Clinical examination and applied medicine: gastroenterology series. Volume I

182 Pages·2018·12.31 MB·English

by  Haroon

EBOOKS Clinical Examination and Applied H
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Bundle — the more This is the first in a series of books dealing simultaneously with e xamination Clinical Examination
books you buy, technique with detail pathophysiological principles, differential diagnosis
the higher your and clinical interpretation, along with applied medicine about the c ommon C
discount! gastrointestinal diseases. Medical students or postgraduates will learn history lin and Applied Medicine
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needed for bedside assessment of the patient. l

THE CONTENT The hope is that the book will guide towards a correct diagnosis by Ex Gastroenterology Series
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• Nutrition and history and examination, but also provide relevant differential diagnosis, m
Dietetics Practice localize the disease and identify the cause. This book intends to fill this gap in
• Psychology and inspire the reader to gain confidence not only in the performance of at Volume I
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• Health, Wellness, the examination but also to answer most bedside queries and problems. o
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and Exercise It will serve as an indispensable resource for preparation of undergraduate a
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Science and postgraduate viva and short and long case examination. This text is
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• Health Education not a replacement for standard textbooks on the subject, but should serve A
as collection of facts and relevant details in the clinical assessment of the p
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patient. This book is complemented by a second volume, in which numerous li
THE TERMS e
diagrams and figures have been included to stimulate understanding and d
• Perpetual access for learning along with a picture test and MCQ. M
a one time fee e
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Dr Mushtaq Haroon, born in Pakistan, is an academician, educationist, and c
access fees in
consultant in medicine for over 25 years with over 10 years experience as e
• Unlimited ,
professor of medicine at various medical colleges in Pakistan. To his credit, V
concurrent usage he has 25 publications in peer-reviewed medical journals and published five o
• Downloadable PDFs lu
medical books as first author. He completed his early training in m edical m
• Free MARC records
unit 1 of Services Hospital attached to Allama Iqbal Medical College, e

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Lahore and went to UK for higher training. He passed MRCP in 1988 and
was awarded FRCP from London in 2000. Dr Haroon has been a pioneer in
For further information,
a free trial, or to order, computer-based medical education, having developed a vast collection of
contact:  software for teaching. He was awarded the Life Time Achievement Award
[email protected] for the most distinguished Iqbalian for professional excellence by the Chief Mushtaq Haroon
Minister of Punjab in Dec 2008. He is presently consultant in Pakistan Kidney
and Liver Institute and Research Centre, Lahore Pakistan.
ISBN: 978-1-94664-693-4
Clinical Examination and
Applied Medicine

Clinical Examination and
Applied Medicine
Gastroenterology Series
Volume I
Mushtaq Haroon
MOMENTUM PRESS, LLC, NEW YORK
Clinical Examination and Applied Medicine: Gastroenterology Series,
Volume I
Copyright © Momentum Press, LLC, 2018.
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means—electronic, mechanical, photocopy, recording, or any other
except for brief quotations, not to exceed 400 words, without the prior
permission of the publisher.
First published in 2018 by
Momentum Press, LLC
222 East 46th Street, New York, NY 10017
www.momentumpress.net
ISBN-13: 978-1-94664-693-4 (paperback)
ISBN-13: 978-1-94664-694-1 (e-book)
Momentum Press Health Education C ollection
Cover and interior design by Exeter Premedia Services Private Ltd.,
Chennai, India
First edition: 2018
10 9 8 7 6 5 4 3 2 1
Printed in the United States of America.
This book is dedicated to my loving wife, Romana.
My mother Asafa Ashfaq and father Engr. Ashfaq Hasan.

Abstract
This is the first in the series of books dealing simultaneously with exam-
ination technique with detail pathophysiological principles, differential
diagnosis and clinical interpretation, along with correlated and applied
medicine about the common diseases. A medical student or a postgraduate
doctor studying for higher exam will learn to take a good history, examine
the patient, and find relevant applied medical knowledge, which is needed
for assessment of the patient. It should also serve as an invaluable collec-
tion of facts to get through undergraduate or postgraduate examination.
This book attempts to answer pertinent questions such as how? and
why? about clinical examination while providing relevant information
needed for a thorough bedside assessment. It is hoped that the book will
not only serve to make a correct diagnosis by examination, but also give
relevant differential diagnosis, and localize the disease and determine its
cause. The book intends to fill this gap and inspire the reader to gain
confidence not only in the performance of the examination but also to
answer most bedside queries and problems. It will hopefully serve as an
indispensable resource for preparation of undergraduate and postgradu-
ate viva and bedside short and long case examination.
The Volume II of this book includes a section on radiology and endos-
copy. A wealth of diagrams and figures along with brief clinical note has
been included to stimulate understanding and learning. As a stimulus for
learning, picture test with MCQ and a short applied medical note has
been added. The book is not a replacement for standard textbook on the
subject, but it is hoped that it would be mastering relevant knowledge and
clinical skills to diagnose and assess the patient’s problem at the bedside
and also prepare for undergraduate and postgraduate examination.
Keywords
bedside assessment, esophageal diseases, gall bladder diseases, gastroenter-
ology images, GI clinical examination, GI diseases, GI examination skills,
GI investigations, history taking, intestinal diseases, intestinal pathology,
kidney diseases, liver diseases, pancreatic diseases, physical examination,
radiology, signs and symptoms, stomach diseases

Contents
Part I
Introduction and History Taking
Introduction 1
History taking 1
Physical findings 2
Diagnosis 2
Objective of history taking 2
Introductory remarks 2
History taking 3
Presenting complaints 3
History of presenting illness 3
Epigastric pain 4
Direct questions 5
Past history 5
Family history 6
Personal history 7
Socioeconomic status 8
Occupational history 8
History of Allergy and immunization 8
Travel history 8
Treatment history 9
Concluding remarks 9
Objective of examination 10
Common GI symptoms 10
Abdominal pain 11
Nausea and vomiting 14
Hematemesis 15
Hematochezia 15
Occult blood loss 16
Anorexia 16
Heartburn 16