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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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