A detailed review of the resources you will need for a residency in General Medicine.
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I shall start with books.
I created this post on books on clinical medicine in 2022.
It is still appropriately up to date in my opinion.
Boloor is the best textbook for the Indian education system in my humble opinion considering how well organized it is. It also carries all the historically significant information you need to learn or know for your exams like coin percussion and trail sign.
Kundu's medicine is a case based text and it is really difficult to organize your own index of topics. This is its biggest drawback. Otherwise a good text if you can organize it.
You will have to use one of these two as a basic text. You can you use the others as a reference. I would personally recommend Sapira and Talley and Conner both of which are pretty fun texts.
The best thing a neurologist can do for a patient with atherosclerotic stroke is refer to an internist/endocrinologist/nephrologist to adequately evaluate the manage the underlying diabetes and hypertension.
I don't how it makes sense to talk about carotid stents and long term AF monitoring when the patient has a BMI of 40 or resistant HTN, possibly due to 1° hyperaldosteronism.
Its bad practice to hold onto a patient for years on suboptimal therapy while their stroke burden goes on increasing and they eventually develop vascular cognitive impairment.
A 45 year old lady with significant vascular risk factors presented with hyperacute onset dimness in the L side of her field of vision, specially in the bottom half.
There is no other significant neurological or systemic hx.
Clinical examination revealed only a BP - 150/90, R arm, sitting position with confrontation perimetry showing an incongruent, incomplete L sided homonymous hemianopia.
A homonymous hemianopia localizes posterior to the optic chiasma where the nasal hemiretinal fibers decussate.
A L sided HH localizes a lesion to the R post-chiasmatic visual pathway.
Incongruency argues for a relatively anterior localization of the lesion ie away from cortex.
A lot of referrals to neurology are basically what I like to call 'lazy' referrals.
For example, you get a patient with paraparesis and instead of performing a detailed clinical evaluation, you shotgun some MRI and NCS and send a quick referral to neurology.
Since these investigations are poorly chosen and poorly aimed, the end result is mass confusion where localization goes for a toss.
General medicine has been particularly egregious in this regard.
If your knee jerk reaction is to just get an MRI LS spine for every low back pain, don't be surprised when the patient then develops an LMN type of lower limb weakness. Low back pain can be severe in GBS.
I have always been tremendously interested in the history of medicine and its quirky stories.
One of the most interesting is West syndrome.
This is one of the rare syndromes which is simultaneously named after a physician and a patient.
In 1841, the general practitioner W.J. West from Turnbridge wrote a letter to the Lancet entitled 'on a peculiar form of infantile convulsions' describing symptomatology in his own son.
William James West was born im 1794 and became a member of the Royal College of Surgeons in 1815.
His 'son' was James Edwin, born in 1840 and transferred to the Earlwood Asylum for the Feeble-Minded in Redhill in 1853. He died 7 years later and was buried with his father.