The book covers basic theories, basic knowledge and basic skills on clinical diagnosis, basic requirements for doctors’ ethical conduct, clinical reasoning and documentation of medical records during the process of making a diagnosis. It consists of six parts, including ‘Symptoms’, ‘History Taking’, ‘Physical Examination’, ‘Supplementary Examination’, ‘Common Clinical Diagnosis Techniques’, and ‘Diagnostic Process and Clinical Reasoning’. A vocabulary index is included for easy reference at the end of the book.
This book is compiled by authors of 14 Chinese medical schools and universities, whose years of experience in clinical diagnostics, rich overseas learning and working experiences.
This book is included in the first round of English textbooks series for clinical medicine major of China's higher medical colleges; and is among "13th Five-Year" planning textbooks of National Health Commission of the People’s Republic of China. It is also an ideal textbook for MBBS (Bachelor of Medicine and Bachelor of Surgery) student
It is a co-publication book with People's Medical Publishing House (PMPH). The ISBN of PMPH version in China is 978-7-117-23852-6.
Author(s): Xue-Hong Wan, Rui Zeng
Edition: 1st
Publisher: Springer
Year: 2019
Language: English
Pages: 382
Tags: Clinical Diagnosis
Preface......Page 5
Contents......Page 7
Part I: Symptoms......Page 12
1.1.2 Noninfectious Causes......Page 13
1.3 Fever Patterns......Page 14
1.4 Accompanying Symptoms and Signs......Page 16
2.2 Pathogenesis......Page 18
2.4 Accompanying Symptoms......Page 19
3.2 Clinical Manifestations......Page 20
3.3 Accompanying Symptoms......Page 21
4.1 Measurements of Obesity......Page 22
4.3 Clinical Manifestations and Accompanying Symptoms......Page 23
5.2 Clinical Manifestations and Accompanying Symptoms......Page 25
6.2 Clinical Manifestation......Page 27
6.3 Accompanying Symptom......Page 28
7.1 Etiology and Pathogenesis......Page 30
7.3 Accompanying Symptom......Page 31
8.1 Etiology and Mechanism......Page 33
8.3 Accompanying Symptoms......Page 34
9.1 Etiology and Mechanism......Page 36
9.3 Accompanying Symptoms......Page 37
10.2 Clinical Manifestations......Page 38
10.3 Accompanying Symptoms......Page 39
11.1.2 Cardiac Dyspnea......Page 40
11.2.1 Respiratory Dyspnea......Page 41
11.3 Accompanying Symptoms......Page 42
12.1 Etiology and Mechanism......Page 44
12.3 Accompanying Symptom......Page 45
13.2 Accompanying Symptoms......Page 46
14.2 Etiology......Page 48
14.3 Clinical Manifestation......Page 49
15.2.2 Motility Dysphagia......Page 51
15.3.3 Points of Clinical Symptoms of Common Diseases......Page 52
16.2 Clinical Manifestations......Page 54
17.2 Mechanism......Page 56
17.3 Clinical Manifestations......Page 57
18.2 Clinical Manifestations......Page 59
19.2 Clinical Manifestations......Page 61
20.2 Mechanism......Page 63
20.3 Clinical Manifestations......Page 64
21.2 Mechanism......Page 66
21.4 Accompanying Symptoms......Page 67
22.3 Etiology and Mechanism......Page 68
22.5 Specific Examinations......Page 70
23.1 Etiology......Page 72
23.3 Clinical Manifestations and Accompanying Symptoms......Page 73
24.2 Clinical Manifestations and Accompanying Symptoms......Page 75
25.1.2 Polyuria......Page 77
25.2.2 Polyuria......Page 78
26.2 Clinical Manifestations and Accompanying Symptoms......Page 79
26.3 Accompanying Symptoms......Page 80
27.2 Clinical Manifestations and Accompanying Symptoms......Page 81
28.2 Mechanism......Page 83
28.5 Differentiation of Inflammatory and Mechanical Back Pain (Table 28.1)......Page 84
29.3 Clinical Manifestations......Page 85
29.4 Accompanying Symptoms......Page 86
30.3 Clinical Manifestations......Page 87
30.4 Accompanying Symptoms......Page 88
31.3 Clinical Manifestations......Page 89
31.4 Accompanying Symptoms......Page 90
32.3 Clinical Manifestations......Page 91
32.4 Accompanying Symptoms......Page 92
33.3 Clinical Manifestations......Page 93
33.4 Accompanying Symptoms......Page 94
34.1 Clinical Manifestations......Page 95
Part II: History Taking......Page 98
35: Necessity and Ethics of History Taking......Page 99
36.5 Review of Systems......Page 100
36.8 Marital History......Page 101
36.10 Family History......Page 102
37.3 Transitional Statements......Page 103
37.5 Questioning Skills-Type of Question......Page 104
37.9 Questioning Skills-Documentation......Page 105
37.13 Patient’s Perspective......Page 106
37.19 Rapport-Encouragement of Questions......Page 107
37.20 Closure of History Taking......Page 108
38: Guide for Focused History Taking......Page 109
39: History Taking in Special Situations......Page 111
40.1 Written Record......Page 113
Suggested Readings......Page 114
Part III: Physical Examination......Page 115
41.1 Inspection......Page 116
41.2.2 Deep Palpation......Page 117
41.3.1.2 Indirect Percussion......Page 118
41.3.2 Percussion Sounds......Page 119
41.4.2 Indirect Auscultation......Page 120
Suggested Readings and Websites......Page 121
42.1.3.1 Temperature......Page 122
42.1.3.4 Blood Pressure......Page 123
42.1.4.1 Development......Page 124
42.1.5.1 Commonly Used Assessment Indicators......Page 125
42.1.6 Consciousness......Page 126
42.1.7.6 Disorientation......Page 127
42.1.9 Facial Features and Expression......Page 128
42.1.10.3 Compulsive Position......Page 129
42.1.12 Gait......Page 130
42.2.1 Color......Page 131
42.2.4 Skin Eruption......Page 132
42.2.8 Edema......Page 133
42.2.10 Ulcer and Erosion......Page 134
42.3.1 Normal Lymph Nodes......Page 135
42.3.1.1 Drainage Area of Superficial Lymph Nodes......Page 136
42.4.1.1 Short Stature......Page 137
Etiology......Page 138
42.4.2.2 Clinical Characteristics and Differential Diagnosis......Page 139
42.4.3.1 Etiology......Page 141
Differential Diagnosis......Page 142
42.4.4.2 Clinical Characteristics and Differential Diagnosis......Page 143
Suggested Websites......Page 144
43.3 Section 3: Face......Page 145
43.3.1.1 Vision Testing......Page 146
43.3.1.2 External Eye Examination (Fig. 43.3)......Page 147
43.3.1.3 Anterior Segment......Page 149
43.3.2 Ear......Page 151
43.3.3 Nose......Page 152
43.3.4 Mouth......Page 153
43.3.5 Parotid Gland......Page 156
Suggested Readings and Websites......Page 157
44.4 Vessels......Page 158
44.5 Thyroid......Page 159
Suggested Reading and Website......Page 161
45.1.1 Bony Landmarks......Page 162
45.1.2 Imaginary Lines......Page 163
45.1.3 Natural Fossa and Anatomic Region......Page 164
45.1.4 Topography of Lungs and Pleura......Page 165
45.2.2 Thorax......Page 167
45.2.3.1 Inspection......Page 168
45.2.3.2 Palpation......Page 169
45.3.1.3 Respiratory Depth......Page 170
45.3.2.1 Thoracic Expansion......Page 171
45.3.2.2 Vocal Fremitus......Page 172
45.3.3.3 Percussion of the Lung Boundary......Page 173
45.3.3.4 Abnormal Percussion Notes of the Thorax......Page 174
Abnormal Vesicular Breath Sound......Page 175
Moist Rales......Page 176
45.3.4.4 Vocal Resonance......Page 177
45.4.1 Inspection......Page 178
45.4.1.2 Apical Impulse......Page 179
45.4.2.1 Apical Impulse and Abnormal Precordial Pulsations......Page 180
45.4.3.1 Percussion Method......Page 181
45.4.3.4 Variation and Clinical Significance......Page 182
Cardiac Rhythm......Page 184
Heart Sound......Page 185
Changes of Heart Sound......Page 186
Extra Cardiac Sound......Page 188
Cardiac Murmurs......Page 189
Pericardial Friction Sound......Page 192
45.5.1.5 Pulse Wave......Page 193
45.5.2.3 Abnormal Blood Pressure......Page 194
45.5.2.4 Ambulatory Blood Pressure Monitoring (ABPM)......Page 195
Suggested Readings......Page 196
46.1.1 Abdominal Landmarks......Page 197
46.1.2.2 The Nine Abdominal Areas......Page 198
Peritoneal Air......Page 199
46.2.1.2 Abdominal Concavity......Page 200
46.2.3 Veins of Abdominal Wall......Page 201
46.2.5 Gastral or Intestinal Pattern and Peristalsis......Page 202
46.3.2 Blood Murmur......Page 203
46.4.1 Abdominal Percussion Sound......Page 204
46.4.3 Traube Semilunar Space......Page 205
46.4.6 Percussion of Bladder......Page 206
46.5.1.1 The Increase of Abdominal Tenseness......Page 208
46.5.2 Tenderness and Rebound Tenderness......Page 209
Size......Page 210
Hepatojugular Reflux......Page 211
46.5.3.2 Palpation of Spleen......Page 212
46.5.3.3 Palpation of Gallbladder......Page 213
46.5.3.5 Palpation of Bladder......Page 214
Transverse Colon......Page 215
46.5.6 Succusion Splash......Page 216
47.1.1.2 Left-Lateral Recumbent Position (Fig. 47.2)......Page 218
47.1.2.4 Hemorrhoids......Page 219
47.1.3 Palpation......Page 220
47.2.2.1 Prepuce......Page 221
Penis size and Shape......Page 222
Scrotum......Page 223
Testis......Page 224
47.2.4 Prostate......Page 225
47.3.1 External Genital Organs......Page 226
Bimanual Pelvic Exam......Page 227
Rectovaginal Exam......Page 228
47.3.2.3 Uterine Accessories......Page 229
48.1.2.1 Posterior Inspection......Page 231
48.1.2.2 Lateral Inspection......Page 232
48.1.2.4 Special Tests of the Vertebrae......Page 233
48.2.1.1 Acromegaly......Page 235
Koilonychia......Page 236
Wrists and Hands......Page 237
Hip Joints......Page 239
Knees......Page 240
Ankles and Feet......Page 241
Suggested Websites......Page 243
49.2.3 Ocular Nerve, Trachlear Nerve and Abducens Nerve......Page 244
49.2.6 Acoustic Nerve......Page 245
49.3.2 Sensory Terminology......Page 246
49.4.1 Muscle Strength......Page 247
49.5 Reflexes......Page 248
49.5.2 Deep Tendon Reflex......Page 249
49.5.4 Menigeal Signs......Page 250
49.6 Autonomic System Examination......Page 252
Suggested Readings......Page 253
50.1 Basic Requirements of Complete Physical Examination......Page 254
50.2.2 Head and Neck......Page 255
50.2.4 Back......Page 256
50.2.7 Lower Limbs......Page 257
50.4 Physical Examination for the Elderly......Page 258
50.5.3 Physical Examination for Patients with Physiological Defects......Page 259
Suggested Readings......Page 260
Part IV: Auxiliary Examination......Page 261
51.1.2.1 The Depolarization and Repolarization of Heart......Page 262
51.1.2.2 Resting Potential of Myocardial Cell......Page 263
51.1.2.3 Action Potential of Cardiac Muscle Cell......Page 264
51.1.2.5 Relationships of Depolarization, Repolarization and Waveforms on ECG......Page 265
51.1.3.1 The Conventional 12-Leads......Page 266
51.1.3.3 The Axis......Page 267
51.2.3 QRS Complex......Page 268
51.2.6 QT Interval......Page 269
51.2.7 U Wave......Page 272
52.1.1 Regular Rhythm......Page 273
ECG Recognition (Fig. 52.6)......Page 274
52.2.1.3 Abnormality in Voltage or Duration of Sinus P Wave......Page 275
52.2.2 Non-Sinus P Wave......Page 276
Atrial Escape Contraction......Page 277
52.2.3.1 Atrial Flutter......Page 278
ECG Recognition (Fig. 52.17)......Page 279
ECG Recognition (Fig. 52.19)......Page 280
ECG Recognition (Fig. 52.21)......Page 281
Third-Degree AV Block......Page 282
52.3.2.2 Shortened PR Interval (Preexcitation Syndromes)......Page 283
Features of Normal QRS Complex Voltage......Page 284
52.4.1.5 Another Weird Retrograde P′ Wave (Dextrocardia)......Page 285
52.4.2.1 Abnormalities in QRS Complex Axis......Page 286
ECG Recognition......Page 288
ECG Recognition (Fig. 52.40)......Page 289
ECG Recognition (Fig. 52.44)......Page 291
ECG Recognition (Fig. 52.47)......Page 293
ECG Recognition (Fig. 52.51)......Page 294
ECG Recognition (Fig. 52.55)......Page 295
52.5 Section 5: Analyze ST Segment......Page 297
ECG Recognition (Fig. 52.58)......Page 298
ECG Recognition (Fig. 52.67)......Page 299
52.6.2 Useful Methods for Analyzing T Wave......Page 301
52.6.3.2 Peaked T wave......Page 303
52.7.1 QT Interval Prolongation......Page 306
52.7.3.1 ECG Recognition (Fig. 52.80)......Page 307
ECG Recognition (Fig. 53.2)......Page 309
ECG Recognition (Fig. 53.5)......Page 311
ECG Recognition (Fig. 53.7)......Page 312
53.2 Section 2: Tachycardia with Wide QRS Complex......Page 313
53.2.2.3 Duration of the QRS Complex......Page 314
53.2.2.6 Others......Page 315
54.1.3 Arterial Oxygen Saturation......Page 317
54.1.6 Buffer Base......Page 318
54.2.2 To Judge the Types and Classification of Acid-Base Disorders......Page 319
54.2.2.1 Siggaard-Andersen Card......Page 320
54.2.2.3 The Common Types of Acid-Base Disorders......Page 321
Expiratory Reserve Volume (ERV)......Page 323
55.1.2.6 Maximal Expiratory Flow-Volume Curve (MEFV)......Page 324
55.1.2.7 Maximum Mid-Expiratory Flow (MMEF)......Page 325
55.2.1.3 Mixed Ventilation Dysfunction......Page 326
55.2.2.3 Bronchial Provocation Test......Page 327
55.2.3 Evaluation of the Tolerance and Security in Operation......Page 328
56.1.1.2 Contraindications......Page 329
Preparation Before Examination......Page 330
56.1.1.5 Endoscopic Diagnosis of Upper Gastrointestinal Disease......Page 331
Preparation......Page 332
56.1.2.4 Complications and Management......Page 333
56.2.1.2 For Treatment......Page 334
56.2.3.5 Postoperation Management......Page 335
56.2.5.5 Postoperative Fever......Page 336
56.2.6.5 Clinical application......Page 337
Part V: Common Diagnostic Techniques......Page 339
57.3 Attention......Page 340
58.4 Attention......Page 342
59.3 Procedure......Page 344
59.4 Attention......Page 345
60.3 Procedure......Page 346
60.4 Attention......Page 347
61.3 Attention......Page 348
62.3 Procedure......Page 350
62.4 Attention......Page 351
63.2 Section 2: Procaine Allergy Skin Test......Page 352
63.4.2 Attention......Page 353
64.3 Clinical Significance......Page 354
64.4 Attention......Page 355
Part VI: Medical Record......Page 356
65: Significance......Page 357
66.1.2 Accurate Expressions and Proper Words......Page 358
66.1.5 Obeying Legislation and Respecting Rights......Page 359
Complete Medical Record......Page 360
Physical Examination......Page 361
67.1.2.2 Medical History......Page 363
67.1.2.3 Physical Examination......Page 364
67.1.3 Other Medical Records......Page 365
67.2.1 Requirements......Page 366
67.2.2.3 Subsequent-Visit Medical Record......Page 367
Development Trend......Page 368
68.2 Written Medical Case Report......Page 369
Part VII: Clinical Reasoning......Page 371
69: The Importance of Clinical Reasoning......Page 372
70: Procedures of Diagnosis-Making......Page 373
71: Clinical Reasoning......Page 375
72: Common Reasons for Misdiagnoses and Omitted Diagnoses......Page 377
References......Page 378
Index......Page 379
