By Lynn S. Bickley MD FACP
This concise pocket-sized advisor provides the vintage Bates method of actual exam and background taking in a quick-reference define structure. The publication incorporates a appealing full-color artwork application and an easy-to-follow two-column structure with step by step exam concepts at the left and abnormalities with differential diagnoses at the correct. This edition's well-being merchandising sections were broadly up-to-date and elevated in all chapters. special info on discomfort overview is now incorporated within the normal survey, very important indicators, and ache bankruptcy. a brand new bankruptcy provides evaluate of psychological well-being prestige and behaviour to surround the psychosocial dimensions of care.
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Extra info for Bates' Pocket Guide to Physical Examination and History Taking
See Plan. qxd 26 9/3/08 2:29 PM Page 26 Clinical Reasoning, Assessment, and Recording Your Findings A SSESSMENT AND P LAN 1. Migraine headaches. A 54-year-old woman with migraine headaches since childhood, with a throbbing vascular pattern and frequent nausea and vomiting. Headaches are associated with stress and relieved by sleep and cold compresses. There is no papilledema, and there are no motor or sensory deficits on the neurologic examination. The differential diagnosis includes tension headache, also associated with stress, but there is no relief with massage, and the pain is more throbbing than aching.
Breath sounds vesicular with no added sounds. Diaphragms descend 4 cm bilaterally. Cardiovascular. Jugular venous pressure 1 cm above the sternal angle, with head of examining table raised to 30°. Carotid upstrokes brisk, without bruits. Apical impulse discrete and tapping, barely palpable in the 5th left interspace, 8 cm lateral to the midsternal line. Good S1, S2; no S3 or S4. A II/VI medium-pitched midsystolic murmur at the 2nd right interspace; does not radiate to the neck. No diastolic murmurs.
Rectovaginal wall intact. qxd 9/3/08 2:29 PM Page 25 Clinical Reasoning, Assessment, and Recording Your Findings 25 Rectal. Rectal vault without masses. Stool brown, negative for occult blood. Extremities. nontender. Warm and without edema. Calves supple, Peripheral Vascular. Trace edema at both ankles. Moderate varicosities of saphenous veins in both lower extremities. No stasis pigmentation or ulcers. Pulses (2 + = brisk, or normal): RT LT Radial Femoral Popliteal Dorsalis Pedis Posterior Tibial 2+ 2+ 2+ 2+ 2+ 2+ 2+ Absent 2+ 2+ Musculoskeletal.