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Doing exam questions is a very good way to revise, and it is highly recom- mended that you re-read a topic where your score is disappointing — you will be even more disappointed if it comes up in the examination and you have neglected to revisit that topic and top up your knowledge. To pass the exam reading and revision is required, but understanding the style of questions and practising questions will improve your chance of success. Learning Outcomes This module covers history taking; clinical examination and investigation; note keeping; legal issues relating to medical certifcation; time management and decision making; communication; and ethics and legal issues.

It is easy to set clinical questions on history, examination, or investigation, but quite a challenge to set written questions to test the other areas. We have also tried to look at attitudes and behaviour using written ques- tions concentrating on issues such as consent, domestic violence, and con- fdentiality. When tak- ing a history, which of the following symptoms suggests that the diagnosis might be endometriosis? The woman seems unsure about her request for termination of unwanted pregnancy Answer [ ] 1. When they suffer an early pregnancy complication, which one of these non- sensitised, rhesus negative women does not need anti-D immunoglobulin? Miscarriage less than 12 weeks when the uterus is evacuated surgically or medically B.

Case 05: Hypochromic Microcytic Anaemia A 29-year-old woman presented with weakness bupron sr 150 mg online, palpitation and shortness of breath on exertion discount bupron sr 150 mg visa. Microcytic hypochromic blood profle with a history of blood loss suggests iron-defciency anaemia. Treatment includes correction of anaemia by blood transfusion, iron therapy for 3—6 months to replenish the store and treatment of primary cause. Case 06: Anaemia, jaundice, frontal and parietal bossing, mongoloid facies and splenomegaly. Presence of microcytic hypochromic anaemia with a high reticulocyte count, jaundice and splenomegaly in a young patient indicates hereditary haemolytic anaemia, most commonly b-thalassaemia major.

Other common hereditary haemolytic anaemia—HbE disease, thalassaemia E disease double heterozygous. Case 07: Macrocytic Anaemia A 50-year-old woman presented with weakness and anorexia for 3 months. As follows: The diagnosis is megaloblas- tic anaemia. Most common cause is megaloblastic anaemia as a result of vitamin B12 or folic acid defciency. Case 08: Leukemoid Reaction A 60-year-old woman presented with fever, cough and weight loss. She was suffering from breast cancer, which was treated by mastectomy and chemotherapy.

Leukemoid reaction means that the peripheral blood profle resembles leukaemia, but there is no leukaemia. Causes of lymphatic leukemoid reaction are viral infectious mononucleosis, cytomegalovirus infection, measles, chickenpox , whooping cough and, rarely, tuberculosis and carcinoma. It is important to distinguish Prior to excision of the cartilages 150mg bupron sr fast delivery, the natural dome is identified caudal septal deflection from footplate flare generic 150 mg bupron sr visa, which can be and marked.

Contraindications Do not use Bupron SR if you have allergy to any of its components. Possible side effect Possible side effects are the following: You should call for medical help immediately, if you feel some symptoms of more serious side effects. Drug interaction You must consult with your doctor about interaction between Bupron SR and the other drugs, especially with: Missed dose Never take more than prescribed dose, even if you missed the one. Try to take it as soon as possible. Or, if it's too late, just skip it and take your usually dose next day in the same regularly time. Overdose In case if you think that you could be overdosed by Bupron SR you should call for medical help immediately.

Symptoms of Bupron SR overdose are following: Storage Store at room temperature between 68-77 F 20-25 C , in a dark and dry place. Save it from children and pets. Watch the expiration date! Note The information presented at the site has a general character. Note please this information cannot be used for self-treatment and self diagnosis. You should consult with your doctor or health care adviser regarding any specific instructions of your condition. Appendix fibrosa Inferior vena cava Esophageal impression Bare area of the liver Caudate lobe Coronary ligament Gastric impression Portal vein Suprarenal impression Hepatic artery Renal impression Porta hepatis Common hepatic duct Cystic duct Edge of lesser omentum Duodenal impression Quadrate lobe Round ligament Colic impression Gallbladder figure 23-1.

The left portal lobe is the left anatomical lobe, quadrate lobe, and the remainder of the caudate lobe. The portal lobes are supplied by lobar branches of the hepatic artery, portal vein, and bile ducts. Although lacking external landmarks, the portal lobes are further divided functionally into hepatic segments. The liver receives a dual blood supply; approximately 30 percent of the blood entering the organ is from the hepatic artery, and 70 percent is from the portal vein. The proper hepatic artery is a branch of the common hepatic artery, one of the three major branches of the celiac artery.

As it approaches the liver, it divides into right and left hepatic branches that enter the liver and divide into lobar, seg- mental, and smaller branches. We have provided a list of websites where you will fnd helpful information about some topics that could come up in the examina- tion, and although this list is not exhaustive, we think you will fnd that the websites contain interesting revision material. Doing exam questions is a very good way to revise, and it is highly recom- mended that you re-read a topic where your score is disappointing — you will be even more disappointed if it comes up in the examination and you have neglected to revisit that topic and top up your knowledge.

To pass the exam reading and revision is required, but understanding the style of questions and practising questions will improve your chance of success. Learning Outcomes This module covers history taking; clinical examination and investigation; note keeping; legal issues relating to medical certifcation; time management and decision making; communication; and ethics and legal issues. It is easy to set clinical questions on history, examination, or investigation, but quite a challenge to set written questions to test the other areas. We have also tried to look at attitudes and behaviour using written ques- tions concentrating on issues such as consent, domestic violence, and con- fdentiality.

When tak- ing a history, which of the following symptoms suggests that the diagnosis might be endometriosis? The woman seems unsure about her request for termination of unwanted pregnancy Answer [ ] 1. When they suffer an early pregnancy complication, which one of these non- sensitised, rhesus negative women does not need anti-D immunoglobulin? Miscarriage less than 12 weeks when the uterus is evacuated surgically or medically B. Case 05: Hypochromic Microcytic Anaemia A 29-year-old woman presented with weakness bupron sr 150 mg online, palpitation and shortness of breath on exertion discount bupron sr 150 mg visa.

Microcytic hypochromic blood profle with a history of blood loss suggests iron-defciency anaemia. Treatment includes correction of anaemia by blood transfusion, iron therapy for 3—6 months to replenish the store and treatment of primary cause. Case 06: Anaemia, jaundice, frontal and parietal bossing, mongoloid facies and splenomegaly. Presence of microcytic hypochromic anaemia with a high reticulocyte count, jaundice and splenomegaly in a young patient indicates hereditary haemolytic anaemia, most commonly b-thalassaemia major. Other common hereditary haemolytic anaemia—HbE disease, thalassaemia E disease double heterozygous.

Case 07: Macrocytic Anaemia A 50-year-old woman presented with weakness and anorexia for 3 months. As follows: The diagnosis is megaloblas- tic anaemia.

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