Abstract
By Michael J Murphy, Rajeev Srivastava and Allan Gaw
Cumbernauld: SA Press, 2012
132 pp, Price £7.99
ISBN: 9780956324245
In this book, the authors present a series of clinical cases and invite the reader to answer key questions using their knowledge of each topic. Each case is accompanied by the authors' answers and explanations, which are found by turning to the next page. It is intended to be a revision aid for those studying medicine, nursing and biomedical sciences and for those preparing for post-graduate examinations. It is available as a paperback or for viewing on a Kindle reader and is designed to be simple to use.
The cases cover a range of common topics in clinical biochemistry. It is assumed that the reader has studied each topic and is ready to put knowledge into practice. Each case study consists of a short history, some clinical findings and biochemistry results and some questions. Appropriate reference ranges are provided in brackets after each result to help with interpretation. The reader is asked to consider several questions and, by turning over the page, will find the solutions and explanations. The main focus is on clinical problems and the interpretation of biochemical results in a clinical context, rather than laboratory analysis. Many common topics are covered, from routine profiles, endocrinology, diabetes and lipids to toxicology and paediatric biochemistry. A further miscellaneous section covers examples such as drug effects, tumour markers, macroenzymes and micronutrients. There is a reference list of books and websites that provide more detailed specialist coverage to enable the reader to explore the topics covered in more detail.
We believe that this book meets its objectives in that study of the cases presented encourages problem-based learning through revision of prior knowledge and the identification of gaps in knowledge requiring further study. Unlike other similar books where the student has to hunt in the back to find answers, the presentation of answers on the overleaf page makes it easy to use. The suggestions on further reading should enable more in depth reading of topics covered. The reference textbook, Clinical Biochemistry: an Illustrated Colour Text (Churchill Livingstone, 2008), written by two of the authors and others, was used as a basis for the cases selected. It might have been better if specific references had been added after each case to guide the reader towards the relevant evidence base in the textbook. There is also scope in some cases for more detailed interpretation and comment, such as a discussion of the relative merits of using 5% dextrose, 0.9% saline or Hartmann's solution in severe hypernatraemia. The blood gas data uses hydrogen ion concentration instead of pH and inclusion of both would have helped those accustomed to interpreting pH results.
We compared this book with two other similar case study books, Cases in Chemical Pathology, a diagnostic approach by Walmsley RN, Watkinson LR and Cain HJ (4th edition, World Scientific, 1999) and Challenges at the Clinical Interface by Freedman DB et al. (AACC Press, 2001). Cases in Chemical Pathology presents a large body of theoretical information before each case. It has more cases than the other two books but most are short and are followed with a brief comment rather than specific questions. Challenges at the Clinical Interface provides very detailed information on the clinical and non-clinical aspects of each case, making the cases closer to real life where the clinician has to sift through large amounts of clinical information, much of which may be irrelevant to the main clinical problem. It provides a detailed discussion of each case, including theoretical background, differential diagnosis, management and follow-up. Again it does not challenge the reader to answer specific questions. Both these other books were published more than 10 years ago, so provide references mostly dated before 2000.
In contrast, Case Studies in Clinical Biochemistry is more interactive, focused and concise. It assumes that the reader is familiar with the theoretical aspects of the cases and draws attention to the most common clinical scenarios a clinician is likely to face. It is more interactive, asking the readers specific questions and directing them to relevant clinical and laboratory information. The book does not list specific references after each case but does provide links to up-to-date textbooks and websites which seem very useful from a practical point of view.
In our opinion, the book would be very useful for trainees looking to link their theoretical knowledge with clinical practice, for scientists or medics preparing for the FRCPath examinations and for more experienced doctors wishing to refresh their biochemistry knowledge.