Part I:History 1
Preface 3
1.Introduction to History Taking 3
Basic Principles 3
Obtaining and Assessing Information 3
Relationship with the Patient 4
Difficult Consultations 4
Overview of History Section 4
Acknowledgements 5
2.The History 5
Introductory Statement 5
History of Presenting Complaint 5
Dedication 8
Past Medical History 8
Drug History 9
Social History 10
History of Drug Allergy 10
Family History 12
Review of Symptoms 14
Summary 16
3.Presenting Problems:Cardiovascular System 17
Chest Pain(Cardiac) 17
Palpitations 20
Heart Failure 22
Deep Vein Thrombosis or Pulmonary Embolism 23
4.Presenting Problems:Respiratory System 25
Asthma 25
Chronic Obstructive Pulmonary Disease 27
Chest Infection 28
5.Presenting Problems:Abdominal 31
Acute Abdominal Pain 31
Acute Diarrhoeal Illness 34
Jaundice 35
Anaemia 38
Melaena and Acute Gastrointestinal Bleeding 40
Change in Bowel Habit 41
Dysphagia 43
6.Presenting Problems:Renal Tract 45
Acute Renal Failure 45
Chronic Renal Failure 47
Haematuria 49
The Unconscious patient 51
7.Presenting Problems:Nervous System 51
Blackouts 52
Headache 54
Epileptic Fit 56
Stroke 58
Off Legs 60
8.Presenting Problems:Psychiatric 63
Drug Overdose 63
Back Pain 65
9.Presenting Problems:Locomotor System 65
Rheumatoid Arthritis 66
10.Presenting Problems:Endocrine System 69
The Diabetic Patient 69
Thyroid Disease 70
Part II:Examination 73
11.Introduction 75
Setting 75
Examination Routine 75
Examining a System 75
Physical Signs 76
Overview of Examination Section 76
12.Cardiovascular Examination 77
Examination Routine 77
Aortic Stenosis 87
Aortic Regurgitation 88
Mitral Stenosis 89
Mitral Regurgitation 90
Tricuspid Regurgitation 91
Infective Endocarditis 92
Heart Failure 93
Myocardial Infarction 94
13.Respiratory Examination 97
Examination Routine 97
Pleural Effusion 101
Pneumothorax 101
Lung Collapse 103
Consolidation 103
Lung Fibrosis 105
Integrating Physical Signs to Diagnosis Pathology 106
Asthma 107
Lung Cancer 108
Examination Routine 111
14.Abdominal Examination 111
Hepatomegaly 118
Splenomegaly 119
Anaemia 122
Acute Gastrointestinal Bleed 123
Acute Abdominal Pain 124
15.Renal Examination 129
Acute Renal Failure 129
Chronic Renal Failure 130
Palpable Kidneys 130
16.Neurological Examination 133
Examination Routine 133
Stroke 151
Epileptic Fit 152
Unconscious Patient 153
Multiple Sclerosis 154
Diabetes Mellitus 157
17.Endocrine Examination 157
Hyperthyroidism 158
Hypothyroidism 160
18.Reticulo-endothelial Examination 163
Examination Routine 163
19.Breast Examination 165
Examination Routine 165
Breast Mass 168
Investigations 169
Breast Pain 169
Gynaecomastia 169
20.Locomotor Examination 171
Examination Routine 171
21.Opthalmic Examination 185
Examination Routine 185
Part III:Clerking and Further Investigations 189
General Notes 191
22.Writing Medical Notes 191
Structuring Your Thoughts 192
Presenting Your Findings 193
Medical Sample Clerking 194
23.Further Investigations 199
Cardiovascular System 199
Respiratory System 202
Abdominal System 204
Renal System 205
Neurological System 206
Part IV:Self-Assessment 209
Multiple-choice Questions 211
Short-answer Questions 217
Case-based Questions 219
MCQ Answers 220
SAQ Answers 221
Index 225