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Macleod's Clinical Diagnosis E-Book

Macleod's Clinical Diagnosis E-Book

Alan G Japp | Colin Robertson | Rohana J. Wright | Matthew Reed | Andrew Robson

(2017)

Additional Information

Book Details

Abstract

Macleod’s Clinical Diagnosis demonstrates how to apply the core clinical skills learned from the companion textbook Macleod’s Clinical Examination to maximum advantage. Charting the course from routine work-up to diagnosis, this book presents a modern and realistic approach to clinical assessment and explains how to integrate information obtained from the history, examination, bedside tests and specialised investigations.

  • The first section Principles of clinical assessment examines different approaches to diagnosis, reviews the fundamental elements necessary for accurate patient assessment, provides a helpful template for a ‘routine workup’ and describes how to adapt the assessment to fit the clinical context.

  • The second core section of the book Assessment of common presenting problems contains a series of ‘diagnostic guides’ that lead the reader, step-by-step through the major presenting problems in medicine and surgery, explaining how to recognise red flag features, eliminate life-threatening conditons and generate a logical differential diagnosis.

This book has been praised as an invaluable resource for senior medical students and junior doctors as they attempt to make the difficult transition from mastering basic clinical skills to assessing patients in the real world of clinical medicine.

  • A unique book allowing a reader to apply the skills of clinical examination in the formulation of a differential diagnosis and placing a patient’s symptoms in context.
  • Takes a problem-based approach to diagnostic reasoning, reflecting both modern medical and current educational practices.
  • Builds on the clinical skills outlined in the companion Macleod’s Clinical Examination textbook.

For this Second Edition the text has been expanded with five new topics covering nausea and vomiting; vaginal bleeding; red eye; urinary incontinence; and weight loss.


Table of Contents

Section Title Page Action Price
Front Cover cover
Macleod's Clinical Diagnosis i
Copyright Page iv
Table Of Contents v
Preface vii
Acknowledgements viii
Abbreviations ix
1 Principles of Clinical Assessment 1
1 What’s in a diagnosis? 3
From differential diagnosis to final diagnosis 3
Probability and risk 3
Special situations 4
Medically unexplained symptoms 4
Treatment before diagnosis 5
The patient who comes with a diagnosis 6
2 Assessing patients 7
Introduction 7
Rapid assessment of the sick patient 7
Routine assessment of the stable patient: the full clinical assessment 7
The history 11
The clinical examination 11
Additional steps 14
Basic investigations 15
Approach to the frail, elderly patient 15
Specific tips for assessment of the elderly/frail patient 15
Inspection 16
3 The diagnostic process 17
Diagnostic methods 17
Pattern recognition 17
Probability analysis 17
A different approach: tailored diagnostic guides 18
How to use the diagnostic guides 19
2 Assessment of Common Presenting Problems 22
4 Abdominal pain 24
Differential diagnosis 24
Acute abdominal pain 24
Key questions 24
What are the characteristics of the pain? 24
Is there a systemic inflammatory response? 25
Chronic/episodic abdominal pain 28
Gastroduodenal disorders 28
Gallstones 28
Pancreatic pain 28
Mesenteric ischaemia 28
Inflammatory bowel disease 29
Colon cancer 29
Functional disorders 29
Renal tract disorders 29
Gynaecological conditions 29
Other diagnostic possibilities 29
Acute abdominal pain: overview 30
Acute abdominal pain: step-by-step assessment 31
Acute upper abdominal pain: overview 34
Acute upper abdominal pain: step-by-step assessment 35
Acute lower abdominal pain: overview 38
Acute lower abdominal pain: step-by-step assessment 39
Chronic/relapsing abdominal pain: overview 42
Chronic/relapsing abdominal pain: step-by-step assessment 43
5 Breast lump 46
Differential diagnosis 46
Breast cancer 46
Breast abscess 46
Fibroadenoma 46
Fibrocystic change 46
Fat necrosis 47
Other causes 47
Nipple lesions 47
Male breast disease 47
Overview 48
Step-by-step assessment 49
6 Chest pain 50
Differential diagnosis 50
Acute chest pain 50
Acute coronary syndromes 50
Aortic dissection 50
Pulmonary embolism 51
Acute pericarditis 51
Gastro-oesophageal disorders 51
Pneumothorax 51
Pneumonia 51
Musculoskeletal problems 52
Anxiety 52
Other causes 52
Intermittent chest pain 52
Angina pectoris 52
Gastro-oesophageal disorders 52
Musculoskeletal disorders 53
Asthma 53
Anxiety 53
Clinical tool: the ECG in acute chest pain 54
Acute chest pain: overview 60
Acute chest pain: step-by-step assessment 61
Acute chest pain: further assessment 65
Further assessment of NSTEMI/ unstable angina 65
Step 1 Identify critically unwell patients 65
Step 2 Consider all potential factors contributing to myocardial ischaemia 65
Step 3 Identify high-risk patients 65
Step 4 Use cardiac biomarkers to differentiate unstable angina from NSTEMI 65
Acute pleuritic pain: overview 66
Acute pleuritic pain: step-by-step assessment 67
Intermittent chest pain: overview 68
Intermittent chest pain: step-by-step assessment 69
Intermittent chest pain: further assessment 71
Further assessment of suspected angina 71
Step 1 Consider unstable angina and structural heart disease 71
Step 2 Confirm or refute the diagnosis 71
Step 3 Assess symptom severity and risk 71
7 Coma and altered consciousness 72
Differential diagnosis 72
Metabolic causes 72
Drugs/toxins 72
CNS causes 73
Organ failure 73
Overview 74
Step-by-step assessment 75
8 Confusion 78
Differential diagnosis 78
Delirium 78
Drugs 78
Metabolic/physiological disturbance 78
Infection 78
Intracranial causes 78
Appendix 301
Index 305
A 305
B 306
C 307
D 307
E 308
F 309
G 309
H 309
I 310
J 310
K 311
L 311
M 311
N 312
O 312
P 312
Q 313
R 313
S 313
T 314
U 315
V 315
W 315
X 315
Y 315