Macleod's Clinical Examination E-Book

Graham Douglas

Description

This classic textbook sets out clearly and concisely how to evaluate symptoms and elicit relevant physical signs. It describes the practical skills which every clinician must acquire and develop in order to evolve diagnostic procedures and management strategies and plans. ‘Highly Commended’ in the 2006 and 2010 BMA Medical Book Competitions, this Thirteenth Edition contains over 500 clinical photographs and diagrams to illustrate the text, with new topics added to make the book even more comprehensive.

This Thirteenth Edition has four sections:

• History taking and general examination.
• System examination covering symptoms and signs.
• Examination in special situations including babies & children and the critically ill.
• How to pass an OSCE.

Included on the Student Consult site are the specially-recorded videos demonstrating many of the clinical examination routines described in the main text.

• The book starts with a general overview section on history taking and the general examination that provide the framework on which to hang the detail.
• The systematic examination section documents clearly the relevant history, examination and special investigations as well as giving advice on their significance.
• The third section covers examination in specific situations and emphasises an integrated and structured approach to these patients.
• A final section spells out how to demonstrate the techniques learned in the book in an OSCE.
• Macleod’s is closely linked to its sister publication, Davidson’s Principles & Practice of Medicine, which complements the information in this text.
• Available with full online access on Student Consult and ancillary videos demonstrating key clinical examination routines following the format laid out in the book.

• There are two new chapters on examination in specific situations:

• The frail elderly
• The adult with fever
• A new section explicitly spells out how to demonstrate the techniques learned in the book in an OSCE and other formative and summative examinations.
• Over 50 new text boxes highlight the evidence-base for the examination techniques discussed.
• An Advisory Board of students, junior doctors, and representatives from the nursing, ambulance, Primary Care and academic communities from six countries has made detailed comments and critically appraised the entire book.
• The text has been substantially rewritten with more on medically unexplained symptoms in the History Taking chapter and extended coverage of diabetes mellitus in the Endocrine System chapter.
• Integrated with the online text are clinical examination videos of trained professionals performing many of the examination routines described in the book with an accompanying commentary by the Editor, Professor Colin Robertson
• Two new videos show how the Glasgow Coma Scale should be performed in clinical situations, demonstrating the correct techniques and also common pitfalls in using the GCS.

Sujets

• Derecho de autor
• Herpes zóster
• Vómito
• Delírium
• Riñón
• Eccema
• Gripe
• Organización Mundial de la Salud
• Reino Unido
• Chronic obstructive pulmonary disease
• Cardiac dysrhythmia
• Cirrhosis
• Reproductive system
• Myocardial infarction
• Influenza
• Nausea
• Photocopier
• Chickenpox
• Propadiene
• Hepatitis B
• The Only Son
• Nose
• Pharmaceutical formulation
• Vomiting
• Clinical Medicine
• Health care provider
• Anorexia
• Systemic disease
• Nurse practitioner
• Wheeze
• In Debt
• Visual impairment
• Pregnancy
• Memory loss
• Medical history
• Glomerulonephritis
• Urinary retention
• Book review
• Traumatic brain injury
• Acute pancreatitis
• Differential diagnosis
• Lichen planus
• Labyrinthitis
• Cutaneous conditions
• Chronic kidney disease
• Anesthetic
• Human musculoskeletal system
• Stroke
• Physical examination
• Abdominal pain
• Urinalysis
• Medical sign
• Chest pain
• Review
• Osteoarthritis
• Acute respiratory distress syndrome
• Septic shock
• Hand washing
• Itch
• Allergic rhinitis
• Weight loss
• Arthralgia
• Hepatitis A
• Echocardiography
• Bronchiectasis
• Intensive-care medicine
• Gallstone
• Renal failure
• Health care
• Heart failure
• Complete blood count
• Tired
• Amenorrhoea
• Criticism
• Drowning
• Erythrocyte sedimentation rate
• Otitis media
• Pulmonary embolism
• Internal medicine
• Alopecia
• Dyspnea
• General practitioner
• Cough
• Infertility
• Delirium
• Paste
• Narrator
• Miscarriage
• Medical ultrasonography
• Infectious mononucleosis
• Cushing's syndrome
• Anemia
• Hypertension
• Electrocardiography
• Emergency medical technician
• Glaucoma
• Headache
• Human gastrointestinal tract
• Respiratory system
• Angina pectoris
• Hypothyroidism
• Peptic ulcer
• Cardiac arrest
• Eczema
• Circulatory system
• Diabetic retinopathy
• Obesity
• Ménière's disease
• Endometriosis
• Pneumonia
• Multiple sclerosis
• Cystic fibrosis
• Philadelphia
• Hearing impairment
• Asthma
• Diabetes mellitus
• Dementia
• Kidney stone
• Encephalitis
• Infection
• World Health Organization
• Urinary tract infection
• United Kingdom
• Tuberculosis
• Sinusitis
• Data storage device
• Epileptic seizure
• Rheumatoid arthritis
• Pediatrics
• Nervous system
• Mechanics
• Erectile dysfunction
• Hyperthyroidism
• Epilepsy
• Endocrine system
• Major depressive disorder
• Chemical element
• Arthritis
• Anxiety
• Author
• Fractures
• Hypertension artérielle
• Headache (EP)
• Blindness
• Pneumothorax
• Amitriptyline
• Delirium tremens
• History
• Palpitation
• Narration
• Consultant
• Wheezing
• Format
• Gout
• Manual
• City
• Fatigue
• Electronic
• Hair
• Maladie infectieuse
• Philadelphie
• Suicide
• Death
• Organisation mondiale de la santé
• Grippe
• London
• Son
• Copyright
• Royaume-Uni

Informations

• Publié par: Churchill Livingstone
• Date de parution: 21 juin 2013
• Nombre de lectures: 8
• EAN13: 9780702053375
• Langue: English
• Poids de l'ouvrage: 24 Mo

Extrait

Macleod's Clinical
Examination
THIRTEENTH EDITION
Graham Douglas, BSc(Hons) MBChB FRCPE
Consultant Physician, Aberdeen Royal Infi rmary, Honorary Reader in Medicine, University
of Aberdeen
Fiona Nicol, BSc(Hons) MBBS FRCGP FRCP(Edin)
Formerly GP Principal and Trainer, Stockbridge Health Centre, Edinburgh, Honorary
Clinical Senior Lecturer, University of Edinburgh
Colin Robertson, BA(Hons) MBChB FRCPEd
FRCSEd FSAScot
Honorary Professor of Accident and Emergency Medicine, University of EdinburghTable of Contents
Cover image
Title page
John Macleod (1915–2006)
Copyright
Preface
Acknowledgements
Picture and box credits
How to get the most out of this book
Glasgow Coma Scale videos
Clinical skills videos
Contributors
Advisory board
Section 1: History Taking and General Examination
Chapter 1: Approach to the patient
Being a ‘good’ doctor
Confidentiality and consent
Personal responsibilities
Dress and demeanourCommunication skills
Expectations and respect
Hand washing and cleanliness
Chapter 2: History taking
Talking with patients
The psychiatric history
Medically unexplained symptoms (MUS)
Documenting the findings: the case notes
Chapter 3: The general examination
The setting for a physical examination
Sequence for performing a physical examination
First impressions
The hands
The tongue
Lumps or swellings
The lymph nodes
Weight and height
Hydration
Temperature
Section 2: System Examination
Chapter 4: The skin, hair and nails
Examination of the skin, hair and nails
Chapter 5: The endocrine system
Endocrine examination
Chapter 6: The cardiovascular system
Cardiovascular examinationThe heart
Peripheral vascular system
Chapter 7: The respiratory system
Respiratory examination
Chapter 8: The gastrointestinal system
Gastrointestinal examination
Chapter 9: The renal system
Renal examination
Chapter 10: The reproductive system
The breast examination
The gynaecological examination
The obstetric examination
The male genital examination
Chapter 11: The nervous system
Nervous system examination
Chapter 12: The visual system
Anatomy
Symptoms and definitions
The history
The physical examination
Investigations
Chapter 13: The ear, nose and throat
The ear
The nose and sinuses
The mouth and throat
Chapter 14: The musculoskeletal systemMusculoskeletal examination
Section 3: Examination in Specific Situations
Chapter 15: Babies and children
Examination of babies
EXAMINATION OF Children
Chapter 16: The frail elderly
Examination of the frail elderly
Chapter 17: The febrile adult
Examination of the febrile adult
Chapter 18: Assessment for anaesthesia and sedation
examination for anaesthesia and sedation
Chapter 19: The critically ill
Examination of the critically ill
Chapter 20: Confirming death
Examination to confirm death
Section 4: Assessing Clinical Examination Technique
Chapter 21: OSCEs and other examination formats
The communication station
The endocrine station
The cardiovascular station
The respiratory station
The gastrointestinal station
The renal station
The visual station
The ear, nose and throat stationThe musculoskeletal station
The nervous station
Index(
John Macleod (1915–2006)
John Macleod was appointed consultant physician at the Western General Hospital,
Edinburgh, in 1950. He had major interests in rheumatology and medical education.
Medical students who attended his clinical teaching sessions remember him as an
inspirational teacher with the ability to present complex problems with great clarity.
He was invariably courteous to his patients and students alike. He had an uncanny
knack of involving all students equally in clinical discussions and used praise rather
than criticism. He paid great attention to the value of history taking and, from this,
expected students to identify what particular aspects of the physical examination
should help to narrow the diagnostic options.
His consultant colleagues at the Western welcomed the opportunity of contributing
when he suggested writing a textbook on clinical examination. The book was rst
published in 1964 and John Macleod edited seven editions. With characteristic
modesty he was very embarrassed when the eighth edition was renamed Macleod's
Clinical Examination. This, however, was a small way of recognising his enormouscontribution to medical education.
He possessed the essential quality of a successful editor – the skill of changing
disparate contributions from individual contributors into a uniform style and format
without causing o, ence; everybody accepted his authority. He avoided being
dogmatic or condescending. He was generous in teaching others his editorial skills
and these attributes were recognised when he was invited to edit Davidson's Principles
and Practice of Medicine.C o p y r i g h t
© 2013 Elsevier Ltd All rights reserved.
No part of this publication may be reproduced or transmitted in any form or by any
means, electronic or mechanical, including photocopying, recording, or any
information storage and retrieval system, without permission in writing from the
publisher. Details on how to seek permission, further information about the
publisher's permissions policies and our arrangements with organisations such as the
Copyright Clearance Center and the Copyright Licensing Agency, can be found at
our website: www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under
copyright by the publisher (other than as may be noted herein).
First edition 1964 Eighth edition 1990
Second edition 1967 Ninth edition 1995
Third edition 1973 Tenth edition 2000
Fourth edition 1976 Eleventh edition 2005
Fifth edition 1979 Twelfth edition 2009
Sixth edition 1983 Thirteenth edition 2013
Seventh edition 1986
ISBN 9780702047282
International ISBN 9780702047299
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
A catalog record for this book is available from the Library of Congress
NoticesKnowledge and best practice in this field are constantly changing. As new research
and experience broaden our understanding, changes in research methods,
professional practices, or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and
knowledge in evaluating and using any information, methods, compounds, or
experiments described herein. In using such information or methods they should be
mindful of their own safety and the safety of others, including parties for whom
they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are
advised to check the most current information provided (i) on procedures featured
or (ii) by the manufacturer of each product to be administered, to verify the
recommended dose or formula, the method and duration of administration, and
contraindications. It is the responsibility of practitioners, relying on their own
experience and knowledge of their patients, to make diagnoses, to determine
dosages and the best treatment for each individual patient, and to take all
appropriate safety precautions.
To the fullest extent of the law, neither the publisher nor the authors, contributors,
or editors, assume any liability for any injury and/or damage to persons or
property as a matter of products liability, negligence or otherwise, or from any use
or operation of any methods, products, instructions, or ideas contained in the
material herein.
Printed in China
Last digit is the print number: 10 9 8 7 6 5 4 3#
#
P r e f a c e
The skills of history taking and physical examination are central to the practice of
clinical medicine. This book describes these and is intended primarily for medical
undergraduates. It is also of value to primary care and postgraduate hospital doctors,
particularly those studying for higher clinical examinations or returning to clinical
practice. The book is also an essential reference for nurse practitioners and other
paramedical staff who are involved in medical assessment of patients.
This edition has four sections: Section 1 details the principles of history taking and
general examination; Section 2 covers symptoms and signs in individual system
examinations; Section 3 reviews speci c situations; and a new Section 4 deals with
how to apply these techniques in an OSCE.
The text has been extensively revised and edited, with two new chapters on the
frail elderly and the febrile adult. The number of illustrations has been increased and
many have been updated. Line drawings illustrate surface anatomy and techniques
of examination; over 330 photographs show normal and abnormal clinical
appearances.
We recognise the current debate where some decry clinical examination because of
the lack of evidence supporting many techniques. Where evidence exists, however,
we highlight this in a new feature for this edition: evidence-based examination boxe