Tutorials in Medicine

Posts by Prof. Shaheen


  • by shaheenmoin
    In 1982, “myelodysplasia” was used by the French–American–British (FAB) group to describe the morphologic abnormalities of the myeloid cell lines of hematopoiesis in preleukemic conditions, which were named myelodysplastic syndromes (MDS). MDS occur mainly, but not exclusively, in patients with a median age of about 70 years, and the crude incidence is 4 to 5 … Continue reading Myelodysplastic Syndromes. Not yet a leukemia but can be fatal.
  • by shaheenmoin
    When a disease can cause multiple neurological deficits it more important to identify the site of the deficits than to just diagnose the disease as in multiple sclerosis. Case 1. A 28 year old patient comes in to the hospital complaining of blurring of vision. He is known to have had an episode of paraplegia … Continue reading Identifying neurological deficits.
  • by shaheenmoin
    COPD is an umbrella term for various clinical entities with multiple causes resulting in airflow limitation that is not fully reversible. COPD is better defined as a clinical syndrome characterized by chronic respiratory symptoms, structural pulmonary abnormalities (airways disease, emphysema, or both), lung function impairment (primarily airflow limitation that is poorly reversible), or any combination … Continue reading COPD and related problems.
  • by shaheenmoin
    Poliomyelitis has disappeared from most of the world except for Afghanistan and the bordering country of Pakistan because of on going internal war and terrorism which prevented the completion of the vaccination program which has again been reinstated in Pakistan. In fact prevention of vaccination has been part of the terrorists’ acts of war. However … Continue reading Ascending paralysis of gradual onset;
  • by shaheenmoin
    This is the way the history was presented. A 38 year old woman developed weakness of her lower limbs 2 and a 1/2 weeks ago. Two weeks later her upper limbs were affected in that her grip strength became weak too. She could dress herself, feed herself and do her hair without assistance. She developed … Continue reading Patient with weakness of the legs: history taking and presentation.
  • by shaheenmoin
    Both ulcerative colitis and Crohn’s disease are diseases of modern life. UC has been known since 1800s and CD tends to occur more in the West than in Asia. Removing the appendix in early life reduces the incidence of UC but not CD. Diets rich in fats and sugar are predisposing to both diseases. The … Continue reading Inflammatory bowel disease.
  • by shaheenmoin
    Cirrhosis is the irreversible fibrosis of the liver. It is the end stage of a final shared pathway in chronic damage to a major vital organ. The pathophysiological features of cirrhosis involve progressive liver injury and fibrosis resulting in portal hypertension and decompensation, including ascites, spontaneous bacterial peritonitis, hepatic encephalopathy, variceal hemorrhage, the hepatorenal syndrome, and … Continue reading Cirrhosis: evaluation and treatment.
  • by shaheenmoin
    Who needs a liver transplant and who does not? What drugs can be used for immunosuppression? Remember that as the liver recovers and regenerates after a successful transplant its enzymes modify and destroy the drugs being used. Close monitoring of drug levels is essential. In chronic liver failure the two most common reasons for a … Continue reading Liver Transplant: important information.
  • by shaheenmoin
    Facing the Examiner in the FCPS 2 Exam in Medicine. It is time for you to be assessed in the knowledge and skills that you have acquired in the last four years of your training. Some of you underwent the training earlier maybe several years ago and have settled into a routine you use daily with … Continue reading What is being practiced currently in teaching hospitals internationally. Good history presentation. […]
  • by shaheenmoin
    I had written two posts on how to take a history in the long case. Nobody bothered to read them. After all you know how to take a history. The problem is that in the exam situation (FCPS 2) in Pakistan the candidate is trying to throw themselves back to their third year days. The … Continue reading Taking a history in the long case: do you sound like a consultant?