Paediatric Clinical Examination Rossa Brugha, Matko Marlais, Ed Abrahamson
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1Paediatric Clinical Examination2
3Paediatric Clinical Examination
Rossa Brugha BMBCh MA (Oxon) MRCPCH Clinical Research Fellow and Honorary Specialist Registrar in Paediatrics Barts and the London School of Medicine and Dentistry London, UK Matko Marlais BSc (Hons) MBBS (Hons) Academic Foundation Doctor University Hospitals Bristol NHS Foundation Trust Bristol, UK Ed Abrahamson MB FRCPCH Consultant Paediatrician Chelsea and Westminster Hospital Honorary Senior Lecturer Imperial College London London, UK
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9781907816352
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5Foreword
History-taking and examination of children initially appears to be a daunting task. Children range in age from tiny newborn infants to young adults. They often do not wish to be examined, and the examiner needs to know exactly what information they are seeking and how to persuade the child to let them obtain it. Additionally, the medical conditions encountered vary markedly with age.
In Pocket Tutor Paediatric Clinical Examination, Rossa Brugha, Matko Marlais and Ed Abrahamson expertly guide one through dealing with these problems. As well as a brief general introduction to history and examination in children, for each system, common presentations and examination are described. This is followed by a couple of case scenarios which demonstrate how they relate to clinical practice. This information is succinctly condensed into a highly readable, pocket-sized book and is an invaluable guide to the clinical examination of children. The authors have admirably succeeded in their aim to provide a structured approach to examining children that is both stimulating and fun.
Tom Lissauer
Hon Consultant Paediatrician
Imperial College Healthcare Trust
Consultant Paediatric Programme Director in Global Health
Imperial College London
London, UK6
7Preface
For those of you who have the patience and genuine passion, working with children will be one of the most rewarding and enjoyable experiences you will have in medicine. It isn't easy. Most of you reading this book will have little or no experience in managing children. Pocket Tutor Paediatric Clinical Examination aims to give you a structure on which to base the development of your skills. From there it's up to you. You will begin to see how flexible and adaptable you will need to be to achieve the best results, and you will develop your own style and approach.
What will also become apparent is that every case is different; each child is different, from infants from the very first minute of life, to teenagers up to 16 years of age. You will have to contend with differing abilities and levels of understanding. With this book, we aim to offer a structure that applies to all ages, but with some tweaks here and there to suit the age or particular situation you find. The book can't cover every aspect of every disease for every child. For each system, we have described a method for clinical examination alongside information about some of the common or important illnesses that you may encounter.
We hope you will find the book stimulating and fun. While occasionally we do have to deal with harrowing and exceptionally difficult situations, these are fortunately rare for most of us. For the majority of the time, paediatrics is rewarding and fulfilling. Good luck.
Rossa Brugha
Matko Marlais
Ed Abrahamson
July 2012
12Acknowledgements
Thank you to Karen and Andrew Young, and their sons Jack and Daniel for kindly posing for photographs. Thank you also to Lucy Morton for photographs and for assisting with illustrations. Finally, thank you to Dr Tom Lissauer for his kind foreword.
RB, MM, EA
To my parents, and to my wife Lucy.
RB
For my wife Tanya, to whom I am eternally grateful.
MM
To my parents for getting me here, and to Stephen for his love and support in keeping me here.
EA