10-Minute Clinical Assessment

Knut Schroeder MD, MSc, DRCOG, DCH, MRCGP, MRCP, PhDGeneral Practitioner, Bristol, UK; and Honorary Senior Clinical Lecturer in General Practice, Centre for Academic Primary Care, University of Bristol, Bristol, UKKnut Schroeder holds a Certificate in Medical Education and developed undergraduate and postgraduate courses on clinical diagnosis and evidence based medicine. While a full-time Consultant Senior Lecturer, he was responsible for developing and running the general practice part of the final examination for medical students at the University of Bristol.In addition to the first edition of The 10-Minute Clinical Assessment, Dr Schroeder has previously written for GP registrars (Top Tips for GPs, Radcliffe Medical Press, 2000) and co-written numerous book chapters, including two chapters for the Oxford Textbook of Primary Medical Care and a chapter on symptoms and signs for the Oxford Handbook of General Practice (3rd ed). He has had papers published in international peer-reviewed journals including the BMJ, Family Practice, and Archives of Internal Medicine, as well as articles in the GP press. His main clinical and teaching interest is clinical assessment and diagnosis.

• Foreword xiPreface to 1st Edition xiiPreface to 2nd edition xivAbout the author xvAcknowledgements xviSelected useful resources xviiThe focused consultation 1Focused clinical assessment 3Useful consultation tools 8Red flags in general practice 12Undifferentiated and miscellaneous presentations 15Suspected cancer 17Weight loss 24Tiredness 29Dizziness 35Chronic pain 41Sudden collapse and syncope 45Frequent attenders 50Medication review and polypharmacy 54Medically unexplained symptoms 58Insomnia 63Irritability and ‘stress’ 67Domestic violence 71Homelessness 75Paediatrics and adolescent health 81The sick and/or feverish child 83Suspected meningococcal meningitis and septicaemia 90Neonatal jaundice 95Faltering growth 99Headache and migraine in children 104Head injury in children 108Suspected cancer in children and adolescents 113Abdominal pain in children 118Hearing loss in children 124Childhood cough 128Childhood wheeze 133Constipation in children 138Childhood obesity 142Suspected child abuse and neglect 148Nocturnal enuresis 153Knee problems in children 158Hip problems in children 163Adolescent health problems 167Self-harm in teenagers 171Eating disorders 175Autism-spectrum disorder 180Cardiovascular 183Chest pain 185Palpitations 191Cardiovascular risk assessment 195Hypertension 200Atrial fibrillation 205Heart failure 209Peripheral vascular disease 215Respiratory 221Shortness of breath 223Haemoptysis 228Suspected lung cancer 233Asthma 237Chronic obstructive pulmonary disease 242Suspected pneumonia 248Pleural effusion 252Pulmonary embolism 256Endocrine and metabolic 261Diabetes review 263Obesity 268Hirsutism in women 273Hypothyroidism 277Hyperthyroidism 281Hyponatraemia 285Hypernatraemia 289Hypokalaemia 292Hyperkalaemia 296Hypocalcaemia 299Hypercalcaemia 302Gastrointestinal 307Nausea and vomiting 309Dysphagia 313Dyspepsia and reflux 317Upper gastrointestinal bleeding and melaena 321Abdominal pain 326Constipation 332Diarrhoea 336Rectal bleeding and suspected bowel cancer 341Abnormal liver function tests 346Irritable bowel syndrome 351Inflammatory bowel disease 356Coeliac disease 361Infectious diseases 365Fever of unknown origin 367Fever and illness in the returning traveller 372HIV infection and AIDS 377Tuberculosis 383Rheumatic fever 388Haematology 393Iron-deficiency anaemia 395Macrocytic anaemia (B12 and folate deficiency) 400Bleeding disorders 405Myeloma 409Musculoskeletal 413Soft-tissue injury 415Acute hot and swollen joint 420Chronic musculoskeletal pain 424Polyarthralgia 429Neck pain 435Back pain 440Shoulder and arm problems 446Elbow problems 452Hand problems 456Hip pain 461Groin problems 466Leg pain and/or swelling 470Knee pain 476Foot and ankle problems 483Gout 489Osteoporosis 493Neurology 499Headache 501Transient ischaemic attack and stroke 508Head injury in adults 514Suspected or confirmed brain tumour 519Tremor 524Motor neurone disease 528Peripheral neuropathy 533Multiple sclerosis 538Gynaecology 543Combined oral contraception 545Menorrhagia 549Amenorrhoea 553Breast lumps 557Loss of libido 561Polycystic ovary syndrome 565Suspected ovarian cancer 570Obstetrics 575Routine antenatal care 577Bleeding in early pregnancy 582Abdominal pain in pregnancy 586Pre-eclampsia 591Urology and renal medicine 595Suspected urinary tract infection in women 597Lower urinary tract symptoms in men 601Urinary incontinence 606Urethral discharge in men 612Scrotal and testicular problems 616Erectile dysfunction 621Renal or ureteric colic (kidney stones) 626Haematuria 631Chronic kidney disease 635Mental health 641Depression 643Self-harm and harm to others 648Anxiety phobias and panic disorder 653Alcohol screening 657Alcohol dependence 662Illicit drug misuse 667Obsessive–compulsive disorder 672Mania 675Schizophrenia 679Skin 685Moles and malignant melanoma 687Pressure ulcers 690Ophthalmology 695Eye injuries 697The acute red eye 701Gradual painless visual disturbance 706Sudden painless visual disturbance 710Eye problems in older people 715Ear nose and throat 719Neck swelling 721Sore throat 725Ear pain 730Hearing loss in adults 734Tinnitus 738Sinusitis and facial pain 742Problems in older people 747General health assessment in older people 749Cognitive problems and dementia 755Falls in older people 760Delirium and acute confusional state 766Depression in older people 772Palliative and end-of-life care 777Parkinson’s disease 781Index 785

"This book does cover all the basics one must keep in mind when diagnosing and treating patients in the outpatient office...While the focus is on younger clinicians, this book clearly has great insights for primary care clinicians at every level of experience...5 Stars!" (Doody Enterprises 24/03/2017)"Although the clinical content is great, this book was a real winner for me in terms of the practical points and guidance provided at the start of each section...I can certainly see myself using this book as a quick reference tool during consultations and have already found a special spot for it on my desk."(British Journal of General Practice 28/04/2017)