The 10-Minute Clinical Assessment
2. Edition November 2016
832 Pages, Softcover
Wiley & Sons Ltd
ISBN:
978-1-119-10634-0
John Wiley & Sons
Clinical assessment is at the heart of medicine. Health professionals working in busy clinical settings, such as general practitioners, nurse practitioners and hospital doctors on-call, often have to assess patients under considerable time constraints. This book teaches the reader how to gather clinical information effectively, accurately and safely even when time is at a premium.
* Provides a systematic method of collecting and assessing relevant clinical information by suggesting step-by-step examination routines, including important patient-centred questions
* Focuses on common symptoms and presentations
* Treatment reflects the latest in evidence based practice (including latest NICE Guidelines)
* Specifically covers the clinical skills assessment (CSA) part of the Membership of the Royal College of General Practitioners (RCGP) examination
* Written by an experienced medical educator and practicing GP, in consultation with a multidisciplinary team of medical students, GPs, PG trainees, hospital doctors and nurses
Foreword, xi
Preface to 1st edition, xii
Preface to 2nd edition, xiv
About the author, xv
Acknowledgements, xvi
Selected useful resources, xvii
The focused consultation, 1
Focused clinical assessment, 3
Useful consultation tools, 8
Red flags in general practice, 12
Undifferentiated and miscellaneous presentations, 15
Suspected cancer, 17
Weight loss, 24
Tiredness, 29
Dizziness, 35
Chronic pain, 41
Sudden collapse and syncope, 45
Frequent attenders, 50
Medication review and polypharmacy, 54
Medically unexplained symptoms, 58
Insomnia, 63
Irritability and 'stress', 67
Domestic violence, 71
Homelessness, 75
Paediatrics and adolescent health, 81
The sick and/or feverish child, 83
Suspected meningococcal meningitis and septicaemia, 90
Neonatal jaundice, 95
Faltering growth, 99
Headache and migraine in children, 104
Head injury in children, 108
Suspected cancer in children and adolescents, 113
Abdominal pain in children, 118
Hearing loss in children, 124
Childhood cough, 128
Childhood wheeze, 133
Constipation in children, 138
Childhood obesity, 142
Suspected child abuse and neglect, 148
Nocturnal enuresis, 153
Knee problems in children, 158
Hip problems in children, 163
Adolescent health problems, 167
Self-harm in teenagers, 171
Eating disorders, 175
Autism-spectrum disorder, 180
Cardiovascular, 183
Chest pain, 185
Palpitations, 191
Cardiovascular risk assessment, 195
Hypertension, 200
Atrial fibrillation, 205
Heart failure, 209
Peripheral vascular disease, 215
Respiratory, 221
Shortness of breath, 223
Haemoptysis, 228
Suspected lung cancer, 233
Asthma, 237
Chronic obstructive pulmonary disease, 242
Suspected pneumonia, 248
Pleural effusion, 252
Pulmonary embolism, 256
Endocrine and metabolic, 261
Diabetes review, 263
Obesity, 268
Hirsutism in women, 273
Hypothyroidism, 277
Hyperthyroidism, 281
Hyponatraemia, 285
Hypernatraemia, 289
Hypokalaemia, 292
Hyperkalaemia, 296
Hypocalcaemia, 299
Hypercalcaemia, 302
Gastrointestinal, 307
Nausea and vomiting, 309
Dysphagia, 313
Dyspepsia and reflux, 317
Upper gastrointestinal bleeding and melaena, 321
Abdominal pain, 326
Constipation, 332
Diarrhoea, 336
Rectal bleeding and suspected bowel cancer, 341
Abnormal liver function tests, 346
Irritable bowel syndrome, 351
Inflammatory bowel disease, 356
Coeliac disease, 361
Infectious diseases, 365
Fever of unknown origin, 367
Fever and illness in the returning traveller, 372
HIV infection and AIDS, 377
Tuberculosis, 383
Rheumatic fever, 388
Haematology, 393
Iron-deficiency anaemia, 395
Macrocytic anaemia (B12 and folate deficiency), 400
Bleeding disorders, 405
Myeloma, 409
Musculoskeletal, 413
Soft-tissue injury, 415
Acute hot and swollen joint, 420
Chronic musculoskeletal pain, 424
Polyarthralgia, 429
Neck pain, 435
Back pain, 440
Shoulder and arm problems, 446
Elbow problems, 452
Hand problems, 456
Hip pain, 461
Groin problems, 466
Leg pain and/or swelling, 470
Knee pain, 476
Foot and ankle problems, 483
Gout, 489
Osteoporosis, 493
Neurology, 499
Headache, 501
Transient ischaemic attack and stroke, 508
Head injury in adults, 514
Suspected or confirmed brain tumour, 519
Tremor, 524
Motor neurone disease, 528
Peripheral neuropathy, 533
Multiple sclerosis, 538
Gynaecology, 543
Combined oral contraception, 545
Menorrhagia, 549
Amenorrhoea, 553
Breast lumps, 557
Loss of libido, 561
Polycystic ovary syndrome, 565
Suspected ovarian cancer, 570
Obstetrics, 575
Routine antenatal care, 577
Bleeding in early pregnancy, 582
Abdominal pain in pregnancy, 586
Pre-eclampsia, 591
Urology and renal medicine, 595
Suspected urinary tract infection in women, 597
Lower urinary tract symptoms in men, 601
Urinary incontinence, 606
Urethral discharge in men, 612
Scrotal and testicular problems, 616
Erectile dysfunction, 621
Renal or ureteric colic (kidney stones), 626
Haematuria, 631
Chronic kidney disease, 635
Mental health, 641
Depression, 643
Self-harm and harm to others, 648
Anxiety, phobias and panic disorder, 653
Alcohol screening, 657
Alcohol dependence, 662
Illicit drug misuse, 667
Obsessive-compulsive disorder, 672
Mania, 675
Schizophrenia, 679
Skin, 685
Moles and malignant melanoma, 687
Pressure ulcers, 690
Ophthalmology, 695
Eye injuries, 697
The acute red eye, 701
Gradual painless visual disturbance, 706
Sudden painless visual disturbance, 710
Eye problems in older people, 715
Ear, nose and throat, 719
Neck swelling, 721
Sore throat, 725
Ear pain, 730
Hearing loss in adults, 734
Tinnitus, 738
Sinusitis and facial pain, 742
Problems in older people, 747
General health assessment in older people, 749
Cognitive problems and dementia, 755
Falls in older people, 760
Delirium and acute confusional state, 766
Depression in older people, 772
Palliative and end-of-life care, 777
Parkinson's disease, 781
Index, 785
Preface to 1st edition, xii
Preface to 2nd edition, xiv
About the author, xv
Acknowledgements, xvi
Selected useful resources, xvii
The focused consultation, 1
Focused clinical assessment, 3
Useful consultation tools, 8
Red flags in general practice, 12
Undifferentiated and miscellaneous presentations, 15
Suspected cancer, 17
Weight loss, 24
Tiredness, 29
Dizziness, 35
Chronic pain, 41
Sudden collapse and syncope, 45
Frequent attenders, 50
Medication review and polypharmacy, 54
Medically unexplained symptoms, 58
Insomnia, 63
Irritability and 'stress', 67
Domestic violence, 71
Homelessness, 75
Paediatrics and adolescent health, 81
The sick and/or feverish child, 83
Suspected meningococcal meningitis and septicaemia, 90
Neonatal jaundice, 95
Faltering growth, 99
Headache and migraine in children, 104
Head injury in children, 108
Suspected cancer in children and adolescents, 113
Abdominal pain in children, 118
Hearing loss in children, 124
Childhood cough, 128
Childhood wheeze, 133
Constipation in children, 138
Childhood obesity, 142
Suspected child abuse and neglect, 148
Nocturnal enuresis, 153
Knee problems in children, 158
Hip problems in children, 163
Adolescent health problems, 167
Self-harm in teenagers, 171
Eating disorders, 175
Autism-spectrum disorder, 180
Cardiovascular, 183
Chest pain, 185
Palpitations, 191
Cardiovascular risk assessment, 195
Hypertension, 200
Atrial fibrillation, 205
Heart failure, 209
Peripheral vascular disease, 215
Respiratory, 221
Shortness of breath, 223
Haemoptysis, 228
Suspected lung cancer, 233
Asthma, 237
Chronic obstructive pulmonary disease, 242
Suspected pneumonia, 248
Pleural effusion, 252
Pulmonary embolism, 256
Endocrine and metabolic, 261
Diabetes review, 263
Obesity, 268
Hirsutism in women, 273
Hypothyroidism, 277
Hyperthyroidism, 281
Hyponatraemia, 285
Hypernatraemia, 289
Hypokalaemia, 292
Hyperkalaemia, 296
Hypocalcaemia, 299
Hypercalcaemia, 302
Gastrointestinal, 307
Nausea and vomiting, 309
Dysphagia, 313
Dyspepsia and reflux, 317
Upper gastrointestinal bleeding and melaena, 321
Abdominal pain, 326
Constipation, 332
Diarrhoea, 336
Rectal bleeding and suspected bowel cancer, 341
Abnormal liver function tests, 346
Irritable bowel syndrome, 351
Inflammatory bowel disease, 356
Coeliac disease, 361
Infectious diseases, 365
Fever of unknown origin, 367
Fever and illness in the returning traveller, 372
HIV infection and AIDS, 377
Tuberculosis, 383
Rheumatic fever, 388
Haematology, 393
Iron-deficiency anaemia, 395
Macrocytic anaemia (B12 and folate deficiency), 400
Bleeding disorders, 405
Myeloma, 409
Musculoskeletal, 413
Soft-tissue injury, 415
Acute hot and swollen joint, 420
Chronic musculoskeletal pain, 424
Polyarthralgia, 429
Neck pain, 435
Back pain, 440
Shoulder and arm problems, 446
Elbow problems, 452
Hand problems, 456
Hip pain, 461
Groin problems, 466
Leg pain and/or swelling, 470
Knee pain, 476
Foot and ankle problems, 483
Gout, 489
Osteoporosis, 493
Neurology, 499
Headache, 501
Transient ischaemic attack and stroke, 508
Head injury in adults, 514
Suspected or confirmed brain tumour, 519
Tremor, 524
Motor neurone disease, 528
Peripheral neuropathy, 533
Multiple sclerosis, 538
Gynaecology, 543
Combined oral contraception, 545
Menorrhagia, 549
Amenorrhoea, 553
Breast lumps, 557
Loss of libido, 561
Polycystic ovary syndrome, 565
Suspected ovarian cancer, 570
Obstetrics, 575
Routine antenatal care, 577
Bleeding in early pregnancy, 582
Abdominal pain in pregnancy, 586
Pre-eclampsia, 591
Urology and renal medicine, 595
Suspected urinary tract infection in women, 597
Lower urinary tract symptoms in men, 601
Urinary incontinence, 606
Urethral discharge in men, 612
Scrotal and testicular problems, 616
Erectile dysfunction, 621
Renal or ureteric colic (kidney stones), 626
Haematuria, 631
Chronic kidney disease, 635
Mental health, 641
Depression, 643
Self-harm and harm to others, 648
Anxiety, phobias and panic disorder, 653
Alcohol screening, 657
Alcohol dependence, 662
Illicit drug misuse, 667
Obsessive-compulsive disorder, 672
Mania, 675
Schizophrenia, 679
Skin, 685
Moles and malignant melanoma, 687
Pressure ulcers, 690
Ophthalmology, 695
Eye injuries, 697
The acute red eye, 701
Gradual painless visual disturbance, 706
Sudden painless visual disturbance, 710
Eye problems in older people, 715
Ear, nose and throat, 719
Neck swelling, 721
Sore throat, 725
Ear pain, 730
Hearing loss in adults, 734
Tinnitus, 738
Sinusitis and facial pain, 742
Problems in older people, 747
General health assessment in older people, 749
Cognitive problems and dementia, 755
Falls in older people, 760
Delirium and acute confusional state, 766
Depression in older people, 772
Palliative and end-of-life care, 777
Parkinson's disease, 781
Index, 785
"This book does cover all the basics one must keep in mind when diagnosing and treating patients in the outpatient office...While the focus is on younger clinicians, this book clearly has great insights for primary care clinicians at every level of experience...5 Stars!" (Doody Enterprises 24/03/2017)
"Although the clinical content is great, this book was a real winner for me in terms of the practical points and guidance provided at the start of each section...I can certainly see myself using this book as a quick reference tool during consultations and have already found a special spot for it on my desk."(British Journal of General Practice 28/04/2017)
"Although the clinical content is great, this book was a real winner for me in terms of the practical points and guidance provided at the start of each section...I can certainly see myself using this book as a quick reference tool during consultations and have already found a special spot for it on my desk."(British Journal of General Practice 28/04/2017)
Knut Schroeder MD, MSc, DRCOG, DCH, MRCGP, MRCP, PhD
General Practitioner, Bristol, UK; and Honorary Senior Clinical Lecturer in General Practice, Centre for Academic Primary Care, University of Bristol, Bristol, UK
Knut Schroeder 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.
In addition to the first edition of The 10-Minute Clinical Assessment, Dr Schroeder has previously written for GP registrars (Top Tips for GPs, Radcliffe Medical Press, 2000) and co-written numerous book chapters, including two chapters for the Oxford Textbook of Primary Medical Care and a chapter on symptoms and signs for the Oxford Handbook of General Practice (3rd ed). He has 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.
General Practitioner, Bristol, UK; and Honorary Senior Clinical Lecturer in General Practice, Centre for Academic Primary Care, University of Bristol, Bristol, UK
Knut Schroeder 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.
In addition to the first edition of The 10-Minute Clinical Assessment, Dr Schroeder has previously written for GP registrars (Top Tips for GPs, Radcliffe Medical Press, 2000) and co-written numerous book chapters, including two chapters for the Oxford Textbook of Primary Medical Care and a chapter on symptoms and signs for the Oxford Handbook of General Practice (3rd ed). He has 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.
