Tutorials in Medicine

Posts by Prof. Shaheen


  • by shaheenmoin
    Salicylates or “aspirin” have become so common that if you write it in your regular prescription you will have to give an explanation to your patient. Often the patient is told that it is being used as a blood thinner or that it is still the “painkiller” against which all the other NSAIDs are titrated … Continue reading Salicylate Poisoning: recognizing and treating it.
  • by shaheenmoin
    Inflammatory diseases of the kidney present to us in a wide variety of ways. They can present as a nephrotic syndrome or with more active sediment in the urine and rapid loss of renal function known as the nephritic syndrome or they may present as gradual loss of renal function usually with some degree of … Continue reading Membranoproliferative Glomerulonephritis.
  • by shaheenmoin
    A 32-year-old woman, who has never been pregnant and who has a 5-year history of hypertension, wants to become pregnant. She has stopped using contraception. Her only medication is lisinopril at a dose of 10 mg per day. Her blood pressure is 124/68 mm Hg, and her body-mass index (the weight in kilograms divided by … Continue reading Pregnancy in a woman with hypertension.
  • by shaheenmoin
    Case 1. A 19 year old college student developed severe sore throat along with fever, dry cough and breathlessness. He saw his doctor three days later. His temperature was 38.6 degrees C, blood pressure was 160/105 mmHg, the throat was congested but there were no pus points in the throat. He had rhonchi in his … Continue reading IgA Nephropathy: commonest cause of kidney disease seen in young adults.
  • by shaheenmoin
    A 56 year old man presented to his doctor with swelling of the feet, tiredness and breathlessness of three weeks duration. He had developed hypertension; BP of 160/100 mmHg about three months back and was on a beta blocker for its control. He was not diabetic, did not have arthralgia or arthritis, a rash or … Continue reading Membranous nephropathy: treatment in the light of the Membranous Nephropathy Trial of […]
  • by shaheenmoin
    The deposition of monosodium urate [MSU] crystal is characterized biochemically by extracellular fluid urate saturation, which is reflected in the blood by hyperuricemia, with serum or plasma urate concentrations exceeding 6.8 mg/dL (approximately 400 micromol/L); this level of urate is the approximate limit of urate solubility [1]. This produces the clinical manifestations of gout which … Continue reading Managing gout.
  • by shaheenmoin
    A 55-year-old male patient was evaluated for foot drop (bilateral), which had begun subtly 4 months earlier with the onset of muscle cramping in the right calf as a result of volitional movement (known as volitional cramping) and had progressed to severe weakness of ankle dorsiflexion and knee extension more so on the right side. … Continue reading ALS: following up foot drop progressing to ankle and knee weakness and more.
  • by shaheenmoin
    As we all know that multiple sclerosis is a disease with a variable neurological deficit which relapses and remits and occurs in different part of the CNS. It will obviously have a wide differential diagnosis and will require a lot of clinical acumen to make a diagnosis. Let us look at a case report in … Continue reading Optic neuritis: Multiple Sclerosis or something else.
  • by shaheenmoin
    A 72-year-old woman presented to the emergency department with a 3-month history of a rash on both legs and an additional 6 months of gingival bleeding. The patient’s medical history was notable for esophageal strictures leading to poor oral intake for at least 2 years. She had not visited her dentist for the gingival bleeding. … Continue reading Overview of water soluble vitamins 1: vitamin C. Can you still encounter scurvy?
  • by shaheenmoin
    A 38 year old man comes to your OPD with a blood sugar fasting of 235 mg/dl, HbA1c of 11, and uncontrolled hypertension. His blood sugar always stays above the baseline values and is often high. He is a big bulky man 6’2″ in height with a BMI of 35. You notice that he has … Continue reading How will you be assessed when dealing with a patient with acromegaly.