Clin Med
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Medical professionalism has been notoriously difficult to define and remains poorly understood. Because of this, graduates often have contrasting views on how it is best taught. ⋯ They were also asked to identify how they felt teaching about professionalism was best delivered from a selection of educational resources. The findings highlight major differences between how the material is taught and how students and graduates feel they learn best about professionalism and more research into this field is needed.
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Medicine is traditionally known as an 'art', and not an exact 'science'. Medical images of clinical signs and pathology were communicated through 'metaphors' in the 19th and early 20th centuries to make recognition easier in anticipation of the clinical counterpart when encountered in medical practice. ⋯ The continued use of metaphors has given rise to an ongoing debate, particularly in Africa, due to the usage of inappropriate or unfamiliar metaphors which are not locally or culturally relevant. Despite this, medical analogies will no doubt continue to be useful for medical education, clinical practice and 'aide memoirs' for examinations, and bring light humour, for a long time to come.
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Case Reports
Addison's disease masked by long-term exogenous steroid treatment for presumed polymyalgia rheumatica.
Addison's disease can present insidiously. A 78-year-old woman presented with non-specific symptoms and hyponatremia, with a previous history of polymyalgia rheumatica treated with glucocorticoids. ⋯ Primary autoimmune Addison's disease can present with protean symptoms and diagnosis is often delayed. A high index of suspicion remains the cornerstone of diagnosis.
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Warfarin-induced skin necrosis is a rare but serious complication of treatment with this commonly prescribed drug. This lesson presents the case of a patient with extensive skin necrosis after inappropriately prolonged warfarinisation and delayed recognition. The condition is briefly reviewed to highlight key features and risk factors.