EBOOKS Clinical Examination and Applied H A FOR THE R Medicine O HEALTH EDUCATION COLLECTION HEALTH O N LIBRARY Gastroenterology Series, Volume I Create your own Mushtaq Haroon Customized Content Bundle — the more This is the first in a series of books dealing simultaneously with e xamination Clinical Examination books you buy, technique with detail pathophysiological principles, differential diagnosis the higher your and clinical interpretation, along with applied medicine about the c ommon C discount! gastrointestinal diseases. Medical students or postgraduates will learn history lin and Applied Medicine taking, clinical examination and find relevant applied medical knowledge ic a needed for bedside assessment of the patient. l THE CONTENT The hope is that the book will guide towards a correct diagnosis by Ex Gastroenterology Series a • Nutrition and history and examination, but also provide relevant differential diagnosis, m Dietetics Practice localize the disease and identify the cause. This book intends to fill this gap in • Psychology and inspire the reader to gain confidence not only in the performance of at Volume I i • Health, Wellness, the examination but also to answer most bedside queries and problems. o n and Exercise It will serve as an indispensable resource for preparation of undergraduate a n Science and postgraduate viva and short and long case examination. This text is d • Health Education not a replacement for standard textbooks on the subject, but should serve A as collection of facts and relevant details in the clinical assessment of the p p patient. This book is complemented by a second volume, in which numerous li THE TERMS e diagrams and figures have been included to stimulate understanding and d • Perpetual access for learning along with a picture test and MCQ. M a one time fee e d • No subscriptions or i Dr Mushtaq Haroon, born in Pakistan, is an academician, educationist, and c access fees in consultant in medicine for over 25 years with over 10 years experience as e • Unlimited , professor of medicine at various medical colleges in Pakistan. To his credit, V concurrent usage he has 25 publications in peer-reviewed medical journals and published five o • Downloadable PDFs lu medical books as first author. He completed his early training in m edical m • Free MARC records unit 1 of Services Hospital attached to Allama Iqbal Medical College, e I Lahore and went to UK for higher training. He passed MRCP in 1988 and was awarded FRCP from London in 2000. Dr Haroon has been a pioneer in For further information, a free trial, or to order, computer-based medical education, having developed a vast collection of contact: software for teaching. He was awarded the Life Time Achievement Award [email protected] for the most distinguished Iqbalian for professional excellence by the Chief Mushtaq Haroon Minister of Punjab in Dec 2008. He is presently consultant in Pakistan Kidney and Liver Institute and Research Centre, Lahore Pakistan. ISBN: 978-1-94664-693-4 Clinical Examination and Applied Medicine Clinical Examination and Applied Medicine Gastroenterology Series Volume I Mushtaq Haroon MOMENTUM PRESS, LLC, NEW YORK Clinical Examination and Applied Medicine: Gastroenterology Series, Volume I Copyright © Momentum Press, LLC, 2018. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted in any form or by any means—electronic, mechanical, photocopy, recording, or any other except for brief quotations, not to exceed 400 words, without the prior permission of the publisher. First published in 2018 by Momentum Press, LLC 222 East 46th Street, New York, NY 10017 www.momentumpress.net ISBN-13: 978-1-94664-693-4 (paperback) ISBN-13: 978-1-94664-694-1 (e-book) Momentum Press Health Education C ollection Cover and interior design by Exeter Premedia Services Private Ltd., Chennai, India First edition: 2018 10 9 8 7 6 5 4 3 2 1 Printed in the United States of America. This book is dedicated to my loving wife, Romana. My mother Asafa Ashfaq and father Engr. Ashfaq Hasan. Abstract This is the first in the series of books dealing simultaneously with exam- ination technique with detail pathophysiological principles, differential diagnosis and clinical interpretation, along with correlated and applied medicine about the common diseases. A medical student or a postgraduate doctor studying for higher exam will learn to take a good history, examine the patient, and find relevant applied medical knowledge, which is needed for assessment of the patient. It should also serve as an invaluable collec- tion of facts to get through undergraduate or postgraduate examination. This book attempts to answer pertinent questions such as how? and why? about clinical examination while providing relevant information needed for a thorough bedside assessment. It is hoped that the book will not only serve to make a correct diagnosis by examination, but also give relevant differential diagnosis, and localize the disease and determine its cause. The book intends to fill this gap and inspire the reader to gain confidence not only in the performance of the examination but also to answer most bedside queries and problems. It will hopefully serve as an indispensable resource for preparation of undergraduate and postgradu- ate viva and bedside short and long case examination. The Volume II of this book includes a section on radiology and endos- copy. A wealth of diagrams and figures along with brief clinical note has been included to stimulate understanding and learning. As a stimulus for learning, picture test with MCQ and a short applied medical note has been added. The book is not a replacement for standard textbook on the subject, but it is hoped that it would be mastering relevant knowledge and clinical skills to diagnose and assess the patient’s problem at the bedside and also prepare for undergraduate and postgraduate examination. Keywords bedside assessment, esophageal diseases, gall bladder diseases, gastroenter- ology images, GI clinical examination, GI diseases, GI examination skills, GI investigations, history taking, intestinal diseases, intestinal pathology, kidney diseases, liver diseases, pancreatic diseases, physical examination, radiology, signs and symptoms, stomach diseases Contents Part I Introduction and History Taking Introduction 1 History taking 1 Physical findings 2 Diagnosis 2 Objective of history taking 2 Introductory remarks 2 History taking 3 Presenting complaints 3 History of presenting illness 3 Epigastric pain 4 Direct questions 5 Past history 5 Family history 6 Personal history 7 Socioeconomic status 8 Occupational history 8 History of Allergy and immunization 8 Travel history 8 Treatment history 9 Concluding remarks 9 Objective of examination 10 Common GI symptoms 10 Abdominal pain 11 Nausea and vomiting 14 Hematemesis 15 Hematochezia 15 Occult blood loss 16 Anorexia 16 Heartburn 16
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