The 10–Minute Clinical Assessment

Clinical assessment is at the heart of medicine. Health professionals working in busy clinical settings, such as general practitioners, emergency physicians, nurse practitioners and hospital doctors on–call, often have to quickly, accurately and safely clinically assess patients under time constraints. This book teaches the reader how to gather clinical information effectively, accurately and safely. Using a focused, evidence–based approach, it provides step–by–step assessment strategies for common and important clinical scenarios particularly those that require lateral and holistic thinking such as falls in the elderly, weight loss, tired all the time , or assessment of diabetic or homeless people. 

This second edition of The 10–Minute Clinical Assessment is fully updated and covers a wide range of common topics, including cardiovascular, respiratory, haematology, musculoskeletal, neurology, mental health, gynaecology, obstetrics, urology, ophthalmology and ear, nose and throat. It also includes sections on undifferentiated and miscellaneous presentations, and on paediatrics and adolescent health, and problems in older people. Each of the individual disease sections are uniformly structured to provide rapid reference, including: 

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 

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, this title specifically covers the clinical skills assessment (CSA) part of the Membership of the Royal College of General Practitioners (RCGP) examination.

New to this edition is a refreshed approach to the methodology employed in clinical assessment to reflect recent trends in the teaching of clinical assessment. This edition also includes the latest evidence based recommendations and recent developments to provide the reader with a concise yet comprehensive resource for clinical reference.

Foreword

Preface

About the author

Acknowledgements

Selected useful resources

The focused consultation

Focused clinical assessment

Useful consultation tools

Red flags in general practice

Undifferentiated and miscellaneous presentations

Suspected cancer

Weight loss

Tiredness

Dizziness

Chronic pain

Sudden collapse

Frequent attenders

Medication review and polypharmacy

Medically unexplained symptoms

InsomniaIrritability 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