A Basic Terminology and Diagnostic Techniques 1. How many skin diseases exist? What are the two main categories of skin lesions ? There are more than 1400 skin diseases. Yet, only 30 are important, common, and worth knowing. The first…
Generalities Measuring vital signs is the initial but still essential part of bedside examination. Unfortunately, this task is often relegated to nonphysicians, sometimes even technicians. Yet, as the word implies, vital signs can provide a wealth of crucial information, some…
General Appearance 1. What is the value of carefully examining the patient’s general appearance? It is the Sherlockian value of making a diagnosis at first sight, sometimes while walking down a street. Attentive and knowledgeable observation is a time-honored skill…
General principles Clinical assessments are integral to undergraduate and postgraduate medical education and training, and are designed to verify that those involved in the care of patients meet safe clinical standards. Assessments can be formative and/or summative. Formative assessments (such…
The previous chapters have covered the idealised process of taking a history and examining each system in depth. This chapter considers how this ‘toolbox’ of skills can be used selectively and adaptively to address the patient’s needs in specific circumstances.…
History taking, examination and investigation are the methods by which clinicians gather information to allow them to understand patients’ problems. Clinical reasoning is the analytical process by which this information is translated into diagnoses, therapeutic possibilities and prognoses. This chapter…
Around 1% of the population in high-income countries die each year. Although some deaths are unexpected, the majority are the result of one or more advanced, progressive conditions and occur in hospital, at the patient’s home or care home, or…
A deteriorating patient is one who becomes acutely unwell in the hospital setting. This can occur at any stage of a patient's illness but is more common if the patient has been admitted as an emergency case, has undergone surgery…
The frail patient A frail person typically suffers from multimorbidity (multiple illnesses) and has associated polypharmacy (multiple medications). They often have cognitive impairment, visual and hearing loss, low bodyweight, poor mobility due to muscular weakness, unstable balance and poor exercise…
Mental disorders are very common, frequently coexist with physical disorders and cause much mortality and morbidity. Psychiatric assessment is, therefore, a required skill for all clinicians. It consists of four elements: history, mental state examination (MSE), selective physical examination and…