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E-book

The 10-minute Clinical Assessment

ISBN: 978-1-4443-5880-3
792 pages
August 2011, BMJ Books
The 10-minute Clinical Assessment (1444358804) cover image
In the space of 10 minutes, how do you confidently assess your patient's condition and make an accurate diagnosis?

This concise guide provides a systematic way of collecting the essential clinical information swiftly and effectively.

The individual disease sections are uniformly structured to provide:

  • Key features of the history, including questions relevant to patients and important for making a diagnosis
  • The 'value' of present or absent symptoms for diagnosis and prognosis
  • What should be examined and why
  • A summary of 'red flags' – issues that must be assessed
  • Important differential diagnoses and their clinical features
  • Useful tips, tricks and hints for effective patient assessment

Every health professional, who has to assess patients under time constraints, as well as advanced medical students preparing for final exams, will find this new, easily accessible and comprehensive guide invaluable

"Being responsible for dealing with most of the health problems of most of the population most of the time is quite a challenge.... Both students and doctors, and not just those at the start of their careers, will benefit from reading this beautifully structured book which will help them get the very best out of clearly focused consultations. Combined with the vital attributes of listening and caring, using the knowledge and support this book provides will help us all become more effective doctors."
—Professor David Haslam, CBE, FRCP, FFPH, FRCGP, Past President of the Royal College of General Practitioners, London, UK

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Foreword.

Preface.

About the author.

Acknowledgements.

Selected useful resources.

Undifferentiated and miscellaneous presentations.

Suspected cancer.

Weight loss.

Tiredness.

Dizziness.

Chronic pain.

Sudden collapse.

Frequent attenders.

Medication review and polypharmacy.

Medically unexplained symptoms.

Insomnia.

Irritability and 'stress'.

Domestic violence.

Homelessness.

Paediatrics and adolescent health.

The sick and/or feverish child.

Suspected meningococcal meningitis and septicaemia.

Neonatal jaundice.

Faltering growth.

Headache and migraine in children.

Head injury in children.

Suspected cancer in children and adolescents.

Abdominal pain in children.

Hearing loss in children.

Childhood cough.

Childhood wheeze.

Constipation in children.

Childhood obesity.

Suspected child abuse and neglect.

Nocturnal enuresis.

Knee problems in children.

Hip problems in children.

Adolescent health problems.

Self-harm in teenagers.

Eating disorders.

Autism spectrum disorder.

Cardiovascular.

Chest pain.

Palpitations.

Cardiovascular risk assessment.

Hypertension.

Atrial fibrillation.

Heart failure.

Peripheral vascular disease.

Respiratory.

Shortness of breath.

Haemoptysis.

Suspected lung cancer.

Asthma.

Chronic obstructive pulmonary disease.

Suspected pneumonia.

Pleural effusion.

Pulmonary embolism.

Endocrine and metabolic.

Diabetes review.

Obesity.

Hirsutism.

Hypothyroidism.

Hyperthyroidism.

Hyponatraemia.

Hypernatraemia.

Hypokalaemia.

Hyperkalaemia.

Hypocalcaemia.

Hypercalcaemia.

Abdominal problems.

Nausea and vomiting.

Dysphagia.

Dyspepsia and reflux.

Upper gastrointestinal bleeding and melaena.

Abdominal pain.

Constipation.

Diarrhoea.

Rectal bleeding and suspected bowel cancer.

Abnormal liver function tests.

Irritable bowel syndrome.

Inflammatory bowel disease.

Coeliac disease.

Infectious diseases.

Fever of unknown origin.

Fever and illness in the returning traveller.

HIV infection and AIDS.

Tuberculosis.

Rheumatic fever.

Haematology.

Iron deficiency anaemia.

Pernicious anaemia and B12 deficiency.

Bleeding disorders.

Myeloma.

Musculoskeletal.

Soft tissue injury.

Acute hot and swollen joint.

Chronic musculoskeletal pain.

Polyarthralgia.

Neck pain.

Back pain.

Shoulder and arm problems.

Elbow problems.

Hand problems.

Hip pain.

Groin problems.

Leg pain and/or swelling.

Knee pain.

Foot and ankle problems.

Gout.

Osteoporosis.

Neurology.

Headache.

Transient ischaemic attack and stroke.

Head injury in adults.

Suspected or confirmed brain tumour.

Tremor.

Motor neurone disease.

Peripheral neuropathy.

Multiple sclerosis.

Gynaecology.

Combined oral contraception.

Menorrhagia.

Amenorrhoea.

Breast lumps.

Loss of libido.

Polycystic ovary syndrome.

Suspected ovarian cancer.

Obstetrics.

Routine antenatal care.

Bleeding in early pregnancy.

Abdominal pain in pregnancy.

Pre-eclampsia.

Urology and renal medicine.

Suspected urinary tract infection in women.

Lower urinary tract symptoms in men.

Urinary incontinence.

Urethral discharge in men.

Scrotal and testicular problems.

Erectile dysfunction.

Kidney stones.

Haematuria.

Chronic kidney disease.

Mental health.

Depression.

Self-harm and harm to others.

Anxiety, phobias and panic disorder.

Alcohol screening.

Alcohol dependence.

Illicit drug misuse.

Obsessive compulsive disorder.

Mania.

Schizophrenia.

Skin.

Moles and malignant melanoma.

Pressure ulcers.

Ophthalmology.

Eye injuries.

The acute red eye.

Gradual painless visual disturbance.

Sudden painless visual disturbance.

Eye problems in older people.

Ear, nose and throat.

Neck swelling.

Sore throat.

Ear pain.

Hearing loss in adults.

Tinnitus.

Rhinosinusitis and facial pain.

Problems in older people.

General health assessment in older people.

Cognitive problems and dementia.

Falls in older people.

Delirium and acute confusional state.

Depression in older people.

Palliative and end of life care.

Parkinson's disease.

Index.

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Knut Schroeder MD MSc DCH DRCOG DGM MRCGP MRCP PhD CertMedEd is a GP Principal and Honorary Senior Clinical Lecturer in General Practice at the University of Bristol. He holds a Certificate in Medical Education and developed undergraduate and postgraduate courses on clinical diagnosis and evidence based medicine. While a full-time Consultant Senior Lecturer, he was responsible for developing and running the general practice part of the final examination for medical students at the University of Bristol for three years. Knut has written a book for GP registrars (Top Tips for GPs, Radcliffe Medical Press, 2000) and co-wrote a number of book chapters, including two chapters for the Oxford Textbook of Primary Medical Care (on haemoptysis and high blood pressure). He had papers published in international peer-reviewed journals including the BMJ, Family Practice, and Archives of Internal Medicine, as well as articles in the GP press. His main clinical and teaching interest is clinical assessment and diagnosis. He is about to qualify as a GP Trainer and continues to teach medical students in years one to four. Knut was Deputy Co-ordinating Editor for the Cochrane Heart Group for four years and has experience in writing and assessing systematic reviews of clinical literature. For a brief CV and list of relevant publications please see http://www.bristol.ac.uk/primaryhealthcare/staff/knuts.htm

Gill Jenkins BM DRCOG DFFP BA
A part-time GP in Bristol, Gill is an experienced medical writer and broadcaster, writing for medical newspapers such as GP, Doctor; journals including The British Journal of Cardiology, Cardiology International, Update and Practice Nurse; consumer media including Woman's Own, Your Family and non-medical magazines such as Flyer and Helicopter Life, and reporting for BBC Radio, BBC News24, Sky News etc. Her particular interests and medical experience lie in rheumatology, family planning, travel and aviation medicine and diabetes.

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"I suspect it has less value as an immediate reference in the blood and thunder of a tricky consultation, but medical students and GP trainees will appreciate its cut-down simplicity." (Casebook, 1 May 2011)

"This excellent book will appeal not only to its intended target audience but also to experienced health professionals who have to assess patients swiftly." (Journal of Tropical Pediatrics, 2010)

"Being responsible for dealing with most of the health problems of most of the population most of the time is quite a challenge.... Both students and doctors, and not just those at the start of their careers, will benefit from reading this beautifully structured book which will help them get the very best out of clearly focused consultations. Combined with the vital attributes of listening and caring, using the knowledge and support this book provides will help us all become more effective doctors."
—Professor David Haslam, CBE, FRCP, FFPH, FRCGP, Past President of the Royal College of General Practitioners, London, UK

"Even for experienced health professionals this book will be extremely useful as a quick reference to have handy in the surgery. Because it is impossible to cover everything during a brief clinical assessment, the book tries to point out those areas that should be considered when faced with important and potentially tricky clinical presentations. (...) As someone who is passionate about general practice and GP education, I'm proud to recommend this book by Knut Schroeder as an excellent contribution to the genre."
—Professor Steve Field FRCGP, Chairman, Royal College of General Practitioners in the Foreword

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