Hutchison's Clinical Methods - An Integrated Approach to Clinical Practice (Hutchinson's Clinical Methods), 25e (Jul 27, 2022)_(0702082651)_(Elsevier)

Hutchison's Clinical Methods, First Published More Than A Century Ago, Is The Classic Textbook On Clinical Skills. It Provides An Outstanding Source Of Learning And Reference For Undergraduate Medical Students And Postgraduate Doctors. It Seeks To Teach An Integrated Approach To Clinical Practice, So That New Methods And Investigations Are Grafted Onto Established Patterns Of Clinical Practice, Rather Than Added On As Something Extra. The Text Is Organised So That Both System-related And Problem-oriented Chapters Are Included. Particular Emphasis Is Placed On The Importance Of The Doctor-patient Relationship, The Essential Skills Needed For Clinical Examination, And For Planning The Appropriate Choice Of Investigations In Diagnosis And Management. Hutchison's Clinical Methods Is An Invaluable Resource For All Those Learning And Training In Medicine And Is An Essential Adjunct To A Standard Textbook Of Medicine, Surgery Or Other Specialty. Provides A Comprehensive Account Of The Traditional Methods Of Patient History-taking And Examination But Updated With A Full Account Of The Role Of Modern Investigative Techniques. The Book Begins With A Group Of Chapters That Describe The Overall Approach To A Patient, The General Clinical Examination Together With Ethical Considerations, And Includes A New Chapter On Differential Diagnosis. The Second Section Of Chapters Groups Together The Clinical Methods Relevant To Particular Patient Groups Such As The Elderly, The Young, And Those Presenting In Emergency Situations, With Fever And Those In Pain. The Third Section Of Ten Chapters Covers The Assessment Of The Basic Systems Together With The Key Clinical Specialties Including Skin, Eyes And Ent. Cover Hutchison's Clinical Methods Copyright Preface to the Twenty-­fifth Edition Sir Robert Hutchison MD FRCP Contributors International Advisory Board Acknowledgements Contents ONE - General patient assessment 1 - Doctor and patient: General principles of history taking Setting the scene Emergency presentations History taking Disease-­centred versus patient-­centred Which issues are important Direct questions about bodily systems Pain Drug history Family history Occupational history Alcohol history Retrospective history Garrulous patients Angry patients The well-­informed patient Accompanying persons Using interpreters/advocates Analysing symptoms Conclusion 2 - General patient examination and differential diagnosis General examination of a patient Putting it all together Neck (while sitting forward) Documentation and communication Presenting a case Summary 3 - The next steps: Differential diagnosis and initial management Introduction Management plan Selecting appropriate investigations Conclusion WWW.BOOKBAZ.IR 4 - Ethical considerations Introduction Autonomy Consent Competence and capacity for consent Appropriately informed Confidentiality After death Organ donation Resuscitation Other ethical problems Genetic counselling Decisions regarding the protection of vulnerable patients Principles of medical ethics TWO - Assessment in particular groups 5 - Women Introduction Gynaecological history Gynaecological examination Cervical smear Examination under general anaesthesia Vaginismus Intact hymen Pregnancy Taking a cervical (Papanicolaou) smear History relating to current pregnancy Drug/smoking/alcohol history Obstetric examination General examination Investigations in obstetrics and gynaecology Tests of fetal wellbeing Late pregnancy Cardiotocography (CTG) Ultrasound visualization Doppler blood flow 6 - Children and adolescents Introduction History Family history Social history Examination Routine measurements Developmental screening examination Examination of the newborn 7 - Older people Introduction Presentation of disease in older people History Comprehensive geriatric assessment Falls and bone health Key areas of examination Appetite and weight Key areas for examination Continence Key areas for examination Skin Key areas for examination Pain Key areas for examination Memory, mood and energy Delirium Mood/mental state Key areas for examination Medication Key areas for examination Vision, hearing and teeth Key areas for examination 8 - Psychiatric assessment Introduction Preparation Circumstances of the interview Detailed cognitive examination (neuropsychiatric assessment) Children and young people People with intellectual disabilities and/or on the autism spectrum Patients with eating disorders/disordered eating Persistent physical symptoms (PPS)/Medically unexplained symptoms (MUS) Assessing forensic risk Referring someone for psychotherapy 9 - Patients presenting as emergencies The importance of clinical assessment Diagnosis versus resuscitation The pyrexial and septic patient The patient with chest pain The breathless patient The patient with hypotension or shock The patient with diminished consciousness The syncopal patient The patient with seizures The patient with delirium (acute confusion) The patient with acute headache The acutely weak patient The patient with acute abdominal pain The patient with haematemesis and/or melaena Summary WWW.BOOKBAZ.IR 10 - Patients with a fever Introduction Approach to a patient with a fever—causes of fever Main presenting complaint History of the presenting complaint Personal history History of associated and constitutional symptoms History of behaviours and exposures are important in infectious diseases Past medical and surgical history Respiratory tract Genitourinary tract Gastrointestinal tract Nervous system Skin and soft tissue Musculoskeletal system Cardiovascular system Examination General assessment Skin and mucous membranes Respiratory tract Cardiovascular system Genitourinary tract Gastrointestinal tract Nervous system Musculoskeletal system Drug fever Investigations for infectious causes of fever Full blood count with differential and film Platelets Inflammatory markers Basic biochemistry tests Microbiology and virology tests Serology Molecular diagnostics Immunological tests Histopathology Radiology 11 - Patients in pain Introduction Definition Classification of pain Mechanisms of pain The patient in pain Unidimensional scales Multidimensional (complex) scales Treatment strategies Acute pain Non-­pharmacological options Essential pain management approach Conclusion THREE - Basic systems 12 - Respiratory system Introduction The history Upper airway The smoking and recreational drug history The family history The occupational history The examination General assessment Upper airways Hands Respiratory rate and rhythm Venous pulses Head Movement of the chest Swellings and tenderness Trachea and heart Chest expansion Feeling: percussion of the chest Listening: auscultation of the chest The breath sounds Added sounds Vocal resonance Vocal fremitus Other investigations In the laboratory Exhaled nitric oxide Six-­minute walking test Cardiopulmonary exercise testing (CPET) Overnight oximetry and nocturnal polygraphy The position of the patient The outline of the heart and the mediastinum The position of the trachea The diaphragm The lung fields The bony skeleton The computed tomography (CT) scan Radioisotope imaging Magnetic resonance imaging Ultrasound Positron emission tomography (PET) scanning Flexible bronchoscopy and endobronchial ultrasound (EBUS) Pleural aspiration and biopsy Ridge thoracoscopy and video-­assisted thoracoscopic surgery (VATS) Lung biopsy Immunological tests Tests for tuberculosis (TB) 13 - Cardiovascular system Introduction The cardiac history Myocardial ischaemia Box 13.2 Angina Box 13.3 Causes of angina Acute coronary syndromes Box 13.5 Acute coronary syndromes Pericarditis Box 13.6 Causes of acute pericarditis Aortic dissection Box 13.7 Aortic dissection Pulmonary embolism Box 13.8 Pulmonary embolism Dyspnoea Table 13.1 Causes of heart failure Box 13.9 Acute left ventricular failure Box 13.10 Congestive heart failure Table 13.2 NYHA classification Exertional dyspnoea Orthopnoea Paroxysmal nocturnal dyspnoea Postural hypotension Vasovagal syncope Carotid sinus hypersensitivity Valvular obstruction Stokes–Adams attacks The cardiac examination Anaemia Cyanosis Clubbing of the fingers and toes Other cutaneous and ocular signs of infective endocarditis Coldness of the extremities Pyrexia Oedema Rate and rhythm Character Symmetry Jugular venous pulse Jugular venous pressure Waveform of jugular venous pulses First sound (S1) Second sound (S2) Third and fourth sounds (S3, S4) Systolic clicks and opening snaps Heart murmurs Friction rubs and venous hums Finishing the cardiovascular examination Routine for the cardiovascular systemexamination The electrocardiogram Inscription of the QRS complex Electrical axis Rhythm Electrical axis P-­wave morphology PR interval QRS morphology QT interval ST segment morphology T-­wave morphology Clinical applications of ECG Diagnosis of coronary artery disease Stable angina Exercise stress testing Acute coronary syndromes In-­hospital ECG monitoring Ambulatory (Holter) ECG monitoring Patient-­activated ECG recording Implantable loop recording Exercise testing Tilt testing Electrophysiological study Atrial ectopic beats Atrial fibrillation Atrial flutter Atrioventricular nodal re-­entry tachycardia (AVNRT) Wolff-­Parkinson-­White syndrome Ventricular tachycardia Ventricular fibrillation Sinus bradycardia (