Medical science, drawn into focus.

Endometriosis

A healthy 25-year-old woman presents with worsening dysmenorrhea, pain of recent onset in the left lower quadrant, and dyspareunia. She has regular menstrual cycles, and her last menstrual period was 3 weeks before presentation. She has been trying to fall pregnant over the past 10 months without success and she is becoming more concerned. Overview…

Polymyalgia Rheumatica (PMR)

Overview Polymyalgia rheumatica is a common inflammatory condition affecting older adults, typically over 50 years of age, characterised by pain and stiffness in the shoulder and pelvic girdles. It is strongly associated with elevated inflammatory markers and responds dramatically to low-dose corticosteroids. PMR is a clinical diagnosis and can mimic other rheumatic or non-rheumatic disorders.…

Hyperemesis Gravidarum

Overview Hyperemesis gravidarum (HG) exists on a spectrum of nausea and vomiting in pregnancy (NVP). NVP refers to symptoms of nausea, vomiting or dry retching commencing in the first trimester, with no other cause identified. 1 HG refers to severe, persistent vomiting that may result in malnutrition, dehydration, weight loss and debility due to illness.…

AC Joint Separation

Overview Acromioclavicular (AC) joint separation is a common shoulder injury, usually sustained from direct trauma such as a fall onto the tip of the shoulder. It involves varying degrees of injury to the stabilising structures of the AC joint — primarily the acromioclavicular and coracoclavicular ligaments. Clinical presentation ranges from localised tenderness and mild pain…

Hydrocephalus

Overview Hydrocephalus is excessive accumulation of CSF in the cerebral ventricles. In children, look for increasing head circumference, increased intracranial pressure, a bulging fontanelle, scalp vein engorgement, and paralysis of upward gaze. The most common causes include: Congenital malformations Tumors Inflammation (i.e hemorrhage, meningitis). Treat the underlying cause, if possible; otherwise a surgical shunt is created…

Carotid Artery Disease

Overview Carotid artery disease refers to atherosclerotic narrowing of the carotid artery lumen. It is associated with approximately 10-15% of all ischaemic strokes. Stroke is the third leading cause of death and a principal cause of long-term disability in much of the industrialised world. The degree of internal carotid artery stenosis is the most important…

Neural Tube Defect

Overview Neural tube defects (NTDs) are a group of major congenital anomalies comprising anencephaly, spina bifida and encephalocele that result from very early disruption in the development of the brain and spinal cord. These conditions are often incompatible with life. Survivors frequently require intensive, costly, lifelong health and social care. Neural tube defect (NTD): Severe…

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