Oxford Handbook of Clinical Examination and Practical Skills (2025)

Oxford Handbook of Clinical Specialties

Annals of Internal Medicine, 1992

Oxford Handbook of Clinical and Laboratory Investigation

2010

This book fills an obvious gap in the Handbook series and indeed a major lacuna in the medical literature. Too often investigations of a particular condition are lost in the welter of other text. Alternatively, they appear as specialist books in pathology and radiology. One unique feature of this book is the inclusion of all clinical investigative techniques, i.e. both truly clinical tests in the shape of symptoms and signs and then laboratorybased investigations. This stops what is often an artificial separation. Each section is clearly put together with the intent of easing rapid reference. This is essential if the book is to have (and I believe it does have) real usefulness for bedside medicine. There are many other useful aspects of the text. These include a comprehensive list of abbreviations-the bugbear of medicine, as well as reference ranges which some laboratories still do not append to results. Overall, the Handbook should be of benefit to not just clinical students and junior doctors in training, but all who have patient contact. With this in one pocket, and Longmore in the other, there should be little excuse for errors in diagnosis and investigation, with the added benefit that the balance between the two will allow the upright posture to be maintained.

An Overview of Physical Examination and History Taking An Overview of Physical Examination and History Taking

1 The techniques of physical examination and history taking that you are about to learn embody time-honored skills of healing and patient care. Your ability to gather a sensitive and nuanced history and to perform a thorough and accurate examination deepens your patient relationships, focuses your patient assessment, and sets the direction of your clinical thinking. The quality of your history and physical examination governs your next steps with the patient and guides your choices from the initially bewildering array of secondary testing and technology. Over the course of becoming an accomplished clinician, you will polish these important relational and clinical skills for a lifetime. As you enter the realm of patient assessment, you begin integrating the essential elements of clinical care: empathic listening; the ability to interview patients of all ages, moods, and backgrounds; the techniques for examining the different body systems; and, finally, the process of clinical reasoning. Your experience with history taking and physical examination will grow and expand, and the steps of clinical reasoning will soon begin with the first moments of the patient encounter: identifying problem symptoms and abnormal findings ; linking findings to an underlying process of pathophysiology or psycho-pathology; and establishing and testing a set of explanatory hypotheses. Working through these steps will reveal the multifaceted profile of the patient before you. Paradoxically, the very skills that allow you to assess all patients also shape the image of the unique human being entrusted to your care. Clinical Assessment: The Road Ahead This chapter provides a road map to clinical proficiency in three critical areas: the health history, the physical examination, and the written record, or " write-up. " It describes the components of the health history and how to organize the patient's story; it gives an approach and overview to the physical examination and suggests a sequence for ensuring patient comfort; and, finally, it provides an example of the written record, showing documentation of findings from a sample patient history and physical examination. By studying the subsequent chapters of the book and perfecting the skills of examination and history taking described, you will cross into the world of patient assessment— gradually at first, but then with growing satisfaction and expertise.

For personal use only. Reproduce with permission from The Lancet Publishing Group

CLINICAL METHODS

Clinical Research_Vol 5_Issue 1_Article_6.docx

Introduction: Globally every day, about 830 women die due to complications of pregnancy and child birth. Of these deaths, 99% occur in low-resource settings, and most could be prevented. Use of Modified Early Obstetric Warning System (MEOWS) would be appropriate. MEOWS is a monitoring chart intended to identify mothers at risk and initiate the right action, at right time by the appropriately skilled clinicians, at a time when treatment might make a difference to reduce maternal mortality and morbidity. Objectives: To determine the sensitivity, specificity and predictive values of Modified Early Obstetric Warning System (MEOWS) in correctly identifying women at risk of developing obstetric morbidity in St. Francis Hospital_Nsambya between January and February, 2016 Methods: The study was a prospective cohort study conducted at St. Francis Hospital Nsambya, maternity ward, from January to February 2016. MEOWS monitoring tool was used alongside with questionnaires. Result: 502 respondent mothers were enrolled in the study. 160patients (31.9%) triggered and of which: 11.5% of them had obstetric morbidity which included postpartum haemorrhage-35.5%, preeclampsia-26.3%, suspected infection-22.4%, third degree perineum tear-5.3%, anaesthetic complications-4% and prolong hospital stay-7%. MEOWS was 81.7% sensitive (95% CI 80-94%), 76.3% specific (95% CI 74-81%), with a positive predictive value 36.3% (95% CI 31-44%) and negative predictive value of 96.2% (95% CI 94-99%). Conclusion: MEOWS chart is even effective for use in low resource setting, like Uganda.

Journal of Health Science 2014.11

September 2011 / Volume 21 / Issue 9 / ISSN 1467-1026 309 CLINICAL FEATURE

Examination Questions and Answers in Basic Anatomy and Physiology

2016

the material is concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.

An Evidence-Based Approach to the Clinical Examination

Journal of General Internal Medicine, 1997

he history and physical examination of a patient remain the cornerstones of clinical medicine. Without an adequate history and physical examination to suggest possible differential diagnoses, the subsequent investigations of the patient may be endless (and fruitless). Although we rely heavily on the clinical examination, until recently there has been little formal evaluation of the information gained from these clinical encounters. A series entitled "The Rational Clinical Exam" in the Journal of the American Medical Association is now making a key contribution to our understanding by critiquing and summarizing the value of the evidence obtained during the initial patient-clinician encounter. 1 In each encounter, we gather information that aids us in establishing a relationship with our patients, generating diagnoses, estimating prognoses, and initiating and monitoring our patients' response to therapy.