This classic textbook aims to assist clinicians develop the consultation skills required to elicit a clear history, and the practical skills needed to detect clinical signs of disease. Where possible, the physical basis of clinical signs is explained to aid understanding. Formulation of a differential diagnosis from the information gained is introduced, and the logical initial investigations are included for each system.
Key Features
The first part of the book addresses the general principles of good interaction with patients, from the basics of taking a history and examining, to the use of pattern recognition to identify spot diagnoses.
The second part documents the relevant history, examination and investigations for all the major body systems.
The third part illustrates the application of these skills to specific clinical situations.
The final part covers preparation for assessments of clinical skills and the use of these skills in everyday practice.
The book has accompanying videos demonstrating many of the key clinical examination routines as set out in the book.
Author(s): J. Alastair Innes, Anna Dover, Karen Fairhurst
Series: Eğitim Tanrısı
Edition: 14th Edition
Publisher: Elsevier
Year: 2018
Language: English
Commentary: TRUE PDF
Pages: 402
City: Ankara
Tags: Clinical Examination
Front Cover......Page 1
Inside Front Cover......Page 2
Half title page......Page 3
John Macleod (1915–2006)......Page 4
Macleod's Clinical Examination......Page 5
Copyright Page......Page 6
Table Of Contents......Page 7
Preface......Page 9
Acknowledgements......Page 11
Examination sequences......Page 13
Patients......Page 15
Contributors......Page 17
1 Principles of Clinical History and Examination......Page 19
1 Managing clinical encounters with patients......Page 21
The clinical environment......Page 22
Showing empathy......Page 23
Professional responsibilities......Page 24
Personal responsibilities......Page 25
2 General aspects of history taking......Page 27
Showing empathy when taking a history......Page 28
The history of the presenting symptoms......Page 29
Non-prescribed drug use......Page 31
Smoking......Page 32
Occupational history and home environment......Page 33
Emotional or angry patients......Page 34
3 General aspects of examination......Page 37
Preparing for physical examination......Page 38
Sequence for performing a physical examination......Page 39
Gait and posture......Page 40
Temperature......Page 41
Nails......Page 42
Discoloration......Page 44
Pallor......Page 45
Characteristic skin changes......Page 46
Short stature......Page 47
Venous causes......Page 48
Lumps......Page 49
Lymph nodes......Page 50
Major chromosomal abnormalities......Page 52
Achondroplasia......Page 54
2 System-Based Examination......Page 55
4 The cardiovascular system......Page 57
Intermittent chest pain......Page 58
Acute chest pain......Page 59
Dyspnoea (breathlessness)......Page 60
Syncope and presyncope......Page 61
Drug history......Page 62
The physical examination......Page 63
Hands......Page 64
Rate and rhythm......Page 65
Volume and character......Page 66
Blood pressure......Page 67
Hypertension......Page 68
Common problems in BP measurement......Page 69
Jugular venous pressure and waveform......Page 70
Inspection......Page 71
Palpation......Page 72
First heart sound......Page 73
Third heart sound......Page 74
Added sounds......Page 75
Murmurs......Page 76
Systolic murmurs......Page 77
Diastolic murmurs......Page 78
Ambulatory blood pressure monitoring......Page 79
Cardiac catheterisation......Page 81
Intermittent claudication......Page 82
Acute limb ischaemia......Page 83
Vasospastic symptoms......Page 84
The physical examination......Page 85
Investigations......Page 87
Common presenting symptoms......Page 88
Pain......Page 89
The physical examination......Page 90
Investigations......Page 91
5 The respiratory system......Page 93
The history......Page 94
Cough......Page 95
Stridor......Page 97
Chest pain......Page 98
Social history......Page 99
Inspection......Page 100
Hands and arms......Page 103
Thorax......Page 104
Percussion......Page 105
Breath sounds......Page 106
Investigations......Page 107
6 The gastrointestinal system......Page 111
Anorexia and weight loss......Page 112
Dyspepsia......Page 113
Radiation......Page 114
Timing......Page 115
Dysphagia......Page 116
Diarrhoea......Page 117
Haematemesis......Page 118
Jaundice......Page 119
Social history......Page 120
General examination......Page 121
Abdominal scars and stomas......Page 122
Enlarged organs......Page 123
Hepatomegaly......Page 124
Percussion......Page 125
Splenomegaly......Page 126
Auscultation......Page 127
Hernias......Page 128
Rectal examination......Page 129
Investigations......Page 131
7 The nervous system......Page 137
Time relationships......Page 138
Seizure......Page 140
Past medical history......Page 141
Meningeal irritation......Page 142
Anatomy......Page 143
Cortical function......Page 144
Anatomy......Page 145
Anatomy......Page 146
Anatomy......Page 148
Glossopharyngeal (IX) and vagus (X) nerves......Page 149
Anatomy......Page 150
Anatomy......Page 151
Stance and gait......Page 152
Myoclonic jerks......Page 154
Hypertonia......Page 155
Power......Page 156
Anatomy......Page 157
Anatomy......Page 159
Anatomy......Page 160
Common presenting symptoms......Page 161
Peripheral nerve and dorsal root......Page 162
Intracranial lesions......Page 163
Ulnar nerve......Page 164
Initial investigations......Page 165
Neurophysiological tests......Page 167
8 The visual system......Page 169
Extraocular muscles......Page 170
Pupillary pathways......Page 171
Swollen eyes......Page 173
Social history......Page 177
Visual acuity......Page 178
Direct and consensual light reflex......Page 179
Visual fields......Page 180
Detection of squint......Page 181
Ophthalmoscopy......Page 182
Investigations......Page 183
9 The ear, nose and throat......Page 189
Middle ear......Page 190
Tinnitus......Page 191
Nystagmus......Page 192
The physical examination......Page 193
Rinne’s test......Page 195
Head impulse test (or head thrust test)......Page 196
Anatomy and physiology......Page 197
Epistaxis (bleeding from inside the nose)......Page 198
Nasal and facial pain......Page 199
The physical examination......Page 200
Investigations......Page 201
Sore mouth......Page 202
Sore throat......Page 203
Neck lump......Page 204
Mouth and throat......Page 205
Neck......Page 207
Investigations......Page 208
10 The endocrine system......Page 211
Neck swelling......Page 212
Neck pain......Page 213
Past medical, drug, family and social history......Page 214
Thyroid gland......Page 215
Common presenting symptoms......Page 216
The physical examination......Page 217
Acromegaly......Page 218
Common presenting symptoms......Page 219
Cushing’s syndrome......Page 220
Common presenting symptoms......Page 222
Past medical, drug, family and social history......Page 223
Assessment of a patient with newly diagnosed diabetes......Page 224
The diabetic foot......Page 225
11 The reproductive system......Page 229
Breast lump......Page 230
Nipple changes......Page 231
The physical examination......Page 232
Anatomy and physiology......Page 234
Abnormal vaginal bleeding......Page 235
Abdominal distension and bloating......Page 236
Drug history......Page 237
Passing a speculum......Page 238
Bimanual examination......Page 240
Investigations......Page 241
Social history......Page 243
Vaginal bleeding in pregnancy......Page 244
Pruritus......Page 245
The physical examination......Page 246
The history......Page 248
Scrotal swelling or pain......Page 249
Erectile dysfunction......Page 250
Penis......Page 251
Hydrocoele......Page 252
Investigations......Page 253
12 The renal system......Page 255
Anatomy and physiology......Page 256
Voiding symptoms......Page 257
Prerenal AKI......Page 258
Chronic kidney disease......Page 259
Other presenting symptoms......Page 260
Face......Page 261
Jugular venous pressure......Page 262
Abdominal examination......Page 263
Urinalysis......Page 264
Investigation of renal function......Page 265
13 The musculoskeletal system......Page 269
Onset......Page 270
Patterns of joint involvement......Page 271
Swelling......Page 272
Extra-articular symptoms......Page 273
Look – feel – move......Page 274
General features......Page 275
Initial questions......Page 276
Definitions......Page 277
The physical examination......Page 278
Anatomy and physiology......Page 279
The history......Page 280
Root compression tests......Page 281
Upper limb......Page 282
The physical examination......Page 283
The history......Page 286
The physical examination......Page 287
The physical examination......Page 289
Anatomy......Page 291
The physical examination......Page 292
Collateral ligament......Page 293
Anatomy......Page 294
Non-traumatic conditions......Page 295
Mulder’s sign for Morton’s neuroma......Page 296
The physical examination......Page 297
Investigations......Page 298
14 The skin, hair and nails......Page 301
Skin......Page 302
Past medical and drug history......Page 303
Morphology of a rash......Page 304
Hair and nail signs......Page 308
Dermatoscopy......Page 309
Patch testing......Page 310
3 Applying History and Examination Skills in Specific Situations......Page 313
15 Babies and children......Page 315
Jaundice......Page 316
Abnormal findings......Page 317
Ophthalmoscopy......Page 318
Cardiovascular examination......Page 319
Respiratory examination......Page 320
Perineum......Page 321
General neurological assessment......Page 322
Limbs......Page 323
Weighing and measuring......Page 324
Obtaining a history from children compared with adults......Page 325
Common presenting symptoms......Page 326
Neurological development......Page 328
The school-age child (5+ years)......Page 329
3–5 years......Page 330
Height......Page 331
Normal findings......Page 332
Child protection......Page 333
16 The patient with mental disorder......Page 337
Behaviour......Page 338
Thought form......Page 339
Delusional beliefs......Page 340
Memory......Page 341
Capacity......Page 342
Putting it all together: clinical vignettes......Page 343
17 The frail elderly patient......Page 347
Communication difficulties, cognition and mood......Page 348
Drug history......Page 349
Systematic enquiry......Page 350
Hydration and nutrition......Page 351
Cardiovascular examination......Page 352
Functional assessment......Page 353
Interpretation of the findings......Page 355
18 The deteriorating patient......Page 357
Early warning scores......Page 358
A: Airway......Page 359
B: Breathing......Page 360
C: Circulation......Page 361
D: Disability......Page 362
Sepsis......Page 363
Ongoing management......Page 364
19 The dying patient......Page 365
The physical examination......Page 366
Brainstem death......Page 367
Looking after yourself and others......Page 368
4 Putting History and Examination Skills to Use......Page 371
20 Preparing for assessment......Page 373
Methods of assessment......Page 374
Marking structures......Page 375
Approach to preparation......Page 376
Communication during assessment......Page 377
Putting it all together......Page 378
21 Preparing for practice......Page 379
Rare diseases......Page 380
Approach to the patient with medically unexplained symptoms......Page 381
Assessment......Page 382
Using SBAR......Page 383
Written communication......Page 392
B......Page 393
D......Page 394
F......Page 395
I......Page 396
M......Page 397
P......Page 398
R......Page 399
T......Page 400
Y......Page 401
