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Record Nr. |
UNINA9910857799403321 |
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Autore |
McGee Steven |
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Titolo |
Evidence-Based Physical Diagnosis |
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Pubbl/distr/stampa |
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Saintt Louis : , : Elsevier, , 2017 |
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©2018 |
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ISBN |
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Edizione |
[4th ed.] |
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Descrizione fisica |
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1 online resource : illustrations (chiefly color) |
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Disciplina |
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Soggetti |
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Physical diagnosis |
Medicina basada en evidencia |
Physical Examination - methods |
Evidence-Based Medicine |x methods. |0 (DNLM)D019317Q000379 |
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Lingua di pubblicazione |
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Formato |
Materiale a stampa |
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Livello bibliografico |
Monografia |
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Nota di bibliografia |
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Includes bibliographical references. |
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Nota di contenuto |
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Front Cover -- IFC -- Evidence-Based Physical Diagnosis -- Evidence-Based Physical Diagnosis -- Copyright -- Dedication -- Preface to the Fourth Edition -- Introduction to the First Edition -- Contents -- 1 - INTRODUCTION -- 1 - What Is Evidence-Based Physical Diagnosis? -- 2 - UNDERSTANDINGTHE EVIDENCE -- 2 - Diagnostic Accuracy of Physical Findings -- I. INTRODUCTION -- II. PRE-TEST PROBABILITY -- III. SENSITIVITY AND SPECIFICITY -- A. DEFINITIONS -- B. USING SENSITIVITY AND SPECIFICITY TO DETERMINE PROBABILITY OF DISEASE -- IV. LIKELIHOOD RATIOS -- A. DEFINITION -- B. USING LIKELIHOOD RATIOS TO DETERMINE PROBABILITY -- 1. USING GRAPHS -- A. PARTS OF THE GRAPH -- B. USING THE GRAPH TO DETERMINE PROBABILITY -- 2. APPROXIMATING PROBABILITY -- 3. CALCULATING PROBABILITY -- C. ADVANTAGES OF LIKELIHOOD RATIOS -- 1. SIMPLICITY -- 2. ACCURACY -- 3. LEVELS OF FINDINGS -- 4. COMBINING FINDINGS -- A. INDEPENDENCE OF FINDINGS -- B. HOW TO COMBINE FINDINGS -- REFERENCES -- 3 - Using the Tables in This Book -- I. INTRODUCTION -- II. FREQUENCY OF FINDINGS TABLES -- A. DEFINITION -- B. PARTS OF THE TABLE -- 1. FINDING -- 2. FREQUENCY -- 3. FOOTNOTES -- C. INTERPRETATION -- III. DIAGNOSTIC ACCURACY TABLES (EBM BOXES) -- A. DEFINITION -- B. PARTS OF THE EBM BOX -- 1. FINDING -- 2. |
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SENSITIVITY AND SPECIFICITY -- 3. LIKELIHOOD RATIOS -- 4. FOOTNOTE -- C. INTERPRETATION OF EBM BOXES -- IV. CRITERIA FOR SELECTING STUDIES USED IN DIAGNOSTIC ACCURACY TABLES -- A. PATIENTS WERE SYMPTOMATIC -- B. DEFINITION OF PHYSICAL SIGN -- C. INDEPENDENT COMPARISON TO A DIAGNOSTIC STANDARD -- D. 2 × 2 TABLE COULD BE CONSTRUCTED -- V. SUMMARIZING LIKELIHOOD RATIOS -- REFERENCES -- 4 - Using the Evidence-Based Medicine Calculator (Expert Consult) -- I. THE EVIDENCE-BASED MEDICINE CALCULATOR -- II. USING THE CALCULATOR -- A. BLANK CALCULATOR. |
B. CALCULATING PROBABILITY FOR SPECIFIC CONDITIONS -- 5 - Reliability of Physical Findings -- APPENDIX: CALCULATION OF THE Κ-STATISTIC -- REFERENCES -- 3 - GENERAL APPEARANCE OF THE PATIENT -- 6 - Mental Status Examination -- I. INTRODUCTION -- II. CLOCK-DRAWING TEST -- A. TECHNIQUE AND SCORING -- B. CLINICAL SIGNIFICANCE -- III. MINI-COG TEST -- A. TECHNIQUE AND SCORING -- B. CLINICAL SIGNIFICANCE -- IV. MINI-MENTAL STATUS EXAMINATION -- A. INTRODUCTION -- B. CLINICAL SIGNIFICANCE -- V. DIAGNOSIS OF DELIRIUM (CONFUSION ASSESSMENT METHOD) -- A. SCORING -- B. CLINICAL SIGNIFICANCE -- REFERENCES -- 7 - Stance and Gait -- I. INTRODUCTION -- II. ETIOLOGY OF GAIT DISORDERS -- III. TYPES OF GAIT DISORDERS AND THEIR SIGNIFICANCE -- A. PAINFUL GAIT (ANTALGIC GAIT) -- 1. SHORT CONTRALATERAL STEP -- 2. OTHER CHARACTERISTIC FEATURES -- A. FOOT PAIN -- B. KNEE PAIN -- C. HIP PAIN (COXALGIC GAIT) -- B. IMMOBILE JOINTS -- C. WEAKNESS OF SPECIFIC MUSCLES -- 1. TRENDELENBURG GAIT AND SIGN (ABNORMAL GLUTEUS MEDIUS AND MINIMUS GAIT) -- A. DEFINITION OF TRENDELENBURG GAIT (OR TRENDELENBURG'S SYMPTOM -- FRIEDRICH TRENDELENBURG 1844-1924) -- B. ETIOLOGY OF TRENDELENBURG GAIT -- C. TRENDELENBURG SIGN -- D. CLINICAL SIGNIFICANCE -- 2. GLUTEUS MAXIMUS GAIT -- 3. WEAK QUADRICEPS GAIT -- D. SPASTICITY -- 1. HEMIPLEGIC GAIT -- 2. DIPLEGIC GAIT -- E. RIGIDITY -- 1. THE PARKINSONIAN GAIT (FIG. 7.5) -- 2. DIFFERENTIAL DIAGNOSIS -- 3. CLINICAL SIGNIFICANCE -- F. ATAXIA -- 1. SENSORY ATAXIA -- 2. CEREBELLAR ATAXIA -- 3. ROMBERG SIGN -- A. INTRODUCTION -- B. DEFINITION OF A POSITIVE ROMBERG SIGN -- G. FRONTAL GAIT DISORDER -- 1. DEFINITION -- 2. CLINICAL SIGNIFICANCE -- IV. EVALUATION OF GAIT DISORDERS -- A. OBSERVATIONAL GAIT ANALYSIS15,16 -- B. PREDICTING FALLS -- 1. THE FINDINGS -- A. STOPS WALKING WHEN TALKING -- B. TIMED UP-AND-GO TEST3 -- 2. CLINICAL SIGNIFICANCE -- V. CANES. |
A. LENGTH OF CANE -- B. CONTRALATERAL VERSUS IPSILATERAL USE OF CANE -- 8 - Jaundice -- I. INTRODUCTION -- II. THE FINDINGS -- A. JAUNDICE -- B. ASSOCIATED FINDINGS -- 1. HEPATOCELLULAR JAUNDICE -- A. SPIDER TELANGIECTASIA (SPIDER ANGIOMAS) -- B. PALMAR ERYTHEMA -- C. GYNECOMASTIA AND DIMINISHED BODY HAIR -- D. DILATED ABDOMINAL VEINS -- E. PALPABLE SPLEEN -- F. ASTERIXIS -- G. FETOR HEPATICUS -- 2. OBSTRUCTIVE JAUNDICE: PALPABLE GALLBLADDER (COURVOISIER SIGN) -- III. CLINICAL SIGNIFICANCE -- A. DETECTION OF JAUNDICE -- B. HEPATOCELLULAR VERSUS OBSTRUCTIVE JAUNDICE -- C. DIAGNOSIS OF CIRRHOSIS -- D. DETECTING LARGE GASTROESOPHAGEAL VARICES IN PATIENTS WITH CIRRHOSIS -- E. DETECTING HEPATOPULMONARY SYNDROME -- F. DETECTING PORTOPULMONARY HYPERTENSION -- 9 - Cyanosis -- I. DEFINITIONS -- II. PATHOGENESIS -- A. THE BLUE COLOR -- B. PERIPHERAL CYANOSIS -- III. THE FINDING -- A. CENTRAL CYANOSIS -- B. PERIPHERAL CYANOSIS -- C. PSEUDOCYANOSIS -- D. CYANOSIS AND OXIMETRY -- IV. CLINICAL SIGNIFICANCE -- A. CENTRAL CYANOSIS -- |
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B. PERIPHERAL CYANOSIS -- C. PSEUDOCYANOSIS -- REFERENCES -- 10 - Anemia -- I. INTRODUCTION -- II. THE FINDINGS -- III. CLINICAL SIGNIFICANCE -- 11 - HYPOVOLEMIA -- I. INTRODUCTION -- II. THE FINDINGS AND THEIR PATHOGENESIS -- III. CLINICAL SIGNIFICANCE -- REFERENCES -- 12 - PROTEIN-ENERGY MALNUTRITION AND WEIGHT LOSS -- PROTEIN-ENERGY MALNUTRITION -- I. INTRODUCTION -- II. THE FINDINGS -- A. ARM MUSCLE CIRCUMFERENCE -- B. GRIP STRENGTH -- III. CLINICAL SIGNIFICANCE -- WEIGHT LOSS -- I. INTRODUCTION -- II. CLINICAL SIGNIFICANCE -- REFERENCES -- 13 - OBESITY -- I. INTRODUCTION -- II. THE FINDINGS AND THEIR SIGNIFICANCE -- A. BODY MASS INDEX -- 1. THE FINDING -- 2. CLINICAL SIGNIFICANCE -- B. SKINFOLD THICKNESS -- C. WAIST-TO-HIP RATIO -- 1. THE FINDING -- 2. CLINICAL SIGNIFICANCE -- 3. PATHOGENESIS -- D. WAIST CIRCUMFERENCE. |
E. SAGITTAL DIAMETER -- REFERENCES -- 14 - CUSHING SYNDROME -- I. INTRODUCTION -- II. THE FINDINGS AND THEIR PATHOGENESIS -- A. BODY HABITUS -- B. HYPERTENSION -- C. SKIN FINDINGS -- D. PROXIMAL WEAKNESS -- E. DEPRESSION -- F. PSEUDO-CUSHING SYNDROME -- III. CLINICAL SIGNIFICANCE -- A. DIAGNOSTIC ACCURACY OF FINDINGS -- B. ETIOLOGY OF CUSHING SYNDROME AND BEDSIDE FINDINGS -- REFERENCES -- 4 - VITAL SIGNS -- 15 - Pulse Rate and Contour -- I. INTRODUCTION -- II. TECHNIQUE -- III. THE FINDING -- IV. CLINICAL SIGNIFICANCE -- A. THE FINDING -- B. TECHNIQUE -- C. CLINICAL SIGNIFICANCE -- D. PATHOGENESIS -- II. PULSUS BISFERIENS -- A. THE FINDING -- B. TECHNIQUE -- C. CLINICAL SIGNIFICANCE -- D. PATHOGENESIS -- III. PULSUS PARADOXUS -- A. THE FINDING -- B. TECHNIQUE -- C. CLINICAL SIGNIFICANCE -- 1. CARDIAC TAMPONADE -- 2. CARDIAC TAMPONADE WITHOUT PULSUS PARADOXUS -- 3. ASTHMA -- 4. PULSUS PARADOXUS IN OTHER CONDITIONS -- 5. REVERSED PULSUS PARADOXUS60 -- D. PATHOGENESIS -- 1. CARDIAC TAMPONADE -- 2. ASTHMA -- IV. PULSUS PARVUS ET TARDUS -- A. THE FINDING AND TECHNIQUE -- B. CLINICAL SIGNIFICANCE -- C. PATHOGENESIS -- V. DICROTIC PULSE -- A. THE FINDING AND TECHNIQUE -- B. CLINICAL SIGNIFICANCE -- C. PATHOGENESIS -- VI. HYPERKINETIC PULSE -- A. THE FINDING -- B. CLINICAL SIGNIFICANCE -- VII. PULSES AND HYPOVOLEMIC SHOCK -- 16 - ABNORMALITIES OF PULSE RHYTHM -- I. INTRODUCTION -- II. TECHNIQUE -- A. THE PAUSE -- 1. TERMINOLOGY -- 2. BASIC MECHANISM OF THE PAUSE -- A. PREMATURE BEAT -- B. HEART BLOCK -- 3. BIGEMINAL AND TRIGEMINAL RHYTHMS, AND GROUPED BEATING -- 4. ATRIAL VERSUS VENTRICULAR PREMATURE CONTRACTIONS -- A. COMPENSATORY PAUSE -- B. CANNON A WAVES -- B. REGULAR BRADYCARDIA -- 1. SINUS BRADYCARDIA -- 2. COMPLETE HEART BLOCK -- A. CHANGING INTENSITY OF THE FIRST HEART SOUND -- B. INTERMITTENT APPEARANCE OF CANNON A WAVES IN THE VENOUS PULSE. |
C. OTHER EVIDENCE OF ATRIOVENTRICULAR DISSOCIATION -- 3. HALVED PULSE -- C. REGULAR TACHYCARDIA -- 1. VAGAL MANEUVERS -- A. TECHNIQUE -- B. RESPONSE OF REGULAR TACHYCARDIAS TO VAGAL MANEUVERS9 -- 2. ATRIOVENTRICULAR DISSOCIATION -- 3. FLUTTER WAVES IN THE VENOUS PULSE -- 4. SENSATION OF POUNDING IN THE NECK -- D. IRREGULAR RHYTHM THAT VARIES WITH RESPIRATION -- E. IRREGULARLY IRREGULAR RHYTHM (CHAOTIC RHYTHM) -- REFERENCES -- 17 - BLOOD PRESSURE -- I. INTRODUCTION -- II. TECHNIQUE -- A. AUSCULTATORY VERSUS OSCILLOMETRIC METHODS -- B. RECOMMENDED TECHNIQUE9,10 -- C. KOROTKOFF SOUNDS (AUSCULTATORY METHOD) -- 1. DEFINITION OF SYSTOLIC AND DIASTOLIC BLOOD PRESSURE -- 2. PATHOGENESIS -- D. |
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MEASUREMENT USING PALPATION -- E. POSTURAL VITAL SIGNS24 -- F. COMMON ERRORS -- 1. WRONG CUFF SIZE -- 2. AUSCULTATORY GAP -- 3. INAPPROPRIATE LEVEL OF THE ARM -- 4. TERMINAL DIGIT PREFERENCE (AUSCULTATORY METHOD)27,28 -- III. THE FINDINGS AND THEIR CLINICAL SIGNIFICANCE -- 1. ESSENTIAL HYPERTENSION -- 2. PSEUDOHYPERTENSION AND OSLER SIGN -- G. OTHER VARIABLES -- B. HYPOTENSION -- C. DIFFERENCES IN PRESSURE BETWEEN THE ARMS -- A. HYPERTENSION -- 1. SUBCLAVIAN STEAL SYNDROME -- 2. AORTIC DISSECTION -- D. DIFFERENCES IN PRESSURE BETWEEN ARMS AND LEGS -- 1. CHRONIC ISCHEMIA OF THE LOWER EXTREMITIES -- 2. COARCTATION OF THE AORTA -- E. ABNORMAL PULSE CONTOUR -- F. ABNORMAL PULSE PRESSURE -- 1. ABNORMALLY SMALL PULSE PRESSURE -- 2. ABNORMALLY LARGE PULSE PRESSURE -- G. ORTHOSTATIC HYPOTENSION -- 1. POSTURAL VITAL SIGNS IN HEALTHY PERSONS -- 2. VITAL SIGNS AND HYPOVOLEMIA -- A. POSTURAL CHANGE IN PULSE -- B. POSTURAL CHANGE IN BLOOD PRESSURE -- C. SUPINE PULSE AND SUPINE BLOOD PRESSURE -- H. BLOOD PRESSURE AND IMPAIRED CONSCIOUSNESS -- I. CAPILLARY FRAGILITY TEST (RUMPEL-LEEDE TEST) -- REFERENCES -- 18 - Temperature -- I. INTRODUCTION -- II. TECHNIQUE -- A. SITE OF MEASUREMENT. |
B. VARIABLES AFFECTING THE TEMPERATURE MEASUREMENT. |
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Sommario/riassunto |
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Fully updated from cover to cover, incorporating over 200 new studies on the evidence-based approach to diagnosis, the 4th Edition of Evidence-Based Physical Diagnosis remains your go-to resource for guidance on interpreting physical signs, enabling you to determine the most appropriate physical finding to confirm a diagnosis. Internationally renowned author Dr. Steven McGee puts the most current evidence at your fingertips, allowing you to quickly compare all physical signs for a given diagnosis, understand their significance, and then select the most accurate ones. |
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