is used to highlight a cross-reference to OHCM, in addition to cross-referencing within this book.With the increasing complexity of modern medicine, we now have literally thousands of possible investigative techniques at our disposal. We are able to examine our patient’s serum and every other body fluid down to the level of individual nucleotides, as well as being able to perform precise imaging through CT, MRI, and other imaging technologies. The problem we have all faced, especially as senior medical students or junior doctors is: Which test should we use in a given setting? What hazards are associated with the tests? Are there any situations where specific tests should not be used or are likely to produce erroneous results? As medical complexity increases, so too does cost; many assays available today are highly expensive and, wherever possible, we would ideally like to use a test that is cheap, reliable, reproducible, and right for a given situation.
Such knowledge takes many years to acquire and it is a fact of life that senior doctors (who have attained such knowledge) are not usually those who request the investigations. In this small volume, we have attempted to distil all that is known about modern tests, from blood, urine, and other body fluids, along with imaging and molecular tests. The book is divided into two principal parts: the first deals with symptoms and signs in The patient section, because that is how patients present. We have tried to cover as many topics as possible, discussing these in some detail and have provided differential diagnoses where possible. We also try to suggest tests that might be of value in determining the cause of the patient’s symptom or sign. The second part of the book Investigations is specialty-specific and is more relevant once you know roughly what type of disease the patient might have. For example, if the symptom section suggests a likely respiratory cause for the patient’s symptoms, then the reader should look to the Respiratory medicine chapter in order to determine which tests to carry out or how to interpret the results.
The entire book is written by active clinicians, rather than scientists, since we wanted to provide a strong clinical approach to investigation. We have tried, wherever possible, to cross-refer to the Oxford Handbook of Clinical Medicine, Oxford University Press, which provides the clinical detail omitted from this handbook. The symbol is used to highlight a cross-reference to OHCM, in addition to cross-referencing within this book.
We would value feedback from readers since there will doubtless be tests omitted, errors in the text, and many other improvements we could, and will, make in future editions. All contributors will be acknowledged individually in the next edition. We would suggest you e-mail us directly.
Drew Provan
Andrew Krentz
2002