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Index
Title page
Table of Contents
Copyright
Foreword
Preface
Acknowledgments
Clinical methods: an historical perspective
The Hippocratic oath
Credits: figures, boxes and tables
SECTION 1: THE GENERAL PRINCIPLES OF HISTORY TAKING AND PHYSICAL EXAMINATION
Chapter 1: The general principles of history taking
Bedside manner and establishing rapport
Obtaining the history
Introductory questions
Presenting (principal) symptom
History of the presenting illness
Drug and treatment history
Past history
Social history
Family history
Systems review
Skills in history-taking
Chapter 2: Advanced history taking
Taking a good history
The differential diagnosis
Fundamental considerations when taking the history
Personal history taking
Cross-cultural history taking
The ‘uncooperative’ or ‘difficult’ patient
Self-harming and Münchhausen’s syndrome
History taking for the maintenance of good health
The elderly patient
Evidence-based history taking and differential diagnosis
The clinical assessment
Concluding the consultation
Chapter 3: The general principles of physical examination
Clinical examination
How to start
First impressions
Facies
Weight, body habitus and posture
Hydration
The hands and nails
Temperature
Smell
Preparing the patient for examination
Evidence-based clinical examination
Introduction to the OSCE
SECTION 2: THE CARDIOVASCULAR SYSTEM
Chapter 4: The cardiovascular history
Presenting symptoms
Risk factors for coronary artery disease
Drug and treatment history
Past history
Social history
Family history
Chapter 5: The cardiac examination
Examination anatomy
Positioning the patient
General appearance
Hands
Arterial pulse
Blood pressure
Face
Neck
Praecordium
The back
The abdomen
Chapter 6: The lower limb examination and peripheral vascular disease
Examination anatomy
Peripheral vascular disease
Acute arterial occlusion
Deep venous thrombosis
Varicose veins
Chapter 7: Correlation of physical signs and cardiovascular disease
Cardiac failure
Chest pain
Pericardial disease
Systemic hypertension
Pulmonary hypertension
Innocent murmurs
Valve diseases of the left heart (see Table 7.1)
Valve diseases of the right heart
Cardiomyopathy
Acyanotic congenital heart disease
Cyanotic congenital heart disease
‘Grown-up’ congenital heart disease
Chapter 8: A summary of the cardiovascular examination and extending the cardiovascular examination
Extending the cardiovascular physical examination
SECTION 3: THE RESPIRATORY SYSTEM
Chapter 9: The respiratory history
Presenting symptoms (see List 9.1)
Other presenting symptoms
Treatment
Past history
Occupational history
Social history
Family history
Chapter 10: The respiratory examination
Examination anatomy
Positioning the patient
General appearance
Hands
Face
Trachea
Chest
The heart
The abdomen
Other
Chapter 11: Correlation of physical signs and respiratory disease
Respiratory distress: respiratory failure
Consolidation (lobar pneumonia)
Atelectasis (collapse)
Pleural effusion
Pneumothorax
Tension pneumothorax
Bronchiectasis
Bronchial asthma
Chronic obstructive pulmonary disease
Chronic bronchitis
Interstitial lung disease (ILD)
Tuberculosis
Carcinoma of the lung
Sarcoidosis
Pulmonary embolism (PE)
Chapter 12: A summary of the respiratory examination and extending the respiratory examination
Extending the respiratory physical examination
SECTION 4: THE GASTROINTESTINAL SYSTEM
Chapter 13: The gastrointestinal history
Presenting symptoms (see List 13.1)
Treatment
Past history
Social history
Chapter 14: The gastrointestinal examination
Examination anatomy
Positioning the patient
General appearance
Hands
Arms
Face
Neck and chest
Abdomen
Hernias
Rectal examination
Proctosigmoidoscopy
Other
Examination of the gastrointestinal contents
Urinalysis
Chapter 15: Correlation of physical signs and gastrointestinal disease
Examination of the acute abdomen
Liver disease
Portal hypertension
Hepatic encephalopathy
Dysphagia
Gastrointestinal bleeding
Inflammatory bowel disease
Malabsorption and nutritional status
Chapter 16: A summary of the gastrointestinal examination and extending the gastrointestinal examination
Extending the gastrointestinal examination
Imaging the gastrointestinal system
SECTION 5: THE GENITOURINARY SYSTEM
Chapter 17: The genitourinary history
Presenting symptoms
Menstrual and sexual history
Treatment
Past history
Social history
Family history
Chapter 18: The genitourinary examination
Examination anatomy
The examination
General appearance
Hands
Arms
Face
Neck
Chest
The abdominal examination
Rectal and pelvic examination
The back
Legs
Blood pressure
Fundi
Male genitalia
Pelvic examination
Chapter 19: A summary of the examination of chronic kidney disease and extending the genitourinary examination
Extending the genitourinary examination
SECTION 6: THE HAEMATOLOGICAL SYSTEM
Chapter 20: The haematological history
Haematological disorders
Presenting symptoms
Treatment history
Past history
Social history
Family history
Chapter 21: The haematological examination
Examination anatomy
General appearance
Hands
Forearms
Epitrochlear nodes
Axillary nodes
Face
Cervical and supraclavicular nodes
Bone tenderness
The abdominal examination
Inguinal nodes
Legs
Fundi
Chapter 22: A summary of the haematological examination and extending the haematological examination
Extending the haematological physical examination
SECTION 7: THE RHEUMATOLOGICAL SYSTEM
Chapter 23: The rheumatological history
Presenting symptoms
Treatment history
Past history
Social history
Family history
Chapter 24: The rheumatological examination
Examination anatomy
Principles of joint examination
Assessment of individual joints
Chapter 25: Correlation of physical signs and rheumatological disease
Rheumatoid arthritis
Seronegative spondyloarthritides
Gouty arthritis
Calcium pyrophosphate arthritis (pseudogout)
Calcium hydroxyapatite arthritis
Systemic lupus erythematosus
CHEST
Systemic sclerosis (scleroderma)
Rheumatic fever
The vasculitides
Soft-tissue rheumatism
Nerve entrapment syndromes
Chapter 26: A summary of the rheumatological examination and extending the rheumatological examination
Extending the rheumatological system examination
SECTION 8: THE ENDOCRINE SYSTEM
Chapter 27: The endocrine history
Presenting symptoms
Past history
Social history
Family history
Chapter 28: The endocrine examination
The thyroid
The pituitary
The adrenals
Chapter 29: Correlation of physical signs and endocrine disease
Calcium metabolism
Osteoporosis and osteomalacia
Syndromes associated with short stature
Hirsutism
Gynaecomastia
Diabetes mellitus
Paget’s disease
Chapter 30: A summary of the endocrine examination and extending the endocrine examination
The endocrine examination: a suggested method
Extending the endocrine physical examination
SECTION 9: THE NERVOUS SYSTEM
Chapter 31: The neurological history
Presenting symptoms
Past health
Medication history
Social history
Family history
Chapter 32: The neurological examination: the cranial nerves
EXAMINATION ANATOMY
General signs
The cranial nerves
Head and neck
Chapter 33: The neurological examination: speech and higher centres
Examination of speech
The cerebral hemispheres
Chapter 34: The neurological examination: the peripheral nervous system
Limbs and trunk
Chapter 35: Correlation of physical signs and neurological syndromes and disease
Upper motor neurone lesions
Lower motor neurone lesions
Motor neurone disease
Peripheral neuropathy
Guillain-Barré syndrome (acute inflammatory polyradiculoneuropathy)
Multiple sclerosis
Thickened peripheral nerves
Spinal cord compression
Important spinal cord syndromes
Myopathy
Dystrophia myotonica
Myasthenia gravis
The cerebellum
Parkinson’s disease
Other extrapyramidal movement disorders (dyskinesia)
The unconscious patient
Chapter 36: A summary of the neurological examination and extending the neurological examination
Diagnostic testing
Chapter 37: The psychiatric history and mental health examination
Obtaining the history
The mental state examination
The diagnosis
SECTION 10: SPECIALTY EXAMINATIONS
Chapter 38: The eyes, ears, nose and throat
Eyes
Ears
Nose and sinuses
Mouth and throat
Common investigations
Chapter 39: The breasts
Examination anatomy
History
Examination
Evaluation of a breast lump
Chapter 40: The skin, nails and lumps
Examination anatomy
Dermatological history
General principles of physical examination of the skin
How to approach the clinical diagnosis of a lump
Correlation of physical signs and skin disease
The nails
Chapter 41: A system for the infectious diseases examination
Pyrexia of unknown origin
HIV infection and AIDS
Chapter 42: Assessment of the geriatric patient
History taking in geriatric patients: special considerations
Physical examination in geriatric patients: special considerations
Chapter 43: Assessment of the acutely ill patient
Initial assessment
Level of consciousness
Further examination (see List 43.1)
Chapter 44: Assessment of death
Assessment
Informing relatives
Completing the death certificate
Postmortem
Organ donation
APPENDIX I: Writing and presenting the history and physical examination
APPENDIX II: A suggested method for a rapid screening physical examination
APPENDIX III: The pre-anaesthetic medical evaluation (PAME)
Index
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