Making a correct diagnosis is one of the key aspects of every medical student's and junior doctor's clinical training, and problem-based learning is now widely used to focus on the causes behind the presentation of a clinical feature. The Fourth Edition of this best-selling book is packed full of information to help the reader move from a presenting problem to an accurate diagnosis.
- This Fourth Edition covers 127 common presenting problems in both medicine and surgery in a consistent format.
- Each topic includes a list of all potential causes of the condition, colour coded to indicate common, occasional or rare causes. Important geographical variations are also highlighted.
- Two sections cover the differential diagnosis of biochemical and haematological disorders which provide a ready check when reviewing abnormal results
- The text includes a targeted guide to the relevant general and specific follow-up investigations which should be carried out as appropriate.
- At the end of each topic a box highlights important learning points, or indicates symptom and signs suggestive of significant pathology which require urgent action.
- Eighty colour photographs of key clinical presentations have been added to assist symptom recognition.
- Two new chapters on Hypotension and Photophobia.
Front Cover 1
Churchill’s Pocketbook of Differential Diagnosis 4
Copyright Page 5
Preface 6
Acknowledgements 7
Figure Acknowledgements 7
How to Use this Book 8
Abbreviations 9
Contents 12
Section A: Clinical Presentations 14
Abdominal Pain 16
Causes 16
History 19
Age 19
Pain 19
Defecation 19
Fever 19
Past history 19
Examination 19
General 19
Pulse, temperature, respiration 20
Cervical lymphadenopathy 20
Chest 20
Abdomen 20
Rectal examination 20
Vaginal examination 20
General Investigations 20
Specific Investigations 21
Abdominal Swellings 23
Right Upper Quadrant 23
Causes 23
History 24
Liver 24
Gall bladder 24
Right colon 24
Right kidney 24
Examination 24
Liver 24
Gall bladder 25
Right colon 25
Right kidney 25
General Investigations 25
Specific Investigations 26
Left Upper Quadrant 26
Causes 26
History 26
Spleen 26
Stomach 26
Pancreas 27
Kidney 27
Colon 27
Examination 27
Stomach 27
Colon 27
General Investigations 27
Specific Investigations 27
Epigastrium 28
Causes 28
History 29
Abdominal wall 29
Stomach 29
Retroperitoneum 29
Examination 29
Abdominal wall 29
Retroperitoneum 29
General Investigations 30
Specific Investigations 30
Umbilical 30
Causes 31
History 31
Superficial 31
Hernia 31
Small bowel 32
Examination 32
Superficial 32
Hernia 32
Small bowel 32
General Investigations 32
Specific Investigations 32
Right and Left Lower Quadrants 33
Causes 33
History 34
Anterior abdominal wall 34
Large bowel 34
Small bowel 35
Spleen 35
Ovary/fallopian tube/uterus 35
Retroperitoneum 35
Examination 35
General Investigations 36
Specific Investigations 36
Suprapubic 37
Causes 37
History 37
Bladder 37
Uterus 37
Urachus 37
Examination 37
Uterus 38
General Investigations 38
Specific Investigations 38
Anorectal Pain 39
Causes 39
History 40
Examination 40
General Investigations 41
Specific Investigations 41
Arm Pain 42
Causes 42
History 43
Examination 44
General Investigations 44
Specific Investigations 45
Arm Swellings 46
Causes 46
History 46
Examination 46
General Investigations 47
Specific Investigations 47
Ascites 48
Causes 48
History 49
Symptoms 49
Onset 49
Past medical history 49
Associated symptoms 49
Examination 50
Inspection 50
Palpation 50
Auscultation 50
Percussion 50
Internal examination 50
General Investigations 50
Ascitic fluid 51
Appearance 51
Chylous 51
Bile-stained 51
Haemorrhagic 51
Straw-coloured 51
Biochemistry 51
Protein 51
Amylase 52
Glucose 52
Triglyceride 52
Bilirubin 52
Microbiology 52
Cytology 52
WCC 52
Specific Investigations 52
Axillary Swellings 53
Causes 53
History 53
Superficial 53
Acute abscess 53
Sebaceous cyst 53
Lipoma 53
Hidradenitis suppurativa 53
Deep 54
Lymphadenopathy (p. 321) 54
Breast lumps 54
Lipoma 54
Chronic abscess 54
Axillary artery aneurysm 54
Examination 54
Superficial 54
Acute abscess 54
Lipoma 54
Sebaceous cyst 54
Hidradenitis suppurativa 55
Deep 55
Chronic abscess 55
Lymphadenopathy 55
Lipoma 55
Axillary artery aneurysm 55
Breast lumps 55
General Investigations 55
Special Investigations 55
Backache 57
Causes 57
History 59
Congenital 59
Acquired 59
General 59
Traumatic 59
Infective 59
Inflammatory 59
Neoplastic 60
Degenerative 60
Metabolic 60
Endocrine 60
Idiopathic 60
Psychogenic 60
Visceral 60
Vascular 61
Renal 61
Gynaecological 61
Examination 61
General 61
Congenital 61
Acquired 61
Traumatic 61
Infective 61
Inflammatory 62
Neoplastic 62
Degenerative 62
Metabolic 62
Endocrine 62
Idiopathic 62
Psychogenic 62
Visceral 63
Vascular 63
Renal 63
Gynaecological 63
General Investigations 63
Specific Investigations 64
Breast Lumps 65
Causes 65
History 66
Examination 66
Carcinoma 66
Phyllodes Tumour 66
Fibroadenoma 67
Cyst 67
Galactocele 67
Fat necrosis 67
Lipoma 67
Duct ectasia 67
Sebaceous cyst 67
Generalised swellings 67
Swellings behind the breast 67
General Investigations 67
Specific Investigations 68
Breast Pain 69
Causes 69
History 70
Examination 70
General Investigations 71
Specific Investigations 71
Chest Pain 72
Causes 72
History 73
Character 73
Location 73
Precipitating factors 73
Relieving factors 73
Trauma 73
Emotion 73
Examination 74
Temperature 74
Pulse 74
JVP 74
Palpation of the chest 74
Auscultation of the chest 74
Lower limbs 74
General Investigations 75
Specific Investigations 75
Clubbing 77
Causes 77
History 78
Duration 78
Respiratory symptoms 78
Gastrointestinal symptoms 79
Family history 79
Examination 79
Inspection 79
Temperature 79
Examination of the chest 80
Abdominal examination 80
General Investigations 80
Specific Investigations 80
Coma 82
Causes 82
History 83
Presentation 83
Onset 84
Trauma 84
Headache 84
Predisposing factors 84
Examination 85
Temperature 85
General examination 85
Neurological examination 85
General Investigations 86
Specific Investigations 87
Confusion 88
Causes 88
History 89
Onset 89
Past medical history 89
Drug history 89
Associated symptoms 89
Examination 89
Temperature 89
General 90
Systemic examination 90
Neurological examination 90
General Investigations 90
Specific Investigations 91
Constipation 92
Causes 92
History 93
Congenital 93
Acquired 93
Obstruction 93
Painful anus 93
Adynamic bowel 93
Endocrine 93
Drugs 93
Other 93
Examination 94
Obstruction 94
Painful anus 94
Adynamic bowel 94
Endocrine 94
General Investigations 94
Specific Investigations 95
Convulsions 96
Causes 96
History 97
Event 97
Precipitating factors 97
Headache 97
Associated neurology 97
Past medical and drug history 97
Examination 97
Temperature 97
General examination 98
Neurological examination 98
General Investigations 98
Specific Investigations 98
Cough 100
Causes 100
History 101
Onset and duration 101
Sputum 101
Smoking history 101
Associated symptoms 101
Examination 102
Temperature 102
Inspection and palpation 102
Auscultation 102
General Investigations 102
Specific Investigations 103
Cyanosis 104
Causes 104
History 104
Central cyanosis 104
Onset 104
Chest pain 104
Dyspnoea 105
Past medical history and drug history 105
Peripheral cyanosis 105
General history 105
Examination 105
Temperature 105
Inspection 105
Respiratory examination 105
General Investigations 106
Specific Investigations 106
Deafness 107
Causes 107
History 108
Duration 108
Onset 108
Pain 108
Precipitating factors 108
Associated symptoms 108
Drug history 108
Examination 108
Examination of the ear 108
Assessment of hearing 109
General examination 109
General Investigations 109
Specific Investigations 109
Diarrhoea 111
Causes 111
History 113
Infective enteritis 113
Inflammatory bowel disease 113
Malabsorption 113
Neoplastic 113
Other intestinal 114
Gastric 114
Pancreatic lesions 114
Endocrine disorders 114
Drugs 114
Other 114
Examination 115
Infective enteritis 115
Inflammatory bowel disease 115
Neoplastic 115
Other intestinal 115
Gastric 115
Pancreatic 115
Endocrine 115
General Investigations 116
Specific Investigations 116
Dizziness 118
Causes 118
History 118
General 118
Precipitating factors 119
Associated symptoms 119
Drug history 119
Examination 119
General Investigations 120
Specific Investigations 120
Dysphagia 122
Causes 122
History 123
Congenital 123
Oesophageal atresia 123
Acquired 124
In the lumen 124
In the wall 124
Outside the wall 124
Neuromuscular 125
Others 125
Examination 125
General Investigations 126
Specific Investigations 126
Dyspnoea 127
Causes 127
History 128
Onset 128
Precipitating factors 128
Relieving factors 129
Associated factors 129
Examination 129
Inspection 129
Pulse 129
JVP 129
Temperature 129
Trachea 130
Expansion 130
Percussion 130
Auscultation of the precordium 130
Breath sounds 130
Added sounds 130
General Investigations 130
Specific Investigations 132
Ear Disorders 134
Causes 134
History 135
Local 135
External ear 135
External auditory meatus 135
Middle ear 136
Referred pain 136
Neurological 136
Examination 136
Local 136
External ear 136
External auditory meatus 136
Middle ear 137
Referred pain 137
Neurological 137
General Investigations 137
Eye Disorders 139
Causes 139
History 140
Pain 140
Visual disturbance 140
Discharge 141
Past medical history 141
Examination 141
General Investigations 142
Specific Investigations 142
Facial Pain 143
Causes 143
History 144
Site 144
Character 144
Precipitating factors 144
Associated symptoms 145
Examination 145
Inspection 145
Palpation 145
General Investigations 146
Specific Investigations 146
Facial Swellings 147
Causes 147
History 148
Traumatic 148
Infective 148
Neoplastic 149
Vascular 149
Endocrine 149
Metabolic 149
Drugs 149
Other 149
Examination 150
Traumatic 150
Infective 150
Neoplastic 150
Vascular 150
Endocrine 150
Metabolic 150
Drugs 151
Other 151
General Investigations 151
Specific Investigations 151
Facial Ulcers 153
Causes 153
History 154
Examination 155
Benign ulcers 155
Malignant ulcers 155
Infective 155
General Investigations 155
Specific Investigations 156
Faecal Incontinence 157
Causes 157
History 158
Examination 158
General Investigations 158
Specific Investigations 158
Finger Lesions 160
Causes 160
History 161
Congenital 161
Acquired 161
Traumatic/degenerative 161
Dupuytren’s contracture 161
Implantation dermoid 161
Pyogenic granuloma 161
Trigger finger 162
Mallet finger 162
Swan-neck deformity 162
Boutonnière deformity 162
Heberden’s nodes 162
Mucous cyst 162
Calluses over knuckles (bulimia) 162
Metabolic 162
Tophaceous gout 162
Ectopic calcification 162
Connective tissue disease 162
CREST syndrome 162
Neoplastic 162
Subungual melanoma 162
Enchondroma 163
Examination 163
Congenital 163
Acquired 163
Traumatic/degenerative 163
Dupuytren’s contracture 163
Implantation dermoid 163
Trigger finger 163
Mallet finger 163
Swan-neck deformity 163
Boutonnière deformity 163
Heberden’s nodes 163
Mucous cyst 164
Metabolic 164
Tophaceous gout 164
Ectopic calcification 164
Connective tissue disease 164
CREST syndrome 164
Neoplastic 164
Subungual melanoma 164
Enchondroma 164
General Investigations 164
Finger Pain 166
Causes 166
History 167
Traumatic 167
Inflammatory/infective 167
Paronychia 167
Pulp space infection 167
Tendon sheath infection 167
Neoplastic 168
Glomus tumour 168
Primary and secondary bone tumours 168
Degenerative 168
Rheumatoid arthritis 168
Vascular 168
Chilblains 168
Small vessel disease 168
Metabolic 168
Gout 168
Autoimmune 169
Scleroderma 169
Neurological 169
Carpal tunnel syndrome 169
Cervical lesions 169
Examination 169
Traumatic 169
Inflammatory/infective 169
Paronychia 169
Pulp space infection 169
Tendon sheath infection 169
Neoplastic 170
Glomus tumours 170
Primary and secondary tumours 170
Degenerative 170
Rheumatoid arthritis 170
Vascular 170
Chilblains 170
Small vessel disease 170
Metabolic 170
Gout 170
Autoimmune 170
Scleroderma 170
Neurological 171
Carpal tunnel syndrome 171
Cervical spondylosis 171
General Investigations 171
Specific Investigations 171
Foot Deformities 173
Causes 173
History 174
Talipes equinovarus 174
Metatarsus adductus 174
Pes planus 174
Pes cavus 174
Acquired talipes 174
Trauma 174
Examination 174
Talipes equinovarus 174
Metatarsus adductus 175
Pes planus 175
Pes cavus 175
Acquired talipes 175
Trauma 175
General Investigations 175
Foot Pain 176
Causes 176
History 177
Traumatic 177
Infective 177
Inflammatory 177
Vascular 177
Metabolic 178
Degenerative 178
Other 178
Examination 178
Traumatic 178
Infective 178
Inflammatory 178
Vascular 179
Metabolic 179
Degenerative 179
Other 179
General Investigations 179
Specific Investigations 179
Foot Ulcers 181
Causes 181
History 182
Vascular 182
Neuropathic 182
Neoplastic 182
Traumatic 183
Infective 183
Examination 183
Vascular 183
Neuropathic 183
Neoplastic 183
Traumatic 183
Infective 184
General Investigations 184
Specific Investigations 184
Gait Abnormalities 185
Causes 185
History 185
Duration 185
Associated symptoms 185
Past medical and drug history 186
Examination 186
The asymmetrical gait 186
The symmetrical gait 186
Orthopaedic examination 187
Neurological examination 187
Specific examination 187
General Investigations 187
Specific Investigations 188
Goitre 189
Causes 189
History 190
Simple hyperplastic goitre 190
Multinodular goitre 190
Toxic goitre 190
Autoimmune 190
Neoplastic goitre 191
Inflammatory (rare) 191
Examination 191
Simple hyperplastic goitre 191
Multinodular goitre 191
Toxic goitre 191
Autoimmune 191
Neoplastic goitre 192
Inflammatory 192
General Investigations 192
Specific Investigations 193
Groin Swellings 194
Causes 194
History 195
Sebaceous cyst 195
Lipoma 195
Hernias 195
Imperfectly descended testis 195
Lipoma of the cord 195
Hydrocele of the cord 195
Hydrocele of the canal of Nuck 195
Lymph nodes 195
Saphena varix 196
Femoral artery aneurysm 196
Imperfectly descended testis 196
Neuroma of the femoral nerve 196
Synovioma of the hip joint 196
Obturator hernia 196
Examination 196
Sebaceous cyst 196
Lipoma 197
Hernias 197
Imperfectly descended testis 197
Lipoma of the cord 197
Hydrocele of the cord 198
Hydrocele of the canal of Nuck 198
Femoral hernia 198
Lymph nodes 198
Saphena varix 198
Femoral artery aneurysm 198
Imperfectly descended testis 199
Neuroma of the femoral nerve 199
Synovioma of the hip joint 199
Obturator hernia 199
Psoas abscess 199
General Investigations 199
Specific Investigations 200
Gum Disorders 201
Causes 201
History 202
Examination 202
Local 202
General 203
General Investigations 203
Specific Investigations 203
Gynaecomastia 204
Causes 204
History 205
Examination 205
Local 205
General 206
General Investigations 206
Specific Investigations 206
Haematemesis 208
Causes 208
History 209
Swallowed blood 209
Oesophagus 209
Stomach 209
Duodenum 210
Bleeding disorders 210
Drugs 210
Others 210
Examination 210
Swallowed blood 210
Oesophagus 211
Stomach 211
Duodenum 211
Bleeding disorders 211
Drugs 211
Others 211
General Investigations 211
Specific Investigations 212
Haematuria 213
Causes 213
History 214
Examination 215
General Investigations 215
Specific Investigations 216
Haemoptysis 217
Causes 217
History 218
Onset 218
Dyspnoea 218
Weight loss 218
Other sites of bleeding 218
Past medical and drug history 218
Examination 219
Inspection 219
Palpation 219
Percussion and auscultation 219
General Investigations 219
Specific Investigations 221
Halitosis 223
Causes 223
History 223
Examination 224
General Investigations 224
Specific Investigations 224
Hallucinations 226
Causes 226
History 227
Examination 227
General Investigations 227
Specific Investigations 227
Hand Deformities 229
Causes 229
History 230
Congenital 230
Acquired 230
Trauma and burns 230
Dupuytren’s contracture 230
Rheumatoid arthritis 230
Volkmann’s ischaemic contracture 230
Spinal cord lesions 231
Brachial plexus lesions 231
Peripheral nerve lesions 231
Ollier’s disease 231
Examination 231
Congenital 231
Acquired 231
Trauma and burns 231
Dupuytren’s contracture 231
Rheumatoid arthritis 231
Volkmann’s ischaemic contracture 232
Spinal cord lesions 232
Brachial plexus injuries 232
Peripheral nerve lesions 232
Ollier’s disease 232
General Investigations 232
Headache 234
Causes 234
History 235
Onset 235
Site 235
Character 235
Precipitating factors 236
Associated symptoms 236
Examination 236
Temperature 236
Inspection 236
Palpation 237
Neurological examination 237
General Investigations 237
Specific Investigations 237
Hemiplegia 239
Causes 239
History 239
Onset 239
Precipitating factors 239
Associated symptoms 240
Examination 240
General Investigations 241
Specific Investigations 241
Hepatomegaly 242
Causes 242
History 243
Hepatitis/infection 243
Congestion 244
Infiltration 244
Biliary tract disease 244
Malignancy 244
Metabolic 244
Others 244
Regular generalised enlargement without jaundice 245
Regular generalised enlargement with jaundice 245
Irregular generalised enlargement without jaundice 245
Irregular generalised enlargement with jaundice 245
Localised swellings 245
Examination 245
General 245
Congestion 246
Biliary tract disease 246
Storage disease 246
Malignancy 246
General Investigations 246
Specific Investigations 246
Hiccups 248
Causes 248
History 248
Respiratory history 248
Abdominal history 249
Neurological history 249
Others 249
Examination 249
General Investigations 250
Specific Investigations 250
Hirsutism 252
Causes 252
History 253
General 253
Menstrual history 253
Drug history 253
Associated symptoms 253
Examination 253
General Investigations 254
Specific Investigations 254
Hypertension 256
Causes 256
Other 257
History 257
Examination 258
Inspection 258
Palpation and auscultation 258
General Investigations 258
Specific Investigations 259
Impotence 261
Causes 261
Examination 262
Vascular 262
Neurological 262
Endocrine 262
Local painful conditions 263
Systemic disease 263
General Investigations 263
Specific Investigations 263
Intestinal Obstruction 265
Causes 265
History 266
Small bowel 266
Large bowel 266
Adynamic obstruction 267
Examination 267
Small bowel 267
Large bowel 267
Adynamic obstruction 267
General Investigations 267
Specific Investigations 268
Jaundice 269
Causes 269
History 271
General 271
Newborn 271
Prehepatic 271
Hepatocellular 271
Cholestatic 271
Examination 272
Prehepatic (haemolytic) 272
Hepatic 272
Cholestatic 272
General Investigations 272
Specific Investigations 273
Jaw Pain and Swellings 275
Causes 275
History 276
Traumatic 276
Infective 276
Temporomandibular joint 276
Cystic 277
Neoplastic 277
Others 277
Examination 278
Traumatic 278
Infective 278
Temporomandibular joint 278
Cystic 278
Neoplastic 278
Other 279
General Investigations 279
Special Investigations 279
Joint Disorders 280
Causes 280
History 282
Congenital 282
Acquired 282
Infective 282
Inflammatory 282
Degenerative 283
Enteropathic 283
Endocrine 283
Metabolic 283
Neuropathic 283
Haematological 284
Drugs 284
Neoplastic 284
Other 284
Examination 284
Congenital 284
Acquired 284
Infective 284
Inflammatory 285
Degenerative 285
Enteropathic 285
Endocrine 285
Metabolic 285
Neuropathic 286
Haematological 286
Drugs 286
Neoplastic 286
Other 286
General Investigations 286
Specific Investigations 287
Individual Joints 288
Shoulder 288
Causes 288
History 289
Congenital 289
Acquired 289
Traumatic 289
Degenerative 289
Inflammatory 290
Infective 290
Neoplastic 290
Referred pain 290
Neurological 291
Examination 291
Congenital 291
Acquired 291
Traumatic 291
Degenerative 291
Inflammatory 291
Infective 291
Neoplastic 291
Referred pain 292
Neurological 292
General Investigations 292
Specific Investigations 292
Elbow 292
Causes 292
History 293
Traumatic 293
Degenerative 293
Inflammatory 294
Neurological 294
Other 294
Examination 294
Traumatic 294
Degenerative 295
Inflammatory 295
Neurological 295
Other 295
General Investigations 295
Specific Investigations 295
Wrist 296
Causes 296
History 296
Traumatic 296
Degenerative 297
Inflammatory 297
Other 297
Examination 297
Traumatic 297
Degenerative 297
Inflammatory 298
Other 298
General Investigations 298
Specific Investigations 298
Hip 299
Causes 299
History 299
Congenital 299
Acquired 300
Traumatic 300
Infective 300
Inflammatory 300
Degenerative 300
Neoplastic 300
Other 301
Examination 301
Congenital 301
Acquired 301
Traumatic 301
Infective 301
Inflammatory 301
Degenerative 302
Neoplastic 302
Other 302
General Investigations 302
Specific Investigations 302
Knee 303
Causes 303
History 304
Traumatic 304
Infective 304
Inflammatory 304
Degenerative 305
Metabolic 305
Neuropathic 305
Neoplastic 305
Other 305
Bursitis 305
Baker’s cyst 305
Disorders of alignment 305
Patellofemoral instability 306
Referred pain 306
Osteochondritis dissecans 306
Osgood–Schlatter’s disease 306
Chondromalacia patellae 306
Examination 306
Traumatic 306
Infective 307
Inflammatory 307
Degenerative 307
Metabolic 307
Neuropathic 307
Other 307
General Investigations 308
Specific Investigations 308
Ankle 309
Causes 309
History 309
Traumatic 309
Infective 309
Inflammatory 309
Degenerative 310
Others 310
Examination 310
Traumatic 310
Infective 310
Inflammatory 310
Degenerative 310
Others 310
General Investigations 311
Specific Investigations 311
Kidney Swellings 312
Causes 312
History 313
Congenital 313
Acquired 313
Examination 313
General Investigations 313
Specific Investigations 314
Leg Pain 315
Causes 315
History 316
Traumatic 316
Inflammatory 316
Infective 317
Degenerative 317
Vascular 317
Neurological 317
Metabolic 317
Neoplastic 318
Other 318
Examination 318
Traumatic 318
Inflammatory 318
Infective 318
Degenerative 318
Vascular 319
Neoplastic 319
Neurological 319
Metabolic 319
Other 319
General Investigations 319
Specific Investigations 320
Leg Swellings 321
Causes 321
History 322
Examination 322
General Investigations 323
Specific Investigations 324
Leg Ulcers 325
Causes 325
History 326
Examination 326
Site 326
Edge 327
Base 327
Surrounding tissues 327
General Investigations 327
Specific Investigations 328
Lip Lesions 329
Causes 329
History 330
Congenital 330
Acquired 330
Flat lesions 330
Raised lesions 330
Erosions 331
Swelling 331
Cheilitis 331
Examination 331
Congenital 331
Acquired 332
Flat lesions 332
Raised lesions 332
Erosions 332
Swellings and cheilitis 332
General Investigations 332
Specific Investigations 333
Lymphadenopathy 334
Causes 334
History 335
Infection 335
Primary malignancy 335
Secondary malignancy 335
Other conditions 335
Examination 335
General Investigations 336
Specific Investigations 336
Melaena 338
Causes 338
History 339
Swallowed blood 339
Oesophagus 339
Stomach 339
Duodenum 340
Small intestine 340
Other causes of dark stools 340
Examination 340
Swallowed blood 340
Oesophagus 340
Stomach 340
Duodenum 340
Small intestine 341
Bleeding disorders 341
General Investigations 341
Specific Investigations 341
Mouth Ulcers 342
Causes 342
History 343
Traumatic 343
Aphthous 343
Inflammatory 343
Infective 343
Neoplastic 344
Haematological disorders 344
Skin disease-associated 344
Connective tissue disease 344
Other 344
Examination 344
Traumatic 344
Aphthous 344
Inflammatory 344
Infective 345
Neoplastic 345
Haematological disorders 345
Skin disease-associated 345
Connective tissue disorders 345
Other 345
General Investigations 345
Muscle Weakness and Wasting 347
Causes 347
History 348
Onset 348
Site 348
Precipitating factors 348
Past medical history 348
Associated symptoms 348
Examination 349
General Investigations 349
Specific Investigations 350
Nail Abnormalities 351
Causes 351
History 352
Congenital 352
Acquired 352
Infections 352
Traumatic 352
Systemic illness 352
Dermatological 353
Other 353
Examination 353
Congenital 353
Acquired 353
Infections 353
Traumatic 353
Systemic illness 353
Dermatological 354
Other 354
General Investigations 354
Specific Investigations 354
Nasal Discharge 356
Causes 356
History 357
Congenital 357
Acquired 357
Infective 357
Allergic 357
Allergic rhinitis 357
Inflammatory 357
Vasomotor rhinitis 357
Nasal polyps 358
Non-eosinophilic vasomotor rhinitis 358
Neoplastic 358
Nasopharyngeal carcinoma 358
Carcinoma of the maxillary sinus 358
Malignant granuloma 358
Granulomatous disease 358
Traumatic 358
Degenerative 359
Examination 359
Choanal atresia 359
Infective 359
Allergic 359
Inflammatory 359
Neoplastic 359
Granulomatous disease 359
Traumatic 360
Degenerative 360
General Investigations 360
Specific Investigations 360
Neck Lumps 361
Causes 361
History 362
Symptoms 362
Past medical history 362
Examination 362
Sebaceous cyst 362
Lipoma 362
Dermoid cyst 363
Abscess 363
Lymphadenopathy 363
Thyroid 363
Thyroglossal cyst 363
Salivary gland 363
Branchial cyst 363
Carotid body tumour 363
Carotid aneurysm 364
Sternomastoid ‘tumour’ 364
Cervical rib 364
Subclavian artery aneurysm 364
Pharyngeal pouch 364
Cystic hygromas 364
General Investigations 364
Specific Investigations 364
Neck Pain 366
Causes 366
History 367
Congenital 367
Acquired 367
Traumatic 367
Inflammatory 367
Infective 367
Degenerative 368
Neoplastic 368
Other 368
Examination 368
Congenital 368
Acquired 368
Traumatic 368
Inflammatory 368
Infective 369
Degenerative 369
Neoplastic 369
Other 369
General Investigations 369
Specific Investigations 369
Nipple Discharge 371
Causes 371
History 371
Examination 372
General Investigations 372
Specific Investigations 372
Oedema 374
Causes 374
History 375
Site and distribution 375
Precipitating factors 375
Past medical and drug history 376
Associated symptoms 376
Cardiac failure 376
Liver disease 376
Renal disease – nephrotic syndrome 376
Malabsorption 376
Venous thrombosis 376
Examination 377
Inspection 377
Cardiovascular system 377
Abdominal examination 377
Legs 377
General Investigations 377
Specific Investigations 378
Oliguria 379
Causes 379
History 379
Renal circulatory insufficiency 379
Renal causes 379
Post-renal 380
Others 380
Anuria 380
Examination 380
General 380
Specific 381
General Investigations 381
Specific Investigations 382
Palpitations 383
Causes 383
History 383
Additional features 384
Examination 384
Initial Investigations 384
12-lead ECG 384
Further Investigations 385
Ambulatory ECG monitoring 385
Penile Lesions 386
Causes 386
History 387
Foreskin and glans 387
Phimosis 387
Paraphimosis 387
Balanoposthitis 387
Balanitis xerotica obliterans 387
Herpes genitalis 387
Condylomata (warts) 387
Trauma 388
Carcinoma 388
Erythroplasia of Queyrat 388
Syphilitic chancre 388
Shaft 388
Peyronie’s disease 388
Priapism 388
Urethra 388
Epispadias 388
Hypospadias 388
Examination 388
Foreskin and glans 388
Phimosis 388
Paraphimosis 389
Balanoposthitis 389
Balanitis xerotica obliterans 389
Herpes genitalis 389
Condylomata (warts) 389
Trauma 389
Carcinoma 389
Erythroplasia of Queyrat 389
Syphilitic chancre 389
Shaft 390
Peyronie’s disease 390
Priapism 390
Urethra 390
General Investigations 390
Specific Investigations 390
Polyuria 392
Causes 392
History 393
General 393
Drug history 393
Past medical history 393
General Investigations 393
Specific Investigations 394
Popliteal Swellings 396
Causes 396
History 397
Superficial 397
Sebaceous cyst 397
Lipoma 397
Varix of the short saphenous vein 397
Deep 397
Lipoma 397
Lymphadenopathy 397
Semi-membranosus bursa 397
Baker’s cyst 397
Popliteal artery aneurysm 397
Bony 397
Exostoses 397
Osteogenic sarcoma 398
Examination 398
Superficial 398
Sebaceous cyst 398
Lipoma 398
Varix of the short saphenous vein 398
Deep 398
Lipoma 398
Lymphadenopathy 398
Semi-membranosus bursa 398
Baker’s cyst 398
Popliteal artery aneurysm 399
Bony 399
Exostoses 399
Osteogenic sarcoma 399
General Investigations 399
Specific Investigations 399
Pruritus 401
Causes 401
History 401
Examination 402
Inspection 402
General Examination 402
General Investigations 402
Specific Investigations 403
Pruritus Ani 404
Causes 404
History 405
Anal discharge 405
Faecal soiling 405
Skin diseases 405
Parasites 405
Psychogenic 406
Examination 406
Anal discharge 406
Faecal soiling 406
Skin diseases 406
Parasites 406
Psychogenic 406
General Investigations 406
Pyrexia of Unknown Origin 408
Causes 408
History 409
Examination 409
Investigations 409
General Investigations 409
Specific Investigations 410
Rectal Bleeding 412
Causes 412
History 413
Anus 413
Haemorrhoids 413
Fissure-in-ano 413
Carcinoma of the anal canal 414
Trauma 414
Colorectal 414
Carcinoma 414
Polyps 414
Diverticular disease 414
Inflammatory bowel disease 414
Ischaemic colitis 414
Angiodysplasia 414
Irradiation proctitis or colitis 414
Rectal prolapse 414
Solitary rectal ulcer 415
Small bowel 415
Meckel’s diverticulum 415
Intussusception 415
Mesenteric infarction 415
Aortoenteric fistula 415
Upper gastrointestinal tract 415
Others 415
Uraemia 415
Examination 416
Anus 416
Haemorrhoids 416
Fissure-in-ano 416
Carcinoma 416
Trauma 416
Colon and rectum 416
Carcinoma 416
Polyps 416
Diverticular disease 416
Inflammatory bowel disease 416
Ischaemic colitis 416
Angiodysplasia 417
Irradiation colitis or proctitis 417
Rectal prolapse 417
Solitary rectal ulcer 417
Small bowel 417
Meckel’s diverticulum 417
Intussusception 417
Mesenteric infarction 417
Aortoenteric fistula 417
Upper gastrointestinal tract 417
Massive haemorrhage 417
Others 417
General Investigations 418
Specific Investigations 418
Scalp Lesions 420
Causes 420
History 421
Traumatic 421
Sebaceous cyst 421
Neoplastic 421
Infective 422
Other 422
Examination 422
Traumatic 422
Sebaceous cyst 422
Neoplastic 422
Infective 422
Other 423
General Investigations 423
Specific Investigations 423
Scrotal Pain 424
Causes 424
History 425
Skin 425
Internal scrotal swellings 425
Referred pain 426
Examination 426
Skin 426
Internal scrotal swellings 426
Referred pain 427
General Investigations 427
Specific Investigations 427
Scrotal Swellings 428
Causes 428
History 429
Sebaceous cyst 429
Indirect inguinal hernia 429
Hydrocele 429
Epididymal cyst 429
Epididymo-orchitis 429
Testicular torsion 429
Testicular tumour 430
Varicocele 430
Haematocele 430
Sperm granuloma 430
TB 430
Gumma 430
Examination 430
Sebaceous cyst 430
Indirect inguinal hernia 430
Hydrocele 431
Epididymal cyst 431
Epididymo-orchitis 431
Testicular torsion 431
Testicular tumour 431
Varicocele 431
Haematocele 431
Sperm granuloma 432
Tuberculosis 432
Gumma 432
General Investigations 432
Specific Investigations 432
Shock 434
Causes 434
History 434
Trauma 434
Dyspnoea 435
Chest pain 435
Precipitating factors 435
Examination 435
Inspection 435
Temperature 435
Pulse 435
JVP 436
Auscultation 436
General Investigations 436
Specific Investigations 436
Splenomegaly 438
Causes 438
History 440
Infective 440
Inflammatory 440
Neoplastic 440
Haemolytic disease 441
Storage diseases 441
Deficiency diseases 441
Splenic vein hypertension 441
Non-parasitic cysts 441
Examination 441
General 441
Infective 441
Inflammatory 442
Neoplastic 442
Haemolytic disease 442
Storage diseases 442
Splenic vein hypertension 442
Non-parasitic cysts 442
General Investigations 442
Specific Investigations 443
Steatorrhoea 444
Causes 444
History 444
Abdominal pain 444
Associated symptoms 445
Past medical history 445
Drug history 445
Examination 445
General Investigations 446
Specific Investigations 446
Stridor 448
Causes 448
History 449
Onset 449
Precipitating factors 449
Associated symptoms 449
Examination 450
Inspection 450
Palpation and auscultation 450
General Investigations 450
Specific Investigations 451
Syncope 456
Causes 456
History 456
Examination 457
Appearance 457
Blood pressure 457
Pulse 457
Auscultation 458
General Investigations 458
Specific Investigations 458
Thirst 460
Causes 460
History 461
Examination 461
General Investigations 461
Specific Investigations 461
Throat Conditions 463
Causes 463
History 464
Infective 464
Inflammatory 464
Neoplastic 464
Neurological 464
Referred pain 464
Other 465
Examination 465
Infective 465
Inflammatory 465
Neoplastic 465
Neurological 465
Referred pain 465
Others 465
General Investigations 466
Specific Investigations 466
Tiredness 467
Causes 467
History 468
Examination 469
General Investigations 469
Specific Investigations 470
Toe Lesions 471
Causes 471
History 472
Nails 472
Deformities 473
Ulcers 473
Discoloration 473
Examination 473
Nails 473
Deformities 474
Ulcers 474
Discoloration 474
General Investigations 474
Specific Investigations 474
Tongue Disorders 476
Causes 476
History 477
Furring 477
Colour change 477
Swelling 478
Chronic superficial glossitis 478
Ulceration 478
Wasting 478
Examination 479
Furring 479
Colour change 479
Swelling 479
Chronic superficial glossitis 479
Ulceration 479
Wasting 480
General Investigations 480
Specific Investigations 480
Tremor 481
Causes 481
History 481
Examination 482
Tremor 482
General 482
General Investigations 482
Specific Investigations 483
Urethral Discharge 484
Causes 484
History 484
General 484
Prostatitis 484
Non-gonococcal urethritis 484
Gonorrhoea 485
Other bacterial 485
Reiter’s disease 485
Trauma 485
Chemical 485
Neoplastic 485
Examination 485
Prostatitis 485
Non-gonococcal urethritis 485
Gonorrhoea 486
Other bacterial 486
Reiter’s disease 486
Traumatic 486
Neoplastic 486
General Investigations 486
Specific Investigations 486
Urinary Incontinence 488
Causes 488
History 489
Stress incontinence 489
Urge incontinence 489
Overflow incontinence 489
Neurological 489
Anatomical 490
Other 490
Examination 490
Stress incontinence 490
Urge incontinence 490
Overflow incontinence 490
Neurological 490
Anatomical 490
General Investigations 490
Specific Investigations 491
Urinary Retention 492
Causes 492
History 493
Local 493
General 493
Examination 494
Local 494
General 494
General Investigations 494
Specific Investigations 494
Vaginal Discharge 496
Causes 496
History 497
Examination 497
General Investigations 497
Specific Investigations 497
Visual Problems 499
Causes 499
History 500
Visual disturbances 501
Blurring of vision 501
Loss of vision 501
Examination 502
Fundoscopy 502
General Investigations 502
Specific Investigations 503
Voice Disorders 504
Causes 504
History 505
Onset 505
Precipitating factors 505
Past medical history 505
Associated symptoms 505
Examination 506
General Investigations 506
Specific Investigations 506
Vomiting 507
Causes 507
History 509
General 509
Nature of the vomiting 509
Time of vomit 509
Relief of pain by vomiting 509
Central vomiting 509
Reflex vomiting 509
Gastrointestinal 509
CNS 509
Psychogenic 509
Others 510
Examination 510
Gastrointestinal 510
CNS 510
Psychogenic 510
Others 510
General Investigations 510
Specific Investigations 511
Weight Gain 513
Causes 513
History 514
General 514
Cushing’s syndrome 514
Hypothyroidism 514
Polycystic ovarian syndrome 514
Hypothalamic disease 515
Cardiac failure 515
Renal failure 515
Ascites 515
Examination 515
Inspection 515
Palpation and auscultation 515
General Investigations 516
Specific Investigations 516
Weight Loss 518
Causes 518
History 519
General 519
Cardiorespiratory system 519
Gastrointestinal system 520
Renal system 520
Haematological system 520
Endocrine system 520
Connective tissue diseases 520
Examination 520
Inspection 520
Palpation and auscultation 521
General Investigations 521
Specific Investigations 522
Section B: Biochemical Presentations 524
Hypercalcaemia 526
Causes 526
Symptoms and Signs 526
Investigations 526
Hyperglycaemia 528
Causes 528
Symptoms and Signs 528
Investigations 529
Hyperkalaemia 531
Causes 531
Symptoms and Signs 531
Investigations 531
Hypokalaemia 533
Causes 533
Symptoms and Signs 533
Investigations 533
Hypernatraemia 535
Causes 535
Symptoms and Signs 535
Investigations 536
Hyponatraemia 537
Causes 537
Symptoms and Signs 538
Investigations 538
Hypoglycaemia 539
Causes 539
Symptoms and Signs 539
Investigations 540
Hypocalcaemia 542
Causes 542
Symptoms and Signs 542
Investigations 542
Hypomagnesaemia 544
Causes 544
Symptoms and Signs 544
Investigations 544
Metabolic Acidosis 545
Causes 545
Symptoms and Signs 545
Investigations 545
Increased anion gap 546
Metabolic Alkalosis 547
Causes 547
Symptoms and Signs 547
Investigations 547
Respiratory Acidosis 548
Causes (Any Cause of Hypoventilation) 548
Symptoms and Signs 548
Investigations 549
Respiratory Alkalosis 550
Causes (Any Cause of Hyperventilation) 550
Symptoms and Signs 550
Investigations 551
Urea (Blood) 552
Causes 552
Symptoms and Signs 552
Investigations 553
Section C: Haematological Presentations 554
Anaemia 556
Causes 556
Symptoms and Signs 557
Symptoms of anaemia 557
History of the underlying disorder 557
Dietary history 557
Past medical and drug history 557
Family history 558
Examination 558
Specific Investigations 558
Microcytic anaemia 558
Normocytic anaemia 559
Macrocytic anaemia 559
Clotting Disorders 561
Causes 561
Symptoms and Signs 561
Onset and duration 561
Past medical history 561
Drug history 562
Examination 562
General Investigations 562
Specific Investigations 563
Leucocytosis 564
Causes 564
Symptoms and Signs 566
Investigations 566
Leucopenia 568
Causes 568
Symptoms and Signs 569
Investigations 569
Polycythaemia 570
Causes 570
Symptoms and Signs 571
Investigations 571
Thrombocytopenia 573
Causes 573
Symptoms and Signs 573
Investigations 574
Thrombocytosis 575
Causes 575
Symptoms and Signs 575
Investigations 575
Index 578
Abbreviations
ABC airway, breathing and circulation
ABGs arterial blood gases
AC air conduction
ACE angiotensin-converting enzyme
ACTH adrenocorticotrophic hormone
ADH antidiuretic hormone
AF atrial fibrillation
AFP alpha fetoprotein
AIDS acquired immunodeficiency syndrome
ANA antinuclear antibody
ANCA antineutrophil cytoplasmic antibody
ANF antinuclear factor
anti-CCP anti-cyclic citrullinated peptide
AP anteroposterior
APTT activated partial thromboplastin time
ARDS acute respiratory distress syndrome
ARF acute renal failure
AXR abdominal X-ray
BC bone conduction
BCG bacille Calmette–Guérin
BPPV benign paroxysmal positional vertigo
c-ANCA cytoplasmic-staining antineutrophil cytoplasmic antibody
CAPD continuous ambulatory peritoneal dialysis
CCF congestive cardiac failure
CK-MB creatine kinase–myocardial type
CMV cytomegalovirus
CNS central nervous system
COPD chronic obstructive pulmonary disease
CRF chronic renal failure
CREST calcinosis cutis–Raynaud’s phenomenon–esophageal hypomobility–sclerodactyly–telangiectasia
CRP C-reactive protein
C&S culture and sensitivity
CSF cerebrospinal fluid
CT computerised tomography
CVA cerebrovascular accident
CVP central venous pressure
CXR chest X-ray
DDAVP 1-deamino-8-D-arginine vasopressin
DDH developmental dysplasia of the hip
DHEA dehydroepiandrosterone
DIC disseminated intravascular coagulation
DIP distal interphalangeal
DMSA dimercaptosuccinic acid
DVT deep venous thrombosis
EBV Epstein–Barr virus
ECG electrocardiogram
EEG electroencephalogram
ELISA enzyme-linked immunosorbent assay
EM electron microscope
EMG electromyography
EMSU early morning specimen of urine
ENT ear nose throat
ERCP endoscopic retrograde cholangiopancreatography
ESR erythrocyte sedimentation rate
FBC full blood count
FEV1 forced expiratory volume (1 second)
FNAC fine-needle aspiration cytology
FSH follicle-stimulating hormone
FVC forced vital capacity
GBM glomerular basement membrane
GCS Glasgow Coma Scale
GH growth hormone
GI gastrointestinal
GORD gastro-oesophageal reflux disease
G6PD glucose-6-phosphate dehydrogenase
GTN glyceryl trinitrate
GUM genito-urinary medicine
Hb haemoglobin
βHCG β-human chorionic gonadotrophin
5HIAA 5-hydroxyindoleacetic acid
HIV human immunodeficiency virus
IGF-1 insulin growth factor-1
Ig immunoglobulin
IP interphalangeal
ITP idiopathic thrombocytopenic purpura
IVC inferior vena cava
IVU intravenous urography
JVP jugular venous pressure
KUB kidney ureter bladder (plain X-ray)
LDH lactate dehydrogenase
LFTs liver function tests
LH luteinising hormone
LIF left iliac fossa
LVF left ventricular failure
MAG3 mercapto acetyl triglycine
MCH mean corpuscular haemoglobin
MCHC mean corpuscular haemoglobin concentration
MCP metacarpophalangeal
MCV mean corpuscular volume
ME myalgic encephalomyelitis
MEN multiple endocrine neoplasia
MRA magnetic resonance angiography
MRCP magnetic resonance cholangiopancreatography
MRI magnetic resonance imaging
MSU midstream specimen of urine
MTP metatarsophalangeal
NSAID non-steroidal anti-inflammatory drug
NSTEMI non-ST elevation myocardial infarction
OGD oesophagogastroduodenoscopy
PAS periodic acid–Schiff
PCR polymerase chain reaction
PCV packed cell volume
PIP proximal interphalangeal
PR per rectum
PSA prostate specific antigen
PT prothrombin time
PTC percutaneous transhepatic cholangiography
PTH parathyroid hormone
PV per vaginam
RAST radio allergen sorbent test
RBC red blood cell
RDW red cell distribution...
| Erscheint lt. Verlag | 15.5.2014 |
|---|---|
| Sprache | englisch |
| Themenwelt | Medizin / Pharmazie ► Medizinische Fachgebiete ► Chirurgie |
| Medizin / Pharmazie ► Medizinische Fachgebiete ► Innere Medizin | |
| Studium ► 2. Studienabschnitt (Klinik) ► Anamnese / Körperliche Untersuchung | |
| ISBN-10 | 0-7020-5404-6 / 0702054046 |
| ISBN-13 | 978-0-7020-5404-4 / 9780702054044 |
| Informationen gemäß Produktsicherheitsverordnung (GPSR) | |
| Haben Sie eine Frage zum Produkt? |
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