Examination Medicine: A Guide to Physician Training
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Authors: Nicholas J. Talley,Simon O’connor
Tags: #Medical, #Internal Medicine, #Diagnosis
examination MEDICINE
A guide to physician training
SEVENTH EDITION
Nicholas J. Talley, MB BS (Hons), MMedSc (Clin Epi) (Newc), MD (NSW), PhD (Syd), FRACP, FAFPHM, FRCP (Lond), FRCP (Edin), FACP
Deputy Vice-Chancellor Research (Acting); Pro Vice-Chancellor and Dean (Health and Medicine), and Professor, University of Newcastle, Callaghan, NSW, Australia
Senior Staff Specialist, John Hunter Hospital, Newcastle, Australia
Simon O’Connor, FRACP, DDU, FCSANZ
Cardiologist, The Canberra Hospital; Clinical Senior Lecturer, Australian National, University Medical School, Canberra, ACT, Australia
Table of Contents
Chapter 1: Basic physician training
Basic Training Units
Trainees’ Committee
Medical Education Officers
Examinations Unit
Chapter 2: The written examination
The examination format
Approaching multiple-choice questions
Preparation for the written examination
Chapter 3: The clinical examination
The examination format
The mini-CEX
Preparation for the clinical examination
The history-taking and physical examination
The presentation
The long case rationale
Types of long case
Chapter 5: The cardiovascular long case
Ischaemic heart disease
Revascularisation
Infective endocarditis
Congestive cardiac failure
Diastolic heart failure (heart failure with preserved ejection fraction)
Hyperlipidaemia
Hypertension
Heart transplantation
Cardiac arrhythmias
Chapter 6: The respiratory long case
Bronchiectasis
Lung carcinoma
Chronic obstructive pulmonary disease
Sleep apnoea
Interstitial lung disease, including idiopathic pulmonary fibrosis
Pulmonary hypertension
Sarcoidosis
Cystic fibrosis
Tuberculosis
Lung transplantation
Chapter 7: The gastrointestinal long case
Peptic ulceration
Malabsorption and chronic diarrhoea
Inflammatory bowel disease
Colon cancer
Chronic liver disease
Liver transplantation
Chapter 8: The haematological long case
Haemolytic anaemia
Thrombophilia
Polycythaemia
Idiopathic myelofibrosis
Essential thrombocythaemia
Chronic myeloid leukaemia (CML)
Lymphomas
Multiple myeloma (myeloma)
Bone marrow (haematopoietic cell) transplantation
Chapter 9: The rheumatological long case
Rheumatoid arthritis
Systemic lupus erythematosus
Systemic vasculitis
Antiphospholipid antibody syndrome
Systemic sclerosis (scleroderma)
Chapter 10: The endocrine long case
Osteoporosis (and osteomalacia)
Hypercalcaemia
Paget’s disease of the bone (osteitis deformans)
Acromegaly
Types 1 and 2 diabetes mellitus
Chapter 11: The renal long case
Chronic kidney disease (chronic renal failure)
Renal transplantation
Chapter 12: The neurological long case
Multiple sclerosis
Myasthenia gravis
Guillain-Barré syndrome
Transient ischaemic attacks and ‘funny turns’
Chapter 13: The infectious disease long case
Pyrexia of unknown origin
HIV/AIDS
Chapter 14: Think like a physician, think like an examiner – an approach with long case examples
Chapter 16: Common short cases
The cardiovascular system
The cardiovascular examination
Notes on valve diseases
The hypertensive examination
Marfan’s syndrome
Oedema
The respiratory system
The respiratory examination
Chest X-ray films
The gastrointestinal system
The abdominal examination
The haematological system
The haemopoietic examination
The endocrine system
The thyroid gland
Panhypopituitarism
Cushing’s syndrome
Acromegaly
Addison’s disease
Diabetes mellitus
Hirsutism
The rheumatological system
The hands
The knees
The feet
The back
The nervous system
Cranial nerves
Eyes
One-and-a-half syndrome
Horner’s syndrome
Notes on the cranial nerves
Higher centres
Speech
Upper limbs
Shoulder girdle examination
Lower limbs
Notes on the neurological examination of the limbs
Notes on spinal cord lesions
Dystrophia myotonica
Gait
Cerebellum
Parkinson’s disease
Chorea
Copyright
Churchill Livingstone is an imprint of Elsevier
Elsevier Australia. ACN 001 002 357 (a division of Reed International Books Australia Pty Ltd)
Tower 1, 475 Victoria Avenue, Chatswood, NSW 2067
This edition © 2014 Elsevier Australia.
6th edn 2010; 5th edn 2006; 4th edn 2001; 3rd edn 1996; 2nd edn 1991; 1st edn 1986
eISBN: 9780729581684
This publication is copyright. Except as expressly provided in the Copyright Act 1968 and the Copyright Amendment (Digital Agenda) Act 2000, no part of this publication may be reproduced, stored in any retrieval system or transmitted by any means (including electronic, mechanical, microcopying, photocopying, recording or otherwise) without prior written permission from the publisher.
Every attempt has been made to trace and acknowledge copyright, but in some cases this may not have been possible. The publisher apologises for any accidental infringement and would welcome any information to redress the situation.
This publication has been carefully reviewed and checked to ensure that the content is as accurate and current as possible at time of publication. We would recommend, however, that the reader verify any procedures, treatments, drug dosages or legal content described in this book. Neither the author, the contributors, nor the publisher assume any liability for injury and/or damage to persons or property arising from any error in or omission from this publication.
National Library of Australia Cataloguing-in-Publication Data
Talley, Nicholas Joseph, author.
Examination medicine : a guide to physician training / Nicholas J. Talley, Simon O’Connor.
7th edition.
9780729541688 (paperback)
Includes index.
Physical diagnosis.
Medical history taking.
O’Connor, Simon, author.
616.0754
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Foreword
The business of becoming a specialist physician requires many years of intensive training, but beyond that there is, in Australia and New Zealand, a major hurdle – the examination set by the Royal Australasian College of Physicians. This hurdle is encountered at the end of basic training, and must be passed before the trainee can begin advanced training.
The College of Physicians exam was undoubtedly the most stressful event that many of us practising physicians had experienced to that point in our lives. Those of us who sat the exam in the years before 1986 (in my case, 1964), when the first edition of
Examination Medicine
appeared, had no authoritative guidance about how best to approach this ordeal. And an ordeal it certainly was. We can still vividly remember details of the written exam and of our long and short cases. We remember well which examiners were terrifying and which were of a gentler disposition.
Examination Medicine
immediately found its niche. It was unapologetically written to help those about to sit the College exam. It was not a textbook of internal medicine, systematically trawling through every known disease of every system. Rather, the knowledge it imparted was particularly directed towards helping the examinee give their best possible performance in the clinical exam, where clinical skills were to be tested, in addition to medical knowledge. One chapter was devoted to requirements for basic training and one to a discussion of the written exam, but the remainder of the book was focused on the approach to the clinical examination, with many examples of the long and short cases likely to be encountered.