Medical Masterclass Clinical ...

Medical Masterclass Clinical Skills, Książki medyczne

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//-->MEDICAL MASTERCLASSEDITOR-IN-CHIEFJOHN D FIRTHDM FRCPConsultant Physician and NephrologistAddenbrooke’s HospitalCambridgeCLINICAL SKILLSEDITORSJOHN D FIRTHDM FRCPConsultant Physician and NephrologistAddenbrooke’s HospitalCambridgeCLAIRE G NICHOLLFRCPConsultant Physician and Clinical DirectorAddenbrooke’s HospitalCambridgeDEE C TRAUEMRCP(UK )Macmillan Consultant in Palliative MedicineAddenbrooke’s HospitalCambridgeSecond EditionDisclaimerAlthough every effort has been made to ensure that drug dosesand other information are presented accurately in this publication, theultimate responsibility rests with the prescribing physician. Neither thepublishers nor the authors can be held responsible for any consequencesarising from the use of information contained herein. Any productmentioned in this publication should be used in accordance with theprescribing information prepared by the manufacturers.The information presented in this publication reflects the opinions of itscontributors and should not be taken to represent the policy and views of theRoyal College of Physicians of London, unless this is specifically stated.Every effort has been made by the contributors to contact holders ofcopyright to obtain permission to reproduce copyrighted material. However,if any have been inadvertently overlooked, the publisher will be pleased tomake the necessary arrangements at the first opportunity.LIST OF CONTRIBUTORSDr JD FirthDM FRCPConsultant Physician and NephrologistAddenbrooke’s HospitalCambridgeDr R MorganBSc FRCPConsultant Physician and Postgraduate Clinical TutorMedicine for the ElderlyArrowe Park HospitalWirralDr CG NichollFRCPConsultant Physician and Clinical DirectorMedicine for the ElderlyAddenbrooke’s HospitalCambridgeDr JR Ross PhDMRCP(UK)Consultant in Palliative MedicineSt Joseph’s HospiceLondonDr DC TraueMRCP(UK)Macmillan Consultant in Palliative MedicinePalliative Care TeamAddenbrooke’s HospitalCambridgeDr KJ WilsonFRCPConsultant PhysicianMedicine for the ElderlyAddenbrooke’s HospitalCambridge© 2008, 2010 Royal College of Physicians of LondonPublished by:Royal College of Physicians of London11 St. Andrews PlaceRegent’s ParkLondon NW1 4LEUnited KingdomSet and printed by Graphicraft Limited, Hong KongAll rights reserved. No part of this publication may be reproduced, storedin a retrieval system, or transmitted, in any form or by any means,electronic, mechanical, photocopying, recording or otherwise, except aspermitted by the UK Copyright, Designs and Patents Act 1988, without theprior permission of the copyright owner.First edition published 2001Reprinted 2004Second edition published 2008This module updated and reprinted 2010ISBN: 978-1-86016-266-4 (this book)ISBN: 978-1-86016-260-2 (set)Distribution Information:Jerwood Medical Education Resource CentreRoyal College of Physicians of London11 St. Andrews PlaceRegent’s ParkLondon NW1 4LEUnited KingdomTel:+44(0)207 935 1174 ext 422/490Fax:+44(0)207 486 6653Email: merc@rcplondon.ac.ukCONTENTSList of contributors iiiForeword viiPreface viiiAcknowledgements xKey features xiPAIN RELIEF ANDPALLIATIVE CAREPACES Stations and AcuteScenarios 61MEDICINE FORTHE ELDERLYPACES Stations and AcuteScenarios 1071.1 History-taking 1071.1.1Frequent falls 1071.1.2Recent onset of confusion1101.1.3Urinary incontinence andimmobility 1141.1.4Collapse 1161.1.5Vague aches and pains 1191.1.6Swollen legs and backpain 1211.1.7Failure to thrive: gradualdecline and weight loss 1271.2 Clinical examination 1291.2.1Confusion (respiratory)1291.2.2Confusion (abdominal)1301.2.3Failure to thrive(abdominal) 1311.2.4Frequent falls(cardiovascular) 1311.2.5Confusion(cardiovascular) 1321.2.6Frequent falls(neurological) 1321.2.7Confusion (neurological)1341.2.8Impaired mobility(neurological) 1351.2.9Confusion (skin) 1351.2.10Frequent falls(locomotor) 1361.2.11Confusion (endocrine)1361.2.12Confusion (eye) 136CLINICAL SKILLSFOR PACESIntroduction 3History-taking for PACES(Station 2) 6Communication Skills andEthics for PACES (Station 4) 10Examination for PACESStations 1, 3 and 5: GeneralConsiderations 12Station 1: RespiratorySystem 15Station 1: AbdominalSystem 20Station 3: CardiovascularSystem 26Station 3: Central NervousSystem 35Station 5: Brief ClinicalConsulations 531.1 History-taking 611.1.1Pain 611.1.2Constipation/bowelobstruction 631.2 Communication skills andethics 651.2.1Pain 651.2.2Breathlessness 661.2.3Nausea and vomiting 671.2.4Bowel obstruction 691.2.5End of life 701.3 Acute scenarios 711.3.1Pain 711.3.2Breathlessness 741.3.3Nausea and vomiting 761.3.4Bowel obstruction 79Diseases and Treatments 82Pain 82Breathlessness 87Nausea and vomiting 88Constipation 89Bowel obstruction 90Anxiety and depression 91Confusion 93End-of-life care:the dying patient 942.9 Specialist palliative careservices 962.12.22.32.42.52.62.72.8Self-assessment 983.1 Self-assessment questions 983.2 Self-assessment answers 101v [ Pobierz całość w formacie PDF ]

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