Defect (ASD) ......................... 191

Patent Ductus Arteriosus (PDA) ................. 194

Coarctation of Aorta .................................... 197

Marfan’s Syndrome ..................................... 201

Dextrocardia ................................................ 205

Examination of Pulse .................................. 206

Atrial Fibrillation (Irregular Pulse) ............. 208

Slow Pulse Rate (Complete Heart Block) ..... 213

Absent Pulse (Takayasu’s Disease) ............... 216

Pericardial Effusion ...................................... 219

Chronic Constrictive Pericarditis .................. 222

Acute Pericarditis .......................................... 225

Rheumatic Fever ........................................... 228

Hypertrophic Cardiomyopathy ..................... 233

CHAPTER 3 Respiratory system .....239  

Introduction ................................................... 239

Pleural Rub or Crepitations ........................... 253

Pleural Effusion ............................................ 255

Pneumothorax ............................................... 265

Bronchiectasis ............................................... 272

Bronchiectasis with Cystic Fibrosis .............. 277

Dpld (Previously Called Fibrosing

Alveolitis or ILD) ..................................... 280

Consolidation ................................................ 284

Collapse of Lung ........................................... 293

Fibrosis of Lung ............................................ 296

Lung Abscess ................................................ 298

Chronic Obstructive Pulmonary

Disease (COPD) ........................................ 302

Chronic Bronchitis ........................................ 309

Emphysema ................................................... 312

Mass Lesion in Lung (Bronchial

Carcinoma) ................................................ 317

Lobectomy and Pneumonectomy .................. 325

Rheumatoid Lung .......................................... 327

CHAPTER 4 Abdomen ...................331  

Introduction ................................................... 331

Splenomegaly (Not Hepatomegaly) .............. 340

Splenomegaly (Tropical Splenomegaly

Syndrome) ................................................. 344

Hepatosplenomegaly ..................................... 346

Hepatosplenomegaly (Discussion

About Malaria) ...........................................350

Hepatosplenomegaly (Discussion

About Kala-Azar) ...................................... 357

Post-Kala-Azar Dermal Leishmaniasis

(PKDL) ..................................................... 362

Hepatomegaly (Isolated) ............................... 364

Hepatomegaly (Discussion About

Hepatoma) ................................................. 368

Hepatomegaly (Enlarged Tender

Liver, Viral Hepatitis) ................................ 372

Tender Hepatomegaly (Discussion

About Liver Abscess) ................................ 378

Hepatomegaly (Discussion About

Hydatid Cyst) ............................................ 382

Ascites ........................................................... 385

Ascites (Discussion About

Tuberculous Peritonitis) ............................ 391

Chronic Liver Disease or Cirrhosis

of Liver ...................................................... 393

Porto-Systemic Encephalopathy

(Discussion About PSE or Hepatic

Precoma) ....................................................406

Hepatomegaly (Discussion about

Primary Biliary Cirrhosis) ..........................410

Hepatomegaly (Discussion about

Haemochromatosis) ...................................415

Abdominal Mass ............................................419

Mass in Different Sites of Abdomen ..............421

Mass in the Epigastrium (Discussion

About Carcinoma of Stomach) ..................429

Mass in the Epigastrium (Discussion

About Carcinoma of Head of Pancreas) ....433

Mass in the Epigastrium (Discussion

About Pancreatic Pseudocyst) ....................436

Mass in the Epigastrium (Discussion

About Aneurysm of Aorta) .........................438

Mass in Right Iliac Fossa (Discussion

About Ileo-Caecal Tuberculosis) ...............442

Mass in Right Iliac Fossa (Discussion

About Crohn’s Disease) .............................445

Carcinoma of Colon .......................................451

CHAPTER 5 Haematology ..............457  

Introduction ................................................... 457

Generalized Lymphadenopathy

(Hodgkin’s Lymphoma) ............................ 459

Generalized Lymphadenopathy

(Chronic Lymphatic Leukaemia) .............. 468

Splenomegaly (Chronic Myeloid

Leukaemia) ............................................... 471

Purpura .......................................................... 475

Purpura (Discussion About Idiopathic

Thrombocytopenic Purpura) ..................... 480

Purpura (Discussion About

Henoch–Schönlein Purpura) ..................... 483

Splenomegaly (Hereditary Haemolytic

Anaemia) ................................................... 486

Anaemia (Iron Deficiency Anaemia) ............ 491

Splenomegaly (Discussion About

Polycythaemia Rubra Vera) ....................... 498

Splenomegaly (Myelofibrosis) ...................... 501

CHAPTER 6 Endocrinology ............505  

Examination of Thyroid Gland ..................... 507

Face in Thyroid Disease (by Looking

at the Face) ................................................ 510

Thyrotoxicosis (Hyperthyroidism) ................ 512

Thyroid disorders in pregnancy .................... 518

Hypothyroidism ............................................ 521

Hypothyroidism in Pregnancy ...................... 528

Graves’ disease .............................................. 531

Goitre ............................................................ 536

Thyroid Malignancy ...................................... 545

Acromegaly ................................................... 548

Cushing’s Syndrome ..................................... 555

Addison’s Disease ......................................... 562

Tall Stature .................................................... 568

Klinefelter’s Syndrome ................................. 569

Short Stature .................................................. 572

Diabetes Mellitus .......................................... 575

CHAPTER 7 Nephrology ................587  

Mass in Flank (Renal) ................................... 589

Bilateral Renal Mass (Polycystic

Kidney Disease) ........................................ 591

Unilateral Mass (Renal Cell

Carcinoma) ................................................ 594

Mass in Left or Right Iliac

Fossa (Transplanted Kidney) .................... 597

Nephrotic Syndrome .................................. 601

CHAPTER 8 Neurology ..................613  

Introduction ................................................... 613

Neurological Examination of

Lower Limb .............................................. 615

Spastic Paraplegia (Spinal Cord

Compression) ............................................ 621

Multiple Sclerosis (Presenting as Spastic

Paraplegia) ................................................ 628

Multiple Sclerosis (Presenting in

other Forms) .............................................. 633

Transverse Myelitis (Presenting

as Spastic Paraplegia) ................................ 635

Flaccid Paraplegia ......................................... 638

Guillain–Barré Syndrome (Presenting

as Flaccid Paraplegia) ............................... 640

Monoplegia (Brown–Séquard

Syndrome) ................................................. 644

Old Poliomyelitis (Presenting

as Monoplegia) .......................................... 646

Polyneuropathy ............................................. 648

Subacute Combined Degeneration

(Presenting as Polyneuropathy) ................ 653

Motor Neuron Disease (MND) ..................... 657

Friedreich’s Ataxia ........................................ 664

Cerebellar Lesion .......................................... 668

Parkinson’s Disease ...................................... 672

Chorea ........................................................... 681

Tremor ........................................................... 685

Speech ........................................................... 688

Dysphasia ...................................................... 691

Dysarthria ...................................................... 694

Examination of Hands (Wasting

of Small Muscles of Hands) ...................... 697

Syringomyelia ............................................... 700

Myotonic Dystrophy ..................................... 703

Myopathy (Muscular Dystrophy) ................. 706

Carpal Tunnel Syndrome (Median

Nerve Palsy) .............................................. 712

Ulnar Nerve Palsy ......................................... 715

Radial Nerve Palsy ........................................ 717

Cranial Nerves .............................................. 719

Facial (VIIth) Nerve Palsy ............................ 723

VIth Nerve Palsy ........................................... 728

Multiple Cranial Nerve Palsy ........................ 729

CVD with Hemiplegia .................................. 732

Gait Abnormality .......................................... 739

Orofacial Dyskinesia ..................................... 741

Foot Drop (Common Peroneal

Nerve Palsy) .............................................. 743

Charcot–Marie–Tooth Disease

(Peroneal Muscle Atrophy) ....................... 745

Cervical Myelopathy ..................................... 748

Cerebello-Pontine (CP) Angle Lesion .......... 751

CHAPTER 9 Rheumatology ............755  

Introduction ................................................... 755

Systemic Sclerosis ........................................ 757

Raynaud’s Phenomenon or Disease .............. 764

Rheumatoid Hand ......................................... 767

Knee Joint Arthritis (Examination

of Knee Joint) ............................................ 780

Juvenile Idiopathic Arthritis (JIA/JCA) ........ 784

Septic Arthritis .............................................. 789

Haemophilic Arthritis .................................... 792

Reiter’s Syndrome (or, Reactive

Arthritis) .................................................... 798

Psoriatic Arthropathy .................................... 801

Ankylosing Spondylitis ................................. 805

Dermatomyositis or Polymyositis ................. 811

Proximal Myopathy ...................................... 817

Gout ............................................................... 820

Systemic Lupus Erythematosus (SLE) ......... 825

Vasculitis ....................................................... 838

Osteoarthrosis ............................................... 842

Charcot’s Joint .............................................. 845

CHAPTER 10 Examination of the Eye .....................................849  

Introduction ................................................... 849

Optic Atrophy ................................................ 851

Papilloedema (Pure) ...................................... 854

Retinal Vein Occlusion (Central and

Branch Retinal Vein Occlusion) ................ 858

Hypertensive Retinopathy ............................. 860

Retinal Haemorrhage .................................... 862

Diabetic Retinopathy .................................... 864

Retinitis Pigmentosa ..................................... 869

Ptosis ............................................................. 871

Horner’s Syndrome ....................................... 875

Argyll Robertson Pupil (AR Pupil) ............... 877

Holmes–Adie Pupil (Myotonic pupil) .......... 878

Brief Discussion about Different

Types of Pupil ........................................... 879

Exophthalmos ............................................... 881

Nystagmus ..................................................... 884

Subhyaloid Haemorrhage .............................. 888

Choroido-Retinitis ........................................ 890

Retinal Detachment ....................................... 892

Drusen ........................................................... 893

Retinal Artery Occlusion ............................... 895

Miscellaneous Ocular Abnormality .............. 897

CHAPTER 11 Dermatology.....................................903  

Introduction ................................................... 903

Psoriasis ........................................................ 905

Erythema Multiforme and Stevens–

Johnson Syndrome .................................... 910

Dermatitis Herpetiformis .............................. 913

Herpes Zoster (Shingles) ............................... 916

Acanthosis Nigricans .................................... 920

Ichthyosis ...................................................... 922

Pemphigus Vulgaris ...................................... 924

Pemphigoid (Bullous) ................................... 927

Arsenicosis (Chronic Arsenic Toxicity) ........ 930

Scabies .......................................................... 933

Lupus Vulgaris .............................................. 936

Lichen Planus ................................................ 939

Exfoliative Dermatitis ................................... 943

Alopecia ........................................................ 947

Vitiligo .......................................................... 950

Neurofibroma ................................................ 952

Mycosis Fungoides ....................................... 955

Tuberous Sclerosis ........................................ 957

Kaposi’s Sarcoma .......................................... 959

Pityriasis Versicolor (Tinea Versicolor) ........ 961

CHAPTER 12 Miscellaneous .........965  

Face in Different Diseases ............................ 965

Wegener’s Granulomatosis ........................... 968

Butterfly Rash ............................................... 969

Turner’s Syndrome ........................................ 971

Down’s Syndrome ......................................... 974

Bilateral Parotid Enlargement ....................... 976

Xanthelasma .................................................. 978

Sturge–Weber’s Syndrome ............................ 980

Hereditary Haemorrhagic Telangiectasia ...... 981

Yellow Nail Syndrome .................................. 983

Skin Cancers ................................................. 984

Normal Case .................................................. 986

Bibliography ..................................................987

Index ..............................................................989

Section B: Common Interpretations in Medicine

(Available Online)

CHAPTER 13 Data Interpretation

CHAPTER 14 X-Ray, CT and MRI

CHAPTER 15 E CG

CHAPTER 16 Pictures

CHAPTER 17 Instruments