K Surendra Menon MD
Professor and Head Department of Pulmonary Medicine Mahatma Gandhi Medical College and Research Institute
Puducherry, India
R Pajanivel MD
Professor Department of Pulmonary Medicine Mahatma Gandhi Medical College and Research Institute
Puducherry, India
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Handbook on Clinical Approach to Respiratory Medicine
First Edition: 2017
9789386261779
Printed at
fm5Dedicated to
Medical profession
fm7PREFACE
Handbook on Clinical Approach to Respiratory Medicine is published with the intention of reaching out to the undergraduates, interns and postgraduates to understand the importance of proper case taking. Medicine is all about knowledge and observation. The essential element is the decisional process by probing history, recognition of signs and clinical reasoning. Hands, ears and the brain play a major role in diagnosing in spite of the laboratory tools available. As scientists, we are on a mission to alleviate the patients' sufferings and have to go deeper into every aspect of the patient's disease process.
The art of history taking and proper examination of the patient has become almost extinct. This book confines basically to case taking in respiratory medicine and will give the reader a deeper insight into history taking and examination of the patient. This methodology will help the reader in examining the other systems like CVS, CNS, etc. Without a correct diagnosis, all our efforts will be futile to treat the patient.
K Surendra Menon
fm9ACKNOWLEDGMENTS
We express our gratitude to our family members, all the faculty and postgraduate students in the Department of Pulmonary Medicine, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
fm13INTRODUCTION
The content of the book emphasizes on the correct way of history taking, examination of the patient, relevant investigations and arriving at a final diagnosis.
History taking is the time when the doctor and the patient get to know each other and the patient's fears and concerns can be understood. The skills in taking history develop with experience; so, students are encouraged to take history independently. Difficult diagnostic problems are more often solved by carefully taken history than by a battery of laboratory tests. At the end of history taking, the examiner may be able to arrive at a few differential diagnoses before even touching the patient. Our studies have shown that the correct history taking will make us zero in, onto a possible diagnosis in nearly 80% of the cases.
From examination point of view, long case includes history taking and examination of the patient. All systems are required to be examined. So, a quick history taking without missing any relevant points is essential and the ‘last minute panic’ can be avoided. It is advisable to finish the history taking in 10–12 minutes. But remember this pattern has to be followed after graduation also to become a successful clinician.
Symptoms narrated by the patient should be carefully listened to and as a ‘medical detective’ ask pertinent questions as some patients may go off the track. Patient's complaints should be documented and analyzed. Like a perfect diplomat, we should show tactfulness and patience when the subject mentions the complaint.