Excerpt

The goal of this book is to "be your guide" and say "see here and see there" as the reader becomes skilled in the techniques and analysis of clinical data. This third edition of Clinical Methods has undergone substantial revision based upon feedback from students and other users of the first two editions. These changes enhance the usefulness of the book and help us to achieve our goal of providing clinicians and students with the best current knowledge of the techniques of collecting and using clinical data.

Contents

• Contributors
• Preface
• Part I. Introduction
  • The Case of Richard Cabot
    Charles Stewart Roberts.
    • References
  • Chapter 1. The Origins of the History and Physical Examination
    H. Kenneth Walker.
    • Hippocrates: A Rational Profession 460–370 b.c
    • Vesalius: Establishment of an Accurate Anatomy, 1543
    • Sydenham: The Nosology of Disease, 1666
    • Morgagni: The Foundation of Pathologic Anatomy, 1761
    • Auenbrugger: The Discovery of Percussion, 1761
    • Laennec: The Stethoscope, 1816
    • Pierre Louis: The French School, 1800–1850
    • Johannes Mueller: The German School, 1830–1900
    • Helmholtz: The Ophthalmoscope, 1850
    • Carl Wunderlich: The Thermometer, 1871
    • Erb and Westphal: The Reflex Hammer, 1875
    • Riva Rocci: The Sphygmomanometer, 1896
    • The Clinical History
    • Clinical Methods in the United States
    • Conclusion
    • References
  • Chapter 2. Collecting and Analyzing Data: Doing and Thinking
    David A. Nardone.
    • Problem Identification
    • Hypothesis Generation
    • Hypothesis Evaluation
    • Hypothesis Analysis
    • Hypothesis Assembling
    • Conclusion
    • References
  • Chapter 3. The Medical Interview
    Peter R. Lichstein.
    • Nature and Goals of the Interview
    • Conducting the Interview
    • Diagnosing and Solving Problems in the Interview
    • A Review of Common Problems
    • Conclusion
    • References
  • Chapter 4. The Physical Examination
    Earl W. Campbell JR and Christopher K. Lynn.
    • Definition
    • The Context
    • The Physician–Patient Interaction
    • The Materials
    • The Examination
    • Conclusion
  • Chapter 5. Use of the Laboratory
    Craig Kaplan.
    • The Probabilistic Nature of Diagnosis
    • Operating Characteristics of Laboratory Tests
    • Purposes for Ordering Laboratory Tests
    • The Normal Test Result and Its Meaning
    • Test Ordering Strategies and Their Misuse
    • Conclusion
    • References
  • Chapter 6. Sensitivity, Specificity, and Predictive Value
    David Simon and John R. Boring III.
    • Clinical Decision Making
    • Characteristics of Diagnostic Tests
    • Use of Likelihood Ratios
    • Caveats
    • References
• Part II. The Cardiovascular System
  • Herrick and Heart Disease
    Charles Stewart Roberts.
    • References
  • Chapter 7. An Overview of the Cardiovascular System
    Joel M. Felner.
    • History
    • Physical Examination
    • Conclusion
  • Chapter 8. Exercise Capacity
    Robert E. Goldstein.
    • Definition
    • Techniques
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 9. Chest Pain or Discomfort
    David H. Hickam.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 10. Palpitations
    David M. Mirvis.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 11. Dyspnea, Orthopnea, and Paroxysmal Nocturnal Dyspnea
    Vaskar Mukerji.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 12. Syncope
    Wishwa N. Kapoor.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 13. Claudication
    Robert B. Smith III.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 14. History of Cardiovascular Disease
    Harry R. Gibbs.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 15. Family History of Heart Disease
    Mark E. Silverman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 16. Blood Pressure
    Walter A. Brzezinski.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 17. Pulse
    John F. Moran.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 18. Bruits and Hums of the Head and Neck
    Kenneth J. Kurtz.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 19. The Jugular Venous Pressure and Pulse Contour
    Mark M. Applefeld.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 20. The Carotid Pulse
    Douglas C. Morris.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 21. Precordial Impulses
    Howard S. Rosman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 22. The First Heart Sound
    Joel M. Felner.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 23. The Second Heart Sound
    Joel M. Felner.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 24. The Third Heart Sound
    Mark E. Silverman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 25. The Fourth Heart Sound
    Eric S. Williams.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 26. Systolic Murmurs
    Martin A. Alpert.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 27. Diastolic Murmurs
    I. Sylvia Crawley.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 28. Ejection Clicks
    William R. Jacobs.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 29. Edema
    Kenneth R. Phelps.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 30. Examination of the Extremities: Pulses, Bruits, and Phlebitis
    R. Dean Hill and Robert B. Smith III.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 31. Cholesterol, Triglycerides, and Associated Lipoproteins
    Rafael A. Cox and Mario R. García-Palmieri.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 32. Creatine Kinase
    C. Daniel Cabaniss.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 33. Electrocardiography
    R. Joe Noble, J Stanley Hillis, and Donald A. Rothbaum.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 34. Chest Roentgenography for Cardiovascular Evaluation
    Eric Manheimer.
    • Definition and Basic Science
    • Technique and Clinical Significance
    • References
• Part III. The Pulmonary System
  • Trudeau at Lake Saranac
    Charles Stewart Roberts.
    • References
  • Chapter 35. An Overview of the Pulmonary System
    Eric Honig.
    • History
    • Physical Examination
    • Additional Evaluation
  • Chapter 36. Dyspnea
    John B. Bass JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 37. Wheezing and Asthma
    Henry Gong JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 38. Cough and Sputum Production
    Sattar Farzan.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 39. Hemoptysis
    Ralph Corey.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 40. Tobacco Use
    Mohamed S. Al-Ibrahim and Joyce Y. Gross.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 41. Environmental Inhalation
    James P Whalen and Ruy V LourenÇo.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Appendix: Inhalational Exposure Resources
    • References
  • Chapter 42. Past Pulmonary Disease
    P. Bailey Francis.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 43. Respiratory Rate and Pattern
    Sheldon R. Braun.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 44. Clubbing
    Stephen J. McPhee.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 45. Cyanosis
    H. L. Snider.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 46. Chest Examination
    Peter G. Tuteur.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 47. Skin Testing for Tuberculosis
    Clifford C. Dacso.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 48. Chest Roentgenography for Pulmonary Evaluation
    Michael Boyars.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 49. Arterial Blood Gases
    E. P. Trulock III.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part IV. The Neurologic System
  • Weir Mitchell of Philadelphia
    Charles Stewart Roberts.
    • References
  • Chapter 50. An Overview of the Nervous System
    H. Kenneth Walker.
    • History
    • Neurologic Examination
  • Chapter 51. Episodic Neurologic Symptoms
    David C. Good.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 52. Pain and Sensory Perversions
    Reynolds G. Jarvis.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 53. Muscle Cramps
    Lawrence Z. Stern and Charles Bernick.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 54. Headache
    G. Kim Bigley.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 55. Cerebrovascular Disease
    David C. Good.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 56. Epilepsy
    Charles M. Epstein.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 57. Level of Consciousness
    Suzie C. Tindall.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 58. The Pupils
    Robert H. Spector.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 59. Cranial Nerve I: The Olfactory Nerve
    H. Kenneth Walker.
    • Definitions
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 60. Cranial Nerves III, IV, and VI: The Oculomotor, Trochlear, and Abducens Nerves
    • Part 1: Conjugate Gaze
    • Part 2: Brainstem Nuclei and Peripheral Nerves
  • Chapter 61. Cranial Nerve V: The Trigeminal Nerve
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 62. Cranial Nerve VII: The Facial Nerve and Taste
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 63. Cranial Nerves IX and X: The Glossopharyngeal and Vagus Nerves
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 64. Cranial Nerve XI: The Spinal Accessory Nerve
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 65. Cranial Nerve XII: The Hypoglossal Nerve
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 66. Speech and Other Lateralizing Cortical Functions
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 67. Sensation
    G. Kim Bigley.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 68. The Motor System and Gait
    Lawrence Z. Stern and Charles Bernick.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 69. The Cerebellum
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 70. Involuntary Movements
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 71. The Suck, Snout, Palmomental, and Grasp Reflexes
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 72. Deep Tendon Reflexes
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 73. The Plantar Reflex
    H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 74. Cerebrospinal Fluid
    Rafael Jurado and H. Kenneth Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part V. The Autonomic Nervous System
  • Cannon of Harvard
    Charles Stewart Roberts.
    • References
  • Chapter 75. An Overview of the Autonomic Nervous System
    W. Dallas Hall.
    • History
    • Physical Examination
  • Chapter 76. Clinical Evidence of Dysautonomia
    Michael J. Reichgott.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 77. Sleep Disturbances
    René E Cormier.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 78. Bedside Evaluation of the Autonomic System
    Anthony L. Barbato.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 79. Laboratory Evaluation of the Autonomic System
    Norman G. Soler.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part VI. The Gastrointestinal System
  • William Beaumont, the Man and the Opportunity
    Charles Stewart Roberts.
    • References
  • Chapter 80. An Overview of the Gastrointestinal System
    Charles M. Ferguson.
    • History
    • Physical Examination
  • Chapter 81. The Nutritional History
    Thomas E. Edes.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 82. Dysphagia
    Douglas C. Wolf.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 83. Indigestion and Heartburn
    Howard Schachter.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 84. Nausea and Vomiting
    William F. Maule.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 85. Hematemesis, Melena, and Hematochezia
    I. Dodd Wilson.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 86. Abdominal Pain
    Roger Sherman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 87. Jaundice
    Alfred E. Stillman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 88. Diarrhea
    Timothy A. Woods.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 89. Constipation
    Marshall Sparberg.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 90. Abdominal Gas
    René E Cormier.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 91. The Alcohol Drinking History
    Michael Phillips.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Acknowledgment
    • References
  • Chapter 92. History of Past Gastrointestinal Diseases
    Eapen Thomas.
    • Definition
    • Technique and Clinical Significance
    • References
  • Chapter 93. Inspection, Auscultation, Palpation, and Percussion of the Abdomen
    Charles M. Ferguson.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 94. Evaluation of the Size, Shape, and Consistency of the Liver
    Douglas C. Wolf.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 95. Auscultation of the Liver
    Joseph E. Hardison.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 96. Inguinal Canal and Hernia Examination
    J. Richard Amerson.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 97. The Rectal Examination
    Michael J. McFarlane.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Acknowledgment
    • References
  • Chapter 98. Tests for Fecal Occult Blood
    J. Donald Ostrow.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 99. Aminotransferases
    David H. Vroon and Zafar Israili.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 100. Alkaline Phosphatase and Gamma Glutamyltransferase
    David H. Vroon and Zafar Israili.
    • Alkaline Phosphatase
    • Gamma Glutamyltransferase
    • References
  • Chapter 101. Serum Albumin and Globulin
    Janice T. Busher.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 102. Abdominal Roentgenography
    Richard M. Gore.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part VII. The Skin and Appendages
  • Goldberger and the Mal de la Rosa
    Charles Stewart Roberts.
    • References
  • Chapter 103. An Overview of the Skin and Appendages
    Marilynne McKay.
    • Principles of Cutaneous Diagnosis (What to Look for)
    • History
    • Physical Examination
    • Summary
  • Chapter 104. The Dermatologic History
    Marilynne McKay.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 105. Skin
    Christopher M. Papa.
    • Definition
    • Technique
    • Clinical Significance
    • References
  • Chapter 106. Urticaria and Angioedema
    James R. Bonner.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 107. Hair
    Christopher M. Papa.
    • Definition
    • Basic Science
    • Clinical Significance
    • Technique
    • References
  • Chapter 108. Nails
    Mark Holzberg.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 109. Office Techniques for Dermatologic Diagnosis
    Marilynne McKay.
    • Manipulative Techniques
    • Wood's Light Evaluation
    • Microscopic Evaluation
    • Other Diagnostic Tests
    • Reference
• Part VIII. The Eye
  • The Eye
    Charles Stewart Roberts.
    • The Doctors Friedenwald
    • References
  • Chapter 110. An Overview of the Ocular System
    Alan Kozarsky.
    • History
    • Ophthalmic Examination
  • Chapter 111. Visual Acuity Change
    Jeffrey H. Levenson and Alan Kozarsky.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 112. Eye Pain
    Alan Kozarsky.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
  • Chapter 113. Diplopia
    Robert H. Spector.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 114. The External Eye Examination
    Frank C. Bell.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 115. Visual Acuity
    Jeffrey H. Levenson and Alan Kozarsky.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 116. Visual Fields
    Robert H. Spector.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 117. The Funduscopic Examination
    Henry Schneiderman.
    • Definitions
    • Technique
    • Problems and Solutions
    • Basic Science
    • Clinical Significance
    • Acknowledgment
    • References
  • Chapter 118. Tonometry
    Patrick C. Alguire.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part IX. The Ear, Nose, Mouth, and Throat
  • IX. The Ear, Nose, Mouth, and Throat
    Charles Stewart Roberts.
    • Horace Green of Vermont
    • References
  • Chapter 119. An Overview of the Head and Neck
    John S. Turner JR.
    • History
    • Physical Examination
  • Chapter 120. Auditory Dysfunction: Hearing Loss
    John S. Turner JR. and John H. Per-Lee.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 121. Auditory Dysfunction: Tinnitus
    John S. Turner JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 122. Otalgia and Otorrhea
    John S. Turner JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 123. Vertigo and Associated Symptoms
    Horst R. Konrad.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 124. Epistaxis
    William J. Grist.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 125. Hoarseness
    William J. Grist.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 126. The Ear and Auditory System
    John S. Turner JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 127. Vertigo and Disequilibrium
    Horst R. Konrad.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Reference
  • Chapter 128. The Nose
    John S. Turner JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Reference
  • Chapter 129. The Oral Cavity and Associated Structures
    William B. Walker.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 130. The Tongue
    Charles M. Huguley JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 131. The Salivary Glands
    William J. Grist.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 132. The Tonsils and Pharynx
    William J. Grist.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 133. Audiometry
    Anne Z. Saunders, Andrea Vallen Stein, and Nancy Lite Shuster.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
• Part X. The Endocrine System
  • The Endocrine System
    Charles Stewart Roberts.
    • Fuller Albright
    • References
  • Chapter 134. An Overview of the Endocrine System
    Victor Silverman.
    • History
    • Physical Examination
    • Conclusion
  • Chapter 135. Thyroid Disease
    John S. Melish.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 136. Diabetes Mellitus
    Mark E. Molitch.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 137. Body Size and Habitus
    Steven L. Zinn.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 138. Neck and Thyroid Examination
    Terry J. Smith.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 139. Glucosuria
    Steven L. Cowart and Max E. Stachura.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 140. Ketonuria
    John P. Comstock and Alan J. Garber.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 141. Blood Glucose
    J. Michael McMillin.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 142. Thyroid Function Tests
    Dickson B. Dunlap.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 143. Serum Calcium
    David A. Goldstein.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 144. Abbreviated Tests of Endocrine Function
    Louis F. Amorosa.
    • Definition and Technique
    • Serum Prolactin
    • Serum Follicle-Stimulating Hormone, Luteinizing Hormone, Testosterone, and Estradiol
    • Serum Human Chorionic Gonadotropin
    • Serum Growth Hormone, Somatomedin C
    • Serum Thyroid Stimulating Hormone, Thyrotropin Releasing Hormone Test
    • Plasma ACTH and Serum Cortisol, Overnight Dexamethasone Suppression Test, Cortrosyn Stimulation Test, Overnight Metyrapone Challenge Test
• Part XI. The Hematopoietic System
  • The Hematopoietic System
    Charles Stewart Roberts.
    • The Castle Approach
    • References
  • Chapter 145. An Overview of the Hematopoietic System
    Charles M. Huguley JR.
    • History
    • Physical Examination
  • Chapter 146. Excessive Bleeding and Bruising
    R. L. Palmer.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 147. Anemia
    Marcel E. Conrad.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 148. Pica
    Bruce E. Johnson.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 149. Lymphadenopathy
    Michael Karpf.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 150. Spleen
    James O. Armitage.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 151. Hemoglobin and Hematocrit
    Henny H. Billett.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 152. Red Cell Indices
    P. Ravi Sarma.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 153. The White Blood Cell and Differential Count
    Martin S. Blumenreich.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 154. Platelets
    Patrick J. Stiff.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 155. Peripheral Blood Smear
    Edward C. Lynch.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 156. Reticulocytes
    J. David Bessman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 157. Coagulation Tests
    Martin N. Raber.
    • Tests of the Vascular Platelet Phase of Hemostasis
    • Tests of the Coagulation Cascade
    • Tests of Fibrinolysis and the Mechanisms That Control Hemostasis
    • References
• Part XII. The Musculoskeletal System
  • The Musculoskeletal System
    Charles Stewart Roberts.
    • Hench at the Mayo Clinic
    • References
  • Chapter 158. An Overview of the Musculoskeletal System
    Stephen B. Miller.
    • History
    • Physical Examination
  • Chapter 159. Rheumatic Pain
    Joe G. Hardin.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 160. Arthralgia
    Joe G. Hardin.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 161. Regional (Nonarticular) Rheumatism
    Joe G. Hardin.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 162. Temporomandibular Joint Pain
    Roger A. Meyer.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 163. The Temporomandibular Joint Examination
    Roger A. Meyer.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 164. The Musculoskeletal Examination
    Colon H. Wilson.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 165. Uric Acid
    Walter G. Barr.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 166. Joint Fluid
    Alice Faryna and Kim Goldenberg.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 167. Immunologic Tests
    Deborah A. Wilson.
    • Acute Phase Reactants
    • Erythrocyte Sedimentation Rate
    • C-Reactive Protein
    • Immunoglobulins and Cryoglobulins
    • Rheumatoid Factor
    • Antinuclear Antibodies
    • The Complement System
    • Immune Complexes
    • The Major Histocompatibility Complex and Human Leukocyte Antigens
• Part XIII. Female Genitalia and Breasts
  • Female Genitalia and Breasts
    Charles Stewart Roberts.
    • The Collaboration of Kelly and Broedel
    • References
  • Chapter 168. An Overview of the Female Genitalia and Breasts
    W. Newton Long.
  • Chapter 169. Breast Pain
    R. Waldo Powell.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 170. Breast Lump
    Michael C. Perry.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 171. Pelvic Pain
    W. Newton Long.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Reference
  • Chapter 172. Vaginal Discharge
    Gene B. Bishop.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 173. Abnormal Vaginal Bleeding
    W. Newton Long.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • Reference
  • Chapter 174. Birth Control
    Robert A. Hatcher and Deborah Kowal.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 175. Nipple Discharge
    Michele Barry.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 176. Breast Examination
    R. Waldo Powell.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 177. Pelvic Examination
    W. Newton Long.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 178. Pap Test
    Zuher M. Naib.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 179. Tests on Vaginal Discharge
    Karen G. Kelly.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part XIV. The Genitourinary System
  • The Genitourinary System
    Charles Stewart Roberts.
    • On the Autobiography of Hugh Young
    • References
  • Chapter 180. An Overview of the Genitourinary System
    J. Maxwell White JR.
    • History
    • Physical Examination
  • Chapter 181. Dysuria, Frequency, and Urgency
    Keith Wrenn.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 182. Flank Pain
    Anton J. Bueschen.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 183. Nocturia
    Leonard L. Vertuno and Gregory A. Kozeny.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 184. Hematuria
    Wanda G. Kirkpatrick.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 185. Incontinence and Stream Abnormalities
    J. Maxwell White JR and David P. O'Brien III.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 186. Testicular Pain
    Stanley L. Wiener.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 187. Organic Impotence
    Jack Ende.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 188. History of Genitourinary Disease
    Arthur Greenberg.
    • Urinary Tract Infection
    • Past History of Stones
    • Family History of Genitourinary Disease
  • Chapter 189. External Male Genitalia
    J. Maxwell White JR and David P. O'Brien III.
    • Definition
    • Technique
    • Basic Science and Clinical Significance
    • References
  • Chapter 190. Prostate Examination
    J. Maxwell White JR and David P. O'Brien III.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 191. Urinalysis
    David M. Roxe.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 192. Proteinuria
    Leon G. Fine and Saleh Salehmoghaddam.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 193. BUN and Creatinine
    Adrian O. Hosten.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 194. Serum Sodium
    George L. Ackerman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 195. Serum Potassium
    Asghar Rastegar.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 196. Serum Total Carbon Dioxide
    Robert M. Centor.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 197. Serum Chloride
    Gail Morrison.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 198. Serum Inorganic Phosphorus
    Vinod K. Bansal.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part XV. The Psychiatric System
  • The Psychiatric System
    Charles Stewart Roberts.
    • The Interpersonal Theory of Harry Stack Sullivan
    • References
  • Chapter 199. An Overview of the Psychiatric System
    John B. Griffin JR.
    • General Principles
    • Psychiatric Evaluation
    • Diagnosis and Prognosis
  • Chapter 200. Previous Psychiatric Problems
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 201. Interpersonal Relationships
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 202. Anxiety
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 203. Depression
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 204. Loss of Control
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 205. Psychological Disturbances of Vegetative Function
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 206. Substance Abuse
    John B. Griffin JR.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 207. The Mental Status Examination
    David C. Martin.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 208. Frequently Performed Psychological Tests
    Wade Silverman.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
• Part XVI. The General Examination
  • The General Examination
    Charles Stewart Roberts.
    • Osler and the Case Study
    • References
  • Chapter 209. An Overview of the General Examination
    W. Dallas Hall.
  • Chapter 210. Weight Change
    Kim Goldenberg.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 211. Fever, Chills, and Night Sweats
    Lawrence Dall and James F. Stanford.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 212. Dizziness
    Brendan M. Reilly.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 213. Weakness and Fatigue
    John H. Holbrook.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 214. Allergic Drug Reactions
    James R. Philp.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 215. The Family History
    Charles E. Driscoll.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 216. The Sexual History
    Malcolm G. Freeman.
    • Introduction
    • Frequency of Intercourse
    • Masturbation
    • Premature Ejaculation
    • Ejaculatory Incompetence
    • Erectile Difficulty (Impotence)
    • Frigidity
    • Anorgasmia
    • Dyspareunia and Vaginismus
  • Chapter 217. General Appearance
    Steven L. Berk and Abraham Verghese.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 218. Temperature
    Victor E. Del Bene.
    • Definition
    • Technique
    • Basic Science
    • Clinical Significance
    • References
  • Chapter 219. Special Screening Tests
    David T. Lush.
    • Definition
    • Proctosigmoidoscopy
    • Stool Occult Blood Testing
    • Mammography
    • Pap Smear
    • Cholesterol Screening
    • References
  • Chapter 220. Laboratory Evaluation of Infectious Disease Emergencies
    Stephen G. Baum.
    • Analysis of Cerebrospinal Fluid in Central Nervous System Infection
    • Analysis of Sputum in Respiratory Tract Infection
    • Analysis of Urine in Urinary Tract Infection
    • Analysis of Blood in Bacteremia
• Part XVII. Special Patient Groups
  • Special Patient Groups
    Charles Stewart Roberts.
    • Engel and the Concept of Disease
    • References
  • Chapter 221. An Overview of Special Patient Groups
    Robert W. Putsch III.
  • Chapter 222. Growth and Development
    Albert Rauber.
    • Assessment of Growth
    • Normal Growth Rates
    • Stages of Development
    • Conclusion
    • References
  • Chapter 223. The Adolescent Patient
    H. Verdain Barnes.
    • The Pubertal Process
    • An Approach to the Adolescent Patient
    • The Medical History
    • The Physical Examination
    • Laboratory Evaluation
    • Preventive Health Care
    • Conclusion
    • References
  • Chapter 224. The Well Adult
    Ruth B. Hoppe.
    • The Modern Era of Periodic Well-Adult Examinations
    • Current Recommendations
    • What Is Actually Performed
    • Conclusion
    • References
  • Chapter 225. The Elderly Patient
    Paul Beck.
    • Approach to Clinical Assessment
    • Conclusion
    • Geriatric Review of Systems (GeriROS)
    • References
  • Chapter 226. The Contagious Patient
    Jack D. McCue.
    • Transmission of Infectious Diseases
    • Nosocomial Infections
    • Protection of Health Care Workers from Infectious Diseases
    • References
  • Chapter 227. The Traveling Patient
    Jonas A. Shulman and Allan Morrison JR.
    • Pretravel Education
    • Immunizations
    • Additional Important Considerations in Travel Medicine
    • Posttravel Assessment
    • Conclusion
    • References
  • Chapter 228. The "Difficult" Medical Patient
    Steven A. Cohen-Cole.
    • Problems with a Data-Gathering Approach
    • The Three-Function Model of the Medical Interview
    • Varieties of Difficult Patients
    • Conclusion
    • References
  • Chapter 229. Dealing with Patients from Other Cultures
    Robert W. Putsch III and Marlie Joyce.
    • Methodology in Cross-Cultural Care
    • Language in Cross-Cultural Care

Illustrations by Leon Schlossberg and Charles H Boyter.

Every effort has been made to ensure that drug dosage schedules within the text are accurate and conform to standards accepted at time of publication. However, as treatment recommendations vary in the light of continuing research and clinical experience, the reader is advised to verify drug dosage schedules herein with information found on product information sheets. This is espescially true in cases of new or infrequently used drugs.