The Fourth Edition of this textbook teaches the artful science of the patient interview and the physical examination. Chapters are filled with clinical pearls, vignettes, step-by-step methods, and explanations of the physiologic significance of findings. New features include "Points to Remember", over 300 questions with answers and discussion, over 120 additional references, and expanded discussions of the usage and pitfalls of evidence-based medicine. Other highlights include expanded and updated discussions of sleep apnea, "minor" head trauma, cervical spine involvement in rheumatoid arthritis, transplantation-related problems, adverse effects of AIDS therapy, and more. A companion Website includes fully searchable text and a 300-question test bank.
Essential reading for beginning and experienced clinicians alike, Sapira's Art & Science of Bedside Diagnosis, Fifth Edition, discusses the patient interview and the physical examination in an engaging, storytelling style. Tried and true methods are described in step-by-step detail, and include clinical pearls, vignettes, practical clinical experiences, personal history, explanations of the physiologic significance of findings, and extensive discussions of evidence-based medicine. It’s a useful guide for learning and reinforcing effective bedside diagnosis techniques at all levels and stages of clinical practice.
A riveting exploration of the most difficult and important part of what doctors do, by Yale School of Medicine physician Dr. Lisa Sanders, author of the monthly New York Times Magazine column "Diagnosis," the inspiration for the hit Fox TV series House, M.D. "The experience of being ill can be like waking up in a foreign country. Life, as you formerly knew it, is on hold while you travel through this other world as unknown as it is unexpected. When I see patients in the hospital or in my office who are suddenly, surprisingly ill, what they really want to know is, ‘What is wrong with me?’ They want a road map that will help them manage their new surroundings. The ability to give this unnerving and unfamiliar place a name, to know it—on some level—restores a measure of control, independent of whether or not that diagnosis comes attached to a cure. Because, even today, a diagnosis is frequently all a good doctor has to offer." A healthy young man suddenly loses his memory—making him unable to remember the events of each passing hour. Two patients diagnosed with Lyme disease improve after antibiotic treatment—only to have their symptoms mysteriously return. A young woman lies dying in the ICU—bleeding, jaundiced, incoherent—and none of her doctors know what is killing her. In Every Patient Tells a Story, Dr. Lisa Sanders takes us bedside to witness the process of solving these and other diagnostic dilemmas, providing a firsthand account of the expertise and intuition that lead a doctor to make the right diagnosis. Never in human history have doctors had the knowledge, the tools, and the skills that they have today to diagnose illness and disease. And yet mistakes are made, diagnoses missed, symptoms or tests misunderstood. In this high-tech world of modern medicine, Sanders shows us that knowledge, while essential, is not sufficient to unravel the complexities of illness. She presents an unflinching look inside the detective story that marks nearly every illness—the diagnosis—revealing the combination of uncertainty and intrigue that doctors face when confronting patients who are sick or dying. Through dramatic stories of patients with baffling symptoms, Sanders portrays the absolute necessity and surprising difficulties of getting the patient’s story, the challenges of the physical exam, the pitfalls of doctor-to-doctor communication, the vagaries of tests, and the near calamity of diagnostic errors. In Every Patient Tells a Story, Dr. Sanders chronicles the real-life drama of doctors solving these difficult medical mysteries that not only illustrate the art and science of diagnosis, but often save the patients’ lives.
This book teaches readers the clinical skills residents in neurology have to acquire in the course of their training, and approaches neurology like a doctor approaches a patient: first there is a chapter on how to perform an efficient neurological history according to neuroanatomical key features, then a chapter on the bedside examination, followed by chapters on differential diagnosis, diagnostic procedures and lastly, the treatment. Neurology at the Bedside aims to provide readers with a personal clinical mentor. It takes them by the hand and guides them through the whole patient encounter from the history to the treatment, at each step pointing out what is essential and what is not. Extensive differential diagnostic flow charts and detailed treatment suggestions make it a perfect coat pocket reference for the wards. In addition, more than 50 unique case histories cover the entire spectrum of the field. Neurology at the Bedside is written for neurologists in training: residents as well as senior house officers. Also medical students, general practitioners and others with an interest in neurology will find invaluable information here that is difficult to look up in traditional textbooks or online references.
The perfect “bridge” book between physical exam textbooks and clinical reference books Covers the essentials of the diagnostic exam procedure and the preparation of the patient record Includes overviews of each organ/region/system, followed by the definition of key presenting signs and their possible causes Unrivaled in its comprehensive coverage of differential diagnosis, organized by systems, signs, and syndromes
Presents a sign-orientated approach to the diagnosis of both common and rare medical disorders that physicians may encounter in hospital or in the community. The comprehensive collection of clinical pictures, organised by anatomical region from scalp to sole, reflects actual clinical practice where a diagnosis has to be constructed from a single sign or a collection of signs. Fundamental, pathognomonic, and commonly seen non-specific clinical signs are presented with clinical features highlighted for rapid recognition and interpretation. In addition, the book provides guidance on appropriate bedside clinical tests for establishing diagnoses.
“Life is short, and the Art so long; the occasion fleeting; experience fallacious; and judgment difficult. The physician must not only be prepared to do what is right himself, but also to make the patient, the attendants, and the externals, cooperate.” –attributed to Hippocrates, c. 400 B.C.E. The award-winning author of How We Die and The Art of Aging, venerated physician Sherwin B. Nuland has now written his most thoughtful and engaging book. The Uncertain Art is a superb collection of essays about the vital mix of expertise, intuition, sound judgment, and pure chance that plays a part in a doctor’s practice and life. Drawing from history, the recent past, and his own life, Nuland weaves a tapestry of compelling stories in which doctors have had to make decisions in the face of uncertainty. Topics include the primitive (and sometimes illegal) procedures doctors once practiced with good intentions, such as grave robbing and prescribing cocaine as an anesthetic (which resulted in a physician becoming America’s first cocaine addict); the curious “cures” for irregularity touted by people from the ancient Egyptians to the cereal titan John Harvey Kellogg and bodybuilder Charles Atlas; and healers grappling with today’s complex moral and ethical quandaries, from cloning to gene therapy to the adoption of Eastern practices like acupuncture. Nuland also recounts his most dramatic experiences in a forty-year medical career: the time he was called out of the audience of a Broadway play to help a man having a heart attack (when no other doctor there would respond), and how he formed a profound friendship with an unforgettable–and doomed–heart patient. Behind these inspiring accounts always lie the mysteries of the human body and human nature, the manner in which the ill can will themselves back to health and the odd and essential interactions between a body’s own healing mechanisms and a doctor’s prescriptions. Riveting and wise, amusing and heartrending, The Uncertain Art is Sherwin Nuland’s best work, gems from a man who has spent his professional life acting in the face of ambiguity and sharing what he has learned.
Clinical reference that takes an evidence-based approach to the physical examination. Updated to reflect the latest advances in the science of physical examination, and expanded to include many new topics.
The real crisis in medicine today is not about economics, insurance, or managed care--it's about the loss of the fundamental human relationship between doctor and patient. In this wise and passionate book, one of our most eminent physicians reacquaints us with a classic notion often overlooked in modern medicine: health care with a human face, in which the time-honored art of healing guides doctors in their approach to patient care and their use of medical technology. Drawing on four decades of practice as a cardiologist and a vast knowledge of literature and medical history, Dr. Lown probes the heart and soul of the doctor-patient relationship. Insightful and accessible to all, The Lost Art of Healing describes how true healers use sympathetic listening and touch to hone their diagnostic skills, how language affects the perception of illness, how doctors and patients can cultivate a relationship of trust, and how patients can obtain the most complete and beneficial care through a combination of healing techniques and conventional practices. As Dr. Lown explains, the art of healing does not mean abandoning the spectacular advances of modern science, but rather incorporating them into a sensitive, humane, enlightened approach to medical care. With its urgent message and poignant, fascinating vignettes, The Lost Art of Healing is a book of vital, universal importance.
