History and Clinical Examination at a Glance

Jonathan Gleadle is Professor of Medicine at Flinders University and Consultant Nephrologist at Flinders Medical Centre, Adelaide, South Australia. He was formerly University Lecturer in Nephrology and General Medicine at Oxford University.

"This is a useful, basic book for all students and clinicians. Regardless of readers' level of professional development -- just starting to learn physical examination or experienced but wishing a quick memory jogger for common complaints they encounter in the primary care setting - they will find this to be a one-of-a-kind resource." (Doody's, 30 August 2012)

• Preface 7 List of abbreviations 9Part 1 Communication skills1 Fundamental communication skills 102 Communicating information 123 Communicating bad news 144 Communicating with relatives 165 Cultural differences 186 Exploring sensitive issues 207 History and examination in clinical exams 22Part 2 Taking a history8 Relationship with patient 249 History of presenting complaint 2610 Past medical history, drugs and allergies 2811 Family and social history 3012 Functional enquiry 31Part 3 History and examination of the systems13 Is the patient ill? 3214 Principles of examination 3415 The cardiovascular system 3616 The respiratory system 4017 The gastrointestinal system 4218 The male genitourinary system 4419 Gynaecological history and examination 4620 Breast examination 4821 Obstetric history and examination 4922 The nervous system 5023 The musculoskeletal system 5424 Skin 5625 The visual system 5826 Examination of the ears, nose, mouth, throat, thyroid and neck 6027 Examination of urine 6128 The psychiatric assessment 6229 Examination of the legs 6530 General examination 6631 Presenting a history and examination 68Part 4 Presentations32 Chest pain 7033 Abdominal pain 7234 Headache 7435 Vomiting, diarrhoea and change in bowel habit 7636 Gastrointestinal haemorrhage 7937 Indigestion and dysphagia 8038 Weight loss 8239 Fatigue 8440 The unconscious patient 8641 The intensive care unit patient 8842 Back pain 9043 Hypertension 9244 Swollen legs 9445 Jaundice 9546 Postoperative fever 9647 Suspected meningitis 9748 Anaemia 9849 Lymphadenopathy 10050 Cough 10151 Confusion 10252 Lump 10453 Breast lump 10554 Palpitations/arrhythmias 10655 Joint problems 10756 Red eye 10857 Dizziness 10958 Breathlessness 11059 Dysuria and haematuria 11260 Attempted suicide 11461 Immunosuppressed patients 11662 Diagnosing death 11763 Shock 11864 Trauma 12065 Alcohol-related problems 12266 Collapse 124Part 5 ConditionsCardiovascular67 Myocardial infarction and angina 12668 Hypovolaemia 12869 Heart failure 13070 Mitral stenosis 13271 Mitral regurgitation 13372 Aortic stenosis 13473 Aortic regurgitation 13674 Tricuspid regurgitation 13875 Pulmonary stenosis 13976 Congenital heart disease 14077 Aortic dissection 14278 Aortic aneurysm 14479 Infective endocarditis 14680 Pulmonary embolism and deep vein thrombosis 14881 Prosthetic cardiac valves 15082 Peripheral vascular disease 151Endocrine/metabolic83 Diabetes mellitus 15284 Hypothyroidism and hyperthyroidism 15485 Addison’s disease and Cushing’s syndrome 15686 Hypopituitarism 15787 Acromegaly 158Nephrology and urology88 Renal failure 16089 Polycystic kidney disease 16290 Nephrotic syndrome 16391 Urinary symptoms 16492 Testicular lumps 166Gastrointestinal93 Chronic liver disease 16894 Infl ammatory bowel disease 17095 Splenomegaly/hepatosplenomegaly 17196 Acute abdomen 17297 Pancreatitis 17498 Abdominal mass 17699 Appendicitis 177Respiratory100 Asthma 178101 Pneumonia 180102 Pleural effusion 181103 Fibrosing alveolitis, bronchiectasis, cystic fibrosis and sarcoidosis 182104 Carcinoma of the lung 184105 Chronic obstructive pulmonary disease 186106 Pneumothorax 188107 Tuberculosis 189Neurology108 Stroke 190109 Parkinson’s disease 192110 Motor neurone disease 193111 Multiple sclerosis 194112 Peripheral neuropathy 196113 Carpal tunnel syndrome 197114 Myotonic dystrophy and muscular dystrophy 198115 Myasthenia gravis 200116 Cerebellar disorders 201117 Dementia 202Musculoskeletal118 Rheumatoid arthritis 204119 Osteoarthritis and osteoporosis 206120 Gout and Paget’s disease 208121 Ankylosing spondylitis 209Other122 Systemic lupus erythematosus and vasculitis 210123 Malignant disease 212124 Scleroderma 213125 AIDS and HIV 214Appendix: A self-assessment framework of communication skills in history and examination 216Index 217